Staffing challenges, DIY dentistry and lax insurance policies are among what dental leaders share are the most dangerous trends in the field today.
Six dental leaders recently spoke with Becker’s to share what they feel are the most dangerous trends happening in dentistry.
Note: Responses were lightly edited for clarity and length.
Question: What is currently the most dangerous trend taking place in the dental industry?
Robert Gershon. CEO of Convergent Dental: Given all the advanced technologies available in modern dentistry, the most dangerous trend that remains is “watching and waiting” instead of prevention and treatment. Advanced technologies now allow the general dentist to no longer “watch and wait” for a condition to progress but rather treat to prevent progression that can result in more invasive and expensive treatment down the road. For example, Convergent Dental released Solea Perioguide in 2025 that enables general dentists to use the Solea All-Tissue Laser to immediately administer periodontal treatments without the need for sutures and with minimal postoperative discomfort all at the avoidance of “watching and waiting” for periodontal disease to progress or waiting for the patient to visit a specialist.
Lee Harris, DDS. Harris Dental Solutions (Los Angeles): The increasingly serious consequences of staff turnover and the difficulty of staff and dentist recruitment remain the most dangerous trends facing dentistry today. Many practices are now facing the need to utilize expensive recruitment firms to find competent staff replacements or new hires. All the more reason to keep your current staff happy and focused on growing your practice through attention to enhancing patient satisfaction.
Phillip Isaacman, DDS. Owner of Bluff City Dental (Memphis, Tenn.): We think the most dangerous trend is insurance companies owning/backing dental offices. They divert patients into offices they control, while choking out others. They do it by reaching into HR departments of major employers and only listing their own dental offices. Negotiating rates with yourself is probably easier than negotiating rates with others. So, do the dental insurance companies now set the standard of care for all of us?
Krista Kappus, DDS. Fitch Mountain Dental (Healdsburg, Calif.): One of the most dangerous trends I’m seeing in dentistry right now is the rise of DIY dentistry. We’re living in a time when inflation has made basic necessities increasingly expensive, dental benefits are providing less and less meaningful coverage, and social media has created enormous pressure to achieve a “perfect” smile. At the same time, people are being priced out of professional dental care. When patients can’t afford treatment, they don’t necessarily stop needing it, they start to look for alternative ways to access care, and the internet is more than happy to provide them. Can’t afford an extraction? There are YouTube videos explaining how to pull your own tooth. Missing a tooth? There are inexpensive online kits that allow you to mold an acrylic “replacement” yourself. Don’t like the appearance of your front teeth? For a couple hundred dollars, you can take your own impression and have a company mail you a snap-on appliance. Chipped a front tooth? Social media will show you how to file it down yourself.
What concerns me most is that these solutions can look deceptively simple and inexpensive while potentially creating much bigger problems. I recently had a patient tell me that he would rather have cancer because at least his cancer treatment would be covered by his health insurance. That statement has stayed with me. It illustrates just how disconnected dental care has become from the healthcare system in the eyes of patients. People understand that they need medical care when they are sick, but dentistry is still too often treated as an optional expense.
I don’t blame patients for looking for cheaper alternatives. I blame a system that has made necessary healthcare unaffordable enough that people feel they have no other choice. We have helped create this problem by separating dentistry from healthcare and treating the mouth as though it exists independently from the rest of the body. Until we address that disconnect, DIY dentistry is only going to become more common. The most dangerous part isn’t that patients are trying to save money. It’s that they are being forced to choose between getting professional care and trying to treat themselves. And when it comes to something as complex as oral health, a $10 solution on the internet can ultimately become a much more expensive and potentially irreversible problem.
Robert Trager, DDS. Dentist at JFK Airport (New York City): In my opinion, the most dangerous trend in the dental industry is that all, if not most, of the insurance companies are finding innovative ways to skirt both state and federal laws on compliance in their industry. These insurance companies are out to make a profit for their investors and stockholders and will come up with scenarios to justify their actions. Many of these companies are compiling statistics to avoid the 83-85% loss ratio law. They are also finding ways to force the providers to accept third-party payments, which will obviously cost a processing fee. They are also leasing out their plans to vendors that are low balling provider fees. One company wants to install a $15 processing fee if you accept payments by check. Other vendors are changing code numbers by bundling together for multiple services which should be paid for by specific code numbers to represent the correct treatment(s). They are also lowering reimbursement fees to keep up with the cost of living and inflation. They are also instituting unreasonable dates of service for replacing prosthetic appliances and retreating teeth, as well as continuing periodontal services.
These insurance companies know that many, if not all, DSOs and multi-specialty practices will accept all these unreasonable fees based on volume like the supermarket chains to increase the bottom line. In order to fight this dangerous trend, organized dentistry has to reach out to the employers that provide dental benefits to their employees via human resources to have input from dental providers as to how to construct a dental insurance plan that would provide fair, needed and reasonable dental benefits to their employees as well as fair and equitable benefits to their providers. I urge all dental providers to review the dental contracts from these insurance companies before accepting their fees and to pick and choose which ones will benefit their patients as well as themselves. Being a panel dentist is an option, not a decree.
Thomas von Sydow. CEO of Cornerstone Dental Specialties (Irvine, Calif.): In my opinion, it’s how dentists are distributed within the U.S. The vast majority of dental students and residents come from urban centers and coastal communities. This is a fundamental issue to get care to dental areas in rural America and flyover states. For example, California has large areas of underserved markets. Yet, there are 24,000 general dentists in California. This spills over to other specialties like endodontics, where 882 out of 5,685 are in California. These numbers hold for many areas like New York, Texas and Florida. However, what you will find is that in California the vast majority live in the direct Bay Area or from south Los Angeles to San Diego on the coast. I believe this is a function of dental schools and residencies not factoring in where applicants intend to practice. This could change if these institutions would include this as a reason to admit a student. I am not suggesting this should be the sole reason, but it needs to be a factor. Humans are more likely to go back to these communities if they were raised there. If 80% of your student body comes from Southern California, the Central Valley of California will remain a dental desert. I believe we need to change this at a fundamental level, especially with the debt load these students carry. Rural and flyover states are very lucrative versus coming to San Diego or Orange County and trying to make a living.
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.
