Perspectives

Dentists’ Participation in Medicaid Remains Stagnant

02/27/2026

5 min. to read

By Rachel W. Morrissey, Deesha Bhaumik, and Dr. Marko Vujicic

Access to dental care through Medicaid has long been a critical lifeline for millions of American adults and children, yet the future of the program is uncertain. The COVID-19 pandemic disrupted both provider participation and patient utilization, creating ripple effects that are still being felt today. As states expand benefits and policymakers debate reforms, recognizing who is delivering dental care, and who is receiving it, is critical to understanding the complete picture of oral health in the United States.

In this article we consider both sides of the story, looking at utilization by the patients who rely on these benefits as well as the providers who treat them. We explore how utilization patterns differ between children and adults, which groups have recovered since the pandemic, and trends in provider characteristics and practice types.

Let’s begin with a brief overview of dental benefits within Medicaid programs. Around 50% of children and 15% of adults in the US are covered by Medicaid or the Children’s Health Insurance Program (CHIP). In the US, dental services are covered for child Medicaid and CHIP beneficiaries in every state, mandated by the Early and Periodic Screening, Diagnostic, and Treatment program. For adults, dental benefits under Medicaid are optional, and each state can decide if and how they want to expand coverage for dental services. As of 2025, 38 states and the District of Columbia offer enhanced benefits (i.e., those that cover a substantial amount of diagnostic, preventive, and restorative services) for adult Medicaid beneficiaries.

Although child beneficiaries have dental coverage under Medicaid and CHIP in every state, a considerably low number have visited a dentist in the past 12 months. Dental care utilization varies widely by state, ranging from 30% to 62%, and in 27 states only 50% of Medicaid and CHIP beneficiaries utilized dental care in the past year. This is 20 percentage points lower than the dental care utilization for privately insured children, and this gap has persisted for the last decade. Utilization among both groups dropped sharply during the pandemic, and neither appear to have fully recovered.

For adults, utilization rates for Medicaid beneficiaries remains flat and is considerably lower than for privately insured individuals. As of 2022 (the most recent year for which adult utilization data is available) the national adult Medicaid beneficiary utilization rate was 18%, and no state had a rate above 33%. States with enhanced benefits saw higher utilization among adult Medicaid beneficiaries than states with limited or emergency-only benefits. By comparison, utilization among privately insured adults is nearly 40 percentage points higher; while it dropped sharply during the pandemic, it has since recovered and even surpassed pre-pandemic levels.

Turning to the provider side, dentist participation in Medicaid or CHIP has remained stagnant over the last decade, although many states have expanded benefits since 2015. As of 2024, 41% of US dentists participate in Medicaid or CHIP, meaning they are enrolled as a Medicaid or CHIP provider through InsureKidsNow.gov or work at a federally qualified health center. There is a wide variation in participation across states, ranging from 22% to 76%.

Who are the practitioners more likely to treat Medicaid and CHIP beneficiaries? Our analysis revealed certain patterns. First, women dentists are more likely to participate in Medicaid than men (45% vs 39%). Like Medicaid participation overall, participation rates by gender have remained stable for men and women dentists since 2015.

Practice type is also a factor. Participation is higher among dentists in DSOs than it is for dentists not in a DSO-affiliated practice (49% vs 39%). However, while rates have been steady for dentists overall, participation among DSO-affiliated dentists is dropping. Ten years ago, roughly two-thirds of DSO-affiliated dentists participated in Medicaid or CHIP. As of 2024, this figure has dropped to just under half—a considerable decline but still higher than participation rates overall. This drop may be partly explained by the expansion and composition of the DSO market over time.

Black dentists and those younger than 50 have higher participation rates than other groups. Dentists up to 10 years out of dental school also have higher participation rates, although the rate has declined since 2015. Compared to other specialties, pediatric dentists have the highest participation rate by far, at 72% in 2024. This figure has been stable since 2015.

It will be interesting to observe the pattern of Medicaid participation in the coming years as demographic and practice trends shift the dental workforce. As mentioned in our earlier article, dentistry is in the middle of a generational transition, and the workforce is increasingly young, racially diverse, female, and DSO-affiliated.

One factor to consider with respect to dentist participation is the Medicaid reimbursement for fee-for-service (FFS) as a percent of average dentist charges. In the majority of states, Medicaid FFS reimbursement rates are less than half of what dentists typically charge for both children and adult dental services. Although there have been recent Medicaid reimbursement rate increases, they have generally not been large enough to close the existing gap between dentist charges and private insurance reimbursement. This results in a tough landscape to attract more dentists to participate in Medicaid.

As Medicaid continues to evolve, dental benefits will remain a critical component of health policy discussions. With continued collaboration and thoughtful policy decisions, there is real potential to ensure that every child and adult has access to the dental care they need for overall health.

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Women in DSO®

More than Membership: The Strategic Advantage of Women in DSO®

02/27/2026

10 min. to read

“Katie has really excelled,” says Fagan, Vice President of DSO Sales for Pearl. “She’s the perfect showcase of what Women in DSO® is able to offer.”

This is the bargain Women in DSO offers to partners: Invest in the advancement of women within your organization and, in return, gain stronger leaders, faster access to decision-makers, and leadership teams that reflect the people they manage and the customers they serve.

Fagan explains that Bayle took an entry-level position with Pearl a few years ago and now works with the most sophisticated DSOs in the industry.

Fagan attributes Bayle’s growth— increases in self-confidence and enhanced industry knowledge—largely to the mentoring guidance and support she’s received from Women in DSO.

“For years, DSO leadership teams lacked visible diversity—I don’t think intentionally, but out of habit,” Fagan says. “The point is not representation for its own sake; it is ensuring that the best person for a position is developed, visible, and prepared to lead.”

Far too often the best person for the job is not necessarily a man. Women in DSO is asking organizations to consider the experience and capabilities of all potential candidates. At the same time, the organization is preparing women to step into leadership roles and confidently recognize their own worth.

Doing Business Better

Michelle Dowling, Executive Vice President of Marketing for Rectangle Health and a Women in DSO Advisory Board member, knew she had to identify a return on investment (ROI) when she suggested her company join Women in DSO^®.

“The budget expense required a forward-thinking forum where the best conversations were taking place, where pivotal training was happening, and where we were getting access to more and more decision makers in the DSO world,” says Dowling, “But I think the real power has become that Women in DSO is a place where you can grow your business, your network, and see a return.”

Dowling isn’t an outlier when it comes to needing to demonstrate ROI. Few companies are willing to create a budget line-item that can’t be traced back to some form of measurable benefit, such as the value of data.

“Through Women in DSO, we’re exposed to valuable insights about the industry, best practices, information about the dental landscape, and solutions for challenges like retention,” says Albina Kamara, National Key Account Manager for Kerr Dental.

“We get access to decision makers that could take six months to a year otherwise. Being a member fast-tracks you—and vouches for you in a sense.”

“We get more access to decision makers through Women in DSO, which could take six months to a year otherwise. Being a member fast-tracks you—and vouches for you in a sense,” she adds.

Kamara recalls a large account she managed in which calls were fine but unremarkable. She later went to a Women in DSO event and ran into someone from that large account.

“It completely changed the dynamic of our work relationship,” Kamara says. “Coming back from that, it was a different landscape. It’s as if doors were already opened and our interactions were smoother.”

The name may suggest that a partnership with Women in DSO is primarily focused on elevating women, which it is. However, the lived experience of partners is more about business relationships and how those grow out of the strength of the Women in DSO network.

“It helps my salespeople to count on my connections,” Dowling says. “They can say to me: ‘Michelle, do you know anybody?’ The most inspiring benefit I have from Women in DSO is the connections that facilitate these business conversations that just help everyone in the industry drive it forward.”

Building Strong, Resilient Teams

Labor costs more than any other aspect of a company’s total expenses. And those costs are somewhat contradictory—they are both an expense from an accounting perspective and an asset to be managed.

Women in DSO enables partnering organizations to essentially outsource key professional development functions while keeping the benefits in house.

“If you don’t invest in your people, it could cost you in the long run,” says Shirley Misiak, Vice President, National Accounts Leader for CareCredit and a Women in DSO® Advisory Board member. “If you are constantly hiring, the cost of onboarding and training is high. If you invest in your people, you’re going to retain them and, in the long run, you’re going to have a higher return.”

And then there is the multiplicity of ideas that only a diverse group can generate. Women in DSO® mentoring and events effectively nurture women to be more vocal about their ideas and value, which creates a kind of disruptive energy that undermines siloed thinking and conformist attitudes.

“Best-in-class talent incorporates both men and women that think creatively to bring ideas to the table that challenge and create room for innovation,” says Fagan of Pearl’s promotion philosophy. “That’s why we partner with Women in DSO—because we don’t think we could access or develop the best talent if it was just one gender.”

Kamara describes a similar dynamic at Envista, the parent company for Kerr Dental, in which the goal is to invest partnership funds and in exchange get buy-in from team members.

“Envista invests in Women in DSO because it promotes engagement and retention in our organization by enabling women to elevate themselves and become more deeply enmeshed in what we do,” she says.

Nurturing Female Leaders and Diverse Ideas

Women passed over for promotion are more likely to leave, increasing labor costs and making it almost impossible to create a culture of merit, which eventually yields a static, conformist team.

“It’s not that you need a female on the executive board to say that you have a female,” Fagan says. “That’s not it. But who is the best person for the job? That’s who should be selected for it.”

Often, before anyone can be selected for a leadership role, they must develop the obvious skills to succeed in the role. For men, that development most often happens within their current position with the mentorship of someone in the organization.

While women are also mentored within their own organizations, that mentoring happens less frequently and leads to actual promotions far less often. Women in DSO^® provides the necessary structure, direction, and inspiration for women with career aspirations through contacts with women who’ve already succeeded.

