S5 E06: Dental Industry Predictions for 2025

Wright: [00:00:00] Dentistry's landscape is evolving and it's more important than ever to understand the shifts and the trends that are affecting our profession. I'm Dr. ArNelle Wright. 

Ioannidou: [00:00:10] And I'm Dr. Effie Ioannidou. And today we are analyzing the data behind the issues that will shape dentistry in 2025. We have an amazing guest, right?

Wright: [00:00:20] Yes. 

Announcer: [00:00:23] From the American Dental Association, this is Dental Sound Bites. Created for dentists, by dentists. Ready? Let's dive right into real talk on dentistry's daily wins and sticky situations.

Wright: [00:00:40] Happy New Year, Effie. 

Ioannidou: [00:00:41] Happy New Year. 

Wright: [00:00:43] Yeah, I can't believe 2025 is here. 

Ioannidou: [00:00:46] It's unbelievable. 

Wright: [00:00:47] Yeah, time is flying always, right? 

Ioannidou: [00:00:49] Oh, oh my God. I'm one year older. One year younger. 

Wright: [00:00:53] One year better. Let's just say better. 

Ioannidou: [00:00:54] One year better. 

Wright: [00:00:56] Yes. Yeah. Well, before we begin today, I want to remind our listeners, if you want to be part of our Dental Sound Bites community, please take a moment to subscribe wherever you listen and stay updated with every new episode.

Ioannidou: [00:01:12] And don't forget, now you can enjoy us on Videos on the ADA YouTube channel. So not only you can listen, but also you can watch. 

Wright: [00:01:21] Yes. Okay. Well, let's get to one of our favorite episodes. We are excited to welcome back a listener favorite, actually, Dr. Marko Vujicic, chief economist and vice president of the Health Policy Institute at the American Dental Association.

We are so happy to have you, Marko, here to give us a sneak peek into your year ahead. 

Ioannidou: Hi, Marko.

Wright: Hey Marko. 

Vujicic: [00:01:46] Great to be here. 

Ioannidou: [00:01:47] Happy New Year. 

Vujicic: [00:01:48] Yeah, happy New Year to both of you, ArNelle and Effie. Happy to be invited back. 

Wright: [00:01:54] Oh, always. Definitely a listener favorite. Well, for our new listeners, why don't you tell us a little bit about yourself, what you and the ADA's Health Policy Institute does, and looking back, what are a couple of big things that you saw in 2024?

Vujicic: [00:02:10] Great. Yeah. So, the Health Policy Institute is, the best way to think of it is as a think tank. We're researchers, statisticians. I'm an economist by training, but we're really data wonks that look at what's going on from an unemotional, data-driven perspective. Nothing clinical. But look at trends in the market for dentistry.

And a couple big things we saw in 2024. We saw stabilization finally of the dental economy in the U.S. Obviously we had a lot of turmoil post pandemic. There was an echo in recovery and then staffing shortages and things kind of really started to stabilize, let's say, in 2024. We also saw, again, continued shifts in the practice models out there in terms of how dentists are practicing. We can talk a little bit more about that. 

Wright: [00:03:06] Okay. 

Vujicic: [00:03:06] And we also had a first a big look at an important issue that, that's quite controversial within healthcare, private equity investment in dentistry. We released the first study ever looking at the prevalence of private equity in the oral health space compared to the rest of the health care. We found about 13% of dentists nationwide were affiliated with private equity in some way in their practice.

But the bottom line here is -- and we'll talk more as we look forward -- you know, 2024 saw a lot of. the same trends that we've been tracking in the Health Policy Institute with the practice modality changes. And on the general dental economy side, it was quite a boring year in the sense that a lot of the trend curves were flat lines. Things were really stable. That's kind of some of the highlights. 

Ioannidou: [00:04:00] Having this in mind, Marko, what do you expect for dentistry in 2025? Like, do you expect to see any changes or do you expect a boring flatline? 

Vujicic: [00:04:10] I don't think it'll be a boring flatline in 2025 for a few reasons. Let's go through, so at the end of last year, in December, we surveyed, we have a quarterly survey that we sent to a very large panel of nationally representative dentists and this is the first time we're sharing those results on this episode. So I think it's important to go through a couple of highlights from those data. 

