Written Communications

FIGURE 9-1 A, Referral thank you letter. B, Informal referral thank letter to a patient who is a personal friend of the dentist. C, General referral thank you letter. D, Referral thank you letter to a colleague.

Letters of Appreciation to Cooperative Patients

A cooperative patient is often overlooked and taken for granted. Often one thinks only of the patients who create frustration. A dentist should acknowledge a patient who is prompt for appointments, who maintains a regular payment plan, and who cooperates with prescribed homecare plans. This is a chance for the dental office staff to offer sincere compliments. When the opportunity presents itself, try writing a letter as shown in Figure 9-2, and see how appreciative patients are to receive it. A letter of appreciation should be sincere, state the purpose briefly, and be written as though conversing with the patient in person.

FIGURE 9-2 Letter of appreciation to a cooperative patient.

Birthday Letters and Holiday Greetings

Patients—especially children and older adults—like to be recognized on their birthdays. These letters should be cheerful and friendly. Figure 9-3 shows a letter that could be sent to an older adult on a special birthday. Another method of handling this form of public relations is to send a birthday card. If an email address is available, eCards could also be an option for a special birthday greeting. Many professional stationers provide appropriate greeting cards for all occasions and dental specialties (Figure 9-4).

FIGURE 9-3 Birthday letter to an older adult.
FIGURE 9-4 Birthday card. (Courtesy Patterson Office Supplies, Champaign, IL.)

Congratulatory Letters

Through conversations with patients and via the daily newspaper, the administrative assistant may learn about the outstanding achievements of the practice’s patients. Such accomplishments should not go unnoticed by the dental office staff. A letter sent to congratulate a patient must be sent promptly. Describe how the event was discovered, and include a sincere expression of congratulations (Figure 9-5). Congratulations may also be sent for the birth of a child, a wedding, or a graduation. A greeting card or a brief letter is appropriate.

FIGURE 9-5 Congratulatory letter.

Referrals for Consultation or Treatment

During the treatment of a patient, it is often necessary to call upon the services of a specialist. A series of letters may be sent between the two dental offices regarding the patient’s treatment. A good example of such an experience is the transfer of a patient to an orthodontist for treatment (Figure 9-6). Figure 9-7 provides examples of several forms of communication that may be used during a patient’s treatment. Note that the specialist’s office has used a basic format that provides information about the patient’s treatment. This letter can be stored electronically, or a preprepared form can be used in a specialty office such as an orthodontics office, because there is a large patient volume and a similarity of basic treatment. Regardless of the type of form used, note that in each case the patient’s name is referenced, the message is brief, and each tooth or condition is diagrammed or written out completely to avoid any error in interpretation.

FIGURE 9-6 Letter for the referral of a patient to an orthodontist.
FIGURE 9-7 A, Basic form letter from an orthodontist to welcome a new patient. Diagnosis text from the patient’s record may be inserted. B, Basic form letter from an orthodontist to a referring dentist after examination of a patient. C, Letter to a patient confirming a consultation appointment and explaining the process. D, Final letter from an orthodontist to inform a referring dentist about a patient’s completed treatment. E, Requisition used by an orthodontist to refer a patient for extraction. (Courtesy J.G. Clinthorne, DDS, and H.L. Kim, DMD, Ann Arbor, MI.)

Sympathy Messages

Many people find it difficult to express sympathy in a letter. Therefore, one of the best ways to handle this difficult situation is to send a sympathy card. This unexpected message often means a great deal to family members during their time of grief.

Miscellaneous Letters

Many letters are not public relations letters and thus are not included in this chapter. Specific examples of recall, broken appointment, and collection letters are discussed in Chapter 15.

Selecting Stationery Supplies

If the administrative assistant begins working in an established dental practice, the stationery supplies will already be available. However, he or she may have to choose business supplies if asked to order them. Many of these supplies are listed in Chapter 6.

The office stationery (letterhead) is usually selected on the basis of simplicity, neatness, and quality. Bond paper, because of its quality, is often used. It can be made from all-cotton fiber (sometimes called rag), all-sulfite (a wood pulp) fiber, or any proportion of the two. High-cotton fiber bond indicates quality and prestige, and it ages without deterioration or chemical breakdown.