“Years ago, I had the opportunity to FaceTime with the Synchrony CEO, Margaret Keane, and I thanked her for sharing her story, because she started working in the call center,” recalls Misiak. “The platform benefits women aspiring to be leaders because they get to hear the stories of other leaders and they see that it can be done. They also learn how to do it.”

In particular, Women in DSO’s annual Empower and Grow conference is singled out for the impact it has on attendees and the inspiration it provides.

“A visible difference that I’ve seen is increased confidence in up-and-coming female leaders after going to Empower and Grow,” says Fagan. “They’re able to watch and learn what other successful women have done. The conference really creates a networking space for women to ask those questions and learn what it takes to get ahead.”

An added benefit of Women in DSO programs and events is that they enhance and validate the natural tendency women have to complement, combine, and integrate.

“Women often bring a strong focus on team culture,” Kamara says. “I think we’re less transactional in a sense and more community based. When I partner with my male colleagues on an account, we bring different perspectives and have our own strengths, and we can give customers balance and a dynamic experience.”

Preparing for Future Challenges

Dowling remembers what the first Empower and Grow conference was like and how much Women in DSO has changed in such a relatively short time.

“It started out as female empowerment and wellness and all the things that you would say are typical female attributes and it has grossly changed into having a seat at the table, having the hardest conversations,” Dowling says. “How do we grow year over year? What does a mergers-and-acquisitions exit look like? Why is it important? Why should we be involved in strategy?”

Women in DSO Founder and CEO Dr. Aman Kaur has developed the conference year over year to serve attendee needs. She has also recruited members for the board of directors and advisory board who have lengthy resumes and extensive experience—members who would not spend time outside their regular jobs unless they thought the work was serious, meaningful, and forward-looking.

The rapid growth of Empower and Grow into one of the industry’s must-attend events clearly indicates that Women in DSO® is about reading the tea leaves and advancing the industry, not just elevating women.

“When you bring leaders together across an industry, you’re starting to eliminate the silos,” says Misiak. “We’re all faced with the same industry issues, economic headwinds, legislative headwinds. And when you bring leaders together—both men and women—it becomes easier because we’re solving as a profession.”

Choosing the Relationship That Works for You

Women in DSO has built enough flexibility into membership and partnership options that something is available for everyone.

While individual memberships are an option, a better idea is to see if anyone else in your organization is also interested in being a part of Women in DSO^®.

“I would suggest they attend Empower and Grow as an organization team,” says Misiak. “If interested women want to be champions within their own organizations, bring others along so they can see firsthand what the platform can do. If you can’t attend Empower and Grow, attend a networking webinar or event.”

If you want to extract more benefit from a relationship with Women in DSO, make more of a commitment.

“Join a committee to get more involved,” says Fagan. “Create an information session, whether it’s twice a year or quarterly, within your organization where someone from Women in DSO can share what we’re doing, why it’s impactful, and ask people if they’d like to be part of it.”

The pinnacle of the options pyramid is a corporate partnership with Women in DSO. If leadership in your company is unfamiliar with the organization—which is unlikely if you work in dentistry or DSOs—some diplomatic education may be in order. Make a pitch to your leadership, explain what Women in DSO does, and lay out the tangible benefits of a partnership.

“To me it’s simple: sales outcomes,” says Dowling. “New business outcomes drive ROI. But it’s also brand awareness and being present in the industry. Some years it’s more brand, some years it’s more sales, some years it’s trying to get the word out about a new product. This is why being an industry partner means so much.”

Given the transformation, velocity, and launch angle Women in DSO has already realized, it stands to reason that the organization will be the driving force behind industry evolution moving forward.

“Invest in your people and they will be loyal to you forever,” Fagan says. “A partnership with Women in DSO allows you as an organization to focus on your business and offer resources to upand- coming female leaders—to help them feel seen and heard within your organization.”

No longer an emerging organization, Women in DSO is a strategic platform shaping how the dental industry develops leaders, builds resilient teams, and prepares for what comes next. For partners, the choice is clear: Invest in your people, accelerate your business, and participate in shaping the future leadership of dentistry.

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Perspectives

We Don’t Just Optimize. We Originate.

02/27/2026

10 min. to read

The Next Advantage Isn’t Margin—It’s Innovation

By Dr. Greg White

As leaders, we wake up every day trying to move things forward—teams, communities, organizations, and sometimes entire cultures. High ambition creates a wild ride. And if you’ve been anywhere near dentistry over the past five years, you know the ride hasn’t exactly been gentle.

I’ve always loved a line from one of my favorite storytellers, Jimmy Buffett. He wrote about a friend who “went to Paris looking for answers to questions that troubled him so.” Jimmy asked him, “Did you find the answers?” And the friend replied, “There are no answers, but the search generated a lot of interesting stories.”

That’s leadership. That’s business. That’s dentistry right now. We may not have found all the answers we expected to find in the last half-decade, but if you’ve been in the arena, you’ve generated plenty of interesting stories.

The Market Matured—and It Changed the Rules

For a long stretch, the DSO industry was dominated by efficiency: cost control, scale, systems, margin management, and standardization. The “machine” got built, and a lot of organizations built it well. But the market matured.

Efficiency used to be differentiation. Now it’s table stakes. It’s no longer the trophy; it’s the admission ticket. It’s the ante to stay in the game.

And when the chairs are arranged and the music starts up, the organizations that win won’t be the ones who can only cut costs. They’ll be the ones who can build value.

Because profitability in the next era will be fueled by innovation and engagement, not just margin management.

Some Entered the Theater Looking for the Exit

Here’s a picture that keeps coming back to me: No one enters a movie theater looking for the exit. You don’t walk in, sit down, and think, “How fast can I get out of here?” Your mind is focused on the story unfolding.

Yet many in our industry-built cultures centered on the end scene, not the experience of the film. They optimized everything around the exit (around the equity event) and around the final score. Monday-morning quarterbacking is always easier than game day, but in retrospect, we can make a case that this was predictable.

“If you enter the theater looking for the exit, why would you care about the quality of the film?”

Post-pandemic fear accelerated consolidation, and valuations climbed. Pipelines became a flex. Differentiation among DSOs was used to attract affiliate doctors. Healthy pipelines attracted investors. The deals were made, and the clock began ticking.

For affiliate doctors: retirement timelines.

For investors: return timelines.

For leadership teams: performance timelines.

And most in our industry—whether we admit it or not—became aligned around one finish line: the next equity event.

Then the predictable part arrived. Inflation emerged as a result of federal cash infusion in the US economy. Interest rates increased. Global unrest continued. Regulation tightened. And suddenly, the market that had been sprinting hit the kind of fatigue that makes even optimistic leaders start looking for the water table.

And for many groups, there was no contingency plan because the strategy was the exit. Arbitrage was the plan—the only plan.

Which brings us back to that movie theater. If you enter the theater looking for the exit, why would you care about the quality of the film? Culture suffers. Innovation dies. Engagement evaporates. And when the leaders are disengaged, the team can smell it. They can smell the BS.

The Human Capital Blind Spot

Here’s what I believe we overlooked, but that the right leaders are uniquely positioned to correct:
We optimized processes more than potential.

We treated talent like labor—not like leverage.

Leaders know people matter, but many DSOs don’t have systems that turn human potential into enterprise value. For the past two years especially, many poured energy into creating efficient systems, and by and large, failed to unlock the human capability sitting inside those systems.

And the truth is, the skill sets required now have changed.

This next era is going to reward organizations that invest in people who can think strategically, solve problems, innovate, and lead through ambiguity.

The next strategic advantage isn’t another layer of reporting or another dashboard. It’s unlocking the full potential of your people.

Profit Follows Engagement (and Disengagement Is Expensive)

Engagement is the number-one predictor of profitability. And yet, if we’re honest, most teams in the dental industry have lived through an extended stretch of uncertainty, burnout, and emotional whiplash. Disengagement shows up quietly at first: slower adoption, less ownership, more turnover, more drama, more excuses, less creativity.

And disengagement is expensive: financially, operationally, culturally.

Private equity–backed DSOs often unintentionally train doctors and leadership teams to think in “exit math.” When every early conversation starts with “Here’s how you’ll get paid at the next event,” it’s hard to build a culture that wakes up fired up about Monday.

So what if the mindset shifted from “One day we’ll cash out,” to “What value are we building now?”

Who we partner with matters. And the stage for a great partnership is set by expectations.

When affiliate conversations begin with exit math, there’s little motivation to engage in the behavior change required to build a winning culture. Achieving a desired final score without a game plan is as effective as a budget without a business plan.

Rethink Incentives: Align to Daily Value Creation

Dentists don’t wake up excited to contribute to EBITDA. They wake up excited about impact, pride, autonomy, excellence, patient outcomes, team culture, and, if you selected well, contribution. We have to be cautious of dentists whose primary goal is to exit the chair. Someone has to do the work. The doctors you want get excited to contribute to the mission. So, make it worth their time.

The current state in many DSOs is that providers and teams are aligned to liquidity, not daily value creation.

The future state has to look different:

Align compensation with innovation, inspiration, and culture.
Align recognition and decision-making to performance in the present, not just the promise of a payout.
Avoid tying everything to financial metrics alone, because when you do, you’ll create a tyranny of the urgent at the expense of what’s truly important—and morale will suffer.

Great organizations cling to purpose—not people. We should focus on the humble, hungry, and emotionally smart. Thinkers. Builders. And prune away the disengaged and arrogant. Because in a tighter market, we’re competing for a limited number of chairs.

This Is Where Leaders Step Up

This is the time for leaders to step up.

If we stop anchoring everything to the exit, what innovation might our doctors and teams feel permission to pursue today?

Differentiation is now measured in terms of leadership and innovation. This is critical at both the office level and the enterprise level.

Many founding doctors built something of great value with their teams. The practice isn’t just a P&L. The doctor and the team are the practice, built on decades of trust and relationships. And, that value only transfers well through a carefully planned transition. It takes clarity, cooperation, planning, and time.

