Good morning. Dentists at the University of Alabama at Birmingham School of Dentistry saw an unusual patient recently: a green aracari bird named Beauregard.

The team of maxillofacial prosthetic experts from the school replaced the toucan-like avian’s damaged beak with a prosthetic crafted to replicate the original’s size, weight, shape, and even color (the latter being important so that—and this is no joke—Beauregard wouldn’t be bullied by the other birds).

Inside this issue:

- The dental enterprise era arrives
- An often-overlooked marketing channel

⏰ Your reading time today: 6 minutes 51 seconds

🏆 Enjoy your coffee break with Word of Mouth, a dental-themed word game inspired by Wordle.

MARKETS

📉 3D Systems ($DDD) – 3.00 | -0.820 (21.47%)
📈 Align Technology ($ALGN) – 172.05 | +5.78 (3.48%)
📈 Colgate-Palmolive ($CL) – 86.07 | +0.23 (0.27%)
📈 Dentsply Sirona ($XRAY) – 10.26 | +0.28 (2.81%)
📈 Envista Holdings ($NVST) – 23.44 | +0.60 (2.63%)
📈 Henry Schein ($HSIC) – 78.05 | +1.50 (1.96%)
📉 Park Dental Partners ($PARK) – 17.97 | -2.30 (11.35%)
📈 Straumann Holding ($STMN) – CHF 95.18 | +1.26 (1.34%)
📉 Weave Communications ($WEAV) – 5.67 | -0.060 (1.05%)

Stock data reflects market close as of the last day of trading, showing changes over the past five trading days.

THE DRILL DOWN

🤖 40% of dentists abandon AI tools within 90 days of adoption, with cost, poor PMS integration, and unreliable results cited as the top reasons for dropping a tool, according to a new survey of 300 dentists.

🚨 California plans to eliminate routine dental coverage for roughly 2 million undocumented Medi-Cal enrollees on July 1, limiting benefits to emergency care only in a move the California Dental Association says will force dentists to turn away patients and reduce provider participation statewide.

🚰 U.S. Court of Appeals overturns a judgement directing the Environmental Protection Agency to increase regulation of fluoride in drinking water, finding that the lower court’s ruling requiring fluoride to be regulated under the Toxic Substances Control Act was improperly made. 

🌴 Dentist pay rose the most in Hawaii last year, according to fresh data from the Bureau of Labor Statistics, with a jump in the average salary of more than $90,000—Nevada and Oregon were distant runners-up, with pay bumps of $31,980 and $30,500, respectively.

🪥 ADHA issues an updated position statement on the hygiene workforce shortage, calling for better pay, autonomy, and culture, while pushing back on proposals to fill gaps with foreign-trained dentists or expanded assistants.

🖥️ HHS extends digital accessibility compliance deadline to May 2027, giving Medicaid providers, dental schools, and community health centers extra time to bring websites, patient portals, and online forms up to federal standards under Section 504 and the ADA.

🔐 DentaQuest hit by cyberattack exposing data on 2.6 million accounts, with extortion group ShinyHunters claiming 234GB of stolen data—including names, government IDs, and health insurance information—after reportedly failing to reach a ransom agreement with the company.

📜 Maryland enacts law barring insurers from blocking assignment of benefits to out-of-network dentists, requiring dental plan organizations to directly reimburse non-preferred providers under an assignment of benefits unless specific conditions are met. 

🦷 Rhode Island’s House of Representatives moves to expand reimbursement options for public health dental hygienists, allowing hygienists in public health settings to bill insurers beyond just Medicaid, while also broadening where they can practice without direct dentist supervision. 

INDUSTRY

The dental enterprise era is here

The playbook behind the DSO success stories of the past couple decades—buy low, bolt on shared services, sell high—is due for a refresh.

Driving the news: A new BCG whitepaper declares the 15-year dental roll-up playbook—acquire at five to eight times EBITDA, layer on shared services, leave dentists alone, and exit at a higher multiple—officially over, calling it "a recipe for mediocrity at scale."

