Full integration of medical and dental care, clear patient education and the creation of a streamlined revenue cycle management system are a few of the ongoing issues in the dental industry.
Dentistry will continue to move forward by expanding cross-industry collaboration, enhancing resources for patients and growing access to care.
The 21 leaders featured in this article are speaking at Becker’s 2026 Fall Future of Dentistry Roundtable, set for Sept. 14-15 at the Hilton Chicago.
If you work at a DSO or dental practice and would like to be considered as a speaker, please contact Scott King at sking@beckershealthcare.com.
Note: Responses were lightly edited for clarity and length.
Question: What is one problem in dentistry that no one has solved yet?
Tarun Agarwal, DDS. Founder and Dentist of Raleigh (N.C.) Dental Arts: One problem dentistry still hasn’t solved is the associate dentist plateau. We know how to teach dentists to get better clinically, but we still haven’t figured out how to consistently help them become leaders, strong producers and people who truly help grow a practice. That gap is why so many groups deal with turnover, frustration and flat organic growth. Until we treat leadership, communication and business skills as part of developing a great dentist, not as optional extras, this problem is going to stick around.
Jerry Asamoah. COO of ClearChoice Dental Implant Centers (Greenwood Village, Colo.): One of the most persistent challenges in dentistry is that the patients who need the most comprehensive care often face the greatest barriers to accessing it. Full-arch and complex treatments can be life-changing, yet too many patients struggle with navigating a fragmented system, unclear treatment pathways, affordability and limited understanding of their options. Until we, as an industry, make care more accessible — through integrated delivery models, clearer patient education and more seamless experiences at every touchpoint — the gap between what is clinically possible and what patients actually pursue will remain. For more than 20 years, ClearChoice has worked to simplify this journey for patients, but there is still more work to do.
Hamza Asumah, MD. Director, Operations of Juniper Services (Sparks, Nev.): Dentistry’s greatest unsolved problem is not clinical — it is architectural. The split between dentistry and medicine was never based on science, but on historical evolution and tradition — and we have never truly corrected it. Oral diseases affect approximately 3.5 billion people globally, with conditions in the mouth serving as early warning signs for rheumatic disease, diabetes, heart disease and certain cancers — yet a cardiologist treating a patient today almost certainly has no visibility into that patient’s periodontal status. Interoperability technology that enables dental data sharing across health systems is now identified as essential to advancing whole-person care, and the tools to make it real — longitudinal data tracking, EHR integration, predictive analytics — already exist. The challenge, as the leading DSO voices in our field now acknowledge, is cultural and structural as much as technological. Until the dental and medical worlds are genuinely connected at the data layer, AI in dentistry will only ever be solving half the equation.
Murat Ayik, DDS. Partner, Specialty1 Partners (Houston): One of the biggest unsolved challenges in dentistry is navigating the growing complexity of revenue cycle management. Insurance processes, reimbursement variability and administrative burden continue to increase, making it difficult for practices to maintain financial clarity. Partnership platforms are helping centralize and streamline these functions, but the industry has yet to fully solve for simplicity and predictability. Without the right support and technology, practices are unknowingly leaving significant revenue on the table.
Jeffrey Carter, DMD, MD. US Dental Surgery Network (Nashville, Tenn.): The integration of oral surgical services and general anesthesia into a multilocation DSO introduces a level of operational complexity that fundamentally transforms an otherwise streamlined business model. This expansion imposes stringent regulatory obligations: compliance with state licensing for anesthesia delivery, adherence to DEA and FDA requirements for controlled substances and rigorous oversight of drug procurement, dispensing, administration and disposal. In the current landscape, no comprehensive solution exists to seamlessly manage this full lifecycle — from pharmaceutical sourcing through safe delivery, monitoring expiration dates and accountable wastage — while maintaining both regulatory compliance and patient safety.
What is required is an integrated technological ecosystem: a unified platform capable of real-time inventory tracking, automated dispensing, anesthesia documentation, anomaly detection and automated reporting to federal and state authorities. Until such a system is developed, the addition of these services remains a high-risk, resource-intensive endeavor — one that most DSOs elect to avoid, limiting access to advanced care within the industry. The development of this “surgical/anesthesia operating system” would represent a significant advancement, enabling safer, scalable delivery of high-margin procedures while preserving the efficiency that defines modern dental group practices.
Joseph Feldsien. President, Medical of PDS Health (Henderson, Nev.): The biggest opportunity in dentistry is for dentists to continue to press into preventive care. Experienced dentists understand what is going to happen if disease is left untreated. More and more dentists are being proactive in their patient conversations leading to preventive care to include the impacts on general health. The opportunity remaining is huge. When the entire community embraces this, the impact on the health crisis in America will be massive.
Haim Haviv. Founder and CEO of Hudson Dental (New York City): One problem dentistry still hasn’t fully solved is making the patient experience truly seamless. From scheduling to treatment acceptance, too many points of friction still cause patients to delay or avoid care. The challenge lies in creating a system where care is easy to access, simple to understand and effortless to follow through on. The organizations that prioritize simplifying this experience will ultimately stand out.