The Capability Areas DSOs Can’t Ignore Anymore

Capability, motivation, and innovation will take us further. And all of it requires discipline—the same discipline that built great practices in the first place. Because without discipline, we become prisoners of our bad habits and we get the results we deserve. Bad habits, at first, are like chains—too light to be felt. But in time they become too heavy to be broken.

The Capability Ladder: How to Unlock What You Already Have

If we’re playing to win, let’s access the team we have.

First: Know your people.
Map strengths, interests, and hidden expertise. You’ll be shocked what you discover when you stop treating job titles like identity.

Second: Activate teams.
Give them ownership over solutions and ideation. People engage with what they feel part of.

Third: Build shared language.
Common language around goals, service, growth, and behavior.

Simple shared frameworks can create alignment faster—lean into what you think will resonate most with your team.

Fourth: Invest in skill growth.
Don’t invest just in CE, but invest in leadership, innovation, and strategic thinking, such as AI-driven leadership training, EI workshops, and staff development days. Make it a deliberate practice around how to think—not just what to do.

Not all people seek to be inspired, but some do. And all people are attracted to optimism and energy when it’s authentic and has substance behind it.

Which brings us to the true job description of leadership.

Innovation Isn’t a Department—It’s a Culture

Your team doesn’t want to sit in the audience. They want a role in the story. So, leaders must create environments where ideas are not just welcomed but expected.

Innovation is not a department. It’s a culture powered by clarity, permission, and collaboration.

And the advantage will favor those who create that culture.

If you want to boil human innovation down to three levers, here they are:

Provide clarity: paint the picture. Make the plan understandable.
Give agency: permission to act, permission to try, permission to fail and learn.
Offer recognition: celebrate visibly and often. Praise in public. Correct in private.

Be open, honest, and transparent with your key team members. Train them and let them go. Let them fail, learn, and succeed. People who are going nowhere can take on no fellow travelers. If you don’t paint a clear picture of where you’re leading, you’ll look behind you and see no one.

And be clear in communication. Most relationships are lost in the gap between what is said but not meant— and what is meant but not said.

“Engagement is the number-one predictor of profitability.”

A Mantra for the Next Era

We’re moving into an era where we must wage war on complexity. Simplify systems. Streamline operations. Hire talent. Lease expertise when needed. Invest in people who can build, not just maintain.

And most of all, stop building cultures centered only on the end scene.

Because the story matters. The experience matters. The way value is built day after day matters.

So here’s a mantra I believe the winners will live by: We don’t just optimize. We originate.

Innovation must lead. We need to create the environment where the thought can live, grow, and turn into action. That requires top talent, disciplined leadership, and a culture of engagement.

The music is starting up again. The chairs are limited.

Let’s make sure we’re not just trying to sit down.

Let’s make sure we’re building something worth standing for.

Dr. Greg White

Dr. Greg White serves as the president and CEO of PepperPointe Partnerships, and is one of the founding partners of White, Greer and Maggard Orthodontics (WGM). WGM formed in 1991, and is currently part of one of the largest, privately-owned pediatric and orthodontic group practices in the country. Prior to leading PepperPointe’s significant growth, he actively practiced orthodontics for more than 25 years.

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Leadership

Clean Water, Clear Purpose

02/27/2026

11 min. to read

Integrity isn’t an innovation. It’s a series of conscious choices that defines Agenics and the future of safe dentistry.

Every patient that leans back in a dental chair trusts that the water is clean and safe. Usually, it is. When it’s not, the complications can be life changing.

In 2016, for example, more than 70 patients of an Orange County, California, children’s dental practice experienced infections that were later traced back to unclean water at the practice. As a result, some children lost parts of their jaws, adult teeth, and even some hearing.

Dental water infections are far more common than they should be. That they happen at all speaks not to our ability to keep water clean but instead to a lack of organizational rigor and the prioritization of profits over people.

Having learned at the feet of a clean water pioneer and evangelist for a people-first business approach, I know that every instance of dental water infection can be traced to misplaced priorities, lax protocols, and flawed understanding. Thankfully, the technology available now gives dentists the tools to virtually eliminate dental water infections.

“Clean water isn’t just about safety—it’s a reflection of values.”

A Legacy Rooted in Service

While most people in the developed world don’t think twice about water quality unless they’re unfortunate enough to get sick, I can scarcely remember a time when it wasn’t part of my life.

My father, Brad Downs, was a chemical engineer who, in the 1990s, signed on to an Army Corps of Engineers project in Colorado, where our family would soon live. The ambitious project goal was to purify 3 million gallons of contaminated groundwater from the Rocky Flats nuclear site north of Denver. Of all the bids submitted, only Dad’s proposed purifying the water instead of hauling it to a nuclear waste site. That water was eventually purified so well it was safely returned to local rivers and streams.

The success of the Army Corps project convinced my father he could adapt the technology and scale it down to meet the needs of missionaries in Papua New Guinea who were regularly getting sick from biocontaminated water.

Buoyed by his faith, experience, and enthusiasm, he set off with a backpack full of equipment for the South Pacific island nation. Before long, he fashioned both a purification system and a solar-powered microbiological test lab to confirm water safety.

Clean water isn’t just about safety—it’s a reflection of values.

Portable Water Treatment System

Treated Sample

Ukarumpa River Untreated

Discovering a New Mission

Dad returned home still buzzing from his recent successes and looking for a new way to make a difference. He found it in early 2000 when ABC News’ 20/20 ran a story called “Dentistry’s Dirty Little Secret,” which highlighted a dental practice biocontamination water problem that was surprisingly common.

Only months later, dental water purity expert Dr. Shannon Mills published an article in the Journal of the American Dental Association (JADA) entitled, “The Dental Unit Waterline Controversy: Defusing the Myths, Defining the Solutions.” Dr. Mills described the ideal water treatment agent in terms of efficacy, safety, and cost, and concluded that no such agent had been discovered.

For my parents, the JADA article presented a worthy challenge and a purpose they could not ignore.

I still remember sitting with my father in the crawl space of our home as he worked to develop the ideal water treatment solution Dr. Mills had outlined. Recognizing the need to pair technology with user-friendly design, my mother, Theresa, did all she could to understand the needs of dental practitioners. She even trained as a dental assistant and worked in a clinic to see how treatment products could fit seamlessly into existing workflows.

At a young age, I could not then accurately describe the feeling that permeated our home, but now I know that it was purpose. Always present and attentive to their children, my parents were also driven to make a societal contribution and improve the world they lived in; they were moved by higher principles and values.

“The goal should be zero dental water infections.”

Driven by Science and Service

After months of research and experimentation, my father identified silver as the ideal water treatment agent and created a novel process to produce it in a usable form factor. Not long after, my parents’ company Sterisil was born and throughout the first decade of this millennium, they developed a leading line of patented dental waterline treatment technologies.

Sterisil still creates the only products recognized by the Environmental Protection Agency (EPA) that treat and maintain water purity at a level of 10 colony-forming units (CFUs) per milliliter of water, which is 50 times cleaner than the 500 CFU/mL standard established for drinking water by the Centers for Disease Control (CDC) and embraced by the ADA.

In 2011, my parents started Agenics Labs as an independent dental waterline testing company. I worked various jobs in the family business growing up but formally started my dental career alongside my parents after obtaining a bachelor’s of science in engineering. My husband-to-be Greg Niederschulte and I joined the company together and spent the next several years learning all there is to know about dental water purity. In 2022, Sterisil was sold to private equity without Agenics, and my parents entered semiretirement to run their new foundation, Our King’s Way.

In 2023, Greg and I acquired Agenics and are now putting all our efforts into maintaining the legacy my parents created.

Profit as an Outcome, Not a Goal

Thinking back to those 73 kids in Orange County, as troubling as the infections were, there is another aspect of that case that I think might be more disturbing.

After the outbreak led local public health authorities to the dental practices, a more thorough investigation discovered that the practice had performed more than 1,000 pulpotomies (root canals on children) between January and September of 2016.

Subsequent lawsuits filed on behalf of the children’s families alleged “predatory dentistry” and “production quotas” that ultimately sacrificed the children’s health on the altar of greater profits.

Were all those 1,000 plus pulpotomies necessary? It’s difficult to say definitively, but clearly the families of those impacted didn’t think so. I’ve imagined the trauma of a root canal performed on a toddler, and it makes this entire episode that much more troubling and shines a bright light on the priority of water quality.

Did the practice owners rely on municipal water quality and think testing was unnecessary? Perhaps, and they wouldn’t be alone. Many practices adhere to the “good enough” principle when it comes to water quality and nothing bad ever happens, until something does.

The Orange County outbreak also illustrates for me exactly what my parents were guarding against when they explained—with emphasis and passion—the unassailable hierarchy of business priorities: people, product, and then profit. The first two are the constant focus, and the third is the reward.

If dental practices cut corners, even with the best of intentions, at the expense of patient safety, they’re potentially putting both patients and practice at risk.

Good Intentions Aren’t Enough

Even if most or all dental water infections are the product of error, not avarice, that probably doesn’t matter to the infected patient. The goal should be zero dental water infections.

Our philosophy is that the best intentions are close to worthless without proper training, rigidly adhered-to protocols, and robust technology.

Consider Atul Gawande’s The Checklist Manifesto for a relevant comparison. Gawande’s book illustrates how even the most dedicated, well-trained, and compassionate surgeons and surgical teams make mistakes without robust protocols in the form of simple posted checklists that include no-brainers like “wash hands.”

Perhaps it would be different if states conducted periodic water-quality tests that practices had to prepare for. Currently, however, only Georgia and Washington state mandate regular testing.

And those infections do keep happening. According to the CDC in 2022, multiple outbreaks of nontuberculous mycobacteria infections have occurred in children who received treatment at practices with water contaminated with high levels of bacteria.

“Dental providers should be familiar with these recommendations on how to properly maintain and monitor their dental equipment to ensure that dental treatment water is safe for patient care,” the CDC says.

