Good morning. It’s Ocean’s 11: Dental Edition. A dental school employee pulled off the ultimate long-game heist—stashing away $150,000 in gold over five years. Guess that’s one way to fund a gold-plated retirement plan.

Inside this issue:
- Medicaid cuts may have teeth
- Dental shortage forever?

⏰ Your reading time today: 5 mins

☕️ Enjoy your coffee break with Word of Mouth, a dental-themed word game inspired by Wordle … guaranteed to leave you grinning, not grinding!

MARKETS

📈 3D Systems Corp. ($DDD) – $2.77 | +0.06 (+2.21%)
📈 Align Technology ($ALGN) – $170.37 | +2.59 (+1.54%)
📈 Colgate-Palmolive ($CL) – $90.90 | +0.35 (+0.39%)
📈 Dentsply Sirona ($XRAY) – $15.80 | +0.22 (+1.41%)
📈 Envista Holdings ($NVST) – $17.48 | +0.39 (+2.28%)
📉 Henry Schein ($HSIC) – $70.76 | -0.74 (-1.04%)
📈 Patterson Companies ($PDCO) – $31.20 | +0.04 (+0.13%)
📈 Weave Communications ($WEAV) – $12.01 | +0.84 (+7.52%)

Data is provided by Google Finance. Stock data as of market close, reflecting changes over the past 5 days, as of 5:00 p.m. ET.

THE DRILL DOWN

🏛️ ADA joins coalition to protect Medicaid funding, urging Congress to preserve health coverage for millions and prevent cuts that could reduce access to essential dental care and affect dental practices, including DSOs, across the U.S.

🧭 ADSO elects new president at 2025 Summit, naming Scotte Hudsmith to lead the executive team. Dustin Netral continues as VP, and Justin Jory remains treasurer, while adding secretary to his title. Power shuffle, DSO edition.

💸 $47M awarded to expand specialty dental clinics, with funds allocated to thirteen projects across California. The initiative aims to enhance facilities serving patients with special health care needs. A significant boost for accessible dental care.

🦷 Sanders pushes for Medicare dental expansion, introducing a bill to include dental, vision, and hearing benefits for seniors. While Senate Finance Committee Chairman Mike Crapo blocked immediate passage, he signaled a willingness to discuss the proposal. A glimmer of bipartisan hope for comprehensive senior care.

💻 ADA approves 2026 CDT Code changes, adding a new code for point-of-care testing and updates to resin-based composites. The revisions aim to improve diagnostic accuracy and treatment reporting. Coding just got a refresh.

🩺 Federal bill seeks to extend dental workforce funding, reintroducing the Action for Dental Health Act. The legislation would expand grants to address access to care and workforce shortages. Investing in smiles nationwide.

🔒 ADA opposes proposed HIPAA cybersecurity rule, arguing it would create excessive costs for providers. The association is pushing for a more balanced approach to protect data security without burdening practices. Security measures under scrutiny.

GOVERNMENT

Medicaid cuts may have teeth

Congress is weighing $880 billion in budget cuts, with Medicaid funding potentially on the line. Even Elon Musk has hinted that major reductions could be coming.

History shows that when Medicaid budgets shrink, dental benefits are often the first to go. And when Medicaid sneezes, dentistry catches a cold.

Past cuts have meant fewer covered patients, lower reimbursements, and more ER visits for preventable dental conditions. DSOs and private practices could see new financial pressures if funding is reduced.

The full impact remains uncertain, but assessing the risks now can help practices stay ahead. Here’s what to watch and how to prepare.

What’s happening: Congress recently advanced a budget resolution mandating at least $880 billion in spending reductions over the next decade from a committee that oversees several programs, including Medicaid. While it remains unclear which services will be affected, history has established a trend: When Medicaid is on the chopping block, adult dental coverage is often the first to go.

Right now, dental benefits under Medicaid remain optional for adults, leaving states with broad discretion. In past economic downturns, states facing budget shortfalls have responded by slashing these benefits. The last major contraction following the 2008 financial crisis led to sweeping reductions in dental coverage across multiple states, including California and Massachusetts, prompting a spike in emergency department visits for preventable dental conditions.

