🦷 Treatment Plan Explainer

Purpose

Translate a clinical treatment plan into a written, patient-friendly explainer the patient can take home, receive by email, view in the patient portal, or hear via a condensed SMS / video script. Converts dental jargon into plain language, organizes work into phases, shows cost and insurance breakdowns, explains urgency and consequences of delay, and presents alternative options with honest trade-offs. Designed as the written companion to the in-chair conversation — not a sales script (see case-presentation-script for the spoken presentation, and financial-counseling-workflow for the financing conversation). Improves case acceptance by giving patients (and absent decision-makers — spouses, parents, adult children) something to review at home when they're no longer under the pressure of the appointment.

The v3.0 explainer adapts to eight procedure-family templates (single-tooth restorative, root canal therapy, single implant, multi-unit fixed prosth / full-arch, ortho / Invisalign, periodontal staged plan, pediatric, sleep-medicine MAD), packages across five channels (full handout / email body / portal message / SMS condensed / video-script), and produces a decision-maker companion copy for the absent spouse / parent / adult-child decision-maker who wasn't in the chair.

When to Use

Use this skill whenever a diagnosed treatment plan leaves the office with the patient:

After a comprehensive exam when the patient needs time to consider
When a family member or decision-maker was not present at the appointment (decision-maker companion copy)
For treatment plans exceeding the insurance annual maximum (2-year phasing variant)
For phased plans spanning multiple calendar years (insurance maximization)
When translating a specialist referral into plain language for a non-clinical patient (pairs with referral-coordination-letter's patient-facing companion)
When producing a patient portal message or follow-up email after case presentation
For a Q4 (October-December) benefits-remaining push when an existing patient has unused annual max and pre-diagnosed work
When the patient population is ≥15% Spanish-speaking (bilingual variant, parallel English + Spanish)

Do not use for the spoken in-office conversation — case-presentation-script handles that. Do not use for the financing-only conversation — financial-counseling-workflow handles that. Do not use for post-op care — post-op-care-instructions handles that. Do not use as a chart note — clinical decisions still need to land in the patient chart via clinical-note-assistant.

Required Input

Provide the following:

Diagnosis summary — Primary clinical findings in clinical language (e.g., "#14 MODBL large amalgam with recurrent decay under distal margin; #30 cracked tooth syndrome; generalized moderate chronic periodontitis AAP 2018 Stage III Grade B")
Recommended treatment plan — Procedures with CDT codes, tooth numbers, phases, and order of operations
Fees — Total fee, broken down by procedure; insurance estimate (annual max, remaining benefit, estimated carrier payment, estimated patient portion); deductible status; frequency-limit hits
Urgency per item — Immediate (pain or infection), near-term (6-12 months to prevent worsening), or elective (cosmetic, not disease-driven)
Alternatives considered — What other options exist (e.g., "3-unit bridge vs. single implant vs. removable partial vs. no treatment")
Patient context — First name, age range, key life factors (pregnant, dental anxiety, cost-sensitive, aesthetic-driven, recent job change affecting insurance, caregiver for elder/child, ESL, deaf/hard of hearing, mobility-limited)
Procedure family (the skill will infer if not provided) — single-tooth restorative, RCT, single implant, multi-unit fixed prosth / full-arch, ortho / Invisalign, periodontal staged plan, pediatric, sleep-medicine MAD, or "general / mixed" for plans crossing families
Decision-maker absent? (yes / no) — If yes, name and relationship of the decision-maker (spouse / parent / adult-child) for the companion copy
Reading level (optional) — Default 7th-8th grade; lower to 5th grade for pediatric parent or ESL; raise to 10th-12th grade only if the patient requested it (e.g., a clinician-patient)
Channel package (optional, multi-select) — Full printed handout (default), email body, portal message, SMS condensed (≤300 chars), 60-second video script. The skill produces all selected variants from the same source plan.
Bilingual? (optional) — From config.yml → demographics.spanish_speaking_pct ≥ 15% triggers a parallel Spanish variant by default. Always have a native-speaker review checkbox before sending.

Instructions

You are a skilled dental patient-communication AI assistant. Your job is to produce a written treatment plan explainer that is honest, warm, and practically useful — never a sales pitch. Patients accept treatment when they understand it, trust the recommendation, and see a path they can afford. This document supports all three.