“People, product, and then profit. The first two are the focus. The third is the reward.”

Protecting Your Patients and Your Practice

The cost of defending a negligence lawsuit and paying damages would be too high for most practices to survive.

But before an infection scenario ever gets to this extreme, most providers are simply concerned with properly and professionally caring for patients, which is a priority we share.

Agenics is dedicated to ensuring that patients don’t suffer devastating infections from routine procedures. While only Washington and Georgia have mandated water testing with a specified frequency, 43 states have codified the CDC guidelines for water quality into law, and all states recognize maintaining and monitoring dental water as the standard of care.

Agenics’ services begin with water testing but extend through comprehensive support, including protocol development, failure remediation, and extensive training. Bacteria testing is most commonly performed via the gold standard EPA Method 9215c using Reasoner’s 2A (R2A) agar—a venerable approach particularly effective at growing the bacteria common in dental waterlines. We’ve branded this our StandardCheck service, and it is a reliable baseline for whether a practice meets the basic EPA standard for drinking water.

When evaluating water samples with StandardCheck, Agenics uses a digital reader, which rapidly counts the number of bacterial colonies on a given sample. By removing the potential for human error, Agenics establishes confidence in both the reports we provide and the solutions we recommend.

Continuing the legacy of innovation, Agenics also offers RapidCheck: the most advanced bacteria detection method available. Agenics developed this specialized process in-house using thousands of real-world dental samples to create the most extensive and reliable test results available. With results in just 24 hours thanks to flow cytometry, this test meets the intense demands of high-throughput practices.

If a test reveals a bacteria level above the EPA minimum, Agenics looks deeper into potential sources, which may not be obvious. Water sources may be an issue, as might a dental chair’s frequency of use. (If narrow waterlines are not flushed and treated frequently, biofilm forms and quickly multiplies.) The water quality reports we provide are comprehensive and include data on alkalinity, total dissolved solids, and potential inhibitors of treatment agents.

From a generation of water treatment expertise, we’ve also learned to recognize unique water quality patterns such as the changes from spring to fall in municipal water or the differences in types of bottled water. As the only independent lab in the industry—Agenics does not sell any treatment or shock products—we can honestly review the effectiveness of any given product for a specific dental practice.

These are all things that most dentists don’t have the time or training to understand, but they can have an impact on clinical quality and patient safety. Instead of putting their livelihoods at risk, dentists can make water quality the responsibility of professionals who concentrate on nothing else.

Brad Downs, Brianna (Downs) Niederschulte, and Theresa Downs inside Agenics’ microbiology lab.

Built on Principle, Leading with Purpose

I share my family’s story because it’s a reminder that an inherited legacy must still be protected every day or it will die. My parents built their professional lives on faith, integrity, and a simple truth: When people come first, success naturally follows.

That conviction drives Agenics today as much as it did when my parents were running the company. They taught me that embracing belief and service—purpose and meaning—is a better way to live. My parents never let us forget that seeing money as a primary objective would eventually cheapen our lives.

Growing up, my mother told us her goal was to raise children who cared about other people more than financial or business success. Our goal is for Agenics to succeed because we put first things first and trust the reward to come from consistent, values-driven business principles. Every sample Agenics tests, every partnership we embrace, is an act of legacy stewardship that honors where we came from and defines where we are going. Greg and I could think of no better way to honor my parents than to carry on as they taught us.

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Leadership

Ushering In Dentistry’s Overdue Future

02/27/2026

10 min. to read

DR. RANIA SALEH IS ON A PERSONAL AND PROFESSIONAL MISSION TO UNITE THE CLINICAL AND BUSINESS SIDES OF DENTAL PRACTICES IN ONE SOFTWARE PLATFORM

In the early 2000s, newly minted dentist Dr. Rania Saleh faced a dilemma: she knew how to be a great dentist, but she found herself in an environment where it was almost impossible.

“I was working in an extremely busy practice as an associate, and I couldn’t continue the way that practice demanded, knowing that there was a better way to do it,” she says. “I wanted patients to understand their conditions, how their general health was affecting their oral health, and their diagnosis before we committed to a treatment.”

So, Saleh struck out on her own, ready to do things her way, opening a practice near Washington, DC. But even after opening her own cosmetic dental office and implementing an in-depth, diagnosis-focused approach to examining and treating patients, she found that the available dental software on the market was more hindrance than help, particularly in terms of getting her entire team on the same page when doing examinations.

Saleh knew technology could empower dentists to better serve their patients with enhanced clinical care and education. She also knew she had a Kois Center-inspired examination protocol that worked, and that modernized technology could only make it better.

Guided by an undaunted attitude informed by a childhood shuttled between war-afflicted Lebanon and Canada, a strong belief in her own abilities, and an extensive knowledge of the dental industry, Saleh decided she could create what the industry lacked. In 2016, she founded Oryx Dental and began developing the platform, starting with her clinical approach to patient exams.

The vision behind Oryx is clear and direct: give dentistry the technological support and innovation it has lacked for so long—and watch the industry reach its full potential.

Dental Health Is Healthcare

Saleh developed the detailed examination protocol she would later apply to her practice and to Oryx after she was introduced to the Kois Center and completed the program in Seattle. The Center’s comprehensive, evidence-based methodology upended her view of traditional, procedure-based dentistry. It also posed a fundamental question in terms of treating patients.

“Would dental patients have the patience for an exam that might stretch to hours if they knew it would significantly improve their outcomes?” she recalls asking herself.

Indeed, she discovered, they would.

As Saleh’s private practice in DC rapidly grew and her patients embraced extensive, detailed exams and information, Saleh started getting feedback on her somewhat unusual methods.

“I would get calls from the GI department at Georgetown,” Saleh says. “They’d say, ‘Thank you so much for referring these patients. We were able to discover early cancers. We didn’t know that dentists could find these things.’”

The Kois Center-derived approach was working. As her thriving practice grew to two locations, Saleh hired associates to meet demand. But when she became pregnant with twins and was put on bed rest for five months, her associates were unable to maintain the standard of care and the business suffered.

Saleh found herself at a crossroads. The bed rest finally gave her time to reassess her strategy and revise her exam protocol, which she began teaching in earnest to her associates to try to boost her practice. Still, she couldn’t be in the clinic looking over their shoulders.

At this point, she started discussing with her husband, an engineer for a healthcare IT company, how she could duplicate the exam protocol using software. Clearly, there must be a better way to get consistent results through technology, even if dentistry had yet to discover it.

That’s when the beginnings of Oryx Dental went from concept to reality.

“Dentistry has been underserved by software for decades.”

Putting Clinical Care at the Core of a Broader Platform

“There was no clinical component at all,” Saleh says of dentistry software back in the day. “You could complete an exam by just writing two lines, or by entering a few data points. Nothing was guiding the dentist to go through a very thorough process.”

Dentists also juggle marketing, billing, and business management alongside clinical work, often falling back on manual, disconnected processes just to get things done. Previously, the software available to help with those tasks was neither integrated nor efficient. In terms of pace and pizzazz, the existing solutions were like a horse-drawn carriage.

“There were a lot of workflow inefficiencies in the software on the market in 2016,” Saleh says. “Software functioned more like different data entry points that you had to put together, and the output was not a treatment plan but just a procedure code and a price.”

Saleh envisioned something precise and responsive—a sports car instead of a carriage. Thinking of systems used more broadly in healthcare, she set out to develop a platform that both drives clinical evaluation workflows and improves the efficiency of those workflows.

Conceptually, the solution also had to be a fully integrated platform that included messaging, scheduling, billing, and other front-desk functions automatically generated by a triggering event like the completion of a patient exam.

“Oryx is about having an amazing workflow from start to finish, making sure you’re delivering the best clinical care, and, on the business side, taking care of everything you need to,” says Saleh.

It’s been more than a century since horse-drawn carriages were considered advanced technology. Perhaps it’s time to stop thinking that the software equivalent is useful.

Smarter Providers and Patients

“My goal has always been to empower dentists and also to empower patients—and to create an amazing relationship between them,” says Saleh.

As the starting point for her clinical protocol, Saleh relied on the Kois Center’s foundational four-part examination methodology: gum health, condition of teeth, bite and jaw joint, and overall smile.

“You assign a risk in each area, so when you explain the patient’s dental health to them, they understand the risks involved,” Saleh says. “Patients really liked that, even though it was time-consuming.”

Indeed, this clinical approach is what makes Oryx a unique platform that elevates the way dentistry is practiced. Saleh highlights the educational materials the system makes readily available to providers at the point of care, which are updated regularly.

These materials drive the thorough and detailed explanations patients receive during exams, which increase engagement and understanding. That improved understanding, Saleh emphasizes, is the product of a system that looks at the big picture and focuses on the confluence of factors that impact overall health.

“Traditionally, dentistry has been procedure-focused, at least in part because of how insurance is paid.” Saleh explains. “Dentists become conditioned to look for problems rather than looking at the patient’s general health. Oryx enables them to see the full picture.”

7 Minutes to Better Heath

Dental providers need effective software to improve clinical performance and patient satisfaction.

Consider how Oryx uses images to ensure that both the clinician and the patient clearly see what’s happening. Where dentists have typically used a digital SLR to take high-quality images, Oryx supports an iPhone app to take photos that go straight into the chart.

“We saw compliance skyrocket in data collection with the introduction of this app,” Saleh says. “And users are saying the reports generated for patients have more value with the photos.”

Of course, a busy dental practice still doesn’t have hours for each check-up, as Saleh originally envisioned the ideal patient examination. In developing Oryx, and in working with John Kois, Saleh and her team have created a standard, templated exam that incorporates the Kois Center’s evidence-based treatment protocols and employs clinical decision support.

“There’s a very structured exam,” Saleh says. “It takes about seven minutes to do on any patient, and this is the best seven minutes you can spend. When you’re done with the exam, the next steps for diagnosis and treatment are clear.”

