Good morning. Dentistry is a noble profession. But according to SNL, it's also a little stabby.

In a cut-for-time sketch from the Season 50 finale, Scarlett Johansson leads a class of dental grads in reciting a "dentocratic" oath that includes promises to "crack, crunch, bust up, jack up, strike, confuse, irritate, penetrate, stab—oh wait, did I already say stab?" Finally, TV that understands us.

Inside this issue:
– Is the fluoride debate coming to your operatory?
– Are Americans giving up on prevention?

⏱️ Your reading time today: 5 mins 4 seconds

🏆 Enjoy your coffee break with Word of Mouth, a dental-themed word game inspired by Wordle. New entrants on the leaderboard this week include Ashley Johnson of Periodontal Care, P.A. and Gregory Nofi of Leading Edge Specialized Dentistry.

MARKETS

📈 Align Technology ($ALGN) – 178.51 | +3.07 (1.75%)
📉 Colgate-Palmolive ($CL) – 91.93 | -0.54 (0.59%)
📉 Dentsply Sirona ($XRAY) – 15.62 | -0.16 (1.01%)
📈 Envista Holdings ($NVST) – 18.10 | +0.61 (3.49%)
📉 Henry Schein ($HSIC) – 69.56 | -2.42 (3.36%)
📉 Straumann Holding AG (STMN.SW) – CHF 104.25 | -3.40 (3.16%)
📉 3D Systems Corp ($DDD) – 1.53 | -0.10 (6.13%)
📉 Weave Communications ($WEAV) – 9.38 | -0.42 (4.29%)

Data is provided by Google Finance. Stock data reflects market close at 5:00 p.m. ET, showing changes over the past five days.

THE DRILL DOWN

💧 Governor DeSantis accuses dentists of backing “forced interventions,” escalating Florida's anti-fluoride rhetoric and framing public health measures as political overreach.  

🛑 ADA urges DOJ to act on health insurance antitrust reform, calling for enforcement of rules to improve competition and reduce barriers to dental care. Fewer networks, fewer choices. 

🦷 Rhode Island redirects $10M from environmental settlement to children’s dental care, funding treatment and prevention programs for underserved  communities. Turning contamination into care.

🪥 Georgia becomes sixth state to require in-person orthodontic exams, tightening oversight on teledentistry and direct-to-consumer models. Smiles now require a handshake.

🛡️ ADHA pushes back on Nevada bill “lowering” hygiene standards, warning that the proposed licensure changes put patient safety at risk. Clinical shortcuts rarely end in prevention.

🦷 ADA presses insurers to cover preventive services, arguing that fluoride and sealants reduce long-term costs and deserve consistent coverage. An ounce of prevention—if your plan allows it.

CULTURE WAR

Is the fluoride debate coming to your operatory?

In the good old days, fluoride used to be the most boring part of your preventive tool kit. Today, this once non-issue is banned in two states, flagged by the FDA, and starring in lawsuits, subpoenas, and late-night monologues about U.S. Health and Human Services Secretary Robert F. Kennedy Jr.

Patients used to simply nod when asked if they wanted fluoride. However, as the debate intensifies, fluoride concerns may start creeping toward your operatories, your patients, and your playbooks. Here's what is changing and what you can do about it. Your hygiene trays just got political.

What’s happening: In 2025, Utah and Florida became the first states to ban community water fluoridation. RFK Jr., now leading HHS, praised the moves and called for the CDC to withdraw its long-standing recommendations. The FDA followed suit, proposing to remove ingestible fluoride prescription drug products for children from the market. Officials cited potential neurodevelopmental concerns in children, referencing a 2025 National Toxicology Program report that became political fuel.

At the same time, attorneys general in Texas and other states launched investigations into fluoride toothpaste, claiming brands are illegally marketing to kids with flavors and packaging that encourage ingestion.

How it got mainstream: The fluoride backlash has been building quietly for years, but recently gained steam as part of RFK Jr.’s Make America Healthy Again movement. It blends health freedom rhetoric, influencer skepticism, and parental concerns, mixed with public distrust of institutions. With politicians now embracing the movement, fluoride opposition is no longer fringe. It’s fast becoming policy.

Why DSOs should care: Until recently, this was a public health fight about water. But that’s changing. As fluoride vanishes from public systems and fluoride products face scrutiny, dentists will become the front line of the conversation.

Parents are declining fluoride varnish more often. Staff may begin to field questions about whether toothpaste is safe. In non-fluoridated markets, caries risk will likely creep up. And if regulators decide to go further, there’s a chance clinical guidance or payer coverage could start to shift.

The ADA’s response: The ADA has stood firm. In statements responding to both FDA actions and state bans, it reiterated fluoride’s long-proven safety and efficacy at recommended levels. They even came out swinging in defense of toothpaste manufacturers.

But the profession’s stance isn’t stopping political momentum or calming patient fears. 

 What DSOs can do now:

• Train teams for calm, clear conversations. Avoid defensiveness. Focus on science, safety, and patient outcomes.

• Monitor water fluoridation locally. When fluoride disappears, expect more decay and more questions, especially from parents.

• Standardize your fluoride protocols. Make sure recommendations are evidence-based, consistent, and aligned with ADA guidance.

• Keep an eye on reimbursements. If payer policy shifts, be ready to update billing and preventive workflows.

Bottom line: The fluoride battlefield keeps growing and growing. What began with water systems and local city councils is now a federal topic and could soon show up in operatories, product guidance, and patient sentiment. DSOs don’t need to jump into the politics, but they should be ready for the effects thereof. Because the next time a parent says “no thanks” to fluoride, it may not be about the treatment or cost but rather about trust. Cavities love a culture war.

BUSINESS BITES

👔 The Smilist appoints Axel Lapica as CEO and expands with BrookBeam Dental, bringing in the former DaVita exec to lead operations, growth, and strategic direction, while the company adds 16 new practices. From kidney care to crown preps.

🧭 Trivest Partners and Vibrant Equity launch True North Dental, forming a new Canadian DPO aimed at cross-country consolidation. 

📊 Henry Schein One unveils the 2025 Catalyst Index, analyzing what drives the top 10% of practices by patient growth and efficiency. 

⚖️ Dentsply Sirona to pay $84M to settle class-action lawsuit, resolving investor claims over misleading reporting and anti-competitive practices. 

🎤 ADA to sunset SmileCon after 2025, ending the flagship event in 2026 due to declining attendance and rising event costs. 

📊 Envista reports Q1 earnings, noting pressure in equipment sales but growth in implants and specialty products. 

DENTAL DATA

Report: Are Americans giving up on prevention?

Americans say they care about their teeth. They just are not acting like it.

That is the tension in the just-released The 2025 State of America’s Oral Health and Wellness Report from Delta Dental. The report finds that patients still rank oral health as essential to overall wellness. But brushing is down. Flossing is fading. Sealants are being skipped. And dental anxiety is on the rise.

For DSOs, this report is more than a survey. It is a window into where patient behavior is starting to drift and what could be coming for retention, revenue, and risk.

Mindset is slipping: 91% of adults say oral health is important to overall health. 95% of parents say the same for their children. But awareness of the stakes is fading.

Only 44% of adults connect oral health to heart disease. Just 31% make the link to respiratory illness. Stroke? 26%. The belief in oral health is still there. The understanding of why is falling apart.

Habits are worsening: The daily routines that support prevention are trending the wrong way:

• Only 74% of adults say they brush twice a day. That is down five points from last year.

• Flossing dropped to 71%.

• Mouthwash use fell to 66%.

• Just 53% of adults replace their toothbrush every three months, down from 64% in 2023.

Millennials and Gen X are sliding fastest. Even Gen Z is losing ground. And that erosion is already showing up in the chair. 

Parents are struggling: 95% of parents brought their child to the dentist last year. But only two-thirds of kids are brushing twice a day. Half are flossing. And 67% of parents say it is hard to keep brushing consistently.

The reasons are predictable: It is boring, the toothpaste tastes bad, and kids do not see the point. But that is not the only challenge.

One in 10 parents say dental anxiety keeps them from bringing their kids in regularly. And those numbers are higher among younger parents. This is not just a pediatric issue; it’s a generational one.

Booked, not balanced: 84% of adults went to the dentist for preventive care. That sounds solid until you realize that cosmetic visits dropped sharply and unexpected visits spiked among younger adults.  

Top reasons for preventive visits are still checkups and cleanings. Cosmetic services fell by nearly half, and routine visits are showing signs of stress in patients who feel overscheduled or underinformed.

Insurance remains the anchor: 67% of insured adults made a preventive dental visit last year. Just 28% of uninsured adults did. Those with coverage also reported better brushing habits, less anxiety, and fewer emergency visits. 

Coverage continues to be the biggest predictor of long-term engagement. But confusion remains. A growing number of patients are not sure what their plan covers or whether routine services are included.

What DSOs can do now:

• Lead with outcomes, not reminders: Frame prevention around what it prevents: pain, cost, and chronic conditions. Patients act faster when they know the stakes.

• Rebuild hygiene as your loyalty engine: Turn cleanings into a retention tool. Use hygiene visits to drive relationships, not just routine.

• Get sharper on benefits: Patients need clarity. Make sure they know what is covered, what is optional, and what saves them money.

• Equip teams to teach, not lecture: Every hygiene conversation should link oral health to something that matters, like sleep, energy, or chronic disease.

• Support parents with tools, not pressure: Give them what works. Think text reminders, quick-win routines, and post-visit kits.

• Make prevention your competitive edge: Use clear messaging, smart packaging, and simple pricing to turn sealants and fluoride into no-brainers.

Bottom line: Delta Dental’s report confirms what many dental professionals are seeing firsthand in their chairs: Patient intent is strong but follow-through is weakening. For dental professionals, this is the moment to tighten messaging, simplify services, and reassert the value of hygiene and prevention as the foundation of long-term whole body health. 

The good news is that patients are still coming. The question, and the opportunity, is what happens once they sit down.

CLINICAL NOTES

🥊 Controversial UK orthodontist defends "mewing" as dental authorities issue public warnings, with the controversial orthodontist promoting facial posture theories while regulators label orthotropics a potentially harmful practice. One man’s jawline is another man’s liability.

🐒 Research links primate facial structure evolution to human dental issues, suggesting our flat faces may be responsible for problematic wisdom teeth, offering insights into modern dental pain.

🦈 Ancient fish anatomy may explain why modern humans have sensitive teeth, with researchers tracing the origin of dental nerve pathways to primitive sensory armor. Your enamel has evolutionary trauma.

🧬 Periodontal disease linked to reduced sperm quality, with oral inflammation shown to impair motility, morphology, and DNA integrity. Floss like your lineage depends on it.

BEYOND THE CUSP

• Are you penalizing your best employees for unplugging?

• Scientists are puzzled by a new trend in the monkey world: kidnapping. Yikes.

• AI revolt! Researchers are warning that ChatGPT is refusing to shut itself off.

• Australian man bought his new home with … trash! This deal is garbage.