The systems dentists are forced to navigate in the current industry must be updated to ensure sustainable growth in the field, according to Krista Kappus, DDS.
Dr. Kappus, of Fitch Mountain Dental in Healdsburg, Calif., recently shared her thoughts with Becker’s on the aspects of dentistry that have not evolved with the increased complexities of the field.
Note: This response was lightly edited for clarity and length.
Question: What’s one issue in dentistry that no one is seriously addressing? How should this issue be addressed?
Dr. Krista Kappus: One of the biggest issues facing dentistry today is that many of the systems governing the profession were designed for a different era and have not evolved to meet the realities of modern healthcare. When many leaders in organized dentistry envision the traditional dental practice, the image is almost nostalgic: a single dentist office with the faint smell of disinfectant and cleaning products, bright overhead fluorescent lights, vinyl waiting room chairs lined neatly against the wall, and artificial flowers arranged carefully on a side table. In the back, the dentist emerges from a private office, coffee mug in hand, dressed in pressed slacks, polished shoes and a white coat to perform an exam before retreating to complete charts or take a phone call. The expectation was that this dentist would be available whenever needed. If a patient had an emergency, they could simply call the office after hours, leave a voicemail, and trust that the doctor would eventually return the call from home. The dentist was the owner, clinician, manager, marketer, emergency provider and community leader all wrapped into one.
The problem is that much of organized dentistry, including many of the policies and assumptions that continue to shape the profession, remains rooted in this vision despite the reality that dentistry has changed dramatically. Today’s dental practices are complex healthcare organizations. Dentists manage sophisticated technology, digital workflows, electronic health records, regulatory compliance, cybersecurity concerns, staffing shortages, insurance challenges, extreme rises in overhead and increasingly complex patient needs. At the same time, younger generations of providers are seeking sustainable careers that allow them to be excellent clinicians without sacrificing their personal lives.
Yet many of the expectations surrounding the profession remain frozen in time. Dentistry continues to operate largely outside the broader healthcare system, a consequence of historical decisions to maintain separation from medicine. While physicians increasingly practice within integrated systems that provide shared call schedules, administrative support and coordinated patient care, dentists are often expected to shoulder every responsibility themselves. This separation has also contributed to outdated dental insurance models. Annual maximums have remained largely unchanged for decades despite dramatic increases in treatment costs, staffing expenses, technology investments and inflation. Nonprofit dental insurance companies have been turning larger and larger profits while patients are left wondering why their benefits cover so little. Dentists are forced to navigate a system that no longer reflects the realities of modern healthcare.
The solution is not to abandon the strengths of dentistry’s independence but to modernize the structures surrounding it. Organized dentistry should advocate for greater integration of oral and systemic health, pursue meaningful insurance reform, support innovative practice models and embrace new approaches to workforce development and work-life balance. Most importantly, it should recognize that the profession no longer resembles the single dentist office that shaped many of its traditions.
Dentistry has become one of the most technologically advanced fields in healthcare. Unfortunately, many of the systems governing it still reflect a world of fluorescent lights, vinyl chairs, home answering machines and the expectation that one dentist can do it all. Until those systems evolve, both patients and providers will continue to bear the cost of a profession that is still, in many ways, practicing within a framework designed for another century.
At the Becker's 5th Annual Future of Dentistry Roundtable, taking place September 14-15 in Chicago, dental leaders and executives will gain insights into emerging technologies, practice growth strategies and the evolving landscape of dental care delivery, with a focus on innovation, patient experience and operational excellence. Apply for complimentary registration now.