YEAR IN REVIEW

The Morning Grind Wrapped

As the year comes to a close, let’s take a stroll down memory lane and revisit some of the most important trends and themes that emerged in 2025. And don’t worry—unlike Spotify Wrapped, we won’t prematurely age you by 40 years or so.

Here are 9 themes that defined the year for the industry:

1. The margin squeeze. Post-pandemic demand never materialized. Instead: 65.8% of dentists raised fees, while 35% said they weren't busy enough. GP dentist income fell $17K to $207,980 despite more hours worked. Insurance reimbursement failed to keep pace with costs. Meanwhile, tariffs and trade fights added to the cost pressures facing practices. Implants, ortho, OS—this was the year everyone remembered where the margins live.

2. The insurer power grab. Delta Dental of Wisconsin acquired Cherry Tree Dental, becoming the first major insurer to own the clinics submitting claims to it. The ADA demanded investigations. Meanwhile, insurers weaponized AI: a Senate investigation found algorithm-driven denial rates up to 16x higher than human review, with 60% of physicians reporting AI drives up rejections. States fought back—Massachusetts enforced 83% dental loss ratios, 23+ states proposed similar mandates. Insurers didn’t just move the goalposts this year—they bought the field.

3. Public market moves. Dentalcorp exited public markets in a C$2.2B take-private by GTCR at a 33% premium, escaping quarterly earnings pressure after its stock ground down 40% from IPO price. Weeks earlier, Park Dental Partners filed for the first U.S. dental IPO in decades, testing whether a doctor-owned group could succeed where others failed. The contrast was stark: one abandoning public markets, one knocking on the door.

4. The workforce crisis intensified. The hygienist shortage escalated into a legislative battle. Nevada's SB 495 would have allowed dentist-trained hygienists without accredited programs. ADHA mobilized nationally to defeat it. Texas limited non-competes to one year and five miles. DSOs will need to respond by focusing on retention: 20% of hygienists and 29% of associate dentists changed jobs in the past year, with 73% citing income as the driver. 

5. AI took center stage. AI transformed from pilot to imperative. VideaHealth landed $40M; Trust AI raised dentistry's largest seed round. About 20% of dental owners installed new software or digital systems, and tech standardization became a valuation factor in M&A diligence. AI also became an important referral channel, influencing 26% of provider choices, matching traditional referrals.

6. The specialty land grab. DSOs chased higher-margin procedures. Smile Doctors acquired myOrthos to become the nation's largest OSO. USOSM expanded to 31 states. The dental implants market was projected to triple to $15.4B by 2035. 

7. Medicaid on the brink. Congress's budget law added work requirements and six-month eligibility renewals, with CBO projecting an increase in the uninsured. With 72M adults lacking dental coverage—triple the number without medical—DSOs with heavy Medicaid exposure must build segmented strategies and prepare for 2026 coverage churn.

8. The fluoride fight goes federal. Utah and Florida enacted America's first water fluoridation bans. Then the FDA restricted prescription fluoride supplements for children. The ADA joined 250+ organizations defending fluoride's safety while JAMA modeling projected bans could cost $9.8B and create 25M new cavities. The fight moved to operatories: staff now face daily questions about toothpaste safety as parents decline fluoride varnish more often. Even fluoride stirred up a fresh debate.

9. Industry titans stepped aside. Stanley Bergman retired after 35 years at Henry Schein amid activist pressure. The ADA faced a reckoning: reserves allegedly dropped from $140M+ to below $50M, a $53M tech project failed, and $20M+ was cut from the budget. Executive Director Dr. Raymond Cohlmia stepped down. The new generation inherits PE pressure, regulatory scrutiny, and technological disruption.

By the numbers: Meanwhile, here are the Grind links that caught your attention (and clicks) this year: 

1. The Inc. 5000 list of fastest-growing companies.

2. The ADA announced its Living Guideline Program.

3. An overview of state-level legislation on dental loss ratios.

4. ADA’s objections to Delta Dental of Wisconsin acquiring Cherry Tree Dental.

5. An academic paper looking at insurers’ views on reimbursement of preventive dental services.

What’s next: We’re looking forward to sharing another healthy and happy year with you and keeping you up to speed on everything dental leaders need to know to thrive.