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Environmental scan shows dentistry entering a new normal

October 07, 2013

By Kelly Soderlund, ADA News staff

Dentistry may be entering a new normal.

Americans have been visiting the dentist less frequently and spending less money on their oral health, according to the ADA Health Policy Resources Center. These habits may be pushing the profession into a new normal when it comes to total U.S. dental spending, HPRC said in an environmental scan of the dental care sector titled “A Profession in Transition: Key Forces Reshaping the Dental Landscape.”

“Using various modeling scenarios, the results indicate that dental spending will remain fairly flat in the coming decades—a departure from the decades of historically robust growth in the dental economy,” according to the scan. “Clearly, the economic recovery, when it does finally kick into gear, may not bring back the dental spending growth many are anticipating.”

This is the second of three articles summarizing the environmental scan, which includes research from HPRC and Diringer and Associates, a consulting firm hired to help the ADA Board of Trustees' Strategic Planning Steering Committee develop a strategic plan for 2015-20, as well as other experts.

“The findings from this scan have shown considerable change is taking place in dentistry,” ADA President Robert Faiella said. “Dentists are facing significant challenges in their practices and business models. They may think it's because of the economic recession, but it's really a change in the dental landscape as a whole. The ADA is here to help dentists navigate and adjust to those changes and look at them as opportunities.”

Among the findings:

  • Dental benefits are likely to continue to erode for adults and potentially further influence dental care utilization. But benefits will expand for children, mostly because of the Affordable Care Act. Up to 8.7 million additional children will gain dental benefits by 2018 as a result of the law.
  • There will be pressure to increase value and reduce costs from all payers—governments, employers and individual consumers. This will be driven by a shift toward value- or outcome-based payment within both public and private plans and a new wave of health care consumerism among the population.
  • Commercial dental plans will increasingly use more selective networks and demand more accountability through data and performance measures.
  • The trend toward larger, consolidated multi-site practices will continue, driven by changes in the practice patterns of new dentists, a drive for efficiency and increased competition for patients.

It's unclear how these trends will manifest in the dental care sector, but they're ones the researchers believe the dental community should take note of.

“If you combine sluggish demand for dental care with an increased focus on value, you have some important implications,” said Dr. Hilton Israelson, member of the ADA Board of Trustees and chair of the Strategic Planning Steering Committee. “Tomorrow's environment will be one where dentists will have to do more with less.”

The environmental scan also shows that some of the underlying principles of the Affordable Care Act provide new opportunities for dentistry, with immediate opportunities lying within the pediatric and Medicaid populations.

“A big part of health reform is about breaking down silos and increasing the coordination of care among providers,” Dr. Israelson said. “This could provide an opportunity to bridge the gap between oral and whole body health, to position dental care more prominently within primary care and to reexamine the role of oral care providers within the health care systems.”

To read the full environmental scan and to watch a video explaining the report, visit