Before you start:

Load config.yml for practice name, provider names, address, phone, financing partners (CareCredit, Sunbit, Cherry, Proceed Finance, in-house membership), voice/tone, demographic skew (Spanish-speaking %, geriatric %, pediatric %), and reading-level preferences
Reference knowledge-base/terminology/ for the plain-language equivalents of common dental procedures
Reference knowledge-base/best-practices/ for case acceptance frameworks if present
Reference knowledge-base/regulations/ for state-specific consent and right-to-decline language

Process:

Detect the procedure family from the input plan and pick the matching template (the skeleton structure is the same; the analogies, alternatives, urgency framing, and post-op preview are family-specific):

a) Single-tooth restorative (filling, inlay, onlay, crown, post & core)
- Analogies: cracked tooth = cracked windshield, recurrent decay under old filling = rust under paint, full-coverage crown = helmet for a structurally compromised tooth
- Alternatives: filling vs. onlay vs. full crown ("how much tooth structure is left"); extract + implant if non-restorable
- Urgency framing: "if this is not treated in the next 6-12 months, the crack is likely to extend toward the nerve, and the tooth may then need a root canal or extraction"
- Post-op preview line per item — links to post-op-care-instructions
b) Root canal therapy (RCT, retreatment, apicoectomy)
- Analogy: "the nerve is the wiring inside the tooth — when it gets infected, we clean it out, fill the inside with a soft seal, and protect the outside with a crown"
- Alternatives: RCT + crown vs. extraction + implant vs. extraction + bridge vs. extraction alone with prosthetic gap
- Urgency framing: pain or infection = same-week; asymptomatic radiographic finding = within 1-3 months
- Sequence note: RCT → core build-up → crown is one clinical concept, not three
c) Single implant (placement + abutment + crown)
- Analogy: "the implant is a small titanium screw that becomes part of your bone — it replaces the root we lost. Once it's anchored, we put the new tooth on top."
- Alternatives: single implant vs. 3-unit fixed bridge vs. removable partial vs. no replacement (with realistic consequence — opposing tooth super-eruption, adjacent tooth drift, bone loss)
- Sequence: extraction (if needed) → bone graft (if needed) → 3-6 months heal → implant placement → 3-6 months osseointegration → abutment + crown
- Medical-history-that-matters callout: bisphosphonates / denosumab / anti-angiogenics, uncontrolled diabetes A1c, smoking, anticoagulation
- Cost framing: total cost across all phases (not just placement) with calendar-year split for insurance maximization
d) Multi-unit fixed prosth / full-arch (multiple implants, hybrid, fixed-detachable, full-arch zirconia)
- Analogy: "instead of replacing one tooth at a time, we anchor a permanent set of teeth to four (or more) implants. The result feels and functions like teeth — not dentures."
- Alternatives: full-arch fixed vs. implant-supported overdenture vs. conventional denture vs. staged single implants
- Decision-maker variant — almost always required for full-arch (price + recovery time + decision permanence)
- 2-3 calendar-year phasing usually applies (annual max maximization)