Wright: [00:04:37] Yay. 

Vujicic: [00:04:38] We asked dentists looking ahead to 2025, what are some of the big things  that you're concerned about that keep you up at night.

So the top three reasons have not changed. So this is not the real exciting part, but the top three reasons remain staffing shortages are a top concern. 

Wright: [00:05:00] Yeah. 

Vujicic: [00:05:01] Dealing with insurance, both reimbursement rates, administrative issues was number two. And number three, rising overhead costs. So in our episode last year, those were the same top three issues when we asked dentists to look ahead.

So that kind of hasn't changed. What has changed is the level of economic confidence. So we track, we asked dentists like, okay, how confident are you looking ahead? In the finances of your practice, the dental sector overall, and the U.S. economy.

At the end of 2024, in December, we saw a big spike in confidence. Both in terms of how dentists are feeling about their practice, about dentistry overall as a sector, and especially the U.S. economy. So I would say things are different in the sense there's a lot more optimism about economic conditions in dental practices.

The last thing I'll say is this issue of staffing shortages. So we've been talking about this in dentistry for, you know, basically post pandemic. And, you know, my team, we get a lot of things wrong, and there's no harm in admitting that. But we nailed this one. I said three, four years ago, this is not an overnight problem. This will take three to five years. We're probably in year four of that prediction.

But here's what's cool. The newest data show that we are finally seeing big increases in graduate numbers from hygiene programs. We had not been seeing that at all for the past three, four years. So I am hoping that as more of those graduates come into the system, and some of the state policy reform some states have been pushing kick into effect, I think this is the year, in 2025, where we're going to see some relief, finally, when we get to the staffing situation. So I think that's exciting. So those are a couple of things I'd want to highlight. 

Wright: [00:07:03] Can I ask about from a staffing perspective, if we're seeing those numbers increase of hygiene graduates, but also one of the trends that we saw was increase in overhead, do you all expect for those of us to also see that trend continue to rise as we begin to have to hire and, you know, what are some of your, I guess, first reactions or thoughts about that? 

Vujicic: [00:07:27] In a nutshell, ArNelle, yes. I don't foresee any big relief coming in in what we've coined, kind of, margin compression.

So the last few years have seen quite substantial growth on the expense side. So equipment supplies and mainly, you know, employment, human costs, right? Human capital costs, wages. At the same time, we are not seeing reimbursement rates rise to the same degree. So, this is this kind of margin compression or this fiscal squeeze.

Now, we're not seeing anything on the horizon to kind of bend some of those curves, right? So I would say that I don't see any big fiscal relief, some big swing back in the reimbursement trends or some swing down on the expense side. Now, the caveat there is technology, right? And then I'm a lesson expert in that area, right?

But is there's more automation, is there more AI involvement in workflows and, and you're on the ground level of this, ArNelle, right? Um, I mean, Effie for you as well, but in a different environment.

Ioannidou: [00:08:36] Yeah. 

Vujicic: [00:08:36] Um, but, but I really, I think maybe there's, there's kind of an opportunity there to get more efficient, to kind of, you know, streamline some of those processes.

But I don't know, I don't know how easy that is to do and how prevalent some of these technologies are. And you know, that constant question we're all asking in the economy, right? Like, what can technology do that humans are doing? And how do you replace that? 

Ioannidou: [00:09:04] And I mean, at the end of the day, you're the expert, but in my understanding, as we talk about technology, maybe we are able to control better the human labor overhead costs, but the inflation that affects the expenses and the supplies that obviously cannot be addressed.

So you know, I see this as, you know, as increasing and increasing, and you're absolutely right on this. But since you spoke about technology, what types of advancements in technology in the field, in the space of technology, do you think that will impact our industry the most in ‘25 and further?

Vujicic: [00:09:46] And again, I'm not an expert. It doesn't stop me from commenting, but let's discuss that a bit. So from my perspective, obviously the game changer, is kind of leveraging AI. Right. And I dunno, just speaking 30,000 foot as an observer things like benefits verification, diagnostic processes. Obviously AI’s big entree into dentistry has been in radiograph reading. I feel the next evolution there is, okay,how do you now go the next step? And, you know, help with some of the treatment planning, or at least, you know, can you use AI to help you soak up all the evidence and best practices on what type of procedure base you should do based on certain diagnoses, right? I feel that's coming.