The following information may be used as guidelines for future stationery needs:

• A color theme for stationery items such as letterhead, envelopes, appointment cards, prescription pads, medicine envelopes, and notepads may be used. Coordinated colors (e.g., light and dark brown or blue) or contrasting tones of gray with black print are attractive combinations. Most dental stationery supply or chain office supply houses have samples of stationery stock and logo designs from which to select.
• A popular alternative to purchasing stationery is to create the letterhead with the use of appropriate computer software. A fine bond paper can be purchased. When a new letter is to be keyboarded, the letterhead is removed from the file where it is stored, the letter is prepared, and then it is printed on bond paper. This becomes less expensive and allows for more frequent changes and creativity. Clip art is available that makes it easy to create professional-looking letterhead that provides the office staff with many options. Labels with the same clip art and office information can also be created in this manner. It is important that the labels selected are compatible with the office printer.



Characteristics of an Effective Letter

Effective letters that generate good public relations have certain common elements. Keep in mind that direct and simple writing is easier to read. The best word depends on context: the situation, the purpose, the audience, and the words used.

Here are some general guidelines:

• Use words that are accurate, appropriate, and familiar. Accurate words mean what the author is wanting to say. Appropriate words convey the attitudes that the author wants to create and fit well with the other words in the document. Familiar words are easy to read and understand.
• Use technical terminology sparingly. The exception to this rule is if the administrative assistant is communicating with another professional and needs to describe a condition or treatment in technical terms. However, when communicating with patients or laypersons, it is wise to use a “plain English” equivalent instead of a technical term.
• Use active verbs most of the time. This is common when writing for a job application or referring a patient to a specialist. If the verb describes something that the subject is doing, the verb is active. If the verb describes something that is being done to the grammatical subject, the verb is passive.

Active: I recommend that the patient’s third molar be removed.

Passive: It was recommended by me for the patient to have the third molar removed.

Active: I can expose digital radiographs.

Passive: Digital radiography is something I could do.

• Tighten the writing. Eliminate words that say nothing. Combine sentences to eliminate unnecessary words. Put the meaning of the sentence into the subject and the verb. Cut words if the idea is already clear from other words in the sentence. Substitute single words for wordy phrases.

Wordy: Keep this information in the patient’s file for future reference.

Tighter: Keep this information for reference.

or: File this information.

Phrases beginning with of, which, and that can often be shortened.

Wordy: The issue of most importance

Tighter: The most important issue

Wordy: The estimate that is enclosed

Tighter: The enclosed estimate

Wordy: It is the case that Registered Dental Assistants are more qualified clinicians in the office.

Tighter: Registered Dental Assistants are more qualified clinicians in the office.

Combine sentences to eliminate unnecessary words. In addition to saying words, combining sentences focuses the reader’s attention on key points; it makes your writing sound more sophisticated and sharpens the relationship between ideas, thus making your writing more coherent.

Wordy: I conducted a survey by telephone on Monday, April 17. I questioned 18 dental assistants, some Registered Dental Assistants, and some Certified Dental Assistants, who—according to the state directory—were all currently working. The purpose of this survey was to find out how many of them were performing advanced functions that were delegated by the state. I also wanted to find out if there were any differences in their salaries.

Tighter: On Monday, April 17, I phoned working Registered and Certified Dental Assistants to determine whether they were performing their state-delegated advanced functions and whether there was a distinction between the salaries for these two credentials.

• Vary sentence length and structure: A readable letter mixes sentence lengths and varies sentence structure. A really short sentence is less than 10 words long and can add punch to your letter. Really long sentences of 30 to 40 words can raise a danger flag.

A simple sentence has one main clause:

We will open a new office this month.

A compound sentence has two main clauses joined with and, but, or, or another conjunction. Compound sentences are used best when the ideas in the two clauses are closely related.

[Clause 1] We have hired three new dental assistants, and [Clause 2] they will complete their orientation next week.

[Clause 1] We hired a new intern, but [Clause 2] she will be unable to begin work until the end of the month.

Complex sentences have one main and one subordinate clause; they are good for showing logical relationships.

[Subordinate clause] When the new office opens, [Main clause] we will have an open house for local dentists and offer refreshments and door prizes.

[Subordinate clause] Because we already have a strong patient base in Livingston County, [Main clause] we expect that the new office will be as successful as the Ann Arbor office.

