Hello and welcome to another episode of Beyond the Arches. I'm your host, Dr. Daniel Noorthoek. With me today, I have our beautiful Erica Pullen.
Thank you. Thank you. Excited to be here.
Welcome. And the reason why we have Erica here today is because we're going to be talking about how I treatment plan, how we treatment plan, how do we get information ahead of time. This is the beginning of a next segment of episodes—step-wise: how we treatment plan, consult, make decisions, make teeth, put them in, all the things that go into creating a case for us.

We're going to talk in-depth, breaking it down—six or seven episodes where we're talking about it. Starting at the beginning is treatment planning. Erica, you're intimately involved with treatment planning, talking to patients, working with them, getting them to the home stretch.

Absolutely.

Where we start is generally getting the patient in, right? Getting the patient to a consult. Erica, you are the first face, either via Zoom or in person. Sometimes friends/periodontists ask about Zoom consults—how is that possible?

Absolutely. It's very possible in our eyes. Patients get set up for their Zoom consultation with us—it's as easy as in-person consultation. We go through our process, introduce our doctors—Dr. Noorthoek (surgeon), other restorative doctors. We explain roles: he does extractions and implant placement, she handles aesthetics, function, comfort.

There's a cheat code in seeing a patient in person or Zoom: dentistry wouldn't be possible doing Zoom consults normally, but full arch is different. We don't put patients in a chair at first—the 13 years I've done this, patients needing full arch know they need it; they don't need a doctor poking their gums to figure it out.

What’s nice is that confirms their need, and we get an environment with no judgment. You're the smile, the no-judgment free zone. Not here to make patients feel bad—they already know their teeth need to come out—they’ve done the research. Past the tipping point.

Different if the consult is for a filling; can’t diagnose remotely, but for full arch, it’s obvious.

Consult is an opportunity—almost like sitting in a living room—comfortable and warm, carpet, quiet, friendly. Personality and aesthetics matter.

We introduce our team, not selling a product—just making patients comfortable through a huge procedure mentally, financially, physically. We want their journey to feel supported.

So before moving past the introduction: as a potential patient at any clinic, what can make Erica’s job easier during consults?

Easiest thing is research. We have a great Facebook group to hear other patient experiences. Information is key. The more knowledge going in, the better prepared you’ll be.

Patients often think they need finances ready, but most of that comes after the first visit—few come in ready with cash/checks; most will be guided later.

Absolutely. It's better when everything is dialed in, but let’s dispel that: most don’t know exact costs or have finances lined up. Maybe 50/50—some save for years, others are impulse or unsure.

Plenty of patients planned for years (“kids out of college, now it’s my time”), others call after inheritance, wanting quick scheduling so they don’t spend the money elsewhere. Some don’t get accepted right away; sometimes we help out in stages. Finances are always a big part and sometimes awkward, but our team coordinates and makes it manageable.

Diagnosing: once I see the patient, plans are easier with X-ray, CT, etc. Much easier in person, but we can work from records too. Major challenge is long-time denture patients; bone width is hard to evaluate remotely.

Right. We give probabilities—“there’s an 85% chance things go normal, 15% another way.” But open, honest discussions make it manageable.

We’re not afraid to have open conversations—let patients know if things can go differently, and keep channels open. That makes both our jobs easier.

That's key: having a podcast/conversation to explain why our treatment planning feels intangible—there's a reason, a thought process.

I can wake up and show up, knowing patients have talked with the team, taken the leap of faith, and trust us—a strong bond, great way to practice.

I don’t have to be false—I’m open and straightforward with patients. If something goes wrong, we talk about it and work through it—sometimes that's more implants, less, or another surgery.

My practice approach came from wanting real connection—I used to wear a tie, a white coat, walk in and immediately have tension, talking costs and cars (“good, better, best”). Walls go up. If something goes wrong, you’re on the hook. Now: no tie, no coat—just conversation, to make everyone comfortable.

Biggest problems come from consults where patients have stone models shown, being told what’s wrong, what’s needed. For me, the treatment plan isn’t for the patient unless it’s for education. Some want to see CT scans and technicals, but most glaze over—just want confidence and clarity.

Treatment planning now is global, patient-based decision. I used to use a score: if 8/12 teeth were failing, I’d discuss full arch. Over time as results increased, I’d lower the threshold. Now, all our patients come for full arch—they already know that's what they need.

Personal decision—huge. Patients go from first contact to lifetime warranty; Erica sees end-to-end.

Never felt the need to require in-person “stab” before treatment plan—they’re different types of patients, need comfort and support first.

We educate: how many implants, steps, soft diet (90 days post-op). Instructions are provided with care—no cheap, copied handouts; everything is prepared for clarity and importance. We stress verbally and in paperwork: soft foods, why, how to succeed.

Success is choosing an on-top-of-their-game care team, but also having good communication for confident decisions. Team signals matter—all need to come together.

Treatment planning isn't pouring models and showing fancy X-rays—it's guiding through hard parts, psychological support, education. Surgical decisions are professional technique; patient education is core.

It’s about repetition, comfort, team preparation, and honesty. Patients need to be educated but not scared.

It's rewarding seeing long-term patient results, connecting with lifetime warranty, and maintaining that bond. Hybrid dentistry can lose that, but we try to do it well.

So—step one: treatment plan and consult. Next episodes will cover next steps (surgery, etc.) and give a backstage look at the patient experience.

Like and subscribe, keep listening, send questions via Facebook or email. This is just our practice, our opinions.

Thank you, Erica, for joining and discussing with me!

Thank you for having me.