ADA chimes in: The American Dental Association (ADA) strongly opposes potential cuts to Medicaid dental benefits, highlighting severe health and economic consequences detailed in a recently released report:

• Nearly $1.9 billion in added medical costs in just one year.

• $298 million increase in emergency dental visits.

• $1.2 billion rise in healthcare costs for diabetic patients lacking periodontal care.

• Significant cost increases linked to pregnancy complications and heart disease.

• Potential job challenges for over two million adults due to worsening oral health.

The business impact: For DSOs and private practices with significant Medicaid exposure, the financial risks are profound, and they’re already talking about it.

• Revenue contraction: Medicaid reimbursement rates are already razor thin. These cuts could push some providers to drop Medicaid patients altogether.

• Declining patient volume: If millions lose coverage, practices that depend on Medicaid patients—especially for preventive and non-emergency care—could see sharp appointment drop-offs.

• More ER visits, fewer dental visits: Without coverage, many low-income patients will turn to emergency departments for untreated infections and pain, overloading hospitals.

• Consolidation ahead: Struggling practices may fold or be absorbed by DSOs, further consolidating the market—especially in underserved rural areas.

Time to adapt: Some DSOs that have traditionally leveraged Medicaid as a volume-driven revenue stream could be forced to pivot away from these patients, reshaping accessibility and availability of care nationwide.

In response, dental leaders should consider how to mitigate the impact of these cuts. Before making changes, it makes sense to analyze your organization’s exposure. If Medicaid cuts hit, you need a strategy—not just quick fixes.

• Assess your risk: How much of your revenue relies on Medicaid? Identify your financial exposure and service mix.

• Develop a transition plan: If cuts make Medicaid unsustainable, plan now on how to rebalance with private insurance, self-pay, and new services.

• Optimize operations: Have a solid plan to reduce inefficiencies, adjust staffing, and streamline scheduling to stay profitable with fewer Medicaid patients.

• Strengthen marketing: If you’re Medicaid heavy, it may be time to target private-pay and insured patients through referral programs, digital ads, and community outreach.

• Loop in on advocacy: Check in with the ADA, ADSO, and state efforts to preserve funding.

The bottom line: Medicaid cuts have the potential to create significant risks for DSOs, providers, and patients alike. However, as with any major policy shift, there are also opportunities for those who can adapt quickly.

The warning signs are clear: Medicaid cuts are likely coming, and dentistry may be in the crosshairs. The question isn’t if the impact will hit—but how hard. Practices that act now to insulate themselves will be the ones still standing when the dust settles.

BUSINESS BITES

📈 Smile Doctors acquires myOrthos, adding 70+ locations and expanding to 36 states. The deal boosts growth and M&A momentum as Smile Doctors cements its position as the nation’s largest OSO. Brace yourself—consolidation season isn’t over yet.

🏬 Malls want dentists as new tenants, with landlords actively recruiting tenants to fill vacant spaces. The push reflects a shift toward more service-based businesses to boost foot traffic. Filling after retail therapy?

🦷 Pearl launches AI tool to streamline insurance claims, introducing Claimcheck, an AI-powered solution designed to optimize the submission process. AI admin incoming!

🤖 Overjet aims to clarify dental billing with AI, unveiling the Dental Clarity Network and ReviewPass, which aims to provide patients with instant cost estimates before procedures.

🖥️ Align Technology introduces AI diagnostic software in Europe, launching Align X-ray Insights, a computer-aided detection tool to enhance radiograph analysis.

🤖 Dentist uses the Neocis Yomi robot to insert over 1,000 implants, marking a milestone for the FDA-cleared robotic dental implant system.

🏭 Shanghai-based Angel Aligner to open manufacturing facility in Milwaukee, announcing a state-of-the-art facility to boost production capacity and meet growing demand. Expanding footprints in the heartland.

DENTAL STAFF

Help wanted … forever 

For years, dental workforce struggles have been called a crisis. But after three years of shortages, hiring challenges, and shifting work expectations, it’s time to ask: What if this isn’t temporary? What if this is just how things are now?

Fewer grads, more retirements, and changing work-life balance priorities aren’t disruptions—they’re the new reality. Waiting for things to “go back to normal” isn’t a strategy. The real question is: How do practices succeed in this landscape?