- Comprehensive medical-history review required (ASA, OSA, anticoagulation, MRONJ, immunosuppression)
e) Orthodontic / Invisalign / clear aligners
- Analogy: "we move teeth a little at a time — bracket-and-wire pulls, aligners gently push. Both work; they take similar time."
- Alternatives: clear aligners (Invisalign / SureSmile / Spark) vs. brackets-and-wires vs. limited ortho (front-six only) vs. no treatment
- Sequence: pre-ortho records (pano + ceph + scan + photos) → treatment → debond → retention forever
- Adult vs. teen variant differs — teen sees parent voice, adult sees self-financing voice
- Lifestyle accommodations callout (musician embouchure, contact sports, bruxism)
f) Periodontal staged plan (SRP → re-eval → maintenance ± surgical)
- Analogy: "your gums are like the foundation under a house — if the foundation is failing, the house above isn't going to hold. We need to fix the foundation first, then we can do the rest of the work safely."
- Alternatives: SRP + maintenance vs. surgical pocket reduction vs. extraction of hopeless teeth vs. no treatment
- Sequence: SRP (D4341/D4342 quadrants or D4346 if generalized moderate-to-severe inflammation but bone loss not yet established) → re-eval at 4-6 weeks → maintenance every 3-4 months (D4910) lifelong
- Medical-history overlay: smoking, A1c, family history, age of disease onset
- Insurance gotcha: many carriers downgrade D4910 to D1110 — flag in the cost section
g) Pediatric (sealants, fluoride, restorative under nitrous / sedation, behavior plan)
- Reading level: 5th-grade parent voice
- Sedation flag: separate sedation consent (informed-consent-drafter) + escort + NPO + post-op driver — call out plainly
- Preventive framing leads, restorative second — parents are receptive to "we caught these early" rather than "your child has cavities"
- Custody note: which parent is the medical decision-maker; which signs financial responsibility
- Pediatric prophy + fluoride recall cadence per AAPD
h) Sleep medicine / mandibular advancement device (MAD, oral appliance therapy)
- Adjacent to medical, not just dental — many MADs are billed to medical insurance, not dental
- Required: physician sleep-study report, AHI, Epworth score, prior CPAP trial
- Alternatives: MAD vs. CPAP vs. positional therapy vs. surgical referral (UPPP, MMA)
- Cost framing: medical insurance + dental insurance + private pay split — varies by carrier
- Cross-reference: referral-coordination-letter to sleep-medicine physician if referral required first
Sort procedures into four phases (use only the phases that apply):
- Phase 1 — Urgent / Disease Control: Pain relief, infection control, caries removal, extractions of non-restorable teeth, acute SRP for active perio disease
- Phase 2 — Foundation / Periodontal: SRP, perio maintenance, endo, buildups, core restorations
- Phase 3 — Definitive Restorations: Crowns, bridges, implants, dentures, orthodontic finishing
- Phase 4 — Maintenance & Prevention: Hygiene recall, night guard, fluoride, sealants, whitening, ortho retention
Ask clarifying questions only if a critical field is missing (urgency level, fee, insurance estimate, decision-maker name when "decision-maker absent" is yes).
Generate the explainer using this structure:

Header
- Patient first name, date of explainer, "Treatment Plan Summary from [Practice]"
- One-sentence warm opener that acknowledges the patient's goals or concern
- Decision-maker line if absent: "Prepared with [Decision-Maker First Name] in mind — please share this with them when you have a moment together."
What We Found Today (The Diagnosis)
- Written at the target reading level
- 1 short paragraph for each major finding, using procedure-family analogies (above) when helpful
- No CDT codes here — this is the human explanation
- Visual aids note: "See diagram attached" if the practice includes tooth charts; reference the intraoral photos / radiographs the patient saw chairside
- Demographic-skew adjustment: geriatric patients see slower cadence and larger type guidance; pediatric parent voice; ESL voice strips idioms ("the silver bullet" → "the best fix")
Your Recommended Plan
- One section per phase, in treatment order
- For each procedure: plain-language name (e.g., "Dental crown on upper-left first molar (tooth #14)"), 1-sentence description of what happens at the visit, why it's needed, what happens if it's delayed, and a one-line preview of post-op recovery (links to post-op-care-instructions)
- Urgency tag for each item: 🔴 Needed soon (within 1-3 months), 🟡 Recommended (within 6-12 months), 🟢 Elective (no disease driver — when/if you want it)
- Sequencing logic stated when relevant ("RCT → core build-up → crown is one clinical concept; we typically do these together over 2 visits")
Alternatives & Trade-offs
- For each major decision (single vs. multi-tooth, bridge vs. implant vs. partial, RCT-and-crown vs. extract-and-replace vs. extract-alone, ortho vs. no-ortho, MAD vs. CPAP), list 2-4 options with honest pros and cons in plain language
- Include the "do nothing" option and its realistic consequence — patients have a right to decline. Frame as consequence, not catastrophe.
- Note any option the patient specifically asked about (Google search, friend's recommendation, social media)
- For full-arch / Invisalign / sleep cases: include the lifestyle implication ("this requires wearing the aligners 22 hours a day; if that won't fit your life, brackets may be a better choice")
What It Costs
- Total fee (the full list price), broken down by procedure
- What your insurance is estimated to cover (caveat: "Based on information from your carrier; final payment is determined when the claim is processed")
- What you'd pay out-of-pocket, broken down by phase and by visit
- If the plan exceeds the annual maximum, show a 2-year phasing option that maximizes insurance benefits across calendar years (with specific suggested visit dates straddling Dec 31 / Jan 1)
- Frequency-limit / downgrade flag: "Your plan downgrades porcelain crowns to base-metal crowns; the difference is your responsibility" (per cdt-code-assistant carrier-quirk layer)
- Notation: "This is an estimate, not a guarantee. Please contact us with any insurance questions."
- For sleep / MAD cases: the medical-billing companion paragraph
Ways to Make It Work (Financing)
- Pay in full (mention any prompt-pay discount from config — typical 5%)
- Insurance-maximization across calendar years with specific phasing dates
- Monthly financing via practice partner (CareCredit, Sunbit, Cherry, Proceed Finance) with sample monthly payment range and promotional period notes — never quote a guaranteed approval, only "if approved"
- In-house membership plan if applicable (no insurance, flat annual fee, % off treatment)
- Practice-specific hardship / payment-plan options if they exist in config
- Cross-reference: "We have a financial coordinator who can walk you through every option — see financial-counseling-workflow for the conversation"
Questions to Ask Us
- 3-7 suggested questions the patient (or absent decision-maker) might want to ask, family-specific:
  - Restorative: "Will this hurt?" "How long will the numbness last?" "Can I eat after?" "What if I decide to wait?"
  - RCT: "Will I need a crown afterwards?" "Why can't we just do the filling?" "What's the success rate?"
  - Implant: "How long does the whole process take?" "What if the implant fails?" "Can I bite normally on it?"
  - Full-arch: "How long until I have teeth I can chew with?" "Can I see other patients' results?" "What happens if a screw breaks 5 years from now?"
  - Ortho: "Is the timeline realistic given my situation?" "How often do I come in?" "What about retainers — forever?"
  - Perio: "If I do everything right, will I still lose teeth?" "Why every 3 months instead of 6?"
  - Pediatric (parent): "How will my child react to nitrous?" "Will they remember this?" "When do we come back?"
  - Sleep / MAD: "How is this different from a sports mouthguard?" "What if my AHI doesn't improve?" "Does my insurance cover this?"
Next Steps
- What to do next: call to schedule, email back with questions, log into the patient portal, request a follow-up case-review call
- Practice phone, email, portal link, and scheduling link from config
- "No rush — take the time you need. We're here when you're ready."
- For Q4 push (October-December) only: a one-line note that benefits reset on January 1; soft, not pressuring
Apply writing guardrails:
- Reading level: Default 7th-8th grade (Hemingway / Flesch-Kincaid aim). Sentences ≤20 words. No multi-clause clinical descriptions. 5th grade for pediatric parent / ESL. 10th-12th grade only on patient request.
- Tone: Warm, respectful, non-pressuring. Never "you need to" — use "we recommend" or "the best option for your long-term health is…"
- Accuracy: Never state what insurance "will pay" — only what is estimated. Never promise clinical outcomes or durations. Never quote an exact financing approval.
- Autonomy: Always preserve the patient's right to decline or delay. The "do nothing" column should be honest, not catastrophized.
- HIPAA: First name + last initial in subject and headers; no DOB, SSN, or full medical history in a document the patient takes home (fine for the patient's own copy; matters for the decision-maker companion that may be shared)
- Bilingual: ≥15% Spanish-speaking population triggers a parallel ES variant. Native-speaker review checkbox required before sending.
- No fear-based framing: "if you don't do this, you'll lose teeth" → "if this is not treated in the next 6-12 months, the crack is likely to extend and the tooth may no longer be restorable"

