Dentistry has long been hailed as one of the most rewarding healthcare professions—a blend of science, art, and service. But in today’s economic climate, many dentists are feeling the squeeze of a broken system: rising costs, stagnant insurance reimbursements, and an increasingly profit-driven insurance industry.

It’s not your imagination—it’s really getting harder to stay profitable while staying in-network. But this moment in dentistry’s history isn’t just a challenge.

It’s a turning point.

The Origin of Dental Insurance: Built by Dentists, Broken by Bureaucracy

Dental insurance began in the 1950s with noble roots. It was pioneered by organized dentistry itself—the California Dental Association helped launch one of the first group dental plans, aiming to make care more accessible and support providers.

But what started as a safety net for patients and dentists was soon hijacked by business interests.

Insurance companies discovered that dental plans—unlike medical plans—had low utilization, predictable costs, and high margins. Over time, Wall Street logic took over:

• Maximize shareholder returns

• Control costs

• Limit payouts

• Decrease “loss ratios” (i.e., what’s paid out to dentists)

Suddenly, the system stopped working for dentists—and started working against them.

The Squeeze Is Real: Inflation vs. Reimbursement

Between 2000 and 2023, inflation in the U.S. rose by over 72%. But dental insurance reimbursements?

In many cases, they’ve remained unchanged—or have even decreased.

According to data from the ADA Health Policy Institute, the cost of providing care (wages, materials, rent, lab fees) has steadily climbed, while most PPO fee schedules have stagnated for more than a decade.

This means every filling you place in-network earns you less in real dollars than it did ten years ago—despite higher costs and more complex patients.

It’s a race to the bottom. And dentists are footing the bill.

The Danger of Saturated Networks

In regions with high in-network participation, insurers feel no pressure to raise fees. Why would they?

They have a surplus of providers willing to accept low reimbursements—so the economics never change.

Let’s compare:

• Southern California, Utah, and New Jersey: These regions have very high in-network participation among dentists. PPO reimbursements in these areas have remained flat or even declined in recent years.

• Montana: With one of the lowest in-network participation rates in the U.S., Montana has seen significantly more fee schedule increases from insurers over time. When fewer providers sign contracts, insurance companies are forced to compete by offering better reimbursements to retain access for their members.

The lesson? Participation weakens leverage.

The more providers that sign up, the less control any one doctor has—and the less incentive insurers have to adjust their fee schedules.

A Way Forward: Reclaiming Power and Profitability

So, what’s a forward-thinking dentist to do?

You start making decisions that put your practice’s sustainability and patient care first—not insurance company profits.

Here are three steps to move from frustration to freedom:

1. Negotiate Your PPO Fees

Don’t assume your fees are set in stone.

Organizations like Veritas Dental Resources specialize in PPO fee negotiations. They analyze your current contracts, identify opportunities, and work on your behalf to raise your fee schedules—sometimes by 10–30%.

Even a modest increase on your most common procedures can make a huge difference over time.

2. Get Inspired by the Right Voices

Great minds like my colleague, Gary Takacs, have built entire platforms around the idea of thriving without insurance dependence. His podcast, The Thriving Dentist Show, is packed with stories, strategies, and interviews that help doctors:

• Transition to fee-for-service

• Improve treatment acceptance without PPO leverage

• Build a relationship-based, trust-driven practice

Takacs believes that dentistry is still one of the most rewarding professions—if you take control of your business model.

3. Shift the Culture—One Patient at a Time

The future of dentistry doesn’t lie in fighting insurance.
It lies in building practices so good—so trustworthy, so patient-focused—that people choose you because of your values, not your PPO list.

And guess what? It’s already happening.

Thousands of dentists across the country have dropped their lowest-paying plans, trained their teams to communicate value, and invested in the patient experience. They’re proof that a sustainable, profitable, low-insurance or no-insurance model is possible.

A Final Word of Hope

Yes, the system is frustrating.
Yes, inflation and reimbursement trends are discouraging.
But dentistry is still a bright and beautiful career.

You have options. You have leverage. You have value.

This is your chance to redefine what success looks like—not just for your practice, but for the profession as a whole.

The era of insurance-driven dentistry may be fading. But what’s rising in its place is a model built on trust, quality, and purpose.

You’re not stuck. You’re standing at the start of something better.

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

Services:
PPO Fee Negotiators | PPO Fee Negotiating | Insurance Fee Negotiating
Insurance Credentialing | Insurance Verifications

Websites:
www.VeritasDentalResources.com | www.VerusDental.com