RJ Jerome. Senior Vice President and Chief Digital Officer of Heartland Dental (Effingham, Ill.): The industry hasn’t yet delivered a unified digital operating system for dentistry. Practice management systems remain the system of record, but not necessarily the system of workflow. As a result, DSOs rely on layers of point solutions stitched together around the PMS, which increases complexity and makes true transformation more difficult, especially in an increasingly AI-centric world.
Craig Kierst. SVP, Sales Strategy and Growth of ClearChoice Dental Implant Centers (Greenwood Village, Colo.): One of the biggest unsolved problems in dentistry is patient education and understanding. Across healthcare and even adjacent industries, we are seeing a clear shift. Companies like NOOM, Hims/Hers and Ro have changed expectations by educating patients, guiding them through personalized journeys and helping them understand that care can be tailored to their specific needs.
Dentistry, as a profession, has not fully caught up to this shift. Providers still rely heavily on clinical explanations that can often be overwhelming and confusing to patients. As a result, many patients do not fully understand their options, the long-term consequences of delaying care, or what a complete treatment journey could look like for them.
This creates a gap where patients aren’t necessarily rejecting treatment; rather, they are saying no because they do not fully understand what is being presented and do not have a simple way of finding the information. In many cases, they are navigating one of the most important health decisions of their lives without a clear, structured and personalized roadmap.
At ClearChoice, we see this every day. When patients understand their condition, their options and the outcomes they can expect, their confidence and willingness to move forward increases. But as an industry, we have not yet standardized this level of patient education and guidance. Clinical excellence alone is not enough. If patients do not understand the path, they will not take the first step. This is why ClearChoice is investing in technology across all lines of the business, from clinical to communication to help the patient become educated and prepared to move forward in improving their oral health.
I believe that the opportunity for education, transparency, and personalization in dentistry is significant. It is up to us to determine how we solve this, at scale.
DeVonte Johnson, DMD. Dentist and Owner of Eastside Dental Group (Norcross, Ga.): One problem dentistry and healthcare have not solved is recognizing that better outcomes follow better experiences. We still think like clinicians when we should be thinking like hosts. Patients do not return because of technical skill alone. They return because they feel understood, respected and cared for. The future belongs to practices that treat hospitality as infrastructure, not decoration. When trust is built at every touchpoint, compliance improves, referrals increase and care becomes proactive instead of reactive. The real innovation is not a new procedure. It is designing an experience people choose to come back to.
Trevor Lines, DDS. Owner and Dentist of Robison Dental (Mesa, Ariz.): From my perspective, the biggest unsolved problem in dentistry is a lack of levers through which a centralized support organization can affect/optimize the highly distributed small group team dynamics that drive patient, practice and aggregate business outcomes. While we often think about provider or office level performance, we very rarely consider how teams must work together to produce, or about what intervention points are or should be available to create cohesive, high performance teams. This is a tractable problem with the right set of tools; the job in front of us is creating those tools.
Jason Mann, DMD. Co-Founder and Chief Dental Officer of Providence Dental Partners (Atlanta): One of the most persistent and largely unsolved problems in dentistry is the true integration of oral health into whole-person care. Despite decades of research confirming the connection between oral disease and systemic conditions like diabetes, cardiovascular disease and even Alzheimer’s, medicine and dentistry continue to operate in separate silos, leaving millions of underserved patients caught in the gap. The patients who need care the most are those in rural communities, lower-income populations and medically complex individuals are precisely the ones our system needs better answers for. The future of dentistry isn’t just about better clinical techniques or smarter technology; it’s about reimagining access as a public health imperative and building care models that meet patients where they are, not where it’s convenient for the system. I believe DSOs are uniquely positioned to lead that charge but only if we’re willing to think beyond the operatory and toward the community.
Tia Meyer. Clinical Director of NBD Partnerships (Sioux Falls, S.D.): One of the biggest unsolved problems in dentistry is aligning clinical excellence with patient understanding and acceptance. We have the diagnostics, the technology and the ability to deliver exceptional care, but too often, patients don’t move forward because they don’t fully understand the value or feel emotionally connected to the “why.” Until we bridge that gap between clinical need and human connection, we will continue to see underdiagnosed and untreated disease. The future of dentistry lies in mastering both science and communication equally.
Francesca Pregano. COO of Smile Makers Dental Center (Tyson’s Corner, Va.): One of the most significant challenges in dentistry today is achieving consistent, long-term patient follow-through. Despite advancements in technology, AI and clinical care, many patients still delay or decline recommended treatment. This gap is often driven by behavioral and emotional factors, timing and perceptions of value and cost. While some individual practices have addressed this internally, the industry has yet to develop a system that consistently addresses these factors across all demographics. Solving this challenge would significantly improve both practice performance and overall patient health.