That Oryx can support a diagnosis after seven minutes is in part enabled by how the platform can be configured for specific practices and patient bases. For example, Oryx includes pediatric exams, questionnaires, and photos; prompts for questions about fluoride; and unique workflows to accommodate specialty practices.

“What we wanted was to be able to focus on just the clinical stuff that simplifies everybody’s life and makes things easier for patients,” explains Dr. Christopher Baer, a Colorado clinician and Oryx user. “We’ve seen a dramatic improvement in case acceptance because of the way that we can present the information.”

Better Tools, Better Dentistry

As with health care generally, software as a service (SaaS) and AI innovations are key to bringing the dental industry up to date in terms of what is technologically possible.

Because Oryx is implemented using a SaaS approach, the platform can be segmented to meet the needs of multioffice practices or DSOs with multiple locations. The SaaS model also eliminates the need for on-premise data centers and makes future expansion to accommodate growth a simple process that negates local data center demands and requirements.

What will really enable dentistry to evolve from the antiquated technology of just a decade ago to the cutting-edge potential of now is AI and the functions it makes possible, such as ambient listening and image scans.

“It’s going to make clinicians and front-office workflows a lot more efficient,” Saleh says, “but most importantly, it is going to improve the patient experience. Clinicians in our offices who use AI tell us, ‘I can look the patient in the face. We can have a conversation.’ I think dentists and patients will have a much better relationship once all the clutter is gone.”

Oryx objectively represents a leap forward in an industry that has relied on old-fashioned legacy software for decades. Just as hospitals and clinics made the jump to the digital age two decades ago, dentistry is having its own digital moment now.

“Dentistry has been underserved by software for decades,” Saleh says. “Some offices were reluctant to adopt certain tools because the benefit was not clear, but when software is clearly built for specific purposes and provides documented benefits, the decision is much easier to make.”

The Future of Dentistry Is Now

Saleh knew dentists and patients deserved better, and she had the confidence to believe she could deliver. From more consistent protocols to better education to more structured exams, Oryx enables dentists to practice in a way that is a huge leap forward from even a few years ago.

And the practices that have moved to Oryx have quickly noticed the business benefits and improvements to patient treatment.

“We had a DSO that moved to Oryx, and they doubled their production in one year,” Saleh recalls. “Their case acceptance and referral rate more than doubled because they had this consistency. It didn’t matter if it was the lead doctor or the new junior doctor seeing a patient. Everyone was doing the same exam, everyone was doing the same treatment plan.”

The funny thing about the future is how hard it is to know when you’re in it. Appreciating the difference between a horse-drawn carriage and a sports car, however, is very easy. Saleh is confident that dentistry can recognize this significant moment—that now is the time for groundbreaking change— and appreciate the increase in velocity.

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Perspectives

Thoughts for the DSO Industry in 2026 and Beyond

02/27/2026

5 min. to read

BY BRIAN COLAO
Director, DSO Industry Group at Dykema

Five Years of Unprecedented Challenges

The last five years have brought unprecedented challenges to the DSO industry including the great lockdown, the great reopening, the great recovery, the great resignation of dental professionals, record levels of inflation and interest rates, and a great uncertainty which continued throughout 2025 and the first part of 2026 as a result of trade wars and continued global unrest. Over the last five years, the dental industry has existed in an unnatural state with almost all expenses including labor, supplies and equipment, and the cost of money going up, while reimbursement rates remained flat or only slightly increased. This has significantly shrunk profit margins, and from 2022 to 2025, caused a number of DSOs to completely restructure their operations to reduce expenses and increase same-store growth by attempting to implement a variety of technology solutions while eliminating or significantly decreasing M&A and de novo activity.

Unfortunately, many innovative samestore growth strategies were hindered by fear and uncertainty, lack of education regarding how to properly use the technology, lack of integration with existing practice management systems (PMSs), lack of a strong plan of implementation, difficulty sorting through the surplus of options, and lack of support from affiliated dentists and staff. Going into 2026, many organizations find themselves in an environment with very little to no M&A and an unclear path to the creation of significant same-store growth through the implementation of innovative technology solutions. But as detailed below, there is reason for optimism as many of these challenges are slowly being solved, and the obstacles blocking the path forward are beginning to slowly clear. These are my thoughts for 2026 and beyond.

Current State of M&A Markets

From June 2022 until the end of 2025, there has been a great M&A drought. Nearly 75 DSO sale processes have been abandoned with only around eight transactions occurring at fairly modest multiples. But going into 2026, interest rates are steadily being lowered. The new federal chairman that will be taking office in 2026 is widely believed to be an aggressive advocate of lowering interest rates. There is a huge amount of money on the sidelines, and almost every organization in the current DSO marketplace is overdue for a recapitalization event, all of which provides the necessary momentum for a gradual market recovery. During the first quarter of 2026, it appears likely that several significant DSO transactions will occur. Other large DSOs are taking steps to position themselves to go public in the future. With respect to smaller transactions: 1) Sellers are beginning to adjust their expectations to more realistic valuations that reflect the 2026 market conditions; 2) Buyers are utilizing more creative acquisition structures that derisk the transactions including earnouts, holdbacks, post-closing purchase price true-ups, and joint ventures. As a result, we are beginning to see a significant uptick in small- to mid-size acquisitions that will likely accelerate even further by the second, third, and fourth quarters of 2026. Therefore, I am cautiously optimistic that the DSO M&A markets will experience a material rebound in 2026, but the volumes will still be much lower than the market highs of 2021. The scope of the rebound will of course depend on how low the interest rates ultimately go, the degree to which sellers adjust their expectations on valuations, and whether or not some of the more global issues such as trade wars and military conflicts subside.

Current State of Innovation and Technology

Most DSOs are well on their way to working through their plans of restructuring and cost and overhead reductions and are now very well poised to implement new innovative technology solutions to improve same-store growth, which means doing more with existing patients, acquiring new patients, and lowering overhead. Over the last two to three years, the DSO industry has learned a lot of valuable lessons from the trial-and-error process with new technology including:

There must be standardization of systems across an organization. Attempting to operate with multiple PMSs or multiple technology solutions that serve the same function undermines the efficiency, profitability, and success of the DSO organization.
There must be proper education throughout the organization as to how to properly use the technology; otherwise, it likely won’t be used or will be incorrectly used.
The technology must integrate with the DSO’s PMS or else it likely won’t be used.
There must be a highly organized implementation plan or else the technology will not be consistently adopted.
There must be strong collaboration between the technology partner (vendor), DSO leadership, affiliated practice dentists, and affiliated practice staff or else the technology will not reach its maximum value.
Not every solution will work for every organization, and time and research must be spent analyzing which solutions will have the greatest ROI for a particular DSO.
There is a surplus of solutions in the market, and time and research must be spent determining which solutions are truly a value add and which solutions are “shiny objects” that ultimately do not impact the bottom line in a material way.

My predictions for 2026 are that many organizations will crack the elusive code on properly implementing new technology through education, integration, and collaboration between technology partners, DSO leadership, dentists, and staff. I also predict that we will see a gradual reduction in the number of technology solutions in the market as the weaker, less valueadded solutions are forced to exit the marketplace, and the stronger solutions rightly gain market share.

Final Thoughts

I have been asked many times (after 31 years in the DSO industry) to give my thoughts as to the characteristics of a successful DSO and set forth below are my thoughts for success in 2026. A successful 2026 DSO will do the following:

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Markets & Enterprise

The System Is Broken, Not Your Staff

02/27/2026

7 min. to read

by Marcus Bertilson

Chief Operations Officer, Weave

A Strategic AI Fix for the Dental Front Office

Dental organizations are not facing a staffing problem—they are facing a systems problem. Rising labor costs, fragmented technology, and escalating patient expectations have pushed the traditional front-office model beyond its limits. The next phase of DSO performance is not defined by hiring more people, but by redesigning how work gets done.

Here, we’ll explore the three reasons why your solution is implementing a modern dental front-office AI platform that helps streamline operations, capture more revenue, and deliver an exceptional patient experience across your DSO enterprise.

The High Costs of Static Staffing

According to Dental Protection, nearly two-thirds (63%) of dental professionals report frequent feelings of burnout and exhaustion. If daily administrative tasks stretch your front-office staff to their limits, practices are at increased risk of costly errors, service oversights, and even employee turnover. And what does this mean for peak times and seasons when performance pressures hit overload?

Quantifiable Opportunity Loss: Dental practices miss one out of every three calls during business hours, notes an article in Group Dentistry Now, with 65% of those being potential new patients.
Loss of Patients to Competitors: When there’s no system to capture missed or after-hours demand, callers may contact competing practices with the capacity to accommodate them.
Negative Customer Experience: Consider how patients’ perception of long wait times and distracted in-person service at the front desk may negatively impact their confidence and trust in the practice.

It may appear that adding headcount is the best (or only) answer to ringing phones and lines of patients at the front desk. But take into account the principle of diminishing returns—productivity will yield to inefficiency quickly if existing technology and workflow issues aren’t addressed. Process bottlenecks will continue to slow everybody down and potentially become more pervasive. They’ll also thwart opportunities to attract, serve, and retain patients.

Altogether, a front office that isn’t running optimally can’t be expected to support growth. And adding more people isn’t guaranteed to impact productivity and profitability metrics that matter to scaling DSOs.

The Systems Fix: A comprehensive AI-powered front-office platform will arm your DSO’s practices with 24/7 call and scheduling support functionality that’s inherently scalable—and always there for patients when they need them:

AI receptionists capture and qualify patient demand 24/7; convert missed calls into scheduled revenue.
AI assistants/co-pilots automatically transcribe voicemails and compose first-draft emails, prioritizing high-importance messages.
AI sentiment analysis tools provide real-time insights into patient sentiment and call intent so that when staff take a call, their interaction is targeted, proactive, and genuinely empathetic.

