Dental Practice KPIs (+ Free Scorecard by Role)

By B Wyrick, Orthodontic Operations Consultant & Co-Founder, The Wyrick Outlook, with Megan Wyrick

Dental practice KPIs only change anything when every number has a person in the office who owns it. Most KPI lists hand the doctor a long list of numbers to watch and leave the team out of it. In an orthodontic office, the better approach is to give each seat one to three numbers it controls, review them every month, and start with collections before production.

We coach orthodontic teams seat by seat, from the treatment coordinator to the insurance coordinator, so this scorecard is organized the same way. The broader “dental” language matches how people search, but everything here is built for an ortho office.

What are dental practice KPIs?

Dental practice KPIs are the handful of numbers that show whether the practice is collecting what it produces, filling its schedule and converting consults into starts. The American Dental Association’s practice management guidance suggests starting with “a limited number of factors” and reassessing them at least quarterly (ADA, Guidelines for Practice Success: Measuring Success). That advice holds even more in orthodontics, where a small team carries a long treatment cycle.

The Wyrick Outlook coaches orthodontic practices to assign each KPI to the seat that can move it, through twoTRAIN courses for each role and the twoCREW Collective for the whole office. For an ortho practice, the core dental practice KPIs fall into five groups:

• Collections: what the practice actually collected against what it produced.
• Insurance AR: how many insurance claims are past due, and for how long.
• Patient AR: past due patient balances and how old they are.
• Schedule: broken appointments, open chair time and production goal against actual.
• Conversion: how many consults become starts.

Why most KPI lists fail in an orthodontic office

A long KPI list fails for the same reason a group text fails: everyone sees it and nobody owns it. The doctor looks at production, feels fine, and the aging report keeps growing quietly in the background. Nothing changes until one person is accountable for one number and has the training to move it.

Ortho adds a second problem. Treatment runs for months or years, insurance pays in installments, and patients pay on contracts. A KPI that looks healthy this month can hide money that will not show up for a year. That is why we push teams to watch the numbers that measure money coming in, and to treat production as the starting point rather than the score.

The most common KPI mistake I see is setting goals and then not measuring them consistently. Offices set goals for conversion, starts or new patient exams, but when we dig in, nobody clearly owns tracking those numbers, and nobody is reviewing them or using them to make decisions. The practice knows what it wants to achieve, and does not know whether it is on track until something feels off.

KPIs only work when someone owns them, they are measured consistently, and the team knows what to do with the information. A goal on paper does not move anything. Accountability and follow through do.

The dental practice KPIs scorecard, seat by seat

This scorecard gives every seat in an orthodontic office the dental practice KPIs it owns, how to read them, and the training that teaches the seat to move them. Where we have a target we teach, it is listed. Where the right target depends on your practice, set it with your doctor and write it down.

The targets in the scorecard are the ones we coach toward. Insurance coordinators keep past due insurance claims under 4% of all insurance claims, so an office with 300 insured accounts has no more than 12 past due. Megan coaches financial coordinators to keep patient accounts at or under a 2 to 4% past due rate. Secrets 2 Scheduling coaches scheduling coordinators to bring broken appointments down from the 10 to 15% range to under 5%.

The other targets vary more by practice, so the scorecard leaves them for you to set. Our guides on what a healthy ortho collection rate looks like and how to measure case acceptance go deeper on those two numbers.

For treatment coordinators, the number is conversion, sometimes called closure rate. We coach TCs toward 90%. Before you compare your number to that, check how your practice tracks it and what it counts as a start, because two offices can mean very different things by the same word.

Start with collections, not production

Production means nothing without collections. A month with record production and a growing aging report is a month where the practice did the work and has not been paid for it yet. That is why collections against production sits at the top of the scorecard and belongs to the doctor.

The insurance side has one more report worth running every December: write offs by carrier. Megan’s advice in one of our Tuesday tips is to log write offs for each insurance company separately instead of as one lump, so that at the end of the year you can show your doctor what each contract costs. That one report answers the in network question better than any opinion. If the numbers say a contract costs more than it brings in, our guide to asking a carrier for higher fees is the next step.

How to run the monthly KPI review

The monthly KPI review belongs to the office manager. The doctor attends, but the office manager runs it, and every seat reports its own number. Keep the format the same every month so trends show up:

1. Each seat brings its number and last month’s number.
2. Anything that missed its target gets one question: what happened, and what changes this month?
3. The office manager writes down one action per missed number, with a name and a date.
4. Next month starts by checking those actions.

Learn 2 Lead™ teaches office managers to build this reporting system, including goals for each role. One office manager who took it said the most useful part was “quantitatively assigning #’s to goals for each role.” Another asked us for exactly what this article is: “a list of KPI’s that are important to track in Ortho as an OM.” Our dental practice management tips cover the rest of the office manager’s month.

“We do not have time to track all this”

Most offices that say this are already spending the time, just later and under more stress, chasing the claims and balances that aged because nobody watched them. One or two numbers per seat, reviewed once a month, is less work than one bad quarter of aging.

The harder part is that each seat needs the training to move its number. A scheduling coordinator who has never been taught to run a broken appointment report will not fix the broken appointment rate because it showed up on a scorecard. That is why our courses are built one per seat, and why the twoCREW Collective exists: one membership that trains every role in the office over twelve months, with live monthly coaching from B and Megan, so the whole scorecard moves together instead of one seat at a time. If you only need one seat trained, each course is available on its own through twoTRAIN, and one registration covers your whole office.

Two seats get overlooked on most scorecards. The marketing coordinator should own scheduled new patient exams. It is easy to get caught up in social media engagement and likes, and what matters is whether the marketing is bringing new patients into the practice.

The orthodontic assistant seat deserves a number too. I look at completed appointments per day and staying on schedule: is the clinical team completing the appointments it needs to without consistently running behind and putting the rest of the day off track? Efficiency should never come at the expense of patient care, but every role should own a piece of how the day flows.

Frequently asked questions

How many KPIs should a dental practice track?

Start with one to three per seat, and no more than about eight for the whole office. The ADA recommends starting with a limited number and reassessing at least quarterly. Add a new KPI only when the existing ones are being reviewed every month.

What is the most important KPI for an orthodontic practice?

Collections against production. Every other number on the scorecard feeds it.

Who should own dental practice KPIs?

The office manager owns the review, and each seat owns its own number. When the doctor owns every KPI personally, the review becomes the doctor’s to do list and the team stops looking at its own numbers. When a seat owns a number, the person closest to the work sees the problem first, usually weeks before it would show up in a monthly production report. Our dental team training guide breaks down what each seat needs to learn to own its number.

How often should you review dental practice KPIs?

Monthly for the team review. Some numbers deserve a weekly look by the seat that owns them, such as insurance claims past due and broken appointments, because waiting a month lets them age.

B Wyrick is a co-founder of The Wyrick Outlook and leads the people and process side of the business: team structure, workflow and the systems that keep an orthodontic office running without the doctor in every decision. With 20 or more years across nearly every role in an ortho office, and as a clinical instructor in California, she coaches teams seat by seat. B and her sister Megan have partnered with more than 450 practices. More about B.