Increase clear aligner case acceptance: Why patients say no - and what you can do about it
- Jesper Hatt DDS
- Sep 5
- 5 min read
Updated: Sep 13
Many dentists offering clear aligner treatment experience the same frustrating pattern:They spend 60–90 minutes diagnosing, explaining, and presenting a comprehensive ortho-restorative plan to adult patients... and yet the patient says no.
It's not because the treatment plan is bad.
It's not because you explained it poorly.
And it's definitely not because the patient "can't afford it" - even though that’s what they often say.
It's simply easier to use the price as an excuse than to say, “I’m unsure,” “I’m afraid to make a decision,” or “I don’t fully understand.”Still, as dentists, we take the objection at face value and conclude that the price was the issue.
But that’s rarely the real reason.
The invisible barrier: The patient isn’t ready to say "yes"
Research and daily experience both show that 60–70% of adult patients won’t commit at the first presentation. For treatments exceeding €5,000 / $5,000, hesitation is normal.
If you only measure case acceptance on immediate results, you miss the fact that most patients actually decide much later. Often 12 - 24 months down the line.
That’s why clear aligner case acceptance isn’t just about today’s yes. It’s about keeping the patient’s dream alive until they are ready.
Why “no” today isn’t “no forever”
When patients say:
“It’s too expensive.”
“Not the right time.”
“I need to think about it.”
…they often mean: “I’m uncertain” or “I need more time.”
If you stop there, they’ll never come back. If you instead show them what’s possible, without overloading them, they leave with a vision. That vision is what allows them to say yes 18 months later.
The role of your dental assistant in case acceptance
One of the smartest ways to protect your time while boosting clear aligner case acceptance is to let a dental assistant present the possibilities.
Why?
They avoid technical jargon.
They show simple before/after examples.
They can mention a ballpark cost.
Patients don’t need the full setup at this stage. They need a reason to keep dreaming. The dentist’s role is then to confirm, clarify, and build trust - not to oversell.
The four classic red flags
Here are the four most important red flags that you (and your team) must be able to spot early:
1. The Patient Says They Can’t Afford It - But Mean Something Else
When adult patients say, “It’s too expensive,” it’s often not about the money. It could be uncertainty, confusion, lack of understanding, or simply a desire to postpone the decision.
2. The Patient Cannot Decide Alone
Many adult patients “just need to talk to their partner” and then you never hear from them again. It’s not a no, but it’s not a yes either. If you do not identify the real decision maker and add them to your presentation in some way, you're left with an empty chair and an unresolved treatment plan.
The fix? Clarify decision-making authority before investing time in building a detailed plan.
3. There’s No Urgent Need
Some patients are curious - but not motivated. They “just want to know the price.” They might consider treatment someday - but not today.
If you start planning and presenting before uncovering their motivation and needs - letting the patient explore and express their desires in life, you may be wasting your time if you present treatmet.
4. The Patient Isn’t Ready to Start
“I’m going on vacation soon...”“It’s not the right time...”“I want to wait until next year...”
If you ignore these signals and pitch anyway, you’ll most likely end up with yet another unresolved case - and another hour lost.
The cost of low case acceptance
If you present 10 aligner plans and only 2–3 patients accept, you’ve essentially worked seven hours for free.
But if you shift your approach:
Full plans only for patients who are ready.
Light “dream presentations” for everyone else.
…your clear aligner case acceptance rate increases over time, without exhausting you or your team. Just remember: If you start now, the true results will not show themselves until 1,5 years later.
👉 If you’d like to feel more confident guiding patients - without pressure or endless explanations - you’ll find our online course “Patient Communication and Case Acceptance” helpful. It’s designed for dentists who want a calmer workflow and more yes’s over time.
What needs to be in place before a patient can say yes?
Improving case acceptance isn’t about discounts or pressure. It’s about two core principles:
Pre-qualify so you only spend time on detailed plans when the timing is right.
Keep the dream alive so patients who aren’t ready today still come back tomorrow.
That’s the sustainable way to improve clear aligner case acceptance and build long-term trust with your patients.
Prerequisites
Many believe the most important part is how you present the treatment plan.
But the process starts much earlier.
The patient’s decision is shaped by their entire experience in your clinic:
Their first impression at the phone and front desk
The sense of calm and interest your assistant conveys
The way you ask questions and listen actively as the dentist
Whether your explanations are easy to understand - without pressure
Whether cost and alternatives are presented clearly and transparently
If you’re aiming to increase clear aligner case acceptance, these are the moments that matter most.
The goal isn’t to convince anyone.The goal is to create an atmosphere where it feels natural for the patient to say yes - if the treatment is right for them.
And that requires team involvement.
Receptionists and assistants often have the first important conversations where patients share their wishes, concerns, and past experiences. The better they are at listening, asking clarifying questions, and radiating calm and professionalism, the smoother the rest of the process becomes.
The dentist then picks up the baton - not with a sales pitch, but with trust and clarity.When your conversations are structured right, you don’t need to “sell.”You help the patient uncover their own motivation and provide the information they need to make a decision.
And if the patient still isn’t ready? Then you’ve still given them an experience that makes it easy to come back later.
👉 Ready to strengthen clear aligner case acceptance in your clinic? Join our online course “Patient Communication and Case Acceptance.” You’ll get practical tools, real-life scripts, and a proven process to help more patients say yes - in a way that feels natural for them and for you.
Not ready to join the course yet? Stay connected - sign up for our blog community and receive 1–2 monthly insights you can share with your team.
Kind regards
Jesper Hatt DDS
P: +41 78 268 00 78
AlignerService
We are dentists helping dentists create realistic, safe and predictable treatment plans with clear aligners.
Currently more than1500 dental practices in 19 different countries use our service on a regular basis. We offer expert guidance in the following clear aligner systems: Invisalign, SureSmile, ClearCorrect, TrioClear, Angel Aligners and Spark.
AlignerService is a preferred partner of ClearCorrect and TrioClear.
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