• DSO sales and recapitalizations fell from more than 30 in 2021–2022 to fewer than 12 across 2023–2025, according to DC Advisory's Rich Blann, and dental private-equity deal count dropped 36.5% year over year in 2025—the steepest fall of any major healthcare-services segment.
  

• Meanwhile, multiples that once topped 13 to 16 times EBITDA on the biggest platforms have slid toward the 9 to 10 range.

Why it's happening: The pond everyone's fishing in is too small to support the growth ambitions of the industry, according to BCG. Of roughly 137,000 U.S. dental offices, only about 8,500 unaffiliated practices clear the $2 million revenue bar that fits the classic acquisition profile. That puts a hard cap on how much DSOs can grow just by acquiring reasonably well-run practices.

• There’s also a demographic issue. Only about 21% of recent graduates own a practice, down from 63% to 70% of grads before 2010. The likelihood of owning a practice only starts to align across generations after dentists have been out of school for around 15 years.

Why it matters: The lesson BCG draws is that it's time to shift emphasis from hunting for attractive practices to acquiring and building a platform that can create them—supported by three core pillars:

• A real standard operating model. Where the old rollup let each practice run itself, the platform standardizes the fundamentals: unified systems and tech, consistent front-desk protocols, daily performance dashboards, and procedure-specific scheduling. Done right, this can be a boon for clinical autonomy by freeing up dentists to do the work they’re trained for rather than dealing with billing and admin.
  

• AI woven into every workflow. For AI to deliver results, it needs to be part of a standardized tech stack and set of processes. Platforms shine here because they can feed more data and context into AI systems, improving their performance. Some of the larger players are already reporting results here: Aspen Dental rolled diagnostic AI into more than 1,100 offices in six weeks, and Heartland Dental recovered more than $72 million in 2025 winning back patients lost to missed calls.
  

• A different deal with dentists. Once AI clears the operational drudgery, the platform can offer more of what dentists say they now want, namely mentorship and solid revenue-cycle support. Paired with equity or other partnership incentives and platforms can offer a more attractive option for many dentists than independent practice. 

What it means for you: The shift rewards builders over buyers. Here are a few moves you can make now to get ahead of it:

• Standardize before you automate. Unified systems, consistent front-desk protocols, and daily dashboards have to come first—AI can't compound on top of fragmented workflows.
  

• Go with a platform rather than a patchwork. Favor integrated systems where your tools and software actually talk to each other over patchwork solutions that you have to stitch together.
  

• Lead with revenue cycle and patient communication. They're the fastest path to measurable ROI (and double as a retention tool).
  

• Design the dentist deal for the new generation. Mentorship, culture, and hybrid equity (including phantom or performance-tied structures) land better with the next generation than a transactional paycheck.

Bottom line: The roll-up era was always going to be limited by the pool of well-run practices to target for acquisition. Now that this supply is drying up, the next era of dentistry will belong to operators who can build and manage platforms capable of powering growth even when deals can’t be found.

Share this article: https://www.themorninggrind.com/p/the-dental-enterprise-era-is-here

BUSINESS BITES

👔 Notable leadership changes: William K. Daniel is elected the independent chairman of the board of Henry Schein and Steven Lepowsky is appointed to a second term as dean of the University of Connecticut School of Dental Medicine.

📈 Deals and de novos: Imagen Dental Partners adds a practice in Houston, LADD Dental Group expands to 12 practices in Indiana, Park Dental opens a new practice in Minnesota, Premier Care Dental Management adds practices in Pennsylvania, Aspen Dental opens a new practice in Missouri, and Apex Dental Partners expands with 5 new affiliated practices in Colorado.

💰 Lone Peak Dental Group secures $15 million debt investment from o15 Capital Partners, financing that the Denver-based DSO says will support its growth beyond its current 73 affiliated practices.

MARKETING

The most valuable patient is likely the one you already have

Just like it’s easier to keep old friends than make new ones, it’s also easier to market to your existing patients than get new ones in the door. But when it comes to selling to the patients who already trust them, many dental practices are doing the equivalent of forgetting to call their bestie on their birthday.

