Good morning. Turns out the shot clock runs out on unpaid dental work too.

NBA player Malik Beasley is in the middle of a career resurgence with the Pistons. But even that won’t save him from a wage garnishment from his former dentist. Celebrity or not, skip the bill and the crown still comes for you. No one's too famous for collections.

Inside this issue:
- Insurer buys a DSO
- Non-competes on the chopping block

⏰ Your reading time today: 5 mins 16 seconds

👑  Enjoy your coffee break with Word of Mouth, a dental-themed word game inspired by Wordle … guaranteed to leave you grinning, not grinding! Congrats to Dr. John Lee Roring, dentist and owner of Comfort Dental, and Morgan Mitchell of Crackle PR, for joining this week’s leaderboard. 

MARKETS

📈 3D Systems Corp ($DDD) – 1.68 | +0.040 (2.44%)
📈 Align Technology ($ALGN) – 199.31 | +5.01 (2.58%)
📉 Colgate-Palmolive ($CL) – 88.85 | -4.25 (4.56%)
📉 Dentsply Sirona ($XRAY) – 16.00 | -0.010 (0.062%)
📈 Envista Holdings ($NVST) – 20.03 | +0.30 (1.52%)
📉 Henry Schein ($HSIC) – 70.68 | -2.80 (3.81%)
📉 Straumann Holding AG (STMN.SW) – CHF 103.75 | -0.55 (0.53%)
📉 Weave Communications ($WEAV) – 7.56 | -1.15 (13.20%)

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

⚠️ ADA raises alarms over insurer acquisition of dental practices, warning consolidation by major dental insurers threatens clinical autonomy and could limit access under restrictive networks. When insurers buy the chair …

🚨 CareQuest warns the newly passed One Big Beautiful Bill Act will slash Medicaid dental benefits, urging Congress to prioritize policies that protect and strengthen oral health access. A beautiful bill for deficits, but not dentitions.

🦷 Vermont State University scraps stalled dental therapy program after years of planning, abandoning efforts to train mid-level providers after development stalled due to low enrollment and funding shortfalls. They bit off more than they could drill.

🔐 Scammers impersonate California dental board to defraud dentist of savings, convincing him his license was tied to drug crimes and coercing transfers during a fake FBI investigation. Trust, but verify. Then hang up.

📋 ADA opens applications for Clinical Director program, targeting senior clinicians ready to shape national policies and promote evidence-based dental practice.  

🗳️ ADHA announces new national leadership for 2025–26, including president Lancette VanGuilder, electing fresh officers focused protecting and promoting dental hygienists. Welcome to the new floss boss.

🗂️ Federal judge rules HHS layoffs likely unlawful and halts several cuts, blocking agency job reductions tied, including oral health programs. Perhaps this policy drilled too deeply.

📝 ADA invites applications for its Certified Clinic Director program, kicking off a training pathway to support the development of dental clinic directors.

🏗️ Dr. Burke Soffe launches Arkansas's first dental school, leading the newly accredited program to address the state’s dire oral health shortage. The founding dean didn’t just open doors—he built the building.

INSURER ISSUES

An insurer just became a DSO

Insurers used to write the rules. Now, they’re breaking the unwritten ones. Delta Dental of Wisconsin (DDW) has acquired Cherry Tree Dental, a 40-plus-location group practice operating across four states. For the first time at such a scale, a major dental insurer isn’t just processing claims; it now owns the clinics that submit them.

Let’s unpack why that matters, how it could reshape power dynamics in dentistry, and what DSO leaders should be watching next. Does the payer now sign both sides of the check?

What’s happening: DDW has acquired Cherry Tree Dental, a private equity-backed DSO with over forty practices primarily in Wisconsin, but with smaller footprints in Illinois, Michigan, and Minnesota. While there have been isolated examples of insurer-provider tie-ups in the past, this is the most direct and scaled acquisition of its kind in U.S. dentistry.

DDW is positioning the deal as a move to expand care in underserved parts of Wisconsin, return ownership to local hands, and maintain clinical independence by keeping Cherry Tree Dental as a separate company with its own leadership. According to internal communications, DDW will not influence treatment decisions. The company says this acquisition will help stabilize access while preserving the doctor-patient relationship.