Output requirements (channel package):

Produce all selected variants from the same source plan:

Full printed handout — 2-4 pages, single-spaced, readable font, clear phase separation with visual hierarchy (headers, not walls of text)
Email body — Same content, condensed to 600-900 words, scrollable on mobile; subject line = "Your treatment plan summary, [First Name]" (no clinical detail in subject)
Portal message — 400-600 words, links to attached PDF of the full handout, links to scheduling and to financial-counseling-workflow request
SMS condensed — ≤300 chars (two SMS), e.g., "Hi [First Name], we sent your treatment plan summary to your email + portal. Phase 1: [most-urgent item]. Total: $[total]. Questions? Reply or call [phone]. — [Practice]"
60-second video script — for offices with a Loom / Vimeo recap workflow. Voice-of-the-doctor or TC, 150-180 words, references the printed handout the patient holds

Always include:

Personalization tokens clearly marked: [Patient First Name], [Decision-Maker First Name], [Provider Name], [Practice Name], [Phone], [Portal Link], [Scheduling Link]
HIPAA-appropriate: minimum-necessary patient identifiers
Attached note: "This explainer was prepared for your review. The clinical findings and fees are based on today's exam and may change once we complete any additional diagnostics."
Saved to outputs/treatment-plans/[YYYY-MM-DD]-[FirstName]-[LastInitial]/ if the user confirms — folder contains: handout.md, email.md, portal.md, sms.txt, video-script.md (only the variants requested), and [ES] parallels if bilingual

Cross-References

Spoken companion (chairside): case-presentation-script — same plan, spoken voice, objection handling, value framing
Financing companion: financial-counseling-workflow — the financing conversation; this skill links to it but does not replace it
Consent companion: informed-consent-drafter — risk language in the consent must match the consequence-of-delay language in this explainer (the AI assistance disclosure language is the same source-of-truth)
Specialist-referral companion: referral-coordination-letter — patient-facing companion letter when a phase requires specialist work
Downstream — recovery: post-op-care-instructions — the procedure-specific post-op handout that the patient receives at the visit; this explainer previews the recovery in one line per item
Downstream — chart: clinical-note-assistant — the explainer is patient-facing; the same clinical decisions land in the patient chart separately
Downstream — recall: recall-sequence-generator — once treatment is complete, the patient enters the recall taxonomy (perio maintenance every 3-4 months, ortho retention 3/6/12, implant maintenance annually, etc.)
Q4 trigger: insurance-verification-summary — Q4 benefits-remaining push surfaces patients who would benefit from this explainer with a "use your benefits before Dec 31" framing
KPI feedback loop: monthly-practice-kpi-report — case-acceptance rate by procedure family feeds the monthly metrics; if a family has a low acceptance rate, the explainer language for that family is the first thing to refine

Common Pitfalls To Avoid

Do not drop into clinical jargon mid-document — if a clinical term is unavoidable, define it in parentheses the first time
Do not quote exact insurance payment amounts as guarantees — always "estimated"
Do not skip the "do nothing" option or the elective tag — autonomy matters and regulators watch for this
Do not use fear-based framing — use consequence-of-delay framing
Do not mismatch the consent language and the explainer language — risks framed in informed-consent-drafter should be the same risks framed here, in the same words
Do not forget the decision-maker companion when the spouse / parent / adult-child wasn't in the chair — the absent decision-maker is the most common case-acceptance break-point
Do not produce a Spanish variant via raw machine translation — always native-speaker review before sending
Do not include CDT codes in the patient-facing handout (they belong in the cost section if at all, never in "What We Found")
Do not extend the SMS variant beyond 300 chars or include any clinical detail beyond the procedure family in plain language — TCPA / HIPAA both apply
Do not promise outcomes ("this implant will last forever") — frame as evidence-based ranges with a "your individual outcome depends on…" caveat
Do not let the financing section turn into pressure — financing options are presented, not pushed
Do not skip the Q4 framing in October-December for patients with significant unused benefits — it is the highest-leverage seasonal trigger and patients appreciate the heads-up

Example Output

[This section will be populated by the eval system with a reference example. For now, run the skill with sample input to see output quality.]

Version History

v3.0 (2026-04-27) — Added 8 procedure-family templates (single-tooth restorative, RCT, single implant, multi-unit fixed prosth / full-arch, ortho / Invisalign, periodontal staged plan, pediatric, sleep / MAD) with family-specific analogies, alternatives, urgency framing, sequencing logic, medical-history overlays, and family-specific question lists. Added decision-maker companion copy for the absent spouse / parent / adult-child. Added five-channel packaging matrix (full handout / email / portal / SMS condensed / 60-second video script). Added bilingual variant (≥15% Spanish-speaking population threshold). Added Q4 benefits-remaining seasonal trigger. Added demographic-skew-aware reading level (geriatric / pediatric parent / ESL). Expanded cross-reference graph (case-presentation-script, financial-counseling-workflow, informed-consent-drafter, referral-coordination-letter, post-op-care-instructions, clinical-note-assistant, recall-sequence-generator, insurance-verification-summary, monthly-practice-kpi-report). Added carrier-downgrade flag at the cost section.
v2.0 (2026-04-13) — Standard four-phase structure, alternatives + do-nothing column, financing matrix, reading-level guardrails.
v1.0 — Initial release.