So on the clinical side, that's one application. But I said on the business side, right? Like even automated appointment making, you know, reminders, recalls, again, dealing with third party payers, right? That's time consuming for people. There are technologies out there now that hey can help with that, right? They can instantly see, you know, me as a patient, what's left in my plan and are these three procedures that the dental team has said I should do, are they covered, right? Like that. So you're, you're thinking about replacing people on the phone with carriers, with some automated real time verification.

Those are a couple of things. Again, I'm not an expert there. The other thing that I continue to be amazed by is just how much the clinical side, and again, observer, you should really have experts, people like Forsyth Institute, which you've had on last year, have them back to talk about all the new developments and materials and procedures.

But I feel like we're potentially on the cusp of more of this, let's say, patient-centered care with remote connection. Right? So, you know, can you be connected to the patient through the phone in real time? Can you replace some of the human interaction with digital interaction, especially for younger cadres of patients who want to interact that way.

Certainly, the ortho space has gone through a big revolution with much more, I don't know what you want to call it, friendly, consumer friendly. Right? I mean, it requires less visits. They're technologies now that, you know, at home, I can do things with my phone to take pictures of my mouth, etc.

So I think again, not being an expert, but I feel like the digitization and the AI space there is also very exciting. And again, we have a whole research unit and our Forsyth Institute team that's really, really on the cutting edge of all that. So hopefully you have them on again. 

Ioannidou: [00:12:37] And you're absolutely right because this digital space is utilized so much in medicine, right?

So now you can have your remote visits with your primary care, your text on, you know, MyChart or any other platforms. It's so utilized in medicine. And I wonder to what extent we capitalize on this. I think we are a little bit behind probably, but it's coming, right?

Wright: I think it's here.

Vujicic: [00:13:03] Yeah. And I think it's here. And I don't know, ArNelle, how much you personally have in your practice. Right? But I mean, honestly, the reality is the young patient of today, which is going to be the patient for the next 30 years, is just simply having different expectations. Right. I mean, like it or not is they want to cancel appointments last minute. They want to reschedule on their phone. They want to, you know, have information at my fingertips about what the dentist is saying I should do versus what the science says, et cetera. So I think there's actually huge opportunities to leverage that. I mean, I feel like a golden era is coming for oral health.

I really do because of the convergence of trends. It'll be different. But, you know, we have half the population that's not engaged with the oral health care system, right? Like, that's a huge opportunity. Now, part of that is they report financial barriers and perceived value and costs and all that, but part of it is convenience, right?

Part of it is just the day to day and, you know, we know, you know, dental practices are largely separate from the rest of kind of health care and minute clinics and emergency care centers and primary care, you know, that's starting to change a little bit, too. So I feel there's lots of opportunities to really, really leverage touch points with consumers to get more people connected to dentists.

And that doesn't mean twice visit in the office every year. It could be connected virtually and connected digitally. Lots of opportunities, but different. 

Wright: [00:14:35] Right, right, right. So one of the things we definitely want to cover on this episode is some of the biggest changes that we might see in dentistry over the next few years.

But coupled with that, I had my own question. In your intro, you talked about some of the other trends. So like practice modality has been a constant, you know, topic and, being a newer dentist, you know, I'm still under 10 years. You know, the DSO space has been expanding and, there's always this question in some of my conversations with my friends about going into private practice, like if that is still a trend. If one is listening to this episode and they're hearing these data come out, it may change their minds about, you know, transitioning into private practice, if that was something they wanted to do.

So, could you talk about that in some of those biggest changes that we may see in dentistry over the next few years? In addition to what else we may see? 

Vujicic: [00:15:35] Sure, we can unpack a few of those. So let me just start with just kind of some of the facts, right? So our latest update shows a continued shift away from solo practice towards groups. And I use that term generically, right?

We had also shown a shift towards DSOs, which are a type of group practice, right? But there are many other types of group practice. But bottom line, more dentists are working in groups and more of them are affiliated somehow with the DSO. So that trend continues slowly and steadily. It's not like a revolution. It's again, when 1% more of dentists per year shift into those models. But it's interesting, ArNelle, since you mentioned it, so if we look at super early career dentists less than five years out, right? It's 29% of those dentists that are affiliated with a DSO. 

