Stop Renting Treatment-Plan Software. Excel Tracks Conversion.

The dental-software equation

Dental practices have always had bloated software stacks. The legacy players (Dentrix, Eaglesoft) charge per-seat licensing plus annual support, easily $4,000–$6,000/year for a 2-chair practice. The cloud players (Open Dental Cloud, Curve, Carestack) charge $300–$600/month. Either way, the practice owner is paying for charting, scheduling, billing, imaging, and reporting — and the reporting layer is the part where the math is just math.

The clinical layer (charting, imaging integration, perio probing) genuinely belongs in a purpose-built system. The financial layer — what's our case acceptance rate, what's our chair-hour profit, which insurance pays which CDT codes well — is spreadsheet work that the practice owner should own directly, not rent.

The two numbers that move dental practice revenue

Strip out the dashboard candy. The two metrics that determine whether a practice clears its hygiene-vs-overhead breakeven:

1. Treatment-plan conversion rate. Of the dollars you diagnosed and presented last month, what percentage did the patient actually accept and schedule? Industry baseline is 60–70%. Top quartile is 80%+. The gap between 60% and 80% on a practice doing $1M production is $200K of revenue, every year, that's already been earned clinically but lost at the chair.
2. Chair-hour profitability. Production per chair-hour, less direct cost (assistant labor + supplies + lab). Tells you which procedures earn the practice and which fill the calendar at low margin. The number gets reweighted by insurance mix and write-offs.

Neither needs a practice management system to compute. Each needs a column with a formula.

The Excel workbook for treatment-plan tracking

The gridmoo Treatment Plan Conversion Tracker ($15 once):

• Treatment Plan Log — every plan presented, with date, doctor, patient, total dollar amount, and status (accepted, partial, declined, pending).
• Per-Doctor Conversion — conversion % by provider, by procedure category (operative, prosthetics, perio, ortho), by month.
• Aging Pipeline — pending treatment plans by age. The 30-day-old pending plan with $4K of perio is almost certainly going to convert at <30% — and you need a different conversation than a fresh plan.
• Top-Decline-Reason Tracker — why patients said no (cost, fear, second opinion, timing, insurance). Tells you where the friction is.

The Chair Time Profitability ($15) workbook handles the cost-of-production side:

• Procedure Cost Card — for each CDT code: average chair time, assistant time, supply cost, lab fee.
• Reimbursement Matrix — for each insurance plan: what they pay per CDT code, the write-off, the actual collection.
• Per-Hour Profit — production – direct cost – write-off ÷ chair time. Sortable so you see which procedures pay the chair best.
• Insurance Mix Dashboard — % of production by payor with the avg per-hour profit per payor. (The PPO that pays 60% of UCR but books 40% of your hours is the conversation worth having.)

Why a small practice should own this layer in a spreadsheet

Practice management software does treatment-plan reporting, but every reporting module has the same three problems:

1. The cuts are predetermined. You get the slices the vendor chose. If you want to look at conversion rate by referral source × by treatment category, you're in luck or out of luck depending on whether the vendor's report builder allows it.
2. The cost data is incomplete. Most practice systems track production and collection. Few track true per-procedure direct cost (supplies + assistant time + lab). That's the math you need to manage chair profitability — and the practice owner ends up doing it on a spreadsheet anyway.
3. The data is held hostage. Switching practice management systems is expensive specifically because the data is locked. A .xlsx file in Dropbox migrates in 30 seconds.

The clinical software you keep. The owner-financial layer you should own outright. That layer is worth $30 once, not $4,800/year forever.

The cost comparison over a decade

Dentrix or Eaglesoft full suite for a 2-chair practice: ~$5,000/year (license + support). Over 10 years: $50,000.

Excel ownership layer: Treatment Plan Conversion Tracker $15 + Chair Time Profitability $15 = $30 once. Over 10 years: $30.

The savings ($49,970) is roughly the cost of a new intraoral scanner — the kind of capex that actually moves revenue. Or two years of full-time hygienist labor. Or the difference between a comfortable practice and a stressed one.

What the workbooks don't replace

• Charting. Dental notes, perio charting, treatment-plan presentation — keep the practice management system for these. The clinical layer is genuinely software.
• Insurance claim submission. Electronic claim filing is regulated and integrated; don't try to spreadsheet that.
• Imaging. X-ray storage and retrieval — vendor system.
• Patient communication. Reminders, recall, email — vendor system or a dedicated tool (Solutionreach, Weave).

What the workbooks do replace is the owner-financial reporting layer that practice management vendors charge a premium for. That's the part where the math is just math, and the practice owner should hold the file directly.

The migration pattern

Don't replace anything clinical. The workbooks are an addition, not a replacement. Suggested cadence for a 2-chair practice:

1. Month 1: Set up the Treatment Plan Conversion Tracker. Each Monday morning, export last week's presented plans from your PMS and paste into the workbook. (15 minutes.)
2. Month 2: Set up Chair Time Profitability. Populate the Procedure Cost Card from your supply ledger and your CDT chair-time benchmarks. (One-time 2-hour setup.)
3. Month 3: Run the weekly conversion review with the front desk team using the workbook's per-doctor breakout. The conversation gets sharper because you're looking at causes (decline reasons), not just rates.
4. Month 4 onward: Quarterly insurance-mix audit using the Chair Time Profitability dashboard. The PPO conversations that result from this often pay for the workbook 1,000× over in the first year.

The math hasn't changed since dental practices first opened. The software vendors just figured out how to charge $5K/year for displaying it. Hold the file yourself.