• Use parallel structure: Parallel structure puts words, phrases, or clauses in the same grammatical and logical form. Clarity eliminates long, meaningless words and uses language that the reader will understand. Thus, it is certain that each statement will not be misinterpreted.

Nonparallel: The position is prestigious, challenging, and also offers good money.

Parallel: The position offers prestige, challenge, and good money.

Nonparallel: The steps in the planning process include determining the objectives, an idea of who the reader is, and a list of the facts.

Parallel: Determine the objective, consider the reader, and gather the facts.

• Put your readers in your sentences: Use second-person pronouns (you) rather than third-person pronouns (he, she, one) or first-person pronouns (I) to give your writing a greater team approach. The “you” approach to letter writing requires the writer to place the reader at the center of the message.

Third person: References for patients in this office are made by our office manager, and the patient will be contacted as soon as the appointment has been confirmed with the specialist.

Second person: Once you are referred to a specialist, you will receive a confirmation of your appointment from our office manager.


image Practice Note

The “you” approach to letter writing requires the writer to place the reader at the center of the message.

In addition to considering the ideas presented here, the administrative assistant should review the basic characteristics of effective correspondence. These factors should be used as part of a review of the letter before it is sent. Remember that the letter sent from the dental office is representative of the quality of work or treatment produced in that practice and should contain the following characteristics:

• Completeness: Include all necessary data the reader needs to make a decision or take action.
• Conciseness: State the information briefly.
• Confidentiality: Release information only about the case that is relative to the contents of the letter and only after the patient has given consent to the release of specific information.
• Courtesy: Use good manners for good public relations. Do not make derogatory statements.
• Accuracy: Make sure that all of the data are correct. Check the details carefully. Use correct spelling and grammar.
• Neatness: Avoid smudges, tears, or wrinkles.
• Positive language: Use positive words that indicate helpfulness and caring (Box 9-1).


Box 9-1   Positive and Negative Words

Positive Words Negative Words
I will I’m sorry
Congratulations Complaint
Concern Difficult
Pleasure Unpleasant
Thank you No
Satisfactory Can’t
I can Careless
Welcome Error

• Orientation to reader: Use “you”-oriented pronouns.

Parts of a Business Letter

A review of the parts of a business letter and the proper placement and purpose for each part is appropriate before selecting a letter style and creating the letter. Most business letters contain the following parts:

• Date line
• Inside address (letter address)
• Salutation
• Body
• Complimentary close
• Keyboarded signature
• Reference initials
• Special notations such as attention line, subject line, or enclosures

When using most word processing software, many preformatted letter styles are available. The dates are inserted automatically, and, in most systems, the alignment and letter parts are already defined.

Date Line

The date line contains the date on which the letter is keyboarded. When using printed letterhead, the date usually begins two lines below the lowest line of the letterhead. (The letterhead usually takes up about 2 inches, but this may vary depending on the style and design of the letterhead.) Many times, the length of the letter determines whether the heading should be started lower on the paper; good judgment is needed. When keyboarding a personal business letter, the individual’s return address is placed as the first two lines directly above the date line. The placement of the date line may be modified according to the length of the letter. When using the computer, you may view a “Print Preview” to check the appearance of the letter; necessary changes can then be made before printing. General guidelines that relate to letter length are shown in Box 9-2.


Box 9-2   Placement of a Date Line


Inside Address

The inside address provides all of the information for mailing the letter. The letter address should match the envelope address. When using word processing software, the envelope is often addressed from the letter address with the use of a minor key function on the computer. The information to be included is the recipient’s name, the name of the company (if appropriate), the street number and name, the city, and the zip code. Three lines of space are left between the date and the first line of the letter address.

Use the titles that precede the individual’s name (e.g., Mr., Mrs., Ms., Dr.), but do not use a double title (e.g., Dr. L. B. Crown, D.D.S.), because this is redundant. An official title (e.g., President) may follow the name (e.g., Ms. M. P. Coleman, President). The person’s official title is often placed on the second line if it helps to balance the inside address lines. The city, state, and zip code are placed on the last line. The appropriate two-letter state postal abbreviation should be set in capital letters without a period. Leave two spaces after the abbreviation before entering the zip code.


