Do you need a co-pilot in your surgery?

By borrowing a techniques from flying, dental practices can improve examinations and increase treatment uptake

26 March, 2024 / professional-focus
 Selina Alexander  

The aviation industry has the best safety record of all forms of transport. This is maintained by meticulous checking and attention to detail. By borrowing a few techniques from flying, dental practices can improve the efficiency of their examinations, save time and increase treatment uptake.

One of the best ideas I have heard in a long time to help make sure oral health examinations run smoothly was explained by Dr Barry Oulton on the most recent Practice Plan Workshop Tour. There will have been occasions in every dentist’s working life where they have been distracted or become absorbed in a particular aspect of a patient’s dentition meaning they will have missed something off the examination. It can happen, no matter how thorough you usually are.

To guard against this Dr Oulton borrowed the practise of using a checklist, like the ones used in aircraft pre-flight checks, so that nothing would be omitted from the examination. If you have a list of what needs to be done which you work through and then tick off each item as it’s completed, you’re more likely to cover everything than if you’re simply relying on memory. As the dentist needs to concentrate on what’s happening inside the patient’s mouth, it’s easier for the nurse to take charge of the checklist, which is why he suggests examinations are nurse-led.

Agree the terms

This system is easy to implement in practice. Begin by agreeing what should go on the checklist and then upload that to your practice software. Next you need to establish a traffic light system that your patients can understand easily. At the start of the appointment, explain to the patient how things will work so that they are aware of what’s happening. Often, patients have no understanding of what things like ‘UL3’ mean when you’re calling them out, so they can often shut off to what’s going on around them.

However, with the traffic light system they are more likely to engage with what’s happening as they have a greater chance of understanding things. So, with the traffic light system it becomes obvious that if something is marked as ‘red’ it means action needs to be taken quickly; ‘amber’ can mean action is needed, but not urgently and ‘green’ can signify no action is needed or it’s a cosmetic or elective procedure. Making things easier and more transparent for the patient will help to improve your rapport with them and build trust.


The nurse leads the examination by calling out what needs to be done based on the checklist that’s already been agreed. The nurse also types up the patient notes in real time. This is a far more efficient way of recording patient notes and means the dentist can easily check them over afterwards. It saves time and ensures the examination will be thorough and complete.

From the nurse’s point of view, the greater level of responsibility entrusted in them can lead to increased job satisfaction. As the dentist’s co-pilot, they are integral to the whole process, not just a bystander. The nurse guides the dentist as to what needs doing next, ensuring nothing gets forgotten. This means they both play an important part in the examination. They work together as partners which can result in a strengthening of the partnership between the nurse and the dentist.

Patient involvement

By having the dentist deliver a running commentary that the patient can understand, it helps them to feel more involved in things. If they have a greater appreciation of what the dentist sees during the examination, they’re more likely to accept the reasons why any treatment is being suggested. The traffic light system will also help them to have a better grasp of how urgent any action might be, so they can make better informed decisions.

Using a checklist to guide the examination can also give the patient greater confidence in the process. By working through the list methodically, the patient can be reassured that the examination will have been thorough.

By inviting them to take note of what’s being said and including them in the examination you are also acknowledging the individual surrounding the mouth. It can be easy to become absorbed in the task in hand sometimes and forget that the teeth being examined belong to a person. Including them in the process is a great way to build rapport, which ultimately leads to establishing trust. We all like to feel we’re being treated as an individual, and not just a potential treatment plan.

So, if you hand over the controls to your co-pilot you will:

  • Feel confident everything has been covered
  • Spend less time writing notes
  • Have a better relationship with your nurse
  • Have patients who are engaged which leads to
  • Increased treatment uptake and
  • More patient referrals.

Why not try it and see how things take off!

If you are going to the Scottish Dental Show and would like to find out more about how we help practices to become more profitable why not come and have a chat with us at Stand F03. Otherwise give us a call 01691 684165 or visit

About Selina

Selina Alexander is a Regional Support Manager at Practice Plan with around 28 years’ experience in the dental industry.

She began her career in practice as a Trainee Dental Nurse and progressed to become Regional Manager for 10 practices, through to Mergers and Acquisitions Manager.

Practice Plan is the UK’s leading provider of practice-branded patient membership plans, partnering with more than 2,000 dental practices and offering a wide range of business support services.

Tags: Practice plan

Categories: Professional Focus

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