--- title: "How to dismiss a dental patient: ADA steps and letter notes" description: "Dismissing a dental patient needs care. See what the ADA and its Code of Ethics say about notice, records and the letter, and what to review with an attorney." url: https://joncopeland.multisites.ai/blog/how-to-dismiss-a-dental-patient publisher: Copeland Consulting Services email: drcopeland@joncopelanddds.com contact: https://joncopeland.multisites.ai/contact --- # How to dismiss a dental patient: ADA steps and letter notes The ADA says a dentist may dismiss a patient when differences cannot be resolved, if the reason is not legally impermissible discrimination. Check the state dental practice act, use a template letter, state the days you remain available for emergencies, document everything, and have an attorney review the process. Practice managementPublished October 26, 20264 min read Patient dismissal is the formal end of the dentist and patient relationship, started by the dentist. It is a legal and ethical matter as much as a front-office one. This post summarizes what the American Dental Association (ADA) and its Code of Ethics say, lays out common steps, and points to where an attorney should step in. It is general education, not legal advice. ## When can a dentist dismiss a patient? The ADA says that a dentist “has the right to dismiss a patient in situations where it is impossible to resolve differences or if the dentist cannot abide the patient’s behavior within the practice, as long as the dismissal is not for a legally impermissible discriminatory reason.” The ADA also describes the cause as friction that cannot be resolved or a difference in philosophies of care. The words “legally impermissible” matter. Which reasons are barred depends on federal and state law. A practice owner should ask an attorney before relying on a reason, and before treating one patient differently from another in a similar case. The glossary entry on [patient dismissal](https://joncopeland.multisites.ai/glossary/patient-dismissal) gives the short definition. ## What does the ADA Code of Ethics say about ending care? The Code of Ethics addresses “patient abandonment” in section 2.F: “Once a dentist has undertaken a course of treatment, the dentist should not discontinue that treatment without giving the patient adequate notice and the opportunity to obtain the services of another dentist. Care should be taken that the patient’s oral health is not jeopardized in the process.” In plain words, the ethical concern is a patient left in the middle of care with no time to find another dentist. State law may use the term abandonment with its own legal meaning, so read your state dental practice act. The Code is an ethical standard. It is not the same as the law. ## What steps do practices commonly follow? The ADA page does not give a numbered procedure, but it lists the main elements. The table puts them in order with the reason for each. Step What the ADA page says Why it matters 1\. Check the law Consult state laws and the state dental practice act for requirements, “including how many days you need to be available to that patient in case of an emergency.” The state may set minimum rules. 2\. Review the record Audit patient records to see whether problem patients are seen on a regular basis. A clear record shows what happened. 3\. Document contacts “document all communications with patients in their record, including phone calls.” Dismissals can become emotional. Notes help. 4\. Use a template letter Fill in the cause “objectively” and tell the patient to find another provider. A template keeps tone and content steady. 5\. State emergency access Give the number of days you remain available to treat the patient in an emergency. It supports continuity of care. 6\. Stay professional “It should never become personal.” A calm tone lowers the chance of a dispute. ## What goes in a dismissal letter? The ADA says to “develop a template for a dismissal letter,” fill in the cause objectively, advise the patient to find another provider, and state how many days you remain available for an emergency. Beyond that, the ADA links to sample letters on its practice management pages. Open them, compare them to your state rules, and let an attorney check your version. Points that offices commonly ask about include: - **Tone.** Keep the letter factual and short, without blame. - **Records.** Say how the patient can request a copy of their records. HIPAA and state law may set rules for access and timing. The [HIPAA for dental offices](https://joncopeland.multisites.ai/blog/hipaa-for-dental-offices) post gives the starting point. - **Open treatment.** If care is in progress, ask an attorney how to handle it, in line with the abandonment standard above. - **Delivery.** Ask an attorney whether your state expects a particular delivery method and whether you should keep proof of delivery. ## How do informed consent and documentation connect? Good records protect both sides. The ADA also offers sample forms for [informed consent](https://joncopeland.multisites.ai/glossary/informed-consent) and informed refusal on its patients page. If a patient declines recommended care, a signed refusal on file is part of the record that a later review may look at. Dismissal should follow a pattern of documented attempts to resolve the problem, such as missed visits, unpaid balances or conduct that put staff at risk. It should not come as a surprise. If missed visits are the issue, a written [cancellation policy](https://joncopeland.multisites.ai/glossary/cancellation-policy) gives a clear record of what the patient agreed to. The [dental cancellation policy](https://joncopeland.multisites.ai/blog/dental-cancellation-policy) post covers it. ## What should an owner ask an attorney? Bring a short list to your attorney: 1. Which reasons for dismissal does state law restrict or bar? 2. How many days of emergency availability does the state expect? 3. What must the letter say, and how should it be delivered? 4. How should the practice handle open treatment, unpaid balances and records requests? 5. Does any payer contract or employment agreement affect the process? 6. Should the practice call its professional liability carrier first? The last question is practical. The ADA’s guide to selling a practice, for example, suggests contacting your professional liability company for recommendations, and the same habit helps here. ## Next step Patient relations and written policies sit within the wider topic of running a practice, covered in the [dental practice management guide](https://joncopeland.multisites.ai/guides/dental-practice-management). To discuss practice policies with Dr. Jon Copeland, DDS, a general dentist in Wildwood, Missouri, [contact Dr. Copeland about consulting](https://joncopeland.multisites.ai/contact?topic=consulting). ## Frequently asked questions ### Can a dentist dismiss a patient? The ADA says a dentist has the right to dismiss a patient when differences cannot be resolved or behavior cannot be tolerated, as long as the reason is not a legally impermissible discriminatory one. State law may add rules, so check the dental practice act and ask an attorney. ### What is patient abandonment? The ADA Code of Ethics says that once a dentist has begun a course of treatment, the dentist should not stop it without adequate notice and a chance for the patient to find another dentist. Legal meanings of abandonment vary by state. ### Where can I find a sample dismissal letter? The ADA practice management pages link to sample patient dismissal letters. Treat any sample as a starting point and have an attorney review your final version. ## Terms on this page - [American Dental Association](https://joncopeland.multisites.ai/glossary/american-dental-association) - [Dental practice management](https://joncopeland.multisites.ai/glossary/dental-practice-management) - [Employment agreement](https://joncopeland.multisites.ai/glossary/employment-agreement) - [Cancellation policy](https://joncopeland.multisites.ai/glossary/cancellation-policy) - [Patient dismissal](https://joncopeland.multisites.ai/glossary/patient-dismissal) - [Informed consent](https://joncopeland.multisites.ai/glossary/informed-consent) - [Code of ethics](https://joncopeland.multisites.ai/glossary/code-of-ethics) - [Practice owner](https://joncopeland.multisites.ai/glossary/practice-owner) - [HIPAA](https://joncopeland.multisites.ai/glossary/hipaa) - [ADA](https://joncopeland.multisites.ai/glossary/ada) ## Sources 1. [ADA: Managing Patients Dismissal](https://www.ada.org/resources/practice/practice-management/managing-patients-dismissal) 2. [ADA: Managing Patients Dismissal (legal limits)](https://www.ada.org/resources/practice/practice-management/managing-patients-dismissal) 3. [ADA: Principles of Ethics and Code of Professional Conduct (2026)](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/about/principles/2026_code_of_ethics_complete.pdf) 4. [ADA: Patients (practice management)](https://www.ada.org/resources/practice/practice-management/patients) 5. [ADA: What to Do When Selling a Practice](https://www.ada.org/resources/practice/practice-management/what-to-do-when-selling-a-practice) Written by Copeland Consulting Services and checked against the sources above on October 26, 2026. Rules, data and guidance change, so check the linked page before you act on it. ## Keep reading - [Dental practice management: people, money, schedule, patients and complianceDental practice management is the business side of running a dental office: finances, scheduling, patient communication, insurance decisions, team systems and legal compliance. Track a few core numbers, build written systems, review them on a set schedule, and use federal and ADA sources for compliance basics.](https://joncopeland.multisites.ai/guides/dental-practice-management) - [What to put in a dental no-show and cancellation policyA dental cancellation policy tells patients how much notice to give, what happens if they miss a visit, and how the office applies the rules. The ADA suggests posting it, putting it in the new patient package, and applying any fee with care. Have an attorney review the final wording.](https://joncopeland.multisites.ai/blog/dental-cancellation-policy) - [HIPAA for dental offices: a plain checklist for ownersHIPAA has three rules most dental offices must know: the Privacy Rule, the Security Rule and the Breach Notification Rule. The Security Rule asks for administrative, physical and technical safeguards for electronic patient information. After a breach, notice goes to patients and HHS, and sometimes the media. Ask a qualified adviser about your office.](https://joncopeland.multisites.ai/blog/hipaa-for-dental-offices) - [Dental leadership: team skills, training programs and where to learn themDental leadership is the work of guiding a dental team, a practice or a part of the profession. Core skills include clear communication, delegation, feedback and hiring. Learn them through team routines, mentors, organized dentistry such as the ADA and state societies, and formal programs like the ADEA Leadership Institute.](https://joncopeland.multisites.ai/guides/dental-leadership) - [DSOs and private practice: models, data and questions to askA dental support organization (DSO) manages some or all of a practice's nonclinical work, such as billing, marketing and human resources. ADA data show 16.1% of U.S. dentists were DSO-affiliated in 2024, and 27% of those under 10 years out of school. Each model has trade-offs.](https://joncopeland.multisites.ai/guides/dso-vs-private-practice-guide) - [Implant dentistry in general practice: training paths and what the literature saysGeneral dentists who want implant training can look at continuing education, society credentials and accredited residencies. Each path has its own published requirements, and a credential is not a license. This guide summarizes those paths from their official pages and two published studies. It gives no clinical advice.](https://joncopeland.multisites.ai/guides/implants-in-general-practice) ## Talk with Dr. Copeland [Contact Dr. Copeland](https://joncopeland.multisites.ai/contact)[Email](mailto:drcopeland@joncopelanddds.com)