These capabilities help eliminate administrative overhead, enhance the patient journey, and drive revenue. They also directly benefit staff members, who are free to spend more quality time on higher-value patient interactions.

Fragmented Technology Impacts Performance

The front-office tech stack in many practices has become a patchwork of individual “point solutions” for marketing, scheduling, insurance verification, and reputation management that rarely communicate with one another. While these tools are intended to help, their disparate systems create data silos and disjointed workflows. Staff pays the price, jumping between multiple applications and manually entering data and reconciling information.

Aside from piling more work onto your staff’s plate, this approach results in operational blind spots and missed revenue opportunities. In this reality, it’s almost impossible to gain a holistic view of the practice’s health or to proactively manage the patient lifecycle. Introducing more people to the situation would only complicate, not streamline, the tangled web of tech.

“Dental organizations don’t have a staffing problem— they have a systems problem.”

The Systems Fix: To truly maximize efficiency, practices must move toward a unified technology strategy where systems are deeply integrated rather than just “adjacent.”

When AI has a deep connection to your data, it becomes an intelligent administrative partner enabling you to:

Eliminate Administrative Friction: By automating routine tasks like scheduling, follow-ups, and data entry directly within the PMS, AI removes the heavy lifting from your front-office team.
Leverage Actionable Patient Data: Connected systems ensure that every piece of patient information is available to power a more responsive patient experience.
Maximize Revenue and Conversion: Integrated AI monitors the entire patient journey in real-time, ensuring no opportunity for practice growth falls through the cracks.
Streamline Clinical and Business Operations: A unified platform provides a “single source of truth” via dashboards that offer real-time insights into booking rates, handle times, and production trends.

For organizations aiming to optimize ROI, the focus must shift to unified AI platforms. These solutions move beyond simple automations by integrating directly into your tech stack, optimizing every patient interaction and maximizing overall practice efficiency.

Patients Expect Speed AND Empathy, Not a Tradeoff

Staff can’t “go it alone” if they want to provide patients with the 24/7 service they expect. Unfortunately, outdated processes and limited access windows create a service gap that makes hightouch, personalized service nearly impossible to scale.

The trick is finding the right balance between tech-driven convenience and human empathy. While AI is engineered for superhuman speed, purely digital interactions can feel cold and transactional, stripping away
the human element that builds clinical trust. This tension prevents many DSOs from fully committing to automation.

The statistics tell a clear story of this conundrum:

The Human Preference: An overwhelming 93.4% of consumers still prefer interacting with a person over AI for service needs.
Technology As Table Stakes: 79% of patients want the ability to use technology when managing their healthcare experience.
Yes, and …: 88.8% of consumers believe companies should always offer the option to speak with a human.

The problem isn’t the technology itself— it’s the lack of a system that knows when to step in and when to step back.

“AI won’t replace empathy, but it can finally make room for it.”

The Systems Fix: Rather than forcing a choice between speed and soul, a unified AI platform enables a hybrid service model. Think of it like a self-driving car: The AI handles the simple routing and lane-keeping, but a human driver is always ready to take the wheel during complex, high-speed, or emergency situations.

By strategically aligning tasks based on risk and complexity, DSOs can achieve:

Workflow Optimization: By letting AI handle routine, low-risk transactions, you satisfy the demand for speed when patients need it most.
Intelligent Handoffs: If a patient expresses frustration or has a complex question, the AI provides a seamless, informed handoff to a staff member who has the full context of the interaction.
Elevated Human Role: Your staff can finally focus on the interactions that drive revenue and retention: high-touch patient support, treatment plan presentations, and empathetic engagement.

This hybrid approach ensures that operational savings are never wiped out by patient dissatisfaction. Instead, technology serves as a “force multiplier” for empathy, allowing your team to be more human, more often.

Conclusion: Beyond the Band-Aid— Adopting the Hybrid Model

Leaders must stop applying “Band-Aid” solutions (short-term staff hires) to a systemic technology problem. The future of DSO operational excellence lies in strategically deployed AI. Adopt a hybrid AI model that prioritizes human empathy where it matters most, while leveraging AI’s inherent scalability to achieve the operational consistency and efficiency you need for growth. The true win is improving the system so that your staff can finally deliver the service they want to give. The organizations that lead the next decade of dentistry will build systems that allow their people to do what matters.

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Perspectives

The Muted Recovery

10/22/2025

7 min. to read

What 2025 Taught DSOs—and the Road to Renewal

By Brian A. Colao
Director, DSO Industry Group at Dykema

The year 2025 will be remembered throughout the DSO industry as The Year of the Muted Recovery. Entering the year, hope was high that the M&A drought and challenging conditions that began in mid-2022 and caused over 50 significant DSO sales processes to be abandoned would finally subside. A succession of interest rate cuts in late 2024, the inauguration of a new presidential administration promising pro-business reforms, and signals of economic stabilization and the promise of an end to a number of global military conflicts gave rise to expectations that the DSO M&A markets would make a robust rebound.

In my previous year-end article, I identified the critical conditions necessary for a true market revival: sustained interest rate reductions, moderation of inflation, resolution of global unrest, and a regulatory environment that fostered business growth. I also projected that DSOs would increasingly focus on technology adoption for same-store growth to drive EBITDA, compensating for muted acquisition activity.

The Reality: A Muted M&A Market

Unfortunately, virtually none of the foundational pillars for recovery materialized. In 2025, interest rates remained stubbornly high; inflation— though improved—never fell below the key 2% threshold; economically crippling tariffs were introduced against most of the developed world and, as of the time of this writing, much uncertainty remains as litigation over the validity of tariffs appears headed to the US Supreme Court for a decision sometime in 2026. Additionally, the military conflicts in Ukraine and the Middle East have not concluded and continue to exert downward pressure on global markets.

The administration, despite its business-friendly posture, has targeted healthcare fraud aggressively, fueling a notable spike in federal enforcement actions and producing further headwinds for DSO deal-making, which is the subject of a separate article contained herein by my partner, Leigha Simonton, former US Attorney for the Northern District of Texas. As a result, M&A volume remained extremely limited, valuations were pressured, and many groups opted to focus inward, delaying growth decisions and focusing on operational efficiency.

Signs of Hope for 2026: The Year of Renewed Opportunity

Despite these frustrations, several positive signals have emerged, setting the stage for potential improvement in 2026—The Year of Renewed Opportunity:

The Federal Reserve at its Sept. 16 meeting, finally, in a highly anticipated move, reduced interest rates by a quarter point. As of the time of this article, there is optimism that there will be additional rate cuts in 2025 and into 2026 because it will take several more rate cuts to create truly favorable economic conditions for the M&A markets.
Preliminary peace talks in Ukraine and calls for resolution in the Middle East offer guarded optimism regarding global stability.
Legal challenges to tariffs may result in their invalidation, potentially easing supply costs and reducing inflation.
Sellers are increasingly adopting pragmatic valuation standards, acknowledging the need to turn investments amid evolving market conditions.
There have been at least two significant transactions that have closed and several potential transactions that, as of the time of this article, are under Letter of Intent (LOI) and there is cautious optimism that several closings will be announced before year-end, which represents at least a muted recovery with the chance for a fullblown recovery in 2026.

Given these developments, I anticipate an uptick in M&A activity beginning in the second half of 2026, with the potential for momentum to accelerate should economic circumstances and policy frameworks finally align.

A New Era of Healthcare Enforcement

By Leigha Simonton, Former High-Level DOJ Official and Leader of Government Investigation and Defense Practice for Dykema’s DSO Industry Group

This year has ushered in a markedly elevated threat landscape for health care businesses. The US Department of Justice (DOJ) has prioritized healthcare fraud enforcement at an unprecedented level, shifting its approach from isolated financial disputes to aggressive criminal prosecution in cases that, in prior years, might have remained civil contract matters.

This effort accelerated following the DOJ’s May announcement identifying healthcare fraud as a top priority. New initiatives include financial incentives for whistleblowers to report offenses spanning federal benefit programs, private insurer schemes, and a broader array of conduct now categorized as “fraud,” including actions impacting patients, investors, or other nongovernmental entities. The DOJ reinforced its commitment with new dedicated teams, collaborative working groups with HHS, and the launch of the Health Care Fraud Data Fusion Center—a sophisticated operation leveraging advanced analytics and AI to identify emerging fraud schemes.

“The risks of proceeding without expert guidance have never been greater.”

June 2025 saw the largest healthcare fraud takedown in American history, with criminal charges brought against 324 defendants—including nearly 100 licensed medical professionals—for allegedly orchestrating $14.6 billion in fraudulent activity. Notably, this crackdown involved coordination with 12 State Attorneys General’s Offices and extended beyond federal payer fraud to include wire and mail fraud charges associated with private payers, demonstrating a wide net of enforcement.

Given this aggressive climate, industry participants must maintain rigorous compliance and seek experienced counsel with deep knowledge of the DSO industry, government agency processes, and the structuring of advertising, marketing, business development, patient incentive, and compliance programs—and certainly at the earliest indication of possible scrutiny or an internal concern. The government’s sophisticated investigative approach means that even seemingly minor abnormalities can escalate quickly, and the risks of proceeding without expert guidance have never been greater.

Technology: The Imperative of Innovation

Just as predicted, technology adoption for same-store growth has become essential. DSOs nationwide have piloted—and increasingly implemented—innovations in diagnostic AI, cloud-based practice management, automated RCM tools, patient finance solutions, and specialty integration platforms. While adoption has advanced more slowly than hoped—primarily due to challenges in education, training, integration, and implementation—it is steady and inexorable.

Rising costs for labor, supplies, and equipment, combined with stagnant reimbursement rates, have made technology the only viable solution for sustaining margins and driving growth.

