Did-not-attends (DNAs) and last-minute cancellations are among the most financially damaging and operationally disruptive events in an orthodontic practice. A missed appointment on a clinician’s book is not just lost revenue — it is unfilled clinical time that cannot be recovered, a disruption to the patient’s treatment progress, and a signal that the practice’s engagement with that patient has gaps. For practices running at high appointment density, a DNA rate above 8% to 10% starts to have a meaningful impact on capacity, revenue, and team morale. Effective patient communication — deployed at the right moments, in the right format, with the right message — is the most consistently evidence-supported intervention for reducing DNA rates. This guide provides practical patient communication templates and strategies for orthodontic practices, along with a framework for deciding when and how to communicate with patients at each stage of their journey. Key takeaway The evidence is consistent: appointment reminders sent at 72 hours and again at 24 hours before the appointment reduce DNA rates by 20% to 40% compared to no reminders. SMS outperforms email for time-sensitive reminders — open rates for SMS are above 90%, compared to 20% to 30% for email. The message content matters too: reminders that include the patient’s name, the date and time, what will happen at the appointment, and a clear action to confirm or cancel perform significantly better than generic “you have an appointment” messages. Practices that combine automated reminders with personalised communications from their TC see the lowest DNA rates. A DNA rate of 5% to 8% is considered achievable for most UK orthodontic practices with good reminder systems in place. Rates above 10% typically indicate a systemic communication gap — either reminders are not being sent, they are being sent in a format patients do not engage with, or the practice-patient relationship has weakened enough that appointments are not being prioritised. 20–40% Reduction in DNA rates from structured appointment reminders at 72hrs and 24hrs >90% SMS open rate — vs 20–30% for email, making SMS the preferred format for time-sensitive reminders 5–8% Achievable DNA rate target for practices with a structured reminder system Effective patient communication in orthodontics is not just about appointment reminders — it covers the full treatment journey. Here is a practical communication calendar for a fixed brace or aligner patient from treatment start to debond: Pre-treatment Builds excitement and reduces first-day anxiety During treatment Maintains engagement and reduces mid-treatment dropout The following templates are designed to be adapted for SMS or email, with variables shown in brackets. They are written to maximise open rates, response rates, and the likelihood the patient either confirms or cancels with enough notice for the slot to be refilled. Automate your appointment reminders and patient communications Virtual Consultant Online’s automated reminder and patient messaging tools deploy your communications at the right moments without manual effort from your team. See the features → Last-minute cancellations — within 24 to 48 hours of the appointment — are almost as disruptive as DNAs in terms of their impact on appointment book fill rates. The most effective interventions are: Important Any practice that intends to charge patients for missed appointments or late cancellations must communicate this policy clearly and in writing before treatment starts — ideally in the treatment contract or consent documentation. Attempting to charge patients for DNAs without prior written disclosure of this policy is both legally problematic and likely to generate formal complaints. GDPR also applies to patient communication — ensure your practice has a lawful basis for processing patient contact details for reminder purposes, and that patients have the ability to opt out of marketing communications (though appointment reminders are typically considered a legitimate interest rather than marketing). Reduce Your DNA Rate With Automated Patient Communications Virtual Consultant Online’s automated reminder tools, patient portal notifications, and two-way messaging features give your practice the communication infrastructure to keep DNA rates low without adding manual admin for your team.The DNA Rate Benchmark — and Why It Matters
The Communication Calendar: What to Send and When
Reminder Templates That Work
72-hour reminder (SMS)
24-hour reminder with confirmation request (SMS)
Post-treatment fitting check-in (SMS — sent 1 day after fitting)
DNA recovery message (SMS — sent within 2 hours of missed appointment)
Reducing Cancellations, Not Just No-Shows
Patient Communication Templates That Reduce No-Shows and Cancellations
Published · 6 min read · by Virtual Consultant Online
Welcome message when treatment is booked (within 24 hours)
What to expect at your fitting appointment (3–5 days before)
Appointment confirmation reminder (72 hours before)
Day-before reminder with confirmation request (24 hours before)
Post-adjustment check-in (1–2 days after each appointment)
Routine reminders (72hrs and 24hrs before each appointment)
Milestone messages at treatment midpoint and estimated final stages
Emergency contact information if something breaks or feels wrong
Hi [First Name], a reminder that you have an appointment at [Practice Name] on [Day] at [Time]. This is your [appointment type, e.g. wire change / aligner check]. Please reply YES to confirm or call us on [phone] if you need to rearrange. We look forward to seeing you.
Hi [First Name], just a reminder — you’re with us tomorrow at [Time] for your [appointment type]. Reply YES to confirm or call [phone] if you can’t make it. We need 24 hours notice to offer your slot to another patient. See you tomorrow!
Hi [First Name], hope you’re settling in with your [braces / aligners]! Some discomfort in the first couple of days is completely normal — it should ease off by [Day]. If you have any questions or concerns, just reply to this message or call us. The team at [Practice Name].
Hi [First Name], we had you booked in today at [Time] but didn’t see you. We hope everything’s okay — please call us on [phone] or reply here to rebook as soon as you can. Keeping your treatment on track is important and we want to help. The team at [Practice Name].
Explicit cancellation policy in the welcome pack: Patients who know that cancellations within 24 hours may incur a fee, or that their slot will be noted, are more likely to either attend or provide earlier notice
Easy rescheduling: Making it frictionless to reschedule — a link in the reminder message that goes directly to the booking system — means patients who cannot make it are more likely to rebook rather than simply not showing up
Patient education about why appointments matter: Patients who understand that missing adjustments affects their treatment timeline and outcome are more motivated to attend. A brief explanation of this in the onboarding communication sets the right expectation from the start
Maintaining a short-notice cancellation list: Patients willing to attend at short notice — if they are told a slot has become available — fill most of the gaps left by cancellations and turn a potential revenue loss into a maintained appointment book
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References
NHS England evidence review on interventions to reduce did-not-attend rates, covering systematic review evidence on the effectiveness of SMS and email reminders, optimal reminder timing, and message content characteristics associated with reduced DNA rates.
NHS England — Reducing did-not-attend rates in outpatient servicesBDA guidance on patient communication standards in dental practices, including GDPR compliance for reminder systems, the legal requirements around charging for missed appointments, and best practice for communicating appointment policies to patients.
British Dental Association — Patient communications guidanceUK dental practice management guidance on reducing did-not-attend and cancellation rates, including benchmarks for target DNA rates in orthodontic practices, evidence on SMS versus email reminder effectiveness, and template communications for the full patient journey.
Dental Practice Management — Reducing no-shows: Evidence and practiceNHS England evidence review on interventions to reduce did-not-attend rates, covering systematic review evidence on the effectiveness of SMS and email reminders, optimal reminder timing, and message content characteristics associated with reduced DNA rates.
NHS England — Reducing did-not-attend rates in outpatient servicesBDA guidance on patient communication standards in dental practices, including GDPR compliance for reminder systems, the legal requirements around charging for missed appointments, and best practice for communicating appointment policies to patients.
British Dental Association — Patient communications guidanceUK dental practice management guidance on reducing did-not-attend and cancellation rates, including benchmarks for target DNA rates in orthodontic practices, evidence on SMS versus email reminder effectiveness, and template communications for the full patient journey.
Dental Practice Management — Reducing no-shows: Evidence and practice