Consolidation in the dental industry: a closer look at dental payers and providers

We examine the effect of commercial dental insurance concentration on the size of dental practices, the decision of dentists to own a practice, and the choice of dentists to work at a dental management service organization-a type of corporate group practice that has become more prevalent in the United States in recent years. Using 2013-2015 dentist-level data from the American Dental Association, county-level data on firms and employment from the United States Census, and commercial dental insurance market concentration data from FAIR Health^®, we find a modest effect of dental insurance market concentration on the size of dental practices. We also find that a higher level of commercial dental insurance market concentration is associated with a dentist's decision not to own a practice. There is inconclusive evidence that higher levels of dental insurance market concentration impact a dentist's decision to affiliate with a dental management service organization. Overall, our findings imply that dentists consolidate in response to increases in concentration among commercial dental insurers.

Minimum Intervention (MI) Oral Healthcare Delivery Implementation - Overcoming the Hurdles

The United Nations Minamata Convention aims to protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds. In those 55 countries signed up to it to date (the convention came into force in those countries on 16 August 2017), dental caries management has been thrust indirectly into the limelight once again via the resulting phase down and ultimately, phase out of dental amalgam as a restorative material.20 It is interesting how the dental profession has become fixated on the notion of a post-amalgam world, with significant efforts concentrating on trying to develop the perfect amalgam substitute restorative material to be used to 'treat’ caries.

However, on more detailed examination of the treaty, it is abundantly clear that the United Nations and the WHO, at a global level, appreciates the significant concerns over the lack of an appropriate strategy of preventing this most prevalent of non-communicable diseases known to humankind in the modern world.1–4 Ml oral healthcare is very much now on this global agenda, with developing links between dental caries, general social health determinants and other health and social sectors, and will therefore help drive oral health change with implementation strategies at the population and individual level while also developing sustainable workforce development models globally. Even though minimally invasive surgical skills, procedures and materials need to be developed and taught, the principle consideration should be given as to how “all stakeholders can incite preventive behaviour change in all stakeholders.” This is the biggest challenge in delivering better oral health to current and future generations. The quest continues…

Growth Trends in Dental Service Organizations

There are a number of factors fueling the growth of large group practices managed by corporations across the U.S., including California. These evolving trends are shaping the dental profession and practice models in a variety of ways.

Successful clinical and organisational change in endodontic practice: a qualitative study

The aim of this study was to explicate and describe the qualitative meaning of successful clinical and organizational change in endodontic practice, following a comprehensive implementation program, including the integration of the nickel-titanium-rotary-technique. After an educational intervention in the Public Dental Service in a Swedish county, thematic in-depth interviews were conducted, with special reference to the participants' experience of the successful change. Interviews with four participants, were purposively selected on the basis of occupation (dentist, dental assistant, receptionist, clinical manager), for a phenomenological human scientific analysis. Four constituents were identified as necessary for the invariant, general structure of the phenomenon: 1) disclosed motivation, 2) allowance for individual learning processes, 3) continuous professional collaboration, and 4) a facilitating educator. The perceived requirements for achieving successful clinical and organizational change in endodontic practice were clinical relevance, an atmosphere which facilitated discussion and allowance for individual learning patterns. The qualities required in the educator were acknowledged competence with respect to scientific knowledge and clinical expertise, as well as familiarity with conditions at the dental clinics. The results indicate a complex interelationship among various aspects of the successful change process.

Practice transitions--past, present, and future

Until the 1960s, the value of a practice upon the retirement of the dentist was considered to be nil. In the next several decades, the value of a practice as a going business concern was recognized and formulas based on productivity were used to establish the sales price of "walkaway" practice transitions. Increasingly creative means, such as pre-sale, deferred pre-sale, shareholder process, incremental practice sale, and practice mergers have been created to make practice transitions more flexible, thereby maximizing the financial value of transitions. Dentists at the beginning of their careers will have an increasing range of opportunities in the future, with various combinations of financial security, freedom from manage- ment concerns, control over the practice, and accumulation of equity. Those in the 45- to 55-year age range should be planning in detail for their transition. Those older than 55 should begin exercising their plans since the future will involve much longer transitions.

Evolving trends in size and structure of group dental practices in the United States

In this study, the authors examined recent trends in the growth of dental establishments and dental firms, including geographic location. In this article, they also present information about the demographic characteristics of dentists who work in a dental practice that is part of a larger company that delivers dental care in multiple locations. The number of dental establishments (single locations) and the average size of these establishments grew from 1992 to 2007. Large multi-unit dental firms grew in terms of number of establishments and the percentage of total receipts. Large multi-unit dental firms represent a small but growing segment of the dental market. Dentists less than thirty-five years old were most likely to work in a practice that was part of a larger company, and females were more likely than males to work in such a setting. The percentage of dentists working in these settings was also found to vary by region and state. The authors present a typology of dental group practice and suggest that future research should take into account the differences so that appropriate conclusions can be drawn and generalizations across categories are not made.

New practice models and trends in the practice of oral health

Various internal and external factors are beginning to influence the delivery of dental care in North Carolina. This article reviews some of the current trends that have led to a shift toward new practice models-some of which are in stark contrast to solo private practice.

Office computer systems for the dental office

The role of computers in dental practice has dramatically changed over the past 30 years. We have witnessed the progression from administrative roles to complete integration leading to chartless offices. As the dental community gradually adopts this contemporary development, the move to electronic health records is imminent because of upcoming changes in the health care system. The past, present, and future of dental office computer systems is explored in this article. An understanding of the benefits and current challenges of contemporary dental practice software is also reviewed.

The future as I see it

Predicting the future is always chancy, but when a young practitioner begins a career in dentistry, it is worthwhile to have some well-reasoned expectations. The critical dimensions in the next several decades in dentistry will include technology, marketing, and society.

My vision for the future of dentistry

There are new ways and new places to practice the ultimately unchanging profession of addressing the oral health needs of Americans. New approaches may be needed to achieve traditional values. The rural poor cannot be put aside, corporate business models cannot be allowed to diminish the personal relationship between dentist and patient, and the social values of younger generations of practitioners do matter. They may be listening on Facebook, but they are still listening for the core values of serving patients.

Allied dental personnel: will there be enough?

The escalating number and size of dental practices mean greater dependency on a ready supply of allied dental personnel. However, despite the increasing number of entry places in allied dental training programs, many places remain unfilled and large numbers of individuals do not complete the course of studies. A review of the changes in dental practice sizes and dental assistant, dental hygienist and dental laboratory technician programs raises concerns as to whether there will be enough allied dental personnel to meet the future needs of the profession. The need for increasing attention to this potential eventuality is stressed.