Good morning. Philadelphia 76ers star Joel Embiid’s son interrupted his dad’s postgame press conference last week to alert him to some breaking news: He had lost a tooth. 

It was certainly the most adorable moment from this year’s NBA playoffs, and also got us wondering: How much cash does a lost tooth earn you from the tooth fairy when your dad is on a $62 million per year contract? Does it scale proportionally? If you’re bringing in that sort of dough, please drop us a line.

Inside this issue:

- Diving into data on 8,500+ dental practices
- How hygienist autonomy impacts you

⏰ Your reading time today: 6 minutes 8 seconds

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

MARKETS

📈 3D Systems Corp ($DDD) – 2.51 | +0.17 (7.26%)
📉 Align Technology ($ALGN) – 164.61 | -7.27 (4.23%)
📈 Colgate-Palmolive ($CL) – 86.74 | +1.37 (1.60%)
📉 Dentsply Sirona ($XRAY) – 10.91 | -0.29 (2.59%)
📉 Envista Holdings ($NVST) – 24.20 | -1.61 (6.24%)
📉 Henry Schein ($HSIC) – 68.99 | -3.03 (4.21%)
📈 Park Dental Partners ($PARK) – 18.03 | +0.34 (1.92%)
📉 Straumann Holding AG (STMN.SW) – CHF 83.44 | -1.28 (1.51%)
📉 Weave Communications ($WEAV) – 5.49 | -0.60 (9.85%)

Stock data reflects market close yesterday, showing changes over the past five trading days.

THE DRILL DOWN

🛡️ ADA coalition urges CMS not to roll back adult dental coverage under the ACA, warning that a proposed rule in the 2027 Notice of Benefit and Payment Parameters could limit access to dental benefits for millions of adults enrolled in marketplace plans. Millions of smiles hang in the balance.

🔥 More than 54% of dental hygienists, assistants, and associate dentists report burnout, with hygienists leading at 60.6%, driven by workload, toxic office culture, and low pay, according to GoTu's 2026 State of Work Report. The chair is full, but the tank is empty.

⚖️ ADA urges FTC Healthcare Task Force to scrutinize dental insurance markets, citing concerns over market concentration, network leasing, and lack of transparency in Medicare Advantage supplemental dental benefits.

🏛️ Maine enacts law requiring state approval of private equity healthcare transactions, giving the Department of Health and Human Services authority to review deals involving PE firms, hedge funds, and affiliated MSOs at least 180 days before closing.

🏠 Connecticut House unanimously passes bill allowing hygienists to perform services inside patients' homes, expanding access for elderly and disabled patients, though several dentists have raised concerns over infection control, liability, and Medicaid reimbursement gaps. The (dental) call is coming from inside the house.

✅ Colorado passes law targeting network leasing practices, creating new rules requiring insurers to get consent from dentists in their network before leasing their services to third parties and prohibiting insurers from refusing to contract with dentists that do not opt-in.

🎓 Pennsylvania signs dental faculty bill expanding where restricted-license dentists can practice, allowing faculty to treat patients at dental school-affiliated nonprofit academic health centers.

INDUSTRY

A new deep dive into 8,500+ dental practices shows a growing winners-losers divide

The gap between the winners and losers in dentistry is growing, and the difference is in how well they are executing on the basics, according to an exclusive first look at data shared with The Morning Grind.

What's happening: Planet DDS just released a deep dive analysis of more than 8,500 practices and 497 DSOs operating on its Denticon and Cloud 9 platforms, which paints a picture of an industry bifurcating sharply. Top performers are running away from the field, the bottom is sliding, and the middle is eroding.

• The industry is splitting into winners and losers. A third of dental practices grew by more than 10% last year. Nearly 14% shrank by 10% or more.
  

• New patients are the single strongest growth predictor. Practices seeing 75+ new patients per month grew at 9.0%, nearly double the 4.5% rate of practices below 35. The report identifies 35 new patients per month as the threshold where momentum starts compounding. Below that, practices are essentially treading water.
  

