DSO competition, staffing shortages and stagnant reimbursements are among the biggest concerns for dental industry professionals.
Seven dentists and executives recently shared with Becker's what worries them most about the dental industry.
Editor's note: Responses were lightly edited for length and clarity.
Question: What is your biggest worry about the dental industry?
David Ahearn, DDS. Founder and President of Design/Ergonomics: My biggest concern for dentistry as a whole is office profitability. While the practices we work with are doing incredibly well and have high demand, we are hearing about far too many offices with eroding margins and no real viable plan of attack. The challenge is fairly simple. The marketplace controls wages (by far the biggest cost) while the insurance industry, by and large, determines rates. Given that most dentists primarily focus on their personal net income, we see doctors mostly focusing on efforts at cost cutting to balance the budget. This is an extremely difficult method for closing the gap. And, if this isn't already obvious, one cannot attempt to request that staff members take a pay cut because you are making less. The solution is clear, but not obvious. Increase productivity. This is a science. Most doctors do not know how to apply productivity principles to practice. That is my biggest concern.
Afshin Azmoodeh, DDS. Canyon Creek Family Dentistry (Richardson, Texas): As a small business owner, I am concerned about the sustainability of competing in the marketplace against the larger DSOs, which continuously keep on adding more and more small practices to their portfolios and subsequently are on their way to somewhat monopolize our industry. I have always believed there are plenty of patients for everyone to treat and I am still of that opinion. However, the cost of doing business for small operators in our industry is exponentially increasing, particularly since the pandemic and in these hyper-inflationary market conditions. Naturally, therefore, there is less profit available to small business owners and hence the incentive to join the larger institutions and to promulgate their further rise in the marketplace.
As a fervent supporter of a free (but fair) market, I do not support placing any shackles on our bigger competitors. I just hope to see more actions by small operators to actively organize into larger groups of individual practices and put our weight into action. This could be done, for example, to reduce the costs of supplies we procure from our suppliers. I still believe the future of the dental industry is very bright and even actively encourage my own children to consider stepping into this field. I just would like the marketplace to be as fair as possible for all entities who love this industry and suffer through years of trying to join it.
Dr. Avinash Bidra. Program Director, Maxillofacial Prosthodontist and Clinical Professor at UCONN Health (Farmington, Conn.): My biggest worry about the dental industry is the shortage of skilled workers — dental assistants, hygienists and dental laboratory technicians — to cater to the population. With a limited and aging/retiring workforce and the increase in the number of dental schools and dentists, without a proportional increase in allied staff, the quality and the high standards of dentistry we have in the United States is at risk.
An equally alarming worry is the acute shortage of qualified dental school faculty to educate the next generation of dentists. The number of new dental schools and graduating dental students is barely proportional to the existing aging and retiring dental school faculty. Taken together, we need to seriously think about incentivizing talented people to work in the dental industry.
Robert Gershon. CEO of Convergent Dental: My biggest worry about the dental industry is the lack of breakthrough technology that truly benefits the entire dental operation — the patient, the dentist and the practice. It's essential for the industry to continually embrace and integrate novel technologies that not only improve clinical and practice outcomes, but also enhance the overall patient experience. At Convergent Dental, we are inspired every day to showcase what dental lasers can do today that was impossible just a few years ago. We are committed to creating greater awareness of Solea’s capabilities and driving broad based adoption to elevate the field and benefit practitioners, practices and patients alike.
Scotte Hudsmith. Chair and CEO of Specialized Dental Partners (Franklin, Tenn.): My biggest worry is for patients not having access to care due to the shortage of hygienists and dental assistants. We need to have more programs, expanded programs and a better process for educating high school students on career opportunities in dentistry.
Evan Jaffe. CEO of Mabel Dental Lab: The biggest worry is the demise of knowledgeable dental technicians and educational programs. According to the National Association of Dental Laboratories, there are only 11 accredited programs remaining in the United States. More and more technicians are coming from other industries and although they contain knowledge of CAD/CAM and computer systems, they lack overall basic dental knowledge. This will increase the importance of in-house trainee education programs, which the smaller lab may not have the time or resources to handle.
Charles Weber, DMD (West Chester, Pa.): Being on the 18th hole of my professional life, I see student debt, the high cost of technology and regulation and the limited payment of dental insurance as untenable factors in the future of dentistry. COVID-19 has put a serious dent in our supply of dental team members and I do not see other educational means of production of these very important people for our professional needs.It will be very interesting to follow the DSO’s dental insurance companies and hedge fund investment in dentistry for the next few years. I look forward to watching from the clubhouse.