Wright: [00:16:30] 29% 

Vujicic: [00:16:31] Compared to 14% of all dentists in the U.S. So, it's particularly a sharp increase in early, early career dentists going into those models. Now, many ask, is that simply a steppingstone to, let's say, private practice classic? Right? The answer there resoundingly in the research is no. This is the majority of these early career dentists. When we find them five years later, they're still in those types of models, right? So...

Wright: [00:17:02] I was going to ask that.

Vujicic: [00:17:03] Yes, there is transition, but not the majority. The majority remain. 

Wright: [00:17:07] I was going to ask if they're staying there. Yeah. Thanks for covering that. 

Ioannidou: [00:17:11] So it's an intentional career choice. 

Vujicic: [00:17:15] I don't know that I'm telling you the data, whether it's intentional or not. It's yeah, that's a bit harder to assess, right?

Ioannidou: [00:17:24] Yeah. 

Wright: [00:17:24] He's like, he's just has the numbers. 

Ioannidou: [00:17:26] That's the number because the reasoning, when I say this, I imply it's not a transitional thing. If five years down the road, they remain in the same

Wright:They're still there.

Ioannidou: Yeah, they're still there. This shows a little bit of a more thoughtful decision, if you will, not out of convenience, not out of the first five-year burden, financial burden to recover from loans. I mean, it's complicated, I am sure, but it shows a little bit more a consistent kind of path. 

Wright: [00:17:53] Yeah, which is exactly what the data is showing. That was what you were saying, right, Marko? 

Vujicic: [00:17:58] Yes, exactly. And then, and again, I'm not saying what's good or bad. I'm just reporting to you what the facts say. We do have a really interesting report out and there's a lot of detail like, you know, when you ask dentists, what are you satisfied with? What are you not satisfied with? We took a really large sample of early career dentists in these different models and just some high-level conclusions. So things like, things like clinical autonomy, right? Kind of the smaller group practices tend to score better in terms of how dentists report clinical autonomy than let's say these super large groups in DSO.

So that's an interesting thing. Things like CE opportunities and mentoring, etc., it's the reverse, right? Like the larger practices score better. So to Effie’s point, right? It's like, okay, some people value some things better. You know, am I willing to maybe earn a little less, but it's much more secure and much more guaranteed, right?

Maybe that, and kind of, I don't have to work on weekends. There's all this kind of mix of things going on, right? So, but the point is, I, I really, I think why we're going to see this trend potentially intensify, and that was your root question, ArNelle, is we are really in the thick of a generational transition among the dentist population.

What do I mean by that? We are seeing now a big, big number of baby boomer cohort dentists exiting the market. Right. We're like in this sort of retirement boom. And behind that is a continued ramping up of the number of dental grads. Which by definition are new, young, and super early career. And it's, you know, it's 57% females in the incoming class. Like that is a healthy majority. I think we talked about this last year too, that continues.

You know, different profiles. It's different personality going into dentistry. So I think this whole shift in the demographic of who is coming into the dental market versus who's exiting. They're different.

So I think that's why, plus all the complications of the business side of running, you know, complexities going up in terms of running a successful practice.  I think for those reasons, and again, it's just an HPI prediction, I see these trends somewhat intensifying over the next five years, let's say. Right? Verse like no, we've hit a peak and now things will go back to normal.

Let's say, no. So I think that's an interesting thing. It obviously has implications. You know, we're trying to study what are the implications for not only dentist satisfaction, but like patients. 

Wright: [00:20:44] Patients.

Vujicic: [00:20:44] ArNelle you always bring this up. Like, is there good research on, you know, is quality of care different? Is the patient experience different? Even simpler than that. Like are the procedure mixes different for the same type of conditions? So that's one thing we're going to be digging into a little bit more in 2025. Trying to kind of understand that. Same thing with private equity. We mentioned that at the beginning, right?

It's interesting to report -- and trust me, it took a ton of effort -- that 13% of dentists are in private equity affiliated practices. But at the end of the day, it's like, okay. Does that matter? So what's the difference between a PE invested practice and not? That's the kind of things we want to look at this next, this year in 2025.

Wright: [00:21:29] Awesome. 

