The following article and interview with Andrew Smith, CEO of the Association of Dental Support Organizations (ADSO) appeared in the April 22nd edition of The Morning Grind, the free, fast, and must-read biweekly newsletter for DSO leaders that blends dental news, industry trends, regulatory updates, tech buzz, and clinical breakthroughs

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DENTAL HR

License to drill (anywhere)

Staffing shortages are dentistry’s persistent toothache, and no single treatment seems effective. But some states have started prescribing something new: interstate licensing portability. The Dentist and Dental Hygienist (DDH) Compact aims to ease cross-border licensing headaches, making workforce flexibility actually achievable. Consider it ibuprofen for your HR team.

The Morning Grind recently sat down with Andrew Smith, CEO of the Association of Dental Support Organizations (ADSO), who sees the Compact as a vital, practical response to dentistry’s ongoing workforce challenges.

What’s the Compact: Launched in January 2023, the DDH Compact lets member states recognize each other's dental licenses, allowing dentists and hygienists to practice freely across state lines without the costly, slow relicensing process. Smith notes that the compact creates “reciprocity between states,” significantly reducing “... the time, cost, and burden” when transferring licenses.

Nebraska recently became the twelth state to join, following Arkansas, Colorado, Iowa, Ohio, and others. The Compact offers clear benefits to DSOs, enabling them to respond faster to workforce shortages, place providers exactly where needed, and cut administrative costs tied to licensing delays.

Who’s behind it: Support for the Compact spans the entire dental industry—including the ADSO, American Dental Association (ADA), American Dental Hygienists’ Association (ADHA), and even the U.S. Department of Defense (DoD), which recognizes the Compact’s value in easing frequent relocations for military spouses.

Smith emphasizes that the Compact isn’t just a DSO priority; it has backing from “the full profession.” He highlights a generational shift: “The practice of dentistry is changing, particularly with those graduating dental school today, who do not anticipate being in one location for thirty years.” In other words, the Compact matches exactly how new dentists want to practice.

Who’s pushing back: Not everyone’s sold, however. Resistance, Smith notes, has emerged from certain state dental associations concerned about what they say is a loss of control over licensing standards and, perhaps, a potential increase in competition.

Additionally, a competing compact—led by state dental boards—has surfaced directly in reaction to the DDH Compact’s progress. Unlike the DDH Compact, which promotes broad license portability, this alternative compact maintains tighter control, limiting acceptable types of exams and emphasizing state-board-driven standards. Smith characterizes this competing compact as “protectionary,” suggesting it prioritizes board interests over practitioner flexibility.

Bottom line: The DDH Compact is more than regulatory housekeeping—it is organized dentistry's attempt to manage an increasingly mobile workforce, widening dental deserts, and persistent staffing shortages. 

Whether license portability fully resolves these issues remains an open question, but in an environment where proven solutions are scarce, the Compact represents a meaningful step toward flexibility. For DSOs, it’s not a cure-all, but it is perhaps yet another signal that tomorrow’s workforce strategy will increasingly rely on agility and adaptability.

THE DRILL DOWN

🛃 ADA urges White House to exempt dental supplies from tariffs, warning that additional costs could significantly impact providers already facing rising operational expenses and staffing shortages. Just in case PPE inflation wasn’t nostalgic enough. 

📑 The California Dental Association outlines immigration enforcement obligations for dental practices, noting that dental clinics are considered “sensitive locations” where immigration agents typically require a warrant before entering non-public areas.

🦷 It is the battle of the Compacts in Pennsylvania to tackle workforce shortages, where competing bills, one backed by the ADA and one backed by the Dental Boards, are being debated to allow qualified out-of-state dentists to apply for licensure.

🧬 UK scientists grow human teeth in the lab, offering a potential future alternative to implants through biologically integrated, lab-grown dental tissue​. Coming soon: “regenerative fee codes.”

💧 HHS tells CDC to re-evaluate fluoridation in drinking water, triggering concern among oral health professionals over threats to long-standing public health guidelines. Somewhere, a cavity just fist-pumped.

BUSINESS BITES

⚖️ SmileDirectClub founders sue Align Technology and dental associations, alleging a coordinated effort to undermine their business and force it into bankruptcy through anti-competitive practices. If you can’t straighten teeth, straighten the narrative.

📊 S&P report says private equity and venture capital firms show increased optimism for 2025, with a focus on sectors like AI and healthcare, indicating potential growth opportunities for dental investments.

🏥 PDS Health expands its specialty dental support and ownership model, with multiple enhancements in collaboration between general dentists and specialists to improve patient care and practice growth.

🖥️ PDS also announced the launch of PDS Health Technologies, to expand healthcare technology and operational support, introducing services like EHR integration, revenue cycle management (RCM), and consulting to boost practice performance.

🤖 Rondah AI secures $1.8M to enhance dental appointment bookings, aiming to help dental enterprises double their bookings through advanced AI-driven solutions.

💸 Delta Dental commits up to $1 million to support the future of the oral health workforce, funding scholarships, mentorship, and education programs to expand access and dental careers. Now hiring, hopefully.

CLINICAL NOTES

🧪 Scientists convert dental pulp stem cells into neuron-like cells, paving the way for new treatments in neurodegenerative disease by unlocking neuroplasticity from an oral source.

🧫 HKU study finds oral microbiome could be used to screen for autism, with distinct microbial signatures enabling early diagnosis through non-invasive sampling.

🔩 Titanium microparticles found in gum tissue around dental implants, even in healthy patients, raising questions about implant shedding and long-term biological impact. 

🤖 AI and nanotech combine to detect oral cancer at earlier stages, using nanosensors to identify subtle cell changes invisible to conventional screening.

🔥 Oral microbiome linked to chronic pain in women with central sensitization, with researchers pointing to dental biofilm imbalances as a systemic trigger.

BEYOND THE CUSP

• Hollywood’s special-effects dentist reveals secrets behind iconic smiles, including Jonah Hill’s gold teeth and Austin Powers’ famously bad dentures.
  

• Olympic medalist Yared Nuguse sets sights on gold before starting his dream of becoming an orthodontist. From podiums to palatal expanders.
  

• Aimee Lou Wood slams SNL for mocking her natural smile, after a sketch used exaggerated prosthetic teeth to impersonate her White Lotus character.
  

• Dentists sound alarm on the rising DIY dentistry trend, as viral videos show people whitening teeth with Magic Erasers and much worse. Remember, the algorithm doesn’t have malpractice insurance.