Federal budget cuts, increasing burnout among dentists and the potential impact of tariffs are three of the challenges that dentists, DSO executives and dental practices have unexpectedly come up against so far in 2025.
These seven dental leaders recently connected with Becker’s to share the obstacles facing the dental industry that were not necessarily predicted to arise in 2025.
Editor’s note: Responses have been lightly edited for clarity and length.
Mike Davis, DDS. Dentist of Smiles of Sante Fe (Albuquerque, N.M.):The obstacles in the dental industry are the same as they have been for the past several years.
No. 1: Insurance reimbursements and processing are highly problematic, generally. The same is true in medicine, and it’s getting worse for the entire healthcare industry, by design of the insurance industry.
No. 2: Trained staff such as dental hygienists are increasingly scarce. This may be most reflective of inadequate revenue generated from preventive services, ceilings placed on salaries and benefits of dental hygienists. If inadequate revenue is obtained from insurance participation for dental hygiene services, the system gets squeezed. Dental hygienists retire or leave their profession, and there is minimal economic incentive for a younger generation to enter the field.
No. 3: Many practices will increasingly seek out the lowest-cost provider to keep dental practices fiscally viable. We’re already witnessing expanded use of dental therapists. We’re increasingly seeing dental assistants assume roles of dental hygienists.
No. 4: One should not discount the dark side. Elevated economic pressures created by the insurance industry may force practices to consider unethical activities, such as unbundling and upcoding of dental services.
No. 5: We already observe junior associate dentists in practices with overly pressured clinical schedules. Optimal clinical outcomes can and do often suffer. The dual effects of outrageous student loan debt combined with the unmitigated greed of certain practice beneficial ownership can be highly destructive.
George Hanna, DMD. Dentist of Socorro (N.M.) Dental: Inflation is causing changes in patients’ behavior and interest toward dental services due to the unknown outcome for Medicaid dental services and the cuts happening now.
Richard Huot, DDS. CEO of Beachside Dental Consultants (Vero Beach, Fla.): Because of anticipated cuts in the federal budget, this will have a ripple effect in individual state budgets, and may cause healthcare expenditures or related programs to be cut in turn. If you are one of the 41 states that expanded Medicaid, there is a risk that the feds will lower the 90% level they now fund for the expansion portion of Medicaid reimbursement initiated during COVID-19. If states decide to continue the Medicaid expansion level that the feds lower by funding it themselves, this leaves less money for other types of programs. Some states have already cut or curtailed workforce programs meant to increase the size of dental hygiene or dental assistant classes, or workforce programs in general. One of the most likely “victims” of this would be potential funds to promote an increase in Medicaid fee reimbursement, to attract more dentists to take the state program.
Mike Kang, DDS. Dentist of AppleTree Dental (Anaheim, Calif.): Dentists are increasingly grappling with burnout, a well-known issue in medicine. Despite incentives, retaining associates for more than two years has become increasingly difficult. Many dentists entering the field expect more structure, support or technology like AI to alleviate their workloads. However, they face unrealistic patient demands, scheduling challenges and unimpressive insurance reimbursements. I believe these factors collectively contribute to rising turnover rates among dentists of all experience levels. Recruitment and long-term retention are significant challenges for me in my practice.
Andrew Mintz. CEO of The Smilist (Great Neck, N.Y): To state the obvious, the economic chaos that has recently been created means that we need to be more thoughtful about our cost of supplies, potential patient reticence to agree to treatment and the impact, if any, on the labor market.
Geith Kallas, DDS. Dentist and CEO of Smile Makers Dental Center (Tyson’s Corner, Va.): In 2025, the U.S. dental industry is grappling with a series of unexpected challenges that are impacting both private practices and DSOs. These obstacles span staffing issues, financial pressures, policy changes and evolving patient expectations.
No. 1: Persistent staffing shortages: Despite an increase in dental hygiene program graduates, many practices continue to face difficulties in recruiting and retaining qualified staff. This shortage extends beyond clinical roles to administrative positions, such as medical billing specialists, which are crucial for efficient operations. The lack of trained personnel in these areas can lead to delayed billing cycles and financial losses.
No 2: Financial strains from insurance and rising costs: Low insurance reimbursement rates, coupled with administrative complexities, are placing a heavy burden on dental practices, affecting their financial stability and operational efficiency. Additionally, escalating overhead costs, particularly in employment and supplies, are squeezing profit margins.
No. 3: Impact of tariffs and economic policies: Recent tariff implementations on imported goods, including dental products, have led to increased costs for essential supplies. The American Dental Association has expressed concerns that these tariffs could limit the availability of necessary materials, further straining dental practices.
No 4: High interest rates affecting practice investments: Elevated interest rates have made financing for practice acquisitions and equipment purchases more expensive. This financial environment poses challenges for both new and expanding practices, as higher borrowing costs can deter investment and growth.
No. 5: Potential cuts to medicaid and public health funding: Proposed reductions in Medicaid funding threaten to decrease patient access to dental services, particularly for low-income populations. Such cuts could lead to increased emergency visits for untreated dental issues and place additional financial strain on practices serving these communities.
No. 6: Evolving patient expectations and technological integration: Patients are increasingly seeking practices that offer innovative technologies, such as AI and digital solutions, for enhanced care experiences. This shift necessitates investments in new technologies and adaptations in practice management to meet these expectations.
No. 7: Changing workforce dynamics: The dental workforce is experiencing notable shifts, including a generational transition with more dentists moving from solo practices to group settings or affiliating with [dental service organizations]. Additionally, there’s an increasing number of female dentists entering the profession, influencing practice models and patient care approaches.
Navigating these multifaceted challenges requires strategic planning, adaptability, and proactive engagement with industry trends and policy developments to ensure the continued delivery of quality dental care.
Marc Wilk, DDS. Dentist of Tudor City Dental (New York City): The unexpected challenges, I suppose, weren’t entirely unexpected. Hiring desk personnel, assistants and hygienists continues to be a significant burden for independent offices. On the other hand, the software platforms for [revenue cycle management] and front-desk AI haven’t advanced in functionality enough to fully compensate for this.
They are making progress, though. I see significant improvements in workflows, but I expect them to continue improving until the end of 2025 and into 2026.
