Here are five recent controversies affecting the dental industry:
Delta Dental acquisition
Many dental leaders and providers are concerned that Delta Dental’s recent acquisition represents a conflict of interest.
Delta Dental of Wisconsin recently purchased Cherry Tree Dental, a DSO based in Madison, Wis., with locations in Wisconsin, Illinois, Michigan and Minnesota. In an email sent to providers, the insurer said Cherry Tree Dental will operate as a separate company and the two organizations will have separate leadership structures.
The American Dental Association shared it was concerned about a potential conflict of interest with an insurer being both the provider and payer. The organization said it was looking into the potential legal and regulatory implications of the deal.
Federal budget
President Donald Trump signed the One Big Beautiful Bill Act on July 4. The bill is expected to increase the national debt by $3.3 trillion, and lead to a decrease in Medicaid spending by nearly $1 trillion. The number of uninsured individuals is expected to grow by 11.8 million more people by 2034. The legislation has been criticized by many healthcare organizations, with many leaders denouncing the bill’s cuts to healthcare.
ADHA President Lancette VanGuilder said there are several provisions of the bill that decrease federal support for Medicaid, including new work requirements and restrictions on state financing. She added that the reduction of Medicaid dental benefits could lead to increased rates of untreated oral disease, a greater strain on emergency departments and other long-term health and economic consequences.
The American Dental Association also said that although it is pleased with tax provisions within the bill that will support dental practices, it is concerned with other terms of the bill, including changes to student aid and Medicaid.
“Sadly, the act will disproportionately burden dental students with the loss of the GradPlus loan program, the reduction to two loan repayment options, and caps on student aid,” the ADA said. “The OBBB’s impact on Medicaid’s adult dental benefits is unknown, but the cost-cutting measures and reform requirements OBBB imposes on the program could force states to reduce or eliminate these benefits, which are optional under federal law. The implication of which will increase healthcare costs, worsen health outcomes, and undermine workforce participation.”
Fluoride removal
Dental organizations and providers are still debating lawmakers on initiatives to limit the use of fluoride, including in certain products and through water fluoridation. Several states have implemented or are considering bans on community water fluoridation after the National Toxicology Program concluded in a report that higher levels of fluoride exposure are associated with lower IQ in children.
HHS Secretary Robert F. Kennedy Jr. has taken issue with water fluoridation several times since stepping into his new role with the HHS Department. During an April 30 cabinet meeting, he reportedly said fluoride made kids “stupider,” and said he plans to scale back the amount of fluoride in the country’s drinking water. He has also said he plans to advise the CDC to stop recommending adding fluoride to public water supplies. Additionally, the FDA said it plans to remove ingestible fluoride prescription drug products for children from the market this year.
Many dentists have shared concerns about what these actions could mean for patients’ dental health, while state and national organizations continue to share the benefits of community water fluoridation. U.S. Rep. Emanuel Cleaver II also introduced legislation that would require the Environmental Protection Agency to consult and publish research by independent and nonpartisan experts at the National Academies of Sciences, Engineering, and Medicine when proposing new water fluoridation guidance.
Hygiene legislation
The American Dental Hygienists’ Association and the International Federation of Dental Hygienists recently advocated for the delivery of dental hygiene services exclusively by practitioners who meet certain qualifications.
The two organizations released a joint statement April 17 stating that hygiene services should be provided by people who have completed accredited educational programs and obtained proper licensure. The statement was a response to legislation that expands the ability of other practitioners to perform dental hygiene services. The organizations said they support strategies to enhance hygienist recruitment and address workplace challenges, rather than strategies that could lower professional standards.
Interstate dental compact
The rise of interstate dental compacts are viewed by many as a solution to the industry’s workforce challenges. However, some are concerned about the compacts’ effects on state authority and clinical standards.
There are currently two dental compacts at play: the Council of State Governments’ Interstate Dentist and Dental Hygiene Compact and the American Association of Dental Boards’ Interstate Dental & Dental Hygiene Licensure Compact.
A Virginia court dismissed a lawsuit in December that challenged the state’s participation in the CSG compact. Two dentists filed the lawsuit in June 2024 alleging that the compact gave state power to a non-state entity and would harm Virginia dentists by allowing dentists from states with different licensing requirements to practice. The court found that although the plaintiffs established standing, the complaint failed to state a cause of action, leading to the dismissal.
In Massachusetts, where legislators are considering both compacts, some providers argued that the DDHC framework poses safety risks by not requiring certain clinical skill exams. Another provider raised concerns about the compact diminishing the state’s authority over licensees.