The scale of the problem: Dentistry isn’t just dealing with a temporary staffing shortage—it’s facing a workforce restructuring.

• One-third of the workforce is preparing to leave. In the next six years, almost 21% of practice managers and 32% of billing specialists plan to retire. Within a decade, nearly half of these roles will be empty.

• Hygienists and assistants aren’t returning. The COVID-19 pandemic led to an 8% drop in hygienist employment, and many who left have never come back.

• The pipeline isn’t refilling. Enrollment in dental assisting and some regional hygiene programs has been declining since 2015, and new dental school grads aren’t keeping pace with demand.

• Hiring is harder than ever. Nearly 90% of practices report difficulty filling roles, even with increased pay and bonuses.

Why this isn’t going away: The forces driving the staffing shortage aren’t short term. They’re baked into the structure of the workforce.

• Retirements are accelerating. More dental professionals are aging out than entering the field, leaving a widening gap.

• Work-life balance expectations have shifted. More providers are choosing part-time work, job-sharing, and flexible schedules over traditional full-time roles.

• Burnout is pushing people out. The pressure to meet production targets, the physical demands of the job, and the lack of growth opportunities are driving more professionals away from the field entirely.

What’s being done: The ADA and lawmakers are working on solutions—expanding training programs, streamlining licensing, and boosting workforce funding—but the real impact is still years away.

Meanwhile, the private sector is responding with short-term fixes: higher pay, retention bonuses, AI-driven scheduling, and apprenticeship programs. But despite these efforts, turnover remains high, and many professionals are leaving the field for good.

So now what? If hiring challenges are permanent, smart practices won’t wait for new talent—they’ll redesign how they operate.

• Flexibility isn’t optional: Four-day workweeks, job sharing, and hybrid roles help attract and retain staff.

• Career growth keeps people: Clear advancement paths and leadership roles reduce turnover.

• Burnout prevention is essential: A strong culture and lower production pressure keep teams engaged.

• Tech is survival: Technology on the job, like AI tools and teledentistry, lighten workloads and boost efficiency, lessening the chance of burnout.

Bright spots: Some organizations are experimenting with how dental teams work—and it’s paying off.

• Pacific Dental Services is building its own workforce, launching training programs and scholarships to bring in new staff instead of competing for talent.

• Reich Dental Centers shifted pay structures to prioritize immediate raises over retirement benefits in response to staff trends.

• Dental Express tackled commuting costs with gas stipends—a small perk that made a big impact on staff morale and retention.

The bottom line: This isn’t a crisis—it’s a shift. The staffing shortage isn’t going to magically resolve itself. The practices that refuse to adapt will keep struggling. But those that embrace new workforce models, invest in retention strategies, and rethink how they operate will come out ahead. The question isn’t “How do we get back to normal?” but “How do we succeed in the new normal?”

The answer? By treating your workforce like your most valuable investment—because in this market, it is.

CLINICAL NOTES

• 🧠 Dentists may detect early Alzheimer's signs, as research links bacteria in the mouth to dementia risk. Floss today for tomorrow.

• 🦷 Japan begins human trials for tooth regrowth drug, aiming for natural regeneration by 2030. The Tooth Fairy is about to be between jobs.

• 🪥 New "smart" toothpaste offers all-day protection, using new formulas that give teeth a protective armor for twelve hours to prevent decay. Finally, a toothpaste that works overtime for free.

• 💊 Amitriptyline shows promise for TMD pain relief, with a study finding a 63% reduction in pain for patients taking the medication. A little antidepressant, a lot less jaw pain.

• 🦴 AI helps detect osteoporosis from dental X-rays, with a review finding high accuracy in spotting bone loss using panoramic radiographs.

BEYOND THE CUSP

• Japanese dentist turns clinic into Ohtani baseball star museum, spending over $675,000.

• Comedian-dentist conquers stutter with humor, sharing how authenticity helped him thrive in both fields.

• Thief breaks into dental office—for snacks?

• Renowned star documentarian’s next project focusses on Swiss dentist’s impact on Greek leprosy patients.

• Dentistry gets the Huberman treatment, as Dr. Staci Whitman joins the podcast to explore how the oral microbiome connects to whole-body health. Your molars just made it to mainstream biohacking.