What the ADA says: The ADA and the Wisconsin Dental Association (WDA) have raised serious concerns. They argue the deal could create a conflict of interest between the role of a payer and the responsibilities of a care provider.

Some of the concerns expressed by the associations and other online observers include:

• That clinical decisions may be shaped by cost containment considerations.

• That dental autonomy may erode.

• That patients may be steered toward insurer-owned options.

• That non-dentist ownership models may evade regulatory scrutiny.

The ADA has formally asked for more information and is reviewing the legal, clinical, and regulatory implications. It is likely that they see this transaction as an important precedent to shape, especially if similar deals continue.

Why it’s happening: DDW now owns a delivery network in a region where it insures more than 2.6 million members and already contracts with 90 percent of dentists. DDW says Cherry Tree will continue operating as-is under its current brand and leadership, with no change to clinical protocols. 

The move unlocks dual revenue streams: premiums on the front end and service profits on the back. The acquisition also gives it tighter control over access, consistency, and cost. Owning practices also enables the insurer to address network gaps and potentially pilot models for integrated care. 

But by acquiring a major provider, Delta potentially gives itself a captive delivery system and shields against provider attrition, in light of moves by tough-negotiating providers and DSOs to drop low-reimbursement plans.  

With regulatory pressure mounting around dental loss ratios, it is also possible that owning a provider network could potentially help Delta shift expenses from “admin” to “care,” boosting compliance and margins.

Heads up, DSOs: The buyer landscape just got more complicated. Dental payers have long tried to dictate pricing and access, but now they may be bidding for your next acquisition target. DSOs in overlapping regions could find themselves competing against a well-capitalized insurer that can control both patient flow and reimbursement structures.

While some DSOs may see a new class of buyer emerging, others may feel squeezed by the dual pressure of insurer-owned networks and rising patient steering. For patients and provider talent, the clinical differentiation, brand trust, and operational autonomy within a DSO will become more important if vertical integration reshapes the map.

Bottom line: This is big news. The Cherry Tree deal may mark the start of a new era in dental consolidation, one where insurers move from reimbursement to direct control. Will the ADA fight this in courtrooms or state houses? Will DSOs look to partner with payers or push back on integration? Will other Delta affiliates or national insurers follow the playbook, or will this be a one-off? Fear not, we’ll keep probing.

BUSINESS BITES

👤 U.S. Oral Surgery Management names Doug Drew as CEO, promoting the new exec from Mars Veterinary Health to lead USOSM’s 30-state network. From pet surgeon HQ to oral surgery strategy.

🔗 Vyne Dental partners with Open Dental for live API integration, enabling practices to streamline claims, eligibility checks, and clinical data within one vendor-neutral ecosystem. 

⚖️ Densys sues Medit over intraoral scanner patents, alleging Medit’s entire scanner lineup infringes on 2D imaging technology.

🤝 Allied OMS acquires four oral care practices and secures equity growth investment, expanding its footprint, while raising capital from 65 Equity Partners. 

👔 Dental Care Alliance names Johnny Cho as Director of M&A and Partnerships, bringing private equity deal experience from Sonrava to lead nationwide expansion. From Brident to buy-side. 

LABOR STRUGGLES

Non-competes on the chopping block

Dentists may soon be freer to walk than ever before. Across the U.S., state legislatures are dismantling the legal scaffolding that long propped up non-compete clauses in dental contracts. For DSOs, the implications are big: Retention, recruiting, and valuation strategies all need a rework. Let’s dive into this new wave and how you can surf it. Hint: It involves less lawyers.

What’s happening: Texas is the latest to act on the trend. Senate Bill 1318, effective September 1, 2025, limits dentist non-competes to one year and a five-mile radius from their main practice. It also requires a buyout option equal to one-year’s salary, allowing dentists to exit early if they choose.