• Operational consistency drives growth. The report found the most consistent 10% of practices grew 6.1% while the most volatile 10% shrank 3.4%. Consistent offices also produced meaningfully more per day ($9,927 vs. $7,189).
  

• Efficiency beats size. Practices generating more than $300,000 per chair grew 8.73% vs. 5.31% for those under $50,000 per chair. The report flags roughly 1,050 practices in its dataset as "big but inefficient," averaging 44 chairs but only $56,000 in revenue per chair.
  

• There's a danger zone in the middle of the DSO scale curve. DSOs with 26–50 offices grew just 2.8%, less than one-third the rate of smaller DSOs. Only 55% of their offices were growing, the lowest of any size tier. These DSOs appear to be experiencing an awkward adolescence: too big to be nimble, too small to justify enterprise-scale infrastructure.
  

• Case completion, not acceptance, is the bottleneck. Patients accept 58% of treatment plans on average but complete just 47%. Counterintuitively, practices with a moderate gap between the two (10 to 30 percentage points) grew fastest at around 7%, while those with no gap grew just 2.9% and those with massive 50 point or greater gaps grew only 1.1%. The data suggests healthy practices will typically have a mild acceptance-completion gap, but one that becomes too large likely signals operational problems.
  

• The billing gap is enormous. Across 499 DSOs analyzed, the report estimates that roughly $1.66 billion (24.5% of gross production) leaked between care delivered and cash collected, driven primarily by point-of-service collection gaps and insurance shortfalls.

And don’t forget the Friday opportunity: The report found than average Friday production runs 27% below Tuesday peak ($7,388 vs. $10,152), which is not a surprise, but interestingly the 9% of practices that flip the script—making Friday their peak day—grow at 12.0% vs. 6.2% for everyone else.

Why it matters: The data confirms what every baseball fan knows: The most important thing is fundamentals. Operators on the winning side of the sector are excelling on the basics like filling the top of the funnel, keeping consistent schedules, and closing the loop between accepted and completed treatment. 

Go deeper: Download the full report to get a complete breakdown of all the data and see how your business stacks up against benchmarks on patient acquisition, revenue per chair, cancellation rate, acceptance-completion gap, and more.

Share this article: https://www.themorninggrind.com/p/a-new-deep-dive-into-8-500-dental-practices-shows-a-growing-winners-losers-divide

BUSINESS BITES

👔 Notable leadership changes: The Aspen Group appoints Rafeh Masood as chief commercial officer, the American Association of Orthodontists elects Dr. Michael Durbin as president, and Dr. Nisha D’Silva becomes president of the American Association for Dental, Oral and Craniofacial Research.

📈 Deals and de novos: beBright acquires Pediatric Dentistry of Shreveport-Bossier, adding six locations in Louisiana; Park Dental opens a second Minnesota practice; Heartland adds a Florida practice; Lone Peak Dental Groups expands in Arizona; and SALT Dental Partners opens a de novo orthodontic office in Washington, D.C.

🪥 Colgate-Palmolive posts strong Q1 2026, with net sales rising 8.4% to $5.3 billion while maintaining its dominant 41.1% global toothpaste market share. Still brushing the competition aside.

📦 Henry Schein global dental sales climb 9% in Q1 2026, beating expectations but not by enough to avoid a dip in its share price. 

📈 Align Technology Q1 2026 revenue rises 6.2% to $1.4 billion, driven by a 7.4% year-over-year jump in clear aligner revenue to $856 million, with the company also announcing a new $200 million stock repurchase plan.

🌐 Medit launches a global orthodontics division and acquires Progressive Orthodontics, a 40-year-old California training institute that has educated practitioners from more than 60 countries, to anchor its expanded ortho portfolio.

REGULATIONS

A wave of new laws is expanding what hygienists can do solo

Like a talented drummer who to everyone’s surprise also has a great singing voice, hygienists are getting a chance to launch their solo careers.

