NOVEMBER 1 — While doing housework, I had the TV on, and Sky News was discussing this issue ‘patients who miss their appointment may face fines’ in the UK. It got me thinking whether its implementation could become a reality in the near future.

Dental care is an essential aspect of overall health, yet missed dental appointments are an increasingly common problem worldwide. This issue, which might seem trivial at first, is actually causing significant concerns within the healthcare system, including in countries like Malaysia. Whether it is due to personal reasons, fear of dental procedures, or simply forgetfulness, missed appointments have wide-reaching consequences for both patients and healthcare providers.

In Malaysia, the issue of missed dental appointments is becoming a pressing concern for both healthcare providers and patients alike. No-shows may seem like a minor inconvenience, but they can significantly disrupt the flow of dental clinics, reduce access for other patients, and affect the overall quality of care. As the country continues to improve its healthcare systems, missed dental appointments must be addressed to maintain efficiency and ensure optimal patient outcomes.

A study from the Universiti Sains Islam Malaysia (USIM) in 2022 highlighted that missed dental appointments occur frequently, with 37.1 per cent of patients failing to attend their scheduled visits. The most commonly cited reason for these missed appointments was "personal matters” while other reasons, such as forgetfulness or miscommunication, accounted for a much smaller fraction. While this may not seem like a large percentage at first glance, in the context of the volume of patients Malaysian dental clinics handle, the repercussions can be significant.

This figure aligns with global trends. For instance, research in the UAE found that approximately 22.5 per cent of dental appointments were missed, with fear of pain being a prominent factor. In Malaysia, similar anxieties or lack of awareness about the importance of dental care could contribute to the growing problem.

Why do patients miss appointments? One key factor in Malaysia is the prevalence of misunderstandings about dental care. Many Malaysians only visit the dentist when they experience pain, disregarding routine check-ups or preventive treatments. This behaviour contributes to the high rate of missed appointments, as patients may deprioritise their scheduled visits when they don’t feel any immediate dental discomfort.

Additionally, many patients struggle with work commitments. A significant portion of missed appointments comes from working adults who often find it challenging to balance professional obligations with healthcare needs (Nur Farah Insyirah Khairuddeen et al., 2022). Dental care, in particular, often gets sidelined in favour of more urgent or visible health concerns.

For dental clinics, missed appointments can have severe financial implications. They represent lost income and waste resources, as clinics often prepare extensively for each patient’s visit. The cost of these missed appointments, while difficult to quantify precisely, includes the time spent by dentists and clinic staff, the operational costs of keeping the clinic running, and the potential income lost by not filling the slot with another patient.

Beyond financial losses, no-shows disrupt the continuity of patient care. Regular dental check-ups are critical for early detection and prevention of oral health issues. When patients miss appointments, they delay necessary treatments, increasing the risk of more severe problems down the line, such as advanced cavities or gum disease.

Several potential solutions could be implemented to mitigate the impact of missed appointments in Malaysia. Some countries have adopted fines for missed appointments as a deterrent. While this approach has shown some success, its implementation in Malaysia would require careful consideration to ensure it does not disproportionately affect low-income patients or create further barriers to dental care.

Another solution could involve strengthening communication between clinics and patients. In many cases, simple forgetfulness is to blame. Implementing reminder systems – via SMS or email—could significantly reduce the number of no-shows. Clinics could also offer more flexible scheduling options, such as weekend or evening appointments, to accommodate working adults who may struggle to attend during regular hours (Tandon et al., 2016).

Educational campaigns could also play a vital role in addressing the issue. Many Malaysians are still unaware of the importance of regular dental visits. By educating the public on the long-term benefits of preventive dental care, the healthcare system can foster a culture of responsibility and timely appointment adherence.

A balanced approach could be implemented. While missed appointments are a problem, the solution must be balanced and consider the root causes. Instead of relying solely on punitive measures, a combination of patient education, improved clinic accessibility, and reminder systems may offer a more sustainable solution. In a study conducted on missed appointments in a tertiary hospital in Southern Nigeria, researchers suggested that understanding the factors leading to no-shows is key to addressing the issue effectively. Missed dental appointments are indeed a concern in Malaysia, with consequences for both patients and dental clinics. However, with the right strategies in place – ranging from better communication and scheduling flexibility to public education campaigns – the issue can be mitigated. Ensuring that patients understand the importance of regular dental care, while making the system more accessible, can go a long way in reducing no-shows and improving oral health outcomes in Malaysia.

* Dr Azwatee Abdul Aziz is an associate professor at the Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, and may be reached at azwatee@um.edu.my

** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.