Several other states had already moved ahead. Colorado voided all non-competes for dental professionals. Minnesota and New Mexico have enacted similar healthcare-specific restrictions. These changes are driven by a policy shift aimed at improving patient access, encouraging provider mobility, and lowering barriers to competition. Lawmakers are especially focused on reducing bottlenecks in rural and underserved areas where care shortages are severe.

Feds exit the chat: The FTC attempted a blanket ban on non-competes in 2024. That rule was blocked in court. Since then, the agency has moved toward selective enforcement targeting the most harmful employer practices. The Trump administration has backed off broader action, but regulatory uncertainty continues to shape how DSOs approach contracts.

Why it matters: For DSOs, non-competes can at times serve as a buffer against patient loss, talent poaching, and brand dilution. Now that protection is thinning. In dense markets, a geographic restriction, five-mile rule, can matter on an obvious operational level. A dentist can leave and practice again just down the street, making it harder to control competition, keep patients, or retain talent.

Dentists vs. everyone else: Texas’s SB 1318 applies to dentists, nurses, and physician assistants, not hygienists or assistants. Those team members remain subject to older common-law standards based on "reasonableness," which are more flexible but less predictable. Most other states that have passed healthcare-specific bans or limits also focus primarily on licensed independent providers. So far, there is no strong legislative trend freeing hygienists or assistants from non-compete restrictions, though a few state court decisions have begun to scrutinize such agreements more critically.

What buyout means: In Texas, a non-compete must include an option for the dentist to exit the restriction by paying a buyout. That amount is capped at the total salary and wages earned in the previous year. This allows dentists to leave and compete earlier if they choose to pay. It is not common yet, but it will be standard in new contracts starting September 2025.

Valuation shock: Practice buyers once paid a premium for stable associate contracts. If restrictive clauses are undermined, some of that logic is eroded. Without enforceable non-competes, the goodwill tied to key producers becomes harder to secure. Most states still allow sale-of-business exceptions, which would limit former owners, but associate agreements, especially in de novo clinics, carry more risk.

How DSOs can adapt:

• Non-solicits and NDAs: For many states, these are viable, if properly scoped. They do not prevent competition, but they can protect against staff and patient poaching as well as data loss.

• Equity models: Associate equity could emerge as the new glue. Dental partnership models, buy-ins, and joint ventures give clinicians a financial reason to stay.

• Stronger cultures: Compensation is only part of it. Mentorship, leadership tracks, and positive team dynamics are becoming the core of retention.

• No longer plug-and-play: For multi-state DSOs, contract templates are out. Agreements must be customized by jurisdiction and regularly reviewed. 

Looking ahead: Like it or not, this regulatory trend is accelerating. More states are introducing new laws or reevaluating older ones. Courts are less tolerant of vague or overly broad restrictions. 

Smart DSOs will realize that the key to quality staff retention is not within the orbit of their sharp-penned lawyers. Instead, leaders at all levels must build retention through vision, culture, and incentives, not just contracts. Loyalty has to be earned, not signed.

CLINICAL NOTES

♻️ UC Irvine bioengineered hydroxyapatite from urine waste, turning wastewater into implant-grade bone material ideal for dental and orthopedic applications. Oh my … 

💉 Botox reduces radiation damage to salivary glands in prostate cancer patients, lowering dry mouth side effects from PSMA-targeted therapy without weakening cancer treatment. 

🧬 Wisdom tooth pulp stem cells dubbed “medical gold” for regenerative therapies, with a scientist claiming potential to rebuild bone, nerve, and heart tissue from extracted third molars using salivary pulp cells. Too good to be true?

🧪 Dentures release microplastics during daily use and cleaning, with particles detected in soaking saliva and grinding dust triggering inflammation in oral cells. New fear: unlocked!

BEYOND THE CUSP

• Fan pauses dental cleaning to buy Meghan Markle’s rosé, prompting a royal reaction. 

• Dentist decodes Leonardo’s Vitruvian Man’s hidden geometry.

• Ex-Nevada inmate awarded $4M after dental infection was ignored. 

• Hole in one: Indiana dentist reflects on playing the U.S. Open.

• Here’s why breaking your morning routine can ruin your day.