Ioannidou: [00:21:31] All this data that you're presenting Marko is so interesting. You spoke about the significant difference in the demographic shift as the baby boomers are retiring. And I like that you said the boom retiring, the retirement, the boom. Retirement of the baby boomers.

Wright: [00:21:47] Retirement boom.

Ioannidou: [00:21:49] Retirement boom of the baby boomers. 

Vujicic: [00:21:51] That's a good one. Right. Okay. A boom and boom retired. 

Ioannidou: [00:21:56] We'll be right back people. 

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Ioannidou: [00:22:50] Welcome back to Dental Sound Bites. We are having a conversation about the shifts and trends affecting our profession with Dr. Marko Vujicic. 

Wright: [00:22:59] I remember there was an article, I think it was on the same topic about how we're projected to reach gender parity by 2040. Is that still the case? And if so, like if we are reaching gender parity by 2040, I was thinking like, man, the resources, like the leadership skills, the tools on running practices, running business, being entrepreneurial, managing your finances, all of that. Like, we need that too. So, you know, I know that's not like in your arena. 

Ioannidou: [00:23:30] 2040 or 2140? 

Wright: [00:23:32] Well, it's2040!

Vujicic: [00:23:35] Well, 2040. And to clarify for listeners, right? Yeah. ArNelle is talking gender parity in dentistry. 

Wright: [00:23:42] Yes, in dentistry. In dentistry. I'm sorry. 

Vujicic: [00:23:44] The 202,000 currently working, not of the grads, right? So of the recent grads. 

Wright: [00:23:52] We've already passed that. 

Vujicic: [00:23:54] Yeah, but, it's a great point. So again, this is where, an Effie, you know, you can comment on this, right? Like educators, the education community, and this is a question to them that I asked, right? So with these trends that we see, are we adjusting who we're attracting into the profession, right?

So one school of thought is to say, okay, dentistry is going down the path of all the other healthcare professions, right? Moving away from cottage industry to groups. You know, away from ownership to employment, right? Working, you know, in larger organizations, let's say. And you maybe should advertise that to prospective graduates that they're not going to simply plug into the practice that they observed today or that they grew up with, etc.

Again, that's one school of thought. Another says fight all this. Right? Like give dentists the tools to be small practice owners, to successfully run so they don't quote unquote have to go to these large groups, et cetera. So I really feel like the education community almost has some, I don't know, introspection because it's very like, I don't know, there's a lot of emotion on this.

And I talked to a lot of leaders, obviously, in the ADA and the education community. And some people are like, they're very disturbed by all these trends. They're like, this is not the vision of the profession. We're trying to avoid all that. And at the same time, every year the data come out, it's like, okay, well, the trends continue to go to like, okay, there are less people in their practice. There are less people who are doing the managerial, nonclinical work. The profile of people going into dentistry is not as much, let's say, legacy and people that will plug into their family's practice, etc. So again, just as an observer and commentator, I feel like this is a big tension and I don't know kind of how that gets resolved.

Is it like, should schools adjust and be proactive and say, let's change who goes into this profession? Or no, we simply react to what the market's doing. And, you know, there's space for all practices, obviously, the trends are the trends, but, you know, there's no need for anybody to adjust. 

Ioannidou: [00:26:15] Yeah, I think it should be organic and we can let it evolve, right?

I think you brought up so many, it's, I mean, it's so interesting. I'm very impartial to the issue because I am not in practice. I'm in academia and I can tell you that trying to be unbiased and from the 30,000 foot view of the issue, I would say that you know, education, higher education, is extremely expensive. Those graduates, come out with a, what's the, I mean, you know, the numbers, Marko, they are the average that is what close to $300,000? 

Vujicic: [00:26:57] Not, not as much, but it's high $200. Yeah. 

Ioannidou: [00:27:00] Yeah. And depending on, you know, public, private, right schools. And what kind of undergrad who supported your, I mean, it's, it's very high debt.

So the high debt. 

Vujicic: [00:27:09] That is trending down though, this is important last two, three years, slightly. 

Ioannidou: [00:27:14] Really?

Wright: [00:27:15] Oh, I would love for you to talk about that. 

Ioannidou: [00:27:18] How? 

