The Case Start Gap Calculator
Case Start Gap Calculator

The consults are running.
The right cases still aren't starting.

Two problems tend to run together. High-value inquiries that went quiet before the consult. Consults that came in but never committed. This calculator shows both gaps — and what they're worth at your volume.

Built for practices already running cosmetic consults. If you're still trying to get patients to inquire, the consult gap isn't your bottleneck yet.
Your Numbers
$

Use your most common case type. Run it again for a different service.

Count all of them — including the ones that felt like a waste.

%

Not sure? Most cosmetic practices land 35–50%. Rough estimate is fine.

Most practices undercount this — inquiries that go quiet aren't tracked as lost, they just disappear. If you're unsure, "Sometimes" is the honest starting point.

Your Case Start Snapshot

Based on your numbers, your practice may be leaving

/mo

— per year in cases that were close and didn't start

This gap isn't a case acceptance problem — those tools start after the consult. It's not a marketing problem — that starts before the inquiry. It lives in the window between a patient's first message and the moment she sits in your chair.

Where cases aren't starting Monthly Leaks
Said “I’ll think about it.” Never came back.
Booked. Then didn’t show.
Messaged. Never made it to consult.
Closing your acceptance rate gap to 65% — starting with the patients who were already close — could mean roughly per month in additional case starts. Without booking a single additional consult.

These estimates use case acceptance benchmarks from dental practice management research. Cosmetic practices without structured pre-qualification typically run 35–50% acceptance; with structured intake and post-consult follow-up, 60–80% is consistently documented.

We model three leak sources: (1) post-consult disappearances — patients who said "I need to think about it" then went dark, modeled at 40% of unconverted consults with 40% recoverable with a structured follow-up sequence; (2) booked no-shows — estimated at 18–32% of monthly consults based on your pre-consult drop-off input, valued as opportunity cost of the blocked slot — 35% of your average case value (reflecting the probability that slot could have converted) plus $200 CAC already spent to book it; (3) pre-consult drop-off — inquiries that went quiet before a consult was ever booked, scaled from your selected frequency against a 45% recovery rate. Most practices undercount this category because untracked drop-off doesn't appear in any system as a loss — it simply never becomes a booking.

Not included: right-patient lifetime value gap, second-case compounding, or referral revenue. The intake leak and the patient type gap are modeled separately — both are shown below.

These numbers are directional. The direction holds across virtually every cosmetic practice that has run the math.

Where you go next depends on where you are
Where are you right now with this?
I know the right patients exist — I'm just not getting enough of them. I want a system in place across my practice that consistently brings them in.
I understand the problem. I need exactly what to say and do when an inquiry comes in — starting this week.
I already know what needs to change. I need it running — not another thing for my team to remember.
Based on where you are right now:

Why a full consult schedule
still doesn't feel like it's working

The Fee Shopper Problem

She called three practices on the same Tuesday afternoon. Whoever responded first and quoted fastest got the consult. She no-showed on a Thursday — your doctor had blocked off ninety minutes. She rescheduled once, then disappeared. That slot cost you $400 in chair time and $200 in Google Ads spend. It also meant the patient actively trying to find the right cosmetic dentist couldn't get an appointment that week.

The right patient was looking too. She read six Google reviews and stopped when she found three patients describing the same transformation she wanted. She didn't ask about price in her first message. She confirmed her consult the night before, without being prompted. Whatever your practice signaled in the window between her first message and sitting in your chair either confirmed she'd found the right dentist — or sent her to someone else's calendar.

"The wrong people keep showing up for cosmetic consults."
— DentalTown

Most cosmetic practices run Google ads to fill the consult calendar — which works. The problem is that a typical CAC of $150–$300 per booked consult, applied to a patient who no-shows or says "I need to think about it," means that slot is costing you money, not making you any. Run those numbers across a full month of fee-shopper consults and the ad budget isn't building a cosmetic practice — it's subsidizing a free consult factory.

The same spend applied to the right patient returns $36,000 or more over three years. The budget doesn't change. What changes is who the inquiry signals attract before they ever reach your front desk.

Both patients sent the same first message: "How much for veneers?" What separates them is how they evaluated the response — and everything around it. The right patient was watching what your practice looked like when it answered. The fee shopper was watching the number. The practice that signals the right things before the consult fills its calendar with the right patients. The practice that quotes fast fills it with fee shoppers.

Paid advertising amplifies whatever intake signals currently exist. It cannot fix a signal problem. The signal layer determines who shows up. Volume follows.

3-year right-patient value: first case ($14k avg) + hygiene ($300/yr × 3) + second procedure (55% of these patients add one within 24 months, avg $14k × 55% probability) + referral ($14k × 1.2 referrals / 3yr × avg case value). Fee shopper estimate: ~$800 in net revenue on average (consult cost absorbed, one cleaning, no cosmetic case start). CAC range reflects typical Google Search benchmarks for cosmetic dental practices. Figures are directional — the direction of the math holds across virtually every cosmetic practice that has modeled it.