Hoss Said. CEO of Massoumi Dental Corporation (Chula Vista, Calif.): In my opinion, one of the most significant challenges in dentistry today is the lack of standardization in clinical diagnosis and treatment. Unlike medicine — where protocols and treatment pathways are more consistent — dentistry allows for a wide range of approaches, even for the same condition.
This variation can lead to both overtreatment and undertreatment, depending on the provider. As a result, patient outcomes can differ significantly, and it raises concerns about consistency, trust, and quality of care across the industry. Moving toward more evidence-based guidelines, clinical oversight, and data-driven decision-making — especially within DSOs — will be critical to improving patient care and bringing greater alignment to the profession.
Chris Salierno, DDS. Chief Dental Officer of Tend (Nashville, Tenn.): Dental practices are continuing to experience a “fiscal squeeze.” According to the ADA’s HPI’s Q4 2025 State of the U.S. Dental Economy Report, the core of the problem is a widening gap between expenses and income: prices for dental equipment and supplies, as well as wages, are rising faster than dental reimbursement rates. Additionally, one-third of dentists report not being busy enough.
Khuzaan Screwvalla. Vice President, IT of Great Lakes Dental Partners (Chicago): Our North Star for 2026 remains fixed on RCM; the biggest unsolved problem in dentistry. Many companies, including AI providers, are entering this space, but RCM involves a complex set of interconnected challenges — from claims processing to insurance verification to collections. Even large dental groups with thousands of locations struggle with RCM, while smaller practices with just a few dozen clinics face similar issues. The key is not just who gets there first, but who can solve RCM correctly. It’s a nuanced challenge given the sensitivity around finances, patient interactions with AI for payments, fraud concerns and the ongoing battle with insurance companies. Resolving the RCM challenge is essential for the future success of the dental industry.
Stef Simich. Director, People Development of Lone Peak Dental Group (Denver): One problem dentistry is still working to solve is how to consistently deliver both operational excellence and a truly human-centered patient experience. We’ve made incredible progress in technology, systems and access, but the experience can still vary more than it should. That gap isn’t about a lack of tools, it’s about alignment in how we implement, train and show up every day. The opportunity ahead is creating systems and cultures that scale consistency while still feeling personal. The organizations that get that balance right will shape the future of dentistry.
William Simon, DMD. Owner of City Smiles (Chicago): One unsolved problem that stands out to me is the public’s misconception that dental insurance is insurance. It is not. It is a benefit plan. A virtual coupon that provides in most cases a maximum of $1,500 per year for each enrolled individual. The general public seems to believe that if they have “insurance”, it is the answer to all their dental problems. For those in need of preventative services and maybe one or two basic services, these benefits are helpful, but they are in no way the solution for those with more involved treatment needs. Furthermore, many believe that if they don’t have “dental insurance”, they can’t afford to go to the dentist. This is also not necessarily the case.
Compounding this problem are the stagnant reimbursement levels for the dentists contracted with the benefit plans. As the cost of providing quality care continues to rise, compromises must be made to sustain the dental practice. This could be anything from lower quality materials to decreased appointment times and customer service to inability to implement new equipment and technology.
Curtis Swogger. CEO of North Pittsburgh Oral Surgery (Pittsburgh): When I think about one problem dentistry has yet to solve, I keep coming back to something I learned years ago and continue to see today. There remains a fundamental misunderstanding of dental care and its connection to overall health. Unfortunately, much of our system, particularly insurance, is not designed to reinforce that connection.
At its core, the most important decision a patient makes is simple: Will I start treatment today? However, that decision is often shaped by a fragmented system. Medical and dental operate separately. Patient records are disconnected. Without a unified view, patients are left to interpret which aspects of their health matter most — often delaying care that is more important than they realize. The opportunity is clear: a more aligned, integrated model would lead to better decisions and better patient outcomes.
That is why I find the work of leaders like Stephen Thorne and Joe Feldsien at organizations such as PDS Health so compelling. The movement toward a unified health record — where physicians and dentists operate from a shared understanding — represents a meaningful step toward truly integrated care. A healthy mouth isn’t just good dentistry, it’s foundational to a healthy life.
Mariz Tanious, DDS. Chief Dental Officer of Affinity Dental Management (Holyoke, Mass.): One of the biggest problems we still haven’t cracked in dentistry is actually getting rid of caries and periodontal disease at scale, even though we’ve had great preventive tools for years. These diseases are still the most common issues we see, and they hit vulnerable communities the hardest because cost, coverage gaps and basic access to care haven’t been fixed. Even when patients have insurance, the way we pay for dentistry still leans toward procedures over prevention, so we end up treating advanced disease instead of truly managing risk. Real progress will come when we build care models that use risk prediction, smart technology, and shared medical-dental data to make prevention the default — and pay for it that way. Until incentives, access, and technology are all pointed at prevention, this “solvable” clinical issue will stay an unsolved systems problem.
At the Becker's 5th Annual Future of Dentistry Roundtable, taking place November 12–14 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.
