Dentists are advocating for legislation that could alleviate some of the biggest challenges facing the industry, including insurance reform, technology regulations and licensure compacts.
Nine dentists recently spoke with Becker’s to share the policy updates they’d like to see to enhance dentistry.
Editor’s note: Responses were lightly edited for length and clarity.
Robert Baskies, DMD (Phillipsburg, N.J.): I know that I sound like a Luddite. I would like to ban [artificial intelligence] from reviewing dental claims. After one of the dental AI companies received their patent and approval from the FDA, I was recruited to help the software improve its accuracy for reading X-rays. I moonlight as a third-party claims reviewer, and most frequently the company’s software denies the claims. Also, many offices still fax X-rays, so how can there be a machine standard? We as dentists are paying the price for treatment rejections. Also, the insurance companies are paying for the use of the software which drives up the cost insurance premiums.
Gary Boyajian, DDS. Founder of Nationwide Dental Practice Brokers: Nationwide, dentists feel the reimbursements of insurance companies need to increase rapidly. Dental fee reimbursements by the insurance companies have been consistent and not increasing while the cost of staffing has skyrocketed for the dentist and inflation has increased significantly.
Also, legislation needs to address making a fair playing field for dentists to utilize deductions, such as [pass-through entity tax], that the large corporations are able to utilize, reducing their overall cost. Dentists and small business companies utilizing partnerships or S corporations need these deductions to help cover the massive overhead.
There is a nationwide shortage of dental hygienists to care for the dental population. A huge help from the legislative branch in each individual state would be to create more dental hygiene schools and programs. Following Covid, there was a large exodus of dental hygienists from the profession. If we create new hygiene schools, it will absolutely have a positive effect on staffing shortages in the dental profession.
Mike Davis, DDS. Dentist of Smiles of Sante Fe (Albuquerque, N.M.): Reforms to the abuses of the insurance industry are imperative. However, effective wording in the legislative bills is critical.
For example, many are aware of responsible legislation related to dental loss ratios. Apparently, this would compel insurance companies to spend reasonable sums on covered dental services for patients. A figure like 80-85% of revenue would go toward patient dental services, and the remaining 15-20% would be allotted for administrative costs. Unfortunately, too many dental insurance companies deceptively utilize workarounds.
Dental insurance carriers too often cook their accounting books by reducing revenue numbers through “donations” to nonprofit organizations. These alleged donations are often marketing and advertising schemes. The Alpha Dental Insurance Company (fictitious name) will pay a “donation” to have their logo at a dental school. The Beta Dental Insurance Company (fictitious name) will pay a “donation” to sponsor an event for a district dental society. And on it goes.
Such accounting write-offs to total revenue should be disallowed under DLR legislation and properly included in administrative expenses.
Glen Hall, DDS (Abilene, Texas):
1) End the apparent ERISA exemption in dental benefit contracts and make them comply with state laws and regulations.
2) Work together with the [American Dental Association] to develop a standardized EOB, including a standardized code set when using them to explain benefits. (Example: Q – maximum benefit allows for this procedure).
Bridgett Jorgensen, DMD. Dentist at North Gwinnett Dental Care (Sugar Hill, Ga.): Being able to transfer licenses to different states effortlessly would make dentistry as a career much more competitive. If a dentist [would be] able to accept a position in any state after obtaining a license in one state and passing all the boards, especially for couples in which one spouse needs to move for their job. Currently, it can take two to six months to obtain a license by credentials. Staying in one position or owning a practice right out of school might have been the norm in the 1960s, but that is not true anymore. Dentists need the ability to move as easily as their counterparts in other professions.
Huzefa Kapadia, DDS. Dentist at Kapadia Dental Care (Waterford, Mich.) and Detroit Sterling Dental: Insurance reform. Sixty percent of dentists cite low insurance reimbursement and administrative issues with third-party payers as their second biggest challenge. Legislative changes needed include:
- Standardized claim processing to reduce administrative burden
- Timely payment requirements for insurance companies
- Restrictions on arbitrary coverage denials
- Medicare dental coverage expansion
We [also] need a lot more dental hygienists in the field. It is absolutely a nightmare trying to find a decent one.
Krista Kappus, DDS. Dentist at Fitch Mountain Dental (Healdsburg, Calif.): In general, I believe insurance reform is critical for the future of dentistry. I would like to see legislative changes that require dental insurance plans to be more transparent and truly centered around patient care. Many current plans are vague, filled with confusing clauses, and often deny claims without clear explanation — leaving patients feeling frustrated and misled.
One key improvement would be to prohibit insurance companies from setting fees for services they don’t actually cover. This would give dental offices the freedom to set fair pricing for non-covered services, helping small practices stay financially stable.
I also believe there should be reasonable limits on how much profit dental insurance companies can make. A fair portion of premiums should go directly toward patient care, not just administrative costs or shareholder profits. This would create better alignment between insurers, providers and patients.
Independent dental offices often operate in a difficult financial zone: too large to qualify for government assistance, but too small to benefit from most small business tax breaks. At the same time, costs like rent, staff wages and supplies keep rising, while insurance reimbursements remain flat or even decrease. Thoughtful policy changes could help support small dental practices so they can continue offering high-quality, accessible care in their communities.
Louis Malcmacher, DMD. President of the American Academy of Facial Esthetics: The legislative areas nationally that I would like to see include:
1. A national dental licensure compact, which two different groups are working on at this time: the American Dental Association and the American Association of Dental Boards. This is similar to what is happening with physicians and nurses, which have interstate licensure compacts in place. This allows dentists to practice across state lines without redundant applications, increases workforce mobility in high-need areas, supports telehealth which is vastly underused in dentistry, and would increase opportunity for dentists. The most important result of this would be much increased access to care.
2. A national definition of dentistry should be legally accepted by every state. The impact would be equal access to care for all U.S. citizens. Right now, every state has its own definition of dentistry, of which many were introduced into state dental practice acts decades ago. Imagine trying to have a 2025 dental practice with a definition of dentistry from 1960, 1990 or even 2010, which hamstrings dentists from providing the best treatment options to their patients. Dentistry practiced in 2025 is vastly different than even a decade ago. The American Academy of Facial Esthetics has trained over 25,000 dental professionals from every state in the use of Botox and filler injectables within the scope of dental practice for esthetic and therapeutic purposes. Who would have thought that possible 20 years ago? Dentists in 2025 truly are physicians of the face, head and neck. A nationally accepted definition of dentistry that is up to date is a priority.
Owen Waldman, DMD. Dentist at Waldman Dental Group (Scottsdale, Ariz.): As far as legislative changes that will benefit the dental industry, number one would be to stop the stranglehold insurance companies have. The insurance companies increase their premiums on clients every year, while keeping their maximum benefits the same for years on end. In addition, they keep reimbursement rates to dentists stagnant, or even decrease them, while the cost of doing business increases every year, which squeezes dentists more and more.
There should be mandatory [cost-of-living adjustments] to these reimbursements, commensurate with the annual increase they receive in their premiums for the dentist and an increase in maximums for patients.
Number two: All states should make it legal to have oral preventive assistants, as the salaries that hygienists now demand, regardless of skill or experience, is ridiculous. Somehow, we came out of Covid-19 and hygienists decided as a profession they were getting a 20% raise. Now, you need to be at, at least $50/hr, regardless of what they produce or how skilled they are.