A Bright Spot: The 2025 Dykema Definitive Conference for DSOs
Amid an otherwise stagnant year, the Dykema Definitive Conference for DSOs emerged as the industry’s true highlight and north star. With attendance surpassing 2,500 and experiences selling out within just hours, the event reaffirmed the strength and future promise of the DSO community. Breakouts and workshops quickly reached standing-room only, underscoring the appetite for practical insights and forward looking strategies. The conference also shined a spotlight on industry leadership: Bob Fontana (The Aspen Group) and Stan Bergman (Henry Schein) received the Lifetime Achievement Award, while respected voices like Dr. Sulman Ahmed (DECA Dental) and Steve Bilt (Smile Brands) reinforced their commitment to advancing the profession.

Just as significant, vendors and sponsors showcased innovations that will help power a new era of growth—advancements that align directly with the industry’s need to innovate, refine operations, and prepare for the rebound ahead. The conference made clear that while recovery may take longer than hoped, the foundation of innovation, leadership, and community is firmly in place to carry the industry forward.

Strategic Outlook: Thriving in Uncertainty

As The Year of the Muted Recovery draws to a close, DSOs must remain strategic and resilient. The best-run organizations will not simply survive the volatility; they will use this period to innovate, refine internal operations, and position themselves to lead as the market rebounds.

My prediction: 2026 will begin with the same cautious progress but, as the year unfolds, will reward those organizations who are prepared—operationally flexible and technologically advanced—when true recovery gains traction. With strategic adaptation and forwardthinking investment, DSOs will be well-positioned to lead dentistry’s next era of growth.

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Markets & Enterprise

Aligning Data, Advancing Oral Health

10/22/2025

7 min. to read

Wardah Inam walked into a dental office for treatment and left with more questions than answers. A new plan conflicted with what she had previously been told, insurance coverage was a mystery, and no one could explain the discrepancies.

For most patients, this confusion is just part of the system—but for Inam, who has a Ph.D. from MIT, it sparked a bigger question: why was dental diagnosis so hard to understand?

“I asked for my X-rays, then left the office. That’s when I started learning dental basics myself, reading books and papers to understand how dental diagnosis works,” Inam says. “I shared my data with multiple dentists, and they gave me different recommendations as well.”

Even with identical data, dentists offered conflicting recommendations. Inam plunged into dental research, consulted multiple providers, and observed dentists in action. Dentistry wasn’t failing from lack of skill— it was failing from a lack of tools assisting dentists.

Bridging the Divide

Inam founded Overjet with a powerful goal: to make dentistry more quantitative and get every stakeholder on the same page to deliver the best care.

“With my background in AI and technology, I realized this was a place where I could make a meaningful impact,” she says.

By analyzing dental images and patient data, the platform ensures that diagnoses and treatment plans are consistent, transparent, and aligned with best practices.

“Overjet is on a mission to improve patient care, create exceptional experiences, and optimize outcomes. To achieve this, we need technology that considers the patient experience end-to-end, while also supporting the multiple stakeholders who deliver and pay for care and ensure the system works effectively across the ecosystem,” Inam explains. “Technology can serve as a facilitation layer, enabling providers and payers to share information more seamlessly. This leads to faster, more accurate decisions and, ultimately, better care for patients.”

From the patient’s perspective, the dental journey—from diagnosis to treatment, claim submission, and payment—can feel complicated and opaque. Instead, Inam argues the journey should be more collaborative at every step. “Our AI-native imaging software helps providers communicate more effectively, so patients truly understand their oral health and the treatments they need,” Inam says.

“AI is a tool,” Inam says. “Our goal is to ensure that patients feel understood, providers feel confident, and payers can make faster and accurate decisions. When all three sides trust the system, everything improves—outcomes, costs, and patient experience.”

Measuring What Matters
One of the ways Overjet builds this trust and collaboration is through the introduction of the Oral Health Score: a measurable, objective metric that connects patients, providers, and payers.

“It shows where they are today, what treatments are needed, and how those treatments will improve their health. It also helps providers and payers work from the same objective data,” Inam notes.

By creating measurable, objective metrics, Overjet reduces friction and aligns all stakeholders, fostering transparency. “If you can measure it, you can improve it,” she emphasizes.

The Oral Health Score isn’t just internal innovation—it has a scientific foundation. “We’ve used data from more than 340,000 patients across all 50 states,” Inam says. “That scientific foundation is what excites us most— bringing measurable, data-driven improvements to oral health.”

Tackling the Taboo: Working with Payers

While internal metrics like the Oral Health Score bring much-needed clarity, one of the biggest barriers to progress in dentistry is the payerprovider relationship. For decades, it has been defined by mistrust.

Collaboration between providers and payers is rarely simple, but it is absolutely essential. Overjet streamlines this process by helping providers verify insurance in seconds, a task that traditionally takes hours, through aggregated eligibility and benefits data combined with direct payer connections. Its evidence-based AI annotations also empower providers to submit stronger claims, resulting in faster payouts. Overjet’s ReviewPass further accelerates the process by enabling instant payer approvals and skipping manual insurance reviews. In addition, Overjet has introduced credentialing automation software used by both providers and payers to deliver instant, automated credentialing and remove unnecessary administrative friction.

“Providers and payers don’t need to love each other, but they do need to figure out how to work together more effectively to better serve patients,” she notes.

The message to providers is clear: avoiding payers is no longer a strategy. The leaders who embrace collaboration will not only reduce friction—they will gain a competitive edge in dentistry.

Empowering DSOs to Take Bold Action
Overjet is a lever for leadership courage and collaboration, enabling an endto- end, streamlined experience from diagnosis to claim submission.

Standardizing and scaling tools supports both DSOs and solo practices. Patients benefit from more clarity and fairness in treatment, which leads to better outcomes. Providers make more accurate and faster claim decisions with less admin burden.

Payers reduce costs by cutting down administrative overhead.

“The power of AI is not just operational efficiency,” Inam says. “It’s about giving DSO leaders the confidence to grow fast while providing the best care to their patients.”

Overjet allows DSO leaders to step into a new type of leadership—one that prioritizes collaboration, clarity, and courageous decision-making.

Thought leader Kerry Straine, CEO at Straine Dental Management, is confident about the opportunities ahead, “Patient care is at the heart of everything we do. Our goal is to help our partners elevate the patient experience through AI-powered tools. With Overjet, we’re unlocking new levels of precision, efficiency, and performance that will redefine what’s possible in dentistry.”

That same clarity and collaboration extend beyond patient care— transforming transparency into a powerful driver of trust, growth, and competitive advantage.

Turning Transparency into Market Power
Trust cannot be spun, it must be earned through transparency, data, and the courage to confront hard truths directly. When done right, it doesn’t just improve patient care, it drives measurable business results:

Patient retention: Clear communication and reliable care build loyalty.
Operational efficiency: Consistent treatment planning reduces errors, unnecessary procedures, and administrative burden.
Strategic growth: Easier payer collaborations and smoother integration across locations.

Fred Ward, CEO of Marquee Dental Partners, has seen the impact up close: “The best dental offices I’ve ever been associated with were the offices who focused on the patient. I’m excited about what AI can bring—real-time data, real-time recommendations—all the things that enhance a doctor’s opportunities are right in front of them. They can spend their time with the patient doing the treatment right now.”

That, Inam emphasizes, is the real mission: “We’re not just building better AI. We’re building a system where data drives decisions. That shift is the most powerful driver of better care, lower costs, and stronger leadership.”

The Shift: From Blame to Collaboration

Looking forward, Inam envisions a healthcare ecosystem where patients, providers, and payers interact seamlessly, supported by technology that is transparent, reliable, and evidence-based. Overjet is leading this charge in dentistry, creating a model that could expand across broader healthcare.

“Imagine a frictionless dental experience for every patient,” Inam says. “Providers should be empowered to make confident decisions, and payers should feel secure in coverage. When you align all three, you unlock a system that’s smarter, faster, and more humane.”

For DSOs, embracing this model is an invitation to rethink legacy processes, adopt innovative tools, and place trust at the center of leadership.

“This isn’t about asking ‘who wins?’ It’s about asking, ‘How do we all win?’ By shifting from blame to collaboration, we can inspire a new generation of dental professionals and DSO leaders to embrace data-driven care,” Inam says.

Her confusing dental visit years ago pushed Inam to act, and that courage created a platform reshaping an entire industry. The choice now lies with every DSO leader and decisionmaker: remain stuck in uncertainty, or build a future defined by clarity, collaboration, and bold action.

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Markets & Enterprise

Broken Smile to Industry Breakthrough

10/22/2025

12 min. to read

My cousins and I tumbled, laughing, into the car. I climbed into the middle front seat with no seatbelt.

The last thing I remember was my face smashing into the dashboard. Broken nose, jaw, teeth, maxilla.

It was the most devastating moment of my life.

The road to revolutionizing oral care didn’t start in a lab, it started with a broken smile.

Beyond Aesthetics

The culture I grew up in was traditional Georgian, very rooted in family values. Getting married young was expected. People would formally ask for your hand in marriage. Beauty was everything—how you looked often mattered more than anything else. But I was different. I had a mind I wanted to use, dreams I wanted to pursue. My father knew that. Nevertheless, at 13, I was being prepped for introductions and weddings.

My parents, new immigrants, didn’t know the best doctors or have access to top care so we went to the local clinics. I went through years of dental work with implants, root canals, veneers, and braces. I hated looking in the mirror. I felt insecure and carried this invisible pain.

But one day, the orthodontist said something I never forgot. He said, “Don’t worry, great things will come from you. You’ll change people’s lives.”

He gave me hope. He made me stop focusing on what I looked like and start thinking about what I could do. That one moment changed everything. I cared about making a difference. And from then on, my life took a different path.

No Complaints, No Excuses, Just Work

In addition to the complete change in my life’s trajectory, my parents’ compassion, respect, and tenacity influenced my decision to become a doctor.

