The 'golden age' of dentistry

Henderson, Nev.-based PDS Health stands ready to push boundaries and set new standards for patient care this year, embracing what it calls the "golden age" of dentistry.

Dan Burke, PDS Health's chief enterprise strategy officer, recently spoke with Becker's about what the company has planned for the rest of 2024 and the trends the company is keeping a close eye on. 

Editor's note: Responses were lightly edited for clarity and length.

Question: What are some of the top priorities for PDS Health during the second half of 2024?

Dan Burke: The first half of the year was solid for PDS Health. In addition to some of the larger strategic announcements we made, including our renaming, we enjoyed solid performance in the dental practices and new medical practices, as well as our dental-medical integration initiatives. 

For the remainder of 2024, we will continue to focus on each of the more than 1,000 dental and medical practices we support. At PDS Health, our mission remains unchanged regardless of our growth. We support one practice, one clinician, one patient at a time. Expect more of the same from us in the second half of the year. We will focus on same-practice growth while opening new offices as we have done for many years, focusing on de novo growth rather than acquisitions.

Q: How much of the company's planned de novo growth is slated to be medical-dental integrated practices?

DB: By the end of the year, we will have more than 10 medical practices, which include various practice models, including physicians and nurse practitioners working in standalone medical practices as well as co-located or embedded dental-medical integrated practices. 

Q: Where do you see oral health headed next?

DB: We continue to see a tremendous amount of untapped value in oral healthcare, both within dental practices as well as within the greater U.S. healthcare system. Dentistry will play a growing role in systemic disease prevention and management. Within the four walls of a dental practice, technologies that enable clinicians and patients to see more and know more are leading to more complete diagnoses and more informed decision-making by patients. That's a trend we believe will continue and accelerate. 

These trends will greatly benefit the dental profession as well as the business of dentistry. As patients come to see more and know more about the health of their mouth, they will start to move the dial on the most meaningful metric in the industry today, which is percent served. As is generally accepted and published in dentistry in the U.S., only about 25 to 30% of diagnosed dentistry actually gets done. That number has not changed as long as that metric has been measured. As patients become more aware of the impact of oral health on their overall health, especially patients who have systemic conditions and inflammatory diseases, they are increasingly saying yes to needed dentistry. That is a tectonic shift in the business of dentistry. 

Q: How have patients become more interested in oral-systemic health?

DB: We've seen the growing awareness of patients and the general population about the importance of oral health. We're seeing it in the mainstream news media, including a recent Time Magazine feature, pop culture and even daytime talk shows. Lifetime TV recently ran an entire segment on oral-systemic health. We expect to see accelerating awareness of the oral and gut biome in the general population. 

We sometimes refer to patients as the "sleeping giant." Once the giant is awakened to the realization, both for themselves and their loved ones, that oral healthcare is a critical component of their health management, they will expect their local neighborhood dentist to understand that and to help them realize the promise of oral-systemic health. 

Q: When can the dental industry expect to see that awakening?

DB: That's a billion-dollar question. It may happen first among specific groups. It may even be patient populations before clinicians. For example, when patient groups like people with diabetes learn of the bi-directional relationship between gum health and diabetes health, they will demand to be seen as a whole person, their mouth included. When people with a family history of dementia understand the importance of periodontal health to their brain health, they will seek clinicians who can help them mitigate their risk. When women realize that proper oral healthcare dramatically impacts the risk of a preterm, low birth weight baby, pregnant women and those seeking IVF will expect and demand that oral healthcare is included as an integrated part of their health regimen. The awakening could also be catalyzed by a change in government policy. For example, Medicare has been recently expanded to include some medically necessary dental care related to certain medical conditions. When that becomes common knowledge, it could spark an awakening in our nation's elderly. 

Q: In your opinion, are enough medical and dental clinicians interested in collaboration?

DB: I believe there's tremendous interest, but some of it is buried under a generation of frustration. We have countless clinicians whose training included teachings on the Mouth-Body Connection and the importance of the oral biome. However, when they graduated and came into practice, they were frustrated by their practice’s technology which didn't allow them to connect those dots in their day-to-day professional lives. For example, a dentist may be aware that their patient's oral health, specifically their gum health, may be impacting their patient’s systemic condition, but in the past, the dentist had no access to their patients’ medical data. So, while I believe there's interest, they haven't had the ability to act on that interest. Technology is changing this. For example, with saliva diagnostics, dentists are now able to provide proactive care and counseling to their patients, becoming part of a predictive and preventive care model, rather than waiting until something's broken to fix it.

Q: What are some of the biggest challenges facing DSOs right now?

DB: Many DSOs — not including PDS Health, thankfully — are highly leveraged and have significant debt-service obligations. The interest rate hikes we've experienced over the last couple of years have added pressure to those DSOs. As interest rates begin to come down, I think we'll see a freeing up of capital for many DSOs to invest more, accelerate their acquisition strategies, and strategically use debt to grow.

Q: What other trends are you following in dentistry right now?

DB: We're very optimistic about dental care and have been for quite some time. Our company’s founder and CEO Steve Thorne has been referring to this current era as "the golden age of dentistry," and we've seen nothing to indicate that his magnanimous vision is not correct.  

Our country is experiencing a rapidly growing elderly population with a deep desire to live longer and stronger. This massive group of Americans will invest in their healthcare. They will seek out data and insights to help them make better decisions. They will invest in predictive, preventive, and, ultimately, personalized care. They will be aware that saliva is "the new blood" and that there are important biomarkers in their saliva that can significantly influence the health of their mouth and body. This population megatrend is part of the reason why Steve refers to this as "the golden age of dentistry." This is a generational shift in population demographics, and it is good for dentists. 

The industry also pays more attention to global trends than it did in the past. We are seeing commonalities in different healthcare systems that are interesting to us. For example, in much of Europe, implants have been a significant part of their business for many years, so we are able to learn things about the likely future of the dental implant business in the U.S. We see more cross-border information sharing and collaboration between multinational and international DSOs than we've seen in the past. That's been interesting.

Q: What will DSOs need to finish 2024 strong?

DB: As always, DSOs need to be the best choice for clinicians. When they are clinician-focused, DSOs are able to recruit, onboard and retain the best clinicians. As we know, the patients are coming, and they will continue to come to the dental office for their oral healthcare needs. To build a long-term sustainable business, DSOs must continuously improve on their offerings for dentists and other clinicians.  

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