The salutation formally greets the reader. If the writer wishes the letter to be directed to an individual within a firm, it is acceptable to use an attention line. The salutation line should begin two lines below the letter address, and it should be flush with the left margin. If you are writing to an individual, the most appropriate salutation is the individual’s name. For example, if the letter is addressed to Mr. Ted Monroe, the salutation would be “Dear Mr. Monroe.” The salutation can be altered to be “Dear Ted” if the dentist is a close friend of the recipient. This change in formality should be recognized before the letter is keyboarded. Special situations occur when the letter is to be sent to unknown individuals or to more than one person. Suggestions for salutations to be used in common situations are shown in Box 9-3, A. Addresses and salutations to be used for governmental and academic officials are shown in Box 9-3, B.


Box 9-3, A   Appropriate Salutations for Various Situations

• One person, gender unknown: Dear M.R. Rieger
• One person, name unknown, title known: Dear Director of Surgical Technology
• One woman, title unknown: Dear Ms. Hartwig
• Two or more women, titles known: Dear Ms. Martin, Mrs. Leverett, and Ms. Grey
• If all women are married: Dear Mrs. Franks, Mrs. Johnson, and Mrs. Sullens or Dear Mesdames Franks, Johnson, and Sullens
• If all women are unmarried: Dear Miss Franks, Miss Johnson, and Miss Sullens or Dear Misses Franks, Johnson, and Sullens
• If all recipients are women: Dear Ms. Franks, Johnson, and Coady or Dear Mses. or Mss. Franks, Johnson, and Sullens
• A woman and a man: Dear Ms. Johnson and Mr. Ladley
• A group or organization composed entirely of women: Ladies or Mesdames
• A group or organization composed entirely of men: Gentlemen
• A group composed of women and men: Ladies and Gentlemen


Box 9-3, B   Addresses and Salutations for Government and Academic Officials

The following addresses and salutations are recommended in correspondence with governmental or academic officials. In each case, the proper ways to address letters are illustrated. On the left are the addresses to use, and on the right are the appropriate salutations. When one or more examples are given, they are arranged in order of decreasing formality.

Correspondence with Government Officials

The President

The President Dear Sir, Madam
The White House Dear Mr. (Mrs. or Ms.) President
Washington, DC 20500
The President of the United States
The White House
Washington, DC 20500
Dear Mr. President; Dear Madam President

Chief Justice of the Supreme Court

The Chief Justice of the United States Dear Sir, Madam
Washington, DC 20543
The Honorable (full name)
United States Supreme Court
Washington, DC 20543
Dear Mr. or Madam Chief Justice

Associate Justice of the Supreme Court

The Honorable (full name) Dear Sir, Madam
Associate Justice of the Supreme Court Dear Mr. or Madam Justice
Washington, DC 20543 My dear Justice (surname)
Dear Justice (surname)

Cabinet Member

The Honorable (full name) Dear Sir, Madam
Secretary of State
Washington, DC 20520
My dear Mr. or Madam Secretary
The Secretary of State
Washington, DC 20520
Dear Mr. or Madam Secretary


The Honorable (full name) Dear Sir, Madam
The United States Senate My dear Mr. or Madam Senator
Washington, DC 20510
Senator (full name)
The United States Senate
Washington, DC 20510
My dear Senator (surname)
Dear Senator (surname)


The Honorable (full name) Dear Sir, Madam
The House of Representatives My dear Representative (surname)
Washington, DC 20515
Representative (full name)
The House of Representatives
Washington, DC 20515
Dear Representative (surname)

Chief, Director, or Commissioner of a Government Bureau

Mr., Ms., Mrs., or Miss (full name) Dear Sir, Madam
Director of Public Information
Department of Justice
Washington, DC 20530
Director of Public Information
Department of Justice
Washington, DC 20530
My dear Mr., Ms., Mrs., or Miss (surname)
Dear Mr., Ms., Mrs., or Miss


The Honorable (full name) Dear Sir, Madam
Governor of Ohio
Columbus, OH 43215
The Governor of Ohio
Columbus, OH 43215
My dear Governor (surname)
Dear Governor (surname)
Dear Governor

State Senator

The Honorable (full name) Dear Sir, Madam
The State Senate My dear Senator
Columbus, OH 43215
Senator (full name)
My dear Senator (surname)
Dear Senator (surname)
My dear Mr., Ms., Mrs., or Miss (surname)
The State Senate
Columbus, OH 43215
Dear Mr., Ms., Mrs., or Miss

