By Christian Coachman
⋅ 4 min read
⋅ Updated Jan, 2026
Article summary
The "I understand" trap – when patients nod and say they understand, they're often just being polite, overwhelmed, or avoiding looking confused
Logic isn't enough for case acceptance – patients can repeat technical terms but lack emotional connection to the problem and consequences of inaction
Three warning signs of misunderstanding – immediately focusing on cost, failing to commit to follow-up, or parroting clinical language without personal context
The car showroom mistake – asking patients to pay for a future outcome they cannot see or feel, without emotional understanding of its value
Shift from defending to showing – move beyond clinical correctness to demonstrate personal impact on the patient's life and future health
There is a specific moment of a treatment plan presentation that I know every dentist will recognize: When you’ve explained the diagnosis and the treatment plan, you briefly pause to ask your patient if everything is clear, and the patient simply nods: “Yes, I understand.”
Does that sound familiar?
For many clinicians, that ‘yes’ may feel like relief. It appears to be clarity and agreement – and it might feel like the hardest part of the treatment presentation is over.
Yet in reality, this polite agreement can be a big obstacle to your patient receiving the comprehensive care they need.
In this article I want to explore this moment, why it happens, and why it doesn’t mean your patient has actually accepted your treatment plan.
So what goes wrong during dental treatment presentations?
As dentists, we are trained to communicate clearly, accurately and responsibly. We explain thoroughly, use visuals and rely on science and proven protocols; it’s often flawless. And while from a clinical point of view this is effective, it doesn’t work for treatment plan presentations.
The mistake is simple really: we unconsciously project our own professional understanding onto the patient. As the explanation makes complete sense to us (the expert) we assume it must carry the same weight and meaning for the patient (the non-expert).
Why do patients say “I understand” but still don’t accept dental treatment?
When patients say “I understand,” they are almost always being truthful.
However, they may not be using the word the way the dentist defines it. In reality, they may want to be polite, or be reluctant to admit they are overwhelmed by the detailed clinical explanations. Here’s what the patient might actually be saying with “I understand”:
“I trust your expertise.”
“I feel overwhelmed by all this technical information.”
“I don’t want to look confused or ask a silly question.”
“I want this appointment to move forward now.”
In many cases, the patient can repeat the technical terms involved in their treatment plan but the crucial step of emotional understanding has not yet happened.
Why does logic not always work in dental treatment presentations?
Imagine you’re going to buy a new car. You arrive at the showroom, the salesperson explains all about the model they recommend for you and then they ask you to pay – but never actually show you a real car.
This is how it can feel for our patients: they are asked to say yes to a future outcome they cannot yet see or feel.
FACT: logic alone just isn’t strong enough to support this decision.
Even when patients can follow the step-by-step of the plan, they may not connect emotionally with the depth of the problem or feel the long-term consequences of inaction.
Without that emotional connection, their decision to proceed can easily take a backseat to other priorities.
What are the signs that your patient doesn’t truly understand?
Some common signals that the patient does not truly grasp the personal significance of the plan include:
Immediately focusing on cost: Price quickly becomes the only topic of discussion because the emotional value of the treatment has not yet been established.
Failing to commit to follow-up appointment: Initial acceptance may be followed by unanswered calls and fading motivation.
Repeating technical terms: Patients might repeat clinical language they’ve heard but can’t explain the meaning in relation to their own situation.
These moments can frequently be signs that the patient doesn’t fully understand the plan or the real impact of it. Committing to real ethical dentistry and case acceptance means that we cannot confuse their nod of acceptance with real clarity.
So how do we fix this?
The true goal of a treatment presentation should be to help the patient understand enough to own their decision.
This requires a crucial shift: we must move from defending the plan's clinical correctness to showing its personal impact for the patient.
This means not only listing technical steps, but also ensuring the patient understands the impact on their own experience and future health.
Read more: Why we love Emotional Presentations (and your patients do too!)
When patients truly understand the plan, and how the decision connects with their emotional priorities, the path to comprehensive dental care can become clearer and more stable. Whether they answer “yes” or “no”, the decision belongs to them – and we ensure their best interests are always front and center.
By focusing on creating meaningful understanding in the first and second appointments, you take your practice from one that simply explains options to one that guides people toward the best possible health decisions.
Ready to take a new approach to improving case acceptance?
If this resonates with your commitment to ethical dentistry and you are ready to transform your approach to the first and second appointments, I invite you to explore our new Case Acceptance Mastery course.
This program teaches a pragmatic workflow we have been refined for many years to help you attract, close and delight patients like never before, so you can grow your practice ethically.
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