The patient is in the chair and the case isn’t back: what to do next
When a patient arrives and the lab case has not, the next ten minutes matter. Here is what to check, what to say, and how to use the visit and rebook.
By the Tusko team
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When a patient is seated and the case is not in the building, three things have to happen in order.
Confirm it, tell the patient the truth, and decide what the visit is now for.
The cause can wait until the afternoon. The patient cannot.
This guide covers the first ten minutes, what to say, how to use the visit, and how to make this rare.
The first ten minutes
Work through four steps before anyone improvises.
The first ten minutes, step by step
A flow of four steps for the first ten minutes when a case is not in the building: make sure it is really missing, phone the lab, tell the dentist with options, and tell the patient.
Make sure it is really missing
Check today’s deliveries, the lab shelf, the other operatory and the front desk.
Phone the lab
Ask where the case is and when it can be in your hands. Get a time, and the name of who gave it.
Tell the dentist, with options
“It ships tomorrow” and “the driver can be here by two” lead to different decisions.
Tell the patient
Within a few minutes of sitting down, and before any small talk runs out.
Step one matters more than it sounds. A case that arrived yesterday and went into the wrong drawer does happen, and it is worth two minutes of looking.
Send one person to do steps one and two. The dentist stays with the patient or moves to the next room.
Who does what
| Person | In the first ten minutes |
|---|---|
| Front desk | Checks the deliveries and the shelf, then phones the lab |
| Assistant | Stays with the patient, and readies the room for whatever is decided |
| Dentist | Hears the options, decides, and speaks to the patient |
Agree on this before the day it is needed. In the moment, three people doing the same job means two jobs are not done.
What to say to the patient
Say it plainly, and say it early. Dr. Joel Gaudet, the dentist who founded Tusko, knows how the moment feels from the dentist’s side:
“If the patient shows up in the chair and the case hasn’t arrived, it’s a huge deal. You’re apologizing for wasting their time, and they took time off work. If a lab forgets, they can rush it.”
Dr. Joel Gaudet, Wave Dentistry
A short script covers what the patient needs.
“I am sorry. Your crown has not arrived from the lab, so we cannot fit it today. I know you took time to be here. Here is what we can do.”
Then give the plan, which the next section covers.
Three things to leave out.
- Blame. The patient does not need to know whose date slipped.
- Guesses. Do not promise tomorrow unless the lab has.
- A long explanation. The more detail, the less it sounds like an apology.
Decide what the visit is for
The dentist chooses among three uses of the time.
Rebook and let the patient go
This is the right choice when nothing useful can be done today. Do it quickly and respectfully.
Do something useful with the visit
The patient is here and the room is ready. The dentist may decide to use the time.
- Check the provisional crown, and attend to it if it needs it
- Take a shade photo or a scan the lab has asked for
- Carry out other treatment already planned for this patient
- Answer questions the patient has about the final result
Offer this as a choice. Some patients would sooner leave and come back once.
Wait for the case
If the lab can have the case at your door within the hour, the patient may prefer to wait. Ask them.
Only offer this with a firm time from the lab. A patient who waits forty minutes for a case that then does not come has been let down twice.
Rebook before the patient leaves
Do not send the patient away with “we will call you”.
Confirm the lab’s new date first. Then offer the patient two times after it, with a gap of at least a day.
Give them the first choice of the schedule. This appointment has priority over a routine booking.
If the patient is upset, let the dentist close the conversation. An apology from the person treating them carries more weight than one at the desk.
Tell them you will confirm the day before, and then do it. Check the shelf before you make that call.
Note on the chart how long the provisional has been in place. The dentist may want to see it again if the new date is some way off.
Tell the lab the same day
Phone or message the lab once the patient has gone.
Give them three facts: the patient came, the case was not here, and the new seat appointment.
Ask what happened on their side, and listen. The answer is sometimes a question that sat unanswered at your own front desk.
Keep the tone level. The lab is the partner who will get this case to you, and the next hundred.
If the cause was the lab’s, a good one will say so and tell you what it is changing. If it was yours, say that too.
Ask the lab to confirm the new date in writing. Put it where the front desk will see it.
Find the cause within the week
While it is fresh, trace the case through each handoff.
| Handoff | What to check |
|---|---|
| The Rx | Was it complete, and did it carry the seat date |
| The lab’s questions | Did one arrive, and how long did the answer take |
| The lab’s date | Did it move, and did anyone at the practice hear |
| The delivery | Did the case arrive and go unrecorded |
| The booking | Was the seat booked tighter than the lab’s schedule allows |
| The morning check | Was this appointment looked at in the two days before |
One of those rows will have the answer. Write it down, and write down the one change that would have caught it.
Keep these notes together. After a few, a pattern shows, and the pattern is what to fix.
Why dental lab cases go missing follows the same handoffs in more detail.
Make it rare
A case that is late is a fact of lab work. A case that is late and a surprise can be prevented.
Three habits cover it.
- Book against the lab’s confirmed date, with a gap. Dental lab turnaround times shows how to count.
- Check deliveries in the day they arrive. A box that sits sealed is a case nobody knows about.
- Look two days ahead every morning. Any seat without a received case gets a call to the lab, then to the patient.
How to protect chair time when lab cases run late covers the daily check, and the front desk guide to lab cases covers who does what.
The cost of these visits adds up in chair time. The practice calculator lets you put your own figure on it.
Let the schedule warn you
Every step above depends on someone remembering to look. The surer fix is a system that looks for you.
In Tusko, Chair Time shows each seat appointment beside its case and flags a late one before the patient sits down.
See how it looks for practices, and read how to track dental lab cases in your practice for the whole picture.
Should we tell the patient it was the lab’s fault?
No. The patient chose your practice, and the cause is seldom known in the first ten minutes. Say the crown is not here, apologize for the wasted trip and give a new plan.
Can the lab rush the case the same day?
Sometimes, if it is finished or nearly so and the lab is close by. Ask for a firm time, and only ask the patient to wait or come back if the lab can commit to it.
Should the practice offer the patient something for the trouble?
That is the practice’s choice. What matters most to a patient is a sincere apology, a new time that suits them and no second surprise.
How do we stop this happening again?
Find which handoff failed, and add a daily check of seat appointments against cases received. A look two days ahead every morning catches the usual repeat.
Related guides
Every practice tracks lab cases somehow. Here is what a tracking system has to do, where a spreadsheet works, and when software earns its place.
A new lab workflow sticks when it starts small. Here is how a dental practice can change how it sends and tracks lab cases without losing chair time.
A lab statement shows fees. The real cost of a dental lab includes remakes, adjustments and moved appointments. Here is how to work it out per lab.