Vujicic: [00:27:18] Yeah, I don't know how. I think, I think definitely it's not because governments are subsidizing school most more, right? They're still pulling out. Something has happened with, with tuition levels and I don't know if it's subsidies from somewhere else, but, I don't know. I don't know. 

Ioannidou: [00:27:35] Endowments? NYU has a tuition free medical school. 

Vujicic: [00:27:40] Yeah, you should get an episode where somebody knows the data much more than me. But we seem to have hit a little bit of a crest, right? And a reversal of some of the cost of education things. 

Ioannidou: [00:27:53] You're absolutely right. Something that we should revisit and talk about this. But the cost of education, and as I said, the structure of our society. I speak to the, you know, the younger generation. I speak to the dentist students. I speak to them, to the, you know, undergrads, people that want to go into dentistry.

They want to, they want to secure a comfortable lifestyle. But also a balance between, you know, working life. So they are different. Their priorities are very different than the our, my generation’s priority, and certainly very different than the baby boomers, right. To where, it was, you know, the husband was the working for in the workforce. The bread. Yeah.

Wright: The breadwinner.

Ioannidou: What you say? The breadmaker not the bread maker. Mm-hmm . The breadwinner. The breadmaker. The breadmaker was the bread maker. 

Vujicic: [00:28:48] Breadmaker would be different. 

Ioannidou: [00:28:51] Yeah, exactly. So, very traditional structure. This has changed. This doesn't exist anymore. So both parents now are in the workforce. They want to enjoy life. They want to enjoy their kids, they raise their kids. They want to be on vacation. They want to, you know, they want to spec maybe work nine to five. I don't know. My daughter wanted to go to  medical school and then she said, Oh, you know what? Second thought. I don't want to be on call.

Vujicic: [00:29:15] Right. Interesting. 

Ioannidou: [00:29:16] So, dentistry. 

Vujicic: [00:29:17] Again, there's space for all those. And I think that's what's exciting is that the field is evolving such that, okay, if I want to work in public health, FQHC, and have that lifestyle, I can do that. 

Ioannidou: [00:29:26] It's exciting. 

Vujicic: [00:29:27] I want to work in a group. I have no interests. I just want to come in and do the clinical work. Others are like entrepreneurial. I want to really be involved. I want to grow the business. There's space for that. So I'm talking just the general trends, right? And the general trends were clear are exactly what FA has summarized. And I'm glad you raised that because part of it is this generational mindset shift and there's a whole societal dynamic there.

Wright: [00:29:52] Oh yes. 

Ioannidou: [00:29:53] All these factors that you mentioned, Marko, that are so complicated and affect all the choices that dentists make. How can dentists, dental professionals stay updated with all this, the new trends, the latest trends, the developments and make the right decisions?

Vujicic: [00:30:11] Well, first podcasts like this, and you know, the ADA recently launched.Yeah, exactly. This is a big one. Specific to us, look, if you're into like short little briefs and detailed reports if you want the latest data updates, I would encourage people, if you go to ADA.org/HPI right on our homepage you can sign up for our newsletter with the latest and greatest reports as they come out.

My team does a lot of speaking engagements with study clubs as well, which is great. That's been really, really ramping up. A lot more people are interested in having us out to talk to dentists, talk to their study club, talk to their dental association at the state or local level, which is really, really great.

And you know, stay tuned. The ADA is revamping too. We have a whole platform we wanna do to communicate and inform early career dentists, especially. Right? About a lot of these trends  and changes coming and how the ADA is modernizing to help them navigate it. So for our part at the Health Policy Institute, again, sign up at our webpage, ada.org/HPI and also LinkedIn. I'm on LinkedIn if you want to follow markovujicic as well.

Wright: [00:31:30] So awesome. Well, before we wrap, we have one final question, which you can summarize, I'm sure, is to share with all of our listening community, what's on the agenda for the Health Policy Institute. And if you could, can you tie in if there's any trends or anything that came true from 2024, if there's any new developments that surprised you? That was a loaded question. 

Vujicic: [00:31:54] Yeah. Good one. Awesome. Thank you. Thanks. On the, on the surprise, on the surprise I thought was the fact that it was a lot of stability in the dental economy. I would have thought there'd be a slightly bigger upswing in terms of total dental spending in 2024.So that part again, we didn't