By the numbers: The average dental practice leaves $1 million to $1.5 million in unscheduled treatment for existing patients on the table every year, according to Henry Schein One's benchmark data. And here’s the kicker: Reactivating those patients and booking that revenue is on average both cheaper and faster than chasing new ones.

• Patient-engagement firm Patientdesk reports that while new-patient acquisition campaigns took three to four months to turn ROI positive, a reactivation campaign paid off within weeks.
  

• Further, while practices would typically spend $312 to acquire a new patient, reactivating a dormant one cost just $12.

Why it matters: While new patient acquisition is critical—according to Planet DDS's 2026 Dental Industry Outlook, it’s the single strongest predictor of revenue growth—marketing to existing patients can achieve business goals that new patient acquisition doesn’t. 

• Improves margin: The production you recover from a lapsed recall or an unscheduled crown carries no acquisition cost and is a pure boost to your margins.
  

• Drives acquisition: Apex Dental Partners reports more than 80% of its new patients arrive by referral, at $20 to $40 each versus roughly $300 for a patient from Google Ads, so a loyal base is itself a new-patient engine.
  

• Builds resilience: What happens if one of your marketing channels for new patients suddenly stops working? Or a bad economy dries up the pool of new patients? Having a base of loyal, repeat patients can see you through the ups and downs of growth. 

What you can do now: The highest-return moves are cheap and low risk.

• Start tracking metrics you need to know to plug leaks. Track recall rate, hygiene reappointment, unscheduled-treatment dollars, and attrition—by location—right alongside your new-patient counts. You can't recover what you don't see.
  

• Work your unscheduled treatment every week. Pull a list of patients with more than $1,000 in diagnosed-but-unbooked work, review it in the morning huddle, and text a visual treatment plan with a one-tap scheduling link. And if you don’t have the technology you need to easily do this, that’s another issue to work on.
  

• Pre-book the next visit at checkout. It costs nothing, and it's the sort of basic scheduling discipline that can compound over time into meaningfully better retention.
  

• Run a real reactivation sequence, not a one-off email. Think about how many marketing emails you ignore. Your patients are no different. You’ll often need repeated contacts to break through to someone. Lead with a text, escalate to a call, and time the "use-it-or-lose-it" benefits nudge for October through December.
  

• Turn happy patients into your referral engine. An automated post-visit review request—by text, within the hour—feeds the same new-patient funnel you're already paying to fill.

Bottom line: It’s smart to keep spending to bring new patients through the front door. The data is unambiguous that it's the top growth lever. But treating your existing patient base with as much care rather than a marketing afterthought can protect margin (while boosting your new patient acquisition work as well). After all, the cheapest production you'll book this quarter is the recall you re-book and the crown you finally schedule.

Share this article: https://www.themorninggrind.com/p/the-most-valuable-patient-is-likely-the-one-you-already-have

CLINICAL NOTES

🦴 Osteoporosis may significantly raise the risk of severe periodontitis, with a new Journal of Periodontal Research review pointing to shared inflammatory and bone-resorptive pathways—and estrogen loss as a key driver, particularly in postmenopausal women. Two bones, one battle.

🪥 Regular flossing was linked to lower all-cause mortality in a large study of over 10,000 patients, with the daily practice associated with a nearly 30% lower mortality risk, though the authors caution the findings do not prove that flossing itself is the cause of lower mortality risk.

🦷 Temporomandibular joint replacement significantly improves quality of life in patients with advanced TMJ disorders, with benefits seen broadly regardless of presurgical demographic or pain variables, according to a retrospective cohort study of 84 adults published in the Journal of Oral and Maxillofacial Surgery.

BEYOND THE CUSP

• Botox at the dentist and fillers on your lunch break: How did cosmetic treatments become the new normal?
  

• NHL star Drew Doughty is the new face of dental tech company SprintRay.
  

• A California dental clinic is using a humanoid robot, which (somewhat off-puttingly) is called the “FF Master,” to staff its front desk.
  

• Colgate-Palmolive launches a “wellness podcast” targeting Gen Z’s called Serving Smiles.