Blessing or Curse? The 4 O’Clock Dilemma

By: Ronda Holman

It’s 3:55 p.m. on a Thursday. The 4 o’clock patient just canceled.

You can almost hear the sighs of relief ripple through the back office—until the dentist pops their head in and says,

“Let’s fill that spot with a root canal!”

For the doctor, this is a victory. The schedule stays full, production stays on track, and the patient gets the treatment they need without delay.

For the dental assistant, though? It can feel like a slow-motion horror film where the villain is named “Tear Down and Sterilize.”

This moment—the 4 o’clock dilemma—is where team harmony can either shine or snap.


The Dentist’s Perspective: The Numbers Matter

Every empty chair represents lost opportunity. A doctor’s instinct is to fill it with something productive—ideally something high-value that benefits both patient and practice. Root canals, crowns, and longer procedures make financial sense.

But production doesn’t exist in a vacuum. Every decision affects the rhythm of the team. When an end-of-day add-on stacks stress and forces the crew to stay late, it chips away at morale—and eventually, at the efficiency that supports that very same production.


The Dental Assistant’s Perspective: The Workflow Matters

Your assistant isn’t rolling their eyes because they don’t care about patient care.
They’re rolling them because they do care—and they know what it takes to make that procedure flow smoothly.

They’ve already mentally cleaned, restocked, and clocked out before the next whirlwind hits.

When you drop a root canal on their lap at 4:00, it’s not just about “doing the work.”
It’s about resetting the operatory, sterilizing everything, restocking for tomorrow, and often missing dinner with their family.


The Real Battle: Communication vs. Assumption

This tug-of-war doesn’t have to exist. It only happens when one side assumes the other doesn’t understand.

The truth? You’re both fighting for the same outcome: excellent patient care delivered efficiently.

The fix is language—and leadership.


Here’s How a Dentist Can Bridge the Gap

1. Acknowledge the Impact Out Loud

“I know this adds extra work at the end of the day, and I appreciate how hard you’ve been running. I wouldn’t add this unless it really mattered for the patient.”

Translation: You see your DA. You value their time.


2. Give Them a Say

“Do we have what we need to get this done comfortably before we close, or should we schedule it first thing tomorrow?”

Translation: You trust their judgment and workflow awareness.


3. Protect Recovery Time

If you fill that late spot with a long procedure, give your team a break the next morning.
Let them start 15 minutes later or ease into the day.

Translation: You’re a leader, not just a scheduler.


4. Focus on Shared Win

“This case helps the patient avoid pain and keeps our day productive—thank you for making it happen.”

Translation: You’re building pride, not pressure.


Final Thought

The 4 o’clock root canal isn’t the villain. Poor communication is.

When dentists lead with empathy and assistants respond with professionalism, the “battle” turns into a partnership. The schedule stays full, the patients are cared for, and the team walks out together—still smiling, still on the same side.

Because at the end of the day, filling the schedule isn’t just about time—it’s about trust.

Photo by Cats Coming

Ronda Holman

Ronda Holman

Ronda Holman found her passion for dental assisting while in the Air Force. She assisted in oral surgery, general dentistry, and ended her four-year service as a prophy tech, the military’s version of a dental hygienist. She married and spent 13 years traveling the country while her husband served in the Air Force. Each time Ronda relocated she got the opportunity to work in a new dental office, where she picked up pearls that have helped her become an expert in educating dental assistants. Her interests are immediate denture/partial fabrication, CEREC technology, patient education, and striving for optimal chairside skills. Ronda believes that every dental assistant has the potential to be a rock star assistant if given the right tools and guidance.