What's happening: A wave of state laws is expanding what hygienists can do without a dentist physically on-site. The American Dental Hygienists' Association counts 43 states permitting some form of direct access (a hygienist treating patients without a prior dentist exam), up from 28 in 2008. Recent states that have moved on this include:

• New York created an "RDH-CP" credential that lets experienced hygienists (at least 3 years and 4,500 hours) practice in hospitals, FQHCs, schools, long-term care, and mobile units under a written collaborative agreement without a dentist present.
  

• Utah's added hospitals to the public-health settings where hygienists can practice without dentist supervision.
  

• Colorado broadened diagnostic, prescriptive, and anesthesia authorities as part of its Sunset Dental Practice Act reauthorization.
  

• Maine added "dental hygiene diagnosis" and removed general supervision in a 2023 reform, and proposed changes would extend independent-practice hygienists' anesthesia authority further.
  

• Legislation under review in South Carolina would expand authorized procedures in schools and public-health settings.

Why it’s happening: States are trying to solve the problem of limited access to dental services without waiting years to train more dentists. Amid a broader shortage of oral health providers, the model of every hygiene visit requiring dentist supervision is an expensive bottleneck that’s becoming politically untenable.

Why it matters: For DSOs, expanded hygienist scope has the potential to change where patients enter the system, how dentist time gets allocated, and where growth can happen outside the four walls of a traditional practice. That could include: 

• Building hygiene-led access channels: Depending on local rules, that could mean standalone hygiene facilities to community preventive programs to mobile care.
  

• Free dentists for higher-value work: If hygienists can independently handle more tasks, dentists can focus their time on higher-value jobs with better margins.
  

• Grow in underserved markets with lower fixed costs: Traditional de novo growth requires heavy dentist recruitment, buildout costs, local marketing, and payer contracting. Hygiene-led outreach can test demand before committing to a full clinic.
  

• Stand out as an employer for hygienists: Hygienists who want more responsibility, professional growth, flexible settings, or community-based care may prefer DSOs that offer advanced pathways.
  

• Gain a competitive edge at scale: More autonomy also means more complexity when it comes to regulations and compliance. While smaller practices may struggle to operationalize the rules, DSOs can use this as a competitive strength.

Yes, but: An expanded scope of practice for hygienists also raises the price of talent in an environment where 40% of practices don’t have enough hygienists and 90% say it’s “very” or “extremely” challenging to hire for those roles.

• Amid a shortage, more autonomy will mean higher wages and more options—including, in some states, the ability to start independent practices focused on in-scope treatments.

Bottom line: Hygienist autonomy can unlock new access and revenue models, but it also makes hygienists more powerful in the labor market. More than ever, hygienists will need to be recruited, developed, retained, and paid like providers with true leverage—because they have it.

Share this article: https://www.themorninggrind.com/p/a-wave-of-new-laws-is-expanding-what-hygienists-can-do-solo

CLINICAL NOTES

🧠 Periodontal interventions may reduce the risk of ischemic stroke, with a new review finding moderate certainty that gum health treatments (and tooth scaling in particular) have a statistically significant protective effect against ischemic stroke. Another reason to scale up your perio game.

🪥 Personalized oral health education significantly improves periodontal outcomes, with research finding that tailored patient education boosts gum health knowledge, patient confidence, and brushing and flossing consistency compared to standard education.

💊 U.S. dentists still prescribe opioids at rates 24 times higher than peer nations, according to a new study, despite a 27% drop in U.S. dental opioid fill rates between 2021 and 2024. American dentists recorded 2,022 opioid prescriptions per 100,000 residents in 2024, compared to just 83 in the Netherlands.

BEYOND THE CUSP

• Archaeologists in Scotland found a 20-carat-gold dental bridge dating back to the Middle Ages.
  

• Scientists have discovered that baby teeth can reveal what harmful metals kids have been exposed to, even before they were born.
  

• Is it rude to brush your teeth in the break room at work? The New York Times weighs in (may be paywalled).
  

• The weirdest wearable technology from 100 years ago.