State Representative

The Honorable (full name) Dear Sir, Madam
House of Representatives My dear Representative (surname)
Columbus, OH 43215
Representative (full name)
House of Representatives
Columbus, OH 43215
Dear Representative (surname)
My dear Mr., Ms., Mrs., or Miss (surname)
Dear Mr., Ms., Mrs., or Miss (surname)

Mayor of a City

The Honorable (full name) My dear Sir, Madam
Mayor of the City of Ann Arbor
City Hall
Ann Arbor, MI 48105
Dear Sir, Madam
Dear Mr. or Madam Mayor
My dear Mayor (surname)
Dear Mayor (surname)

Correspondence with Educators

President (College or University)

Dr. (full name)
(full name), Ph.D.
Ohio University
Athens, OH 45701
My dear Sir, Madam
Dear Sir, Madam
My dear President (surname)
Dear President (surname)

Dean of a College

Dean (full name)
College of Business Administration
University of Cincinnati
Cincinnati, OH 45221
Dr. (full name)
Dean of the College of Business Administration
University of Cincinnati
Cincinnati, OH 45221
My dear Sir, Madam
Dear Sir, Madam
My dear Dean (surname)
Dear Dean (surname)

(If the individual has a doctorate degree, the salutation may be “Dear Dr. Wilson” instead of “Dear Dean Wilson.”)

Professor (College or University)

(full name), Ph.D. My dear Sir, Madam
Dr. (full name)
Vanderbilt University
Nashville, TN 37203
Dear Sir, Madam
My dear Professor (surname)
Dear Dr. (surname)

Note: Window envelopes require the date line to be placed on a line 2 inches below the top of the page.

Body of the Letter

The body of the letter contains the message. The body begins two lines after the salutation. The paragraphs within the body are single spaced, with two lines of space set between paragraphs. Paragraphs may or may not be indented, depending on the format selected. Refer to Figures 9-2 through 9-7 for the selection of the format. Many illustrations in this chapter demonstrate variations in letter format styles.

Complimentary Close

The complimentary close provides a courteous ending to the letter. It is keyboarded two lines after the last line of the body of the letter. The complimentary close is indented to the same point as the date line position if using the modified block style, or it is set flush with the left margin if using the block style. Only the first word of the complimentary close should be capitalized. The most common complimentary closes are “Very truly yours” and “Sincerely.” Other acceptable closures are “Yours very truly” and “Sincerely yours.”

Keyboarded Signature

The keyboarded signature appears four lines below the complimentary close. If the name and title of the individual are short, they may be placed on the same line and separated by a comma. However, if the name and title are relatively long, the name is keyboarded on the first line, and the title is placed on the second line. The comma is not placed after the name. You should attempt to make the lines as even as possible.

Reference Initials

Reference initials are the initials of the person who keyboarded the letter. They should appear in lowercase one double space after the keyboarded signature or even with the left margin. If it is policy to enter the dentist’s initials in capital letters before the keyboarder’s initials in lowercase, it would appear as “JWL:db” or “JWL/db.”

Attention Line

You may wish to direct a letter to a particular individual or department within an organization. This can be done by using an attention line. The following example illustrates how an attention line is used if the letter has been addressed to a firm:

Apex Dental Laboratories

Attention Mr. W. W. Thomas, President

1616 W. Riverfront Street

Grand Rapids, MI 49502

The attention line indicates that the letter writer prefers that the letter be directed to a particular individual. The salutation should agree with the inside address and not with the attention line.

Subject Line

The subject line clearly states what the letter is about. For example, if writing to a patient about the office’s policy regarding broken appointments, the subject line would be written as “Subject: Broken Appointments.” The subject line is placed two lines after the salutation and followed by another two lines before continuing with the body of the letter. The subject line may be centered, indented like a paragraph point, or aligned with the left margin when using block style. The style of the letter will often determine the best position for the subject line. The word Subject: or SUBJECT: or the abbreviation Re: or RE: may be used, and any of these options may be underlined. Acceptable methods of using the subject line are illustrated here:

Dear Mrs. Calloway:

SUBJECT: Broken Appointments


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Mar 21, 2015 | Posted by in General Dentistry | Comments Off on Written Communications
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