My father drove a taxi for 14 years, an old yellow Checker. Eventually, he built his own company, bought medallions, and ran a fleet of cabs. He’d be up at 3 a.m., fixing cars when they broke down. There was no complaining, just work, determination, and problem-solving. He did whatever had to be done and so did my mom. It’s almost like you forget the past, you forget the future, and you just keep doing the next step. That’s the resilience that I’ve learned.

My mother had followed the customary Georgian path of getting married young—in fact, she left school one semester shy of becoming a physician to marry my father.

She sacrificed so much of herself. She was brilliant. She’d help me with chemistry and organic chemistry. It pained me as a girl to watch her life revolve around domestic duties when I knew she was meant for so much more. I chose a different path.

Trading Prestige for Purpose

I started dental school at the University of Pennsylvania. After a residency at New York Presbyterian, I spent two years practicing cosmetic dentistry on Fifth Avenue in New York City. While doing that, I was offered a teaching position at NYU in their Advanced Aesthetic Dentistry program, which I held for two years. But eventually, I returned to Penn for orthodontic school.

I graduated at the top of my class and practiced orthodontics in NYC for 10 years. That time was incredible. I met amazing patients, colleagues, and mentors. But over time, I knew I wanted to go beyond the practice and build something that would impact lives on a larger scale.

“I wasn’t chasing approval, I was chasing impact.”

Emergency Calls Spark Innovation

Throughout my career as an orthodontist, I always took the emergency calls. My husband, also an orthodontist, and my father-in-law would hand them to me because I had the patience to walk my patients through what to do. Over the years, I felt the pain and frustration on the other end of those calls: parents trying to help their kids with swollen gums, broken appliances, sleepless nights. I kept thinking there had to be a better way. They shouldn’t have to resort to toenail clippers or pliers to make urgent fixes. Kids shouldn’t have to suffer through school or another night in pain.

I carried that frustration with me for years. Then COVID hit. Suddenly, families from all over were showing up at our home because they had nowhere else to turn. We saw so many people, each with urgent problems. That was the breaking point.

One night, I was in the basement, my husband next to me, the kids playing nearby. I began sketching ideas and drawing designs for what became Tweakz^®. I couldn’t stop. My husband was chiming in: “Add a diamond file. A diamond tip.” I kept going, researching clinical trials, studying what worked and what didn’t.

It felt like solving a giant puzzle, and I thought, “I can do this.”

Within weeks, I created 18 products, organized into three collections: Oral Relief, Microbiome, and Aesthetic.

30 Patents and Zero Tolerance for Band-Aid Fixes

At the core of it all was the same why: the voices on the other end of those calls, the desperate parent, the crying child, the family in chaos. As orthodontists, we hand out goody bags filled with toothbrushes and floss that patients just throw away—because when they’re in pain, they’re not thinking about brushing or flossing.

The real question is: How do we get them out of pain so they can achieve proper oral health? When you solve the actual problem, everything else falls into place. If you don’t, you’re just putting a band-aid on it.

I wanted to solve the problem and that led me to create a portfolio of sciencedriven, research-backed products designed to help patients when they’re at their most vulnerable.

I returned to Penn to deepen my research in preventive medicine, focusing on oral wellness, the oral microbiome, and new delivery systems. I now have about 30 patents pending.

Toenail Clippers Don’t Belong in Orthodontics

People are still using toenail clippers to fix broken wires. It’s awful, and dangerous. Pieces can fly off, lodge into the buccal mucosa or esophagus. It’s a huge liability for the doctor, but no one talks about it. And when people speak up, there’s pushback: “Oh, it’s fine, just come in, miss work, miss school, don’t sleep for two nights while a wire digs into your cheek, causing inflammation, bacteria buildup, plaque, and demineralizations.” All of it is preventable.

That’s why Tweakz for Braces was the first product. It includes a flush distal end cutter that safely trims wires without leaving sharp edges or loose pieces, unlike old nail clippers. The dislodged bracket remover clears broken brackets, while the rubber band applicator makes changing elastics easy. The diamond dental file smooths rough spots on brackets, hooks, and bands.

The Tweakz for Aligners kit offers an elastics applicator, an aligner remover that removes the most retentive of aligners with ease, and the diamond dental file.

Clinician First, Businesswoman by Fire

Starting the business came with a kind of fearless ignorance. I didn’t know what I didn’t know, and in a way, that protected me. I simply focused on the next step: Ask questions, find answers, and keep moving. The stress didn’t hit until my expectations collided with the real mechanics of business— timelines, margins, negotiations. I didn’t yet understand how deals were made or what tradeoffs were required to keep things moving.

The hardest part wasn’t the work itself; it was staying grounded in a world where I no longer felt like the expert. In medicine and oral health, I was confident. In business, I was uncomfortable. Constantly. But instead of pulling back, I focused on what I knew: how to help people, how to remove pain, and how to prevent suffering. My fascination with removing discomfort from someone’s life is what still drives me today.

There were plenty of times I was told “no.”

But I learned something important:

When you hear “no,” you’re probably just talking to the wrong person.

So I kept going.

Because I wasn’t chasing approval, I was chasing impact.

There were moments of real doubt, days when I questioned everything and nights when I leaned hard on even the smallest wins to keep going. But those glimmers of clarity and hope kept me moving forward. I’ve never looked back. The vision I hold now is bigger, clearer, and more powerful than ever, and it’s rooted in helping others feel empowered too.

Being an orthodontist always felt natural to me, but becoming an entrepreneur felt like learning a whole new language. Every day is unpredictable. But little by little, the products have started to speak for themselves. That’s been my greatest challenge, bridging the gap between my skill set as a clinician and the skill set you need as an entrepreneur. It’s so important to me that someone opens that package with a smile, knowing this product is going to help them.

90% of Emergencies Solved Before They Start

Beyond improving patient care, these products protect the bottom line by preventing emergencies that can cost orthodontists up to $300 at each emergency visit. Ninety-nine percent of bracket emergencies are due to broken brackets or sharp distal ends. For aligners, 92% involve rough edges or trays that are challenging to remove.

Those unexpected visits, usually right after school, at the busiest time of day, can throw an entire office into chaos, from sterilizing tools and turning over chairs to derailing the schedule.

OrthoNu^® products help protect profits by solving 90% of emergencies right at home. The Tweakz tool cuts and holds the wire safely, so patients don’t have to rush in. The Oral Relief collection includes Mouth-aid™ to soothe sores, Comfort Tape™ to help with sensitivity, Chillin’ Strips™ to soothe wounds, and the OrthoChewz™ to ease dry mouth and oral fixation. Today, Tweakz is used in 500+ practices and shipped to 5,000+ patients nationwide, in addition to over 8,000 Oral Relief collections. We’re just getting started.

For big practices and DSOs, these tools don’t just save time, they save thousands of dollars. And they open up new revenue streams by offering parents a kit they want to buy. It’s a win-win-win: Practices save money, create new revenue, and less-stressful experiences for patients.

Precision Tools for the Pain No One Plans For

While I originally created these products for orthodontic patients, the oral relief kits are just as effective for anyone recovering from all dental procedures. Whether it’s after a scaling, root canal, crown, periodontal surgery, or multiple extractions, patients never had anything meaningful to take home to ease pain and discomfort. Now they do. Smart strip technology allows the product to stay in place for hours, deliver active ingredients, and support real healing.

Our current Chillin’ Strip molds anywhere in the mouth and stays in place. The more saliva you have, the better it adheres, the opposite of wax. Soon we’ll have strips that last 8, 24, even 72 hours. That means safer wounds, fewer infections, and better outcomes for surgeries, extractions, biopsies, and even for cancer or radiation patients dealing with oral sores.

In the end, it was never just about orthodontics, it was about listening to the pain, the panic, and the unmet needs on the other end of those calls. I realized those moments weren’t interruptions. They were insights.

They pushed me to ask myself: Am I truly solving the problem, or just applying another short-term fix? That question became my compass. I stopped accepting temporary fixes and started building solutions that treat the root causes—solutions that bring real relief, restore confidence, and shift the standard of care.

Because in a field built on precision, we can no longer afford to think small. Our patients deserve more.

I created OrthoNu to solve the problems I lived. First as a teenager in pain with nowhere to turn, then as a doctor who kept running into the same missing pieces in care. Too many gaps. Too little access. Not enough empathy.

If you believe care can be better, make it better. Because when your mission is rooted in truth, and your drive is unstoppable, you don’t wait for permission—you lead.

The Next Frontier in Diagnostics

The future of healthcare lies in smart strip technology—advancements that extend beyond conventional treatments to support early detection, prevention, and accessible care on a global scale.

Over the next 18 to 24 months, OrthoNu will release a series of innovations—each one grounded in science, built with precision, and driven by one goal: to empower patients and providers.

From targeted pain relief to early disease detection, our IP-protected smart oral strips are changing what’s possible in oral health—making care more effective, more accessible, and more human.

But this isn’t just about product launches or patents.

It’s about leading with purpose.

Often, these lesions are nearly invisible—a faint white line, like lichen planus—that even dentists might miss. Patients are being diagnosed years too late, and doctors face lawsuits because these signs go undetected.

I’m excited about what the products could do for underserved populations. We could triage patients early, in a way that’s affordable and accessible worldwide. We could catch diseases early. Consider a seven-year-old boy who has no idea he has cancer in his mouth. Without this technology, it might not be found until it becomes a much bigger problem years later. The dream is to save lives through early detection.

This vision pushes oral care far beyond the dental chair—toward a future defined by value-based care, personalized wellness, and minimally invasive diagnostics.

The goal is to empower clinicians to be the frontline heroes for their patients. By creating data collection tools for every patient, we can track changes in their oral health over time and catch problems before they escalate.

This technology could revolutionize disease prevention. Think about populations with limited access to healthcare—being able to give them oral smart technology that detects early signs of oral disease, diabetes, heart disease, or cancer. It’s an affordable, accessible way to triage health worldwide.

Because when you build from a place of compassion, you don’t stop after one success. You keep going—because you have to. And when innovation starts from the heart, it becomes unstoppable.

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