Good morning. A Canadian woman has claimed the record for the most teeth in one socket, with a grand total of four—three of which are supernumerary. That’s not enough to land her the record for most overall teeth in a person’s mouth, which is held by a Malaysian man with 42 pearly whites. 

Do you think their dentist charges more, or do they get those extra teeth comped?

Inside this issue:

- Oral care’s luxury makeover
- Colorado’s worrying DSO regs

⏰ Your reading time today: 6 minutes 11 seconds

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

MARKETS

📉📉 3D Systems ($DDD) – 3.64 | -0.255 (6.55%)
📉 Align Technology ($ALGN) – 171.16 | -1.68 (0.97%)
📉 Colgate-Palmolive ($CL) – 90.21 | -1.32 (1.44%)
📉 Dentsply Sirona ($XRAY) – 11.19 | -0.30 (2.61%)
📉 Envista Holdings ($NVST) – 27.64 | -0.62 (2.19%)
📈 Henry Schein ($HSIC) – 89.52 | +0.91 (1.03%)
📈 Park Dental Partners ($PARK) – 22.88 | +1.480 (6.92%)
📉 Straumann Holding ($STMN) – CHF 100.45 | -3.50 (3.37%)
📈 Weave Communications ($WEAV) – 5.53 | +0.530 (10.60%)

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

THE DRILL DOWN

🇨🇳 Align Technology wins a patent ruling against Angelalign, with a Chinese court finding that Angelalign infringed on Align's patents and ordering it to stop using and selling the patented technology. A big win for Align in the heart of the competition.

💊 Supply chain disruptions trigger fluoride cutbacks at municipal water systems across the U.S., with Milwaukee among the cities now scaling back fluoride levels after instability in the Middle East choked off a key source of overseas production. The fluoride fight gets a supply chain subplot.

⚖️ The DOJ seeks to permanently shut down a Nevada dental device company, filing a civil complaint against Steiner Biotechnology and its CEO after the FDA allegedly found repeated manufacturing violations, including unapproved bone grafting materials and dental cement.

🤖 University of Colorado uses AI-powered patient avatars to train dental students in real-world communication skills, deploying virtual characters named John and Judy to help students practice gathering health histories and assessing patient needs. Bedside manner meets machine learning.

🏛️ A cross-party push to renew the Action for Dental Health Act gains traction on Capitol Hill, with the measure proposing to extend oral health workforce grants through at least 2030.

📋 North Carolina moves to streamline DSO regulations in the state, scrapping the rule that required DSOs to submit all new and updated management arrangements to the state dental board for review before operating, a change expected to speed up affiliations and reduce costs.

🏆 Massachusetts enforces dental loss ratio rules, ordering six insurers, including Blue Cross Blue Shield and Guardian, to refund a combined $8.4 million to policyholders after the companies failed to direct enough of each premium dollar toward patient care.

🔬 Alberta permits private self-referral diagnostic imaging program for some oral and maxillofacial cancer imaging, letting residents walk into participating private clinics and request a range of scans—from X-rays and ultrasounds to MRIs and CT imaging—without first obtaining a physician's referral.

REGULATION

New Colorado rules pose a risk to the DSO model

Colorado’s push to restrict DSOs could have nationwide implications.

What happened: The Colorado Dental Board has adopted rules that restrict how DSOs can operate in the state, creating significant new compliance requirements for groups and dentists operating in the state.

• The Association of Dental Support Organizations (ADSO) is challenging the rules in court, arguing that the Board exceeded its authority.

The details: The new rules, adopted by the Board as part of its implementation of the 2025 Dental Practice Act sunset legislation, are scheduled to take effect January 1, 2027, and impose a sweeping set of new restrictions on how DSOs operate in the state.

• These restrictions include barring DSOs from being the “proprietor” of a dental practice, requiring that they be owned by dentists unless a statutory exception applies, and requiring dentists to retain specified oversight when financial management is delegated to a DSO.

• The Board also ruled that DSOs cannot lease property to a practice and cannot provide the practice’s clinical materials or equipment. This, the rule says, would make the DSO the “proprietor” of the practice, which is prohibited.

• Dentists themselves could face disciplinary action if they work in a practice that breaks these rules, including loss of their license.

Why it matters: The rule strikes directly at a basic piece of DSO economics and could leave dentists in the state already affiliated with DSOs on the hook for assuming expensive leases and the cost of capital equipment, which, particularly these days, can run into the millions of dollars. 

• “Now you go to a licensee and say, ‘Hey, if you want to continue practicing, take on this multi-million dollar commitment for this lease. Sign on it,’” Smile Brands CEO Steve Bilt said on a recent episode of the The Dental Economist Show, explaining the potential consequences of the rule. “If you want to continue practicing, you've got a million dollars of equipment sitting in your dental office. You now have to take on the commitment for that. An untenable situation for most people.”

Zoom out: The rules could also make Colorado a less attractive place for DSOs to invest, according to Bilt, which could translate into less access and higher prices for patients.

• “Every day I have to pick where to allocate very limited amounts of capital,” said Bilt. “If you say, ‘We're going to make this state very unfriendly to your capital,’ then it just goes elsewhere.” 

What’s next: Even for DSOs not heavily exposed to Colorado’s rules, Bilt warns that rules set in one jurisdiction “can create dominoes elsewhere,” with other state dental boards modeling their own rules off Colorado’s example.

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BUSINESS BITES

👔 Notable leadership changes: U.S. Oral Surgery Management names Jennifer Ellis as its chief financial officer. 

📈 Deals and de novos: Sage Dental acquires nine practices in the Tampa Bay region from Monticciolo Family and Sedation Dentistry, Heartland Dental said it added six practices to its network in July, Imagen Dental Partners added a practice in Houston, Aspen Dental opened new practices in Alabama and North Carolina, and Specialized Dental Partners added a practice in North Carolina.

🚀 More than 30 dental companies are listed on the 2026 Inc. 5000 list of fastest-growing companies, including Videa, Cal Dental USA, Elevate Dental Partners, and Planet DDS. 

​​🦷 Dentsply Sirona posts a $37 million profit in Q2, a sharp reversal from a $45 million loss in Q2 2025, as the company's Return-to-Growth Action Plan progresses and operating cash flow more than doubles.

📦 Henry Schein raises its 2026 full-year guidance after Q2 net sales climbed to $3.5 billion, driven by broad-based growth across dental, medical, specialty, and technology businesses.

CONSUMER

Oral care is getting a luxury makeover

Skincare? That’s so 2025. This year it’s all about the mouth. 

What's happening: Oral care is being repriced and repackaged as a consumer lifestyle category, complete with pastel colors, cool logos, and products tailor made for social media feeds. 

• The Wall Street Journal recently highlighted a growing market for premium oral-care products, including $28 probiotic whitening toothpaste from Agent Nateur, $33 Swedish mouthwash from Selahatin, $20 chewable mouthwash tablets from Boka, and French dental floss in a metallic dispenser for $14.

• The formula behind these brands is familiar: more interesting ingredients and packaging, sustainability claims, direct-to-consumer distribution, and a brand story that turns a mundane task into a wellness and self-care practice.

Why it’s happening: Oral care brands see the same opportunity in the mouth that transformed the skincare category—and the dollars that can follow when a functional product becomes an identity product.

• Consumers are already spending heavily on products promising better sleep, digestion, skin, fitness, and longevity. The mouth is a logical next frontier, particularly as awareness grows around connections between oral health and overall health.

• The category is also unusually ripe for reinvention. Toothpaste and floss have historically been marketed around clinical utility, with relatively little emphasis on design, experience, or personalization.

Why it matters: As marketing-forward consumer brands increasingly shape how people think about oral health, expect to hear more questions from patients about the trendy product du jour, from fluoride-free toothpaste to microbiome-friendly mouthwash to whitening products going viral on TikTok.

What it means for you: The Instagram-ification of oral care could create new opportunities for organizations that get ahead of it. Here are a few tactics to consider adopting in your practices:

• Curate to build trust. Cutting through marketing hype is another way for clinicians to build trust with patients. Develop an evidence-based list of recommended home-care products so staff across the organization can give consistent guidance.

• Use consumer enthusiasm to improve compliance. If a better-designed brush, portable floss product, or more enjoyable toothpaste gets a patient to use it consistently, the branding may be doing useful clinical work.

• Equip clinicians for the questions. Give dentists and hygienists simple talking points on trending ingredients so patients get consistent answers.

• Experiment selectively with retail. Higher-end, carefully selected take-home products or replenishment programs could open up new revenue streams.

Bottom line: Patients thinking more about their oral health than they used to is good news for DSOs, even if it’s consumer brands driving that attention. That doesn’t mean you need to turn your waiting area into a Sephora, but showing up with answers and guidelines grounded in the evidence is a chance to meet patients where they’re at and build trust—and that’s worth a lot more than the margin on a tube of fancy toothpaste.

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CLINICAL NOTES

🧬 Oral health problems may serve as early warning signs for autoimmune disease risk, with a large UK Biobank study finding significant associations between issues like bleeding gums, toothache, and loose teeth and conditions including pernicious anemia.

🐟 Omega-3 supplements may help reduce inflammation in the mouth and throughout the body in people taking statins for stable heart disease, suggesting fish oil could help manage gum inflammation alongside heart treatment.

🦷 University of Alberta researchers are developing self-sterilizing dental fillings as a potential amalgam alternative ahead of the 2034 phase-out, saying the technology could help prevent new decay from forming around fillings. The filling that fights back.

🔬A common enamel defect may not be linked to inflammation early in life, according to an Australian study tracking children from before birth through primary school, casting doubt on one of the leading theories about what causes molar incisor hypomineralization (MIH).

BEYOND THE CUSP

• We’ve entered the age of veneer regret.

• A professor at UTHealth Houston School of Dentistry was awarded $3.54 million to build an AI-powered research platform for large-scale dental research.

• Young people in South Korea who watch mukbangs—videos of people eating and cooking—tend to have more oral health problems.

• Just for fun: Meet the world’s ugliest dogs.