Know which tooth extraction leads are worth consultation time
Ask why the tooth needs to come out, how urgent the timeline is, and whether pain or swelling is already present — then collect intraoral photos so your team can review before booking chair time.
The exact intake your tooth extraction leads complete
This is the real 5-question guided intake for Tooth Extraction — the same flow your customers finish before you ever pick up the phone.
What a qualified tooth extraction lead should tell you
Removal of a single tooth or teeth due to pain, infection, decay, impaction, or orthodontic need — the intake identifies the reason for extraction, symptom severity, and whether a dentist has already recommended treatment.
- This Extraction
- Main Reason Tooth Be
- Experiencing Pain, Swelling, Or
- Soon Have Extraction Done
- Dentist Already Recommended Extraction
The questions your team needs answered
Every tooth extraction intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Who is this extraction for? | Distinguishes a self-pay adult patient from a pediatric or dependent case, which often needs different consent and scheduling handling. |
| What is the main reason the tooth needs to be extracted? | The stated reason carries most of the scoring weight, separating urgent infection or decay cases from lower-weighted crowding or uncertain reasons. |
| Are you currently experiencing pain, swelling, or fever related to this tooth? | Active pain, swelling, or fever pushes the lead toward same-day handling rather than a routine consultation slot. |
| How soon are you hoping to have the extraction done? | Timeline weight runs from 10 for as-soon-as-possible down to 3 for just exploring, letting staff triage which requests need chair time this week. |
| Has a dentist already recommended extraction for this tooth? | Confirms whether a referring dentist has already recommended extraction, reducing the chance of booking a consult that turns into a second-opinion visit instead of treatment. |
How Cliont scores tooth extraction leads
Every answer is weighted automatically — no manual review required.
Value signals
- Pain or infection
- Impacted wisdom tooth
- Orthodontic crowding
- Not sure
- Experiencing Pain, Swelling, Or: yes
- Within a week
Urgency signals
- Broken or badly decayed tooth
- As soon as possible (urgent)
See the lead your team receives
Tooth Extraction Lead — Pain & Swelling, ASAP
From first click to qualified lead
Follow patients and caregivers through one smooth, guided flow.
They land & meet you
Your video greeting plays instantly — a real face instead of a blank form.
They explain the visit
Smart questions adapt to their visit and capture the full scope.
They share details
Symptoms, history, and documents come attached before the visit.
You get a ready lead
Scored and qualified — waiting for you to win it.
Built for tooth extraction workflows
| Cliont capability | Tooth Extraction application |
|---|---|
| Weighted answer scoring | Reasons like pain or infection, a broken/decayed tooth, and impacted wisdom teeth are weighted higher than orthodontic crowding or 'not sure,' so your team sees the most treatment-ready leads first. |
| Conditional intake flow | A 'my child' or 'another person I care for' answer to who the extraction is for can route the lead into a different intake path than a self-submitted adult patient. |
| Required upload capture | Intraoral photos and any existing X-ray or referral note are collected before the consultation, reducing exam-only appointments that book chair time without enough information. |
| CRM delivery with score band | Leads reporting active pain, swelling, or fever alongside an ASAP timeline are flagged and sent to your CRM immediately, instead of sitting in a queue with exploratory inquiries. |
Common tooth extraction lead scenarios
Emergency pain and swelling
Patient selects pain or infection as the reason, confirms swelling or fever, and wants the extraction as soon as possible — the highest-weighted combination the intake produces.
Wisdom tooth already diagnosed
A dentist has already recommended extraction for an impacted wisdom tooth and the patient wants it done within a week, so the lead arrives with the referral context already captured.
Orthodontic crowding referral
A parent submits on behalf of their child for crowding-related extraction with no active pain and a looser 'within a month' timeline, a lower-weight reason than infection or decay.
Uncertain patient just exploring
The patient isn't sure why extraction was suggested, hasn't been told by a dentist yet, and marks 'just exploring options' — the intake flags this for follow-up rather than a same-week slot.
Caregiver booking for a dependent
Someone submits for another person they care for, citing a broken or badly decayed tooth with a within-a-month timeline, a different consent and scheduling path than a self-submitted lead.
Connect Cliont to your workflow
Send leads
HubSpot, HighLevel, Salesforce, JobNimbus
Book visits
Google Calendar, Outlook Calendar, Calendly
Notify your team
Email, SMS, Slack
Automate follow-up
Zapier, Webhooks, API
Simple, transparent pricing
Choose the plan that works for your business.
Professional
Unlimited intake forms and leads for your growing business.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Advanced analytics dashboard
Pay Per Lead
Only pay when you receive a qualified lead.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Charged only for submitted leads
More oral surgery intake templates
Tooth Extraction lead-intake FAQs
How does the intake decide which tooth extraction leads are high priority?
Priority is driven mainly by the stated reason for extraction and whether pain, swelling, or fever is present — pain or infection and active symptoms carry the highest weights, while orthodontic crowding or an uncertain reason score lower.
Can the intake tell whether the extraction is for the patient or a dependent?
Yes — the first question asks whether the extraction is for the patient themselves, their child, or another person they care for, so your front desk knows upfront whether consent forms or a guardian conversation are needed.
What happens if a patient hasn't seen a dentist about this tooth yet?
The intake still qualifies them, but a 'no' to prior dentist recommendation carries a lower weight than a confirmed recommendation, since these cases sometimes need an evaluation before treatment planning rather than a straight extraction booking.
Does the intake collect X-rays or photos before the consultation?
You can request a recent X-ray if the patient has one, a photo of the affected tooth or swollen area, and any referral note from a treating dentist, so your team can review the case before chair time is reserved.
How is this different from the Wisdom Tooth Removal intake?
Tooth Extraction covers any removal reason — pain, decay, impaction, or orthodontic crowding — while Wisdom Tooth Removal is scoped specifically to third molars; a lead reporting an impacted wisdom tooth here still qualifies, just without the wisdom-specific follow-up questions.
Can urgent extraction leads be routed differently than exploratory ones?
Yes — the timeline question separates 'as soon as possible' from 'just exploring options,' and that answer is scored and passed to your CRM alongside the reason and symptom answers so staff can triage same-day requests first.
Turn tooth extraction visitors into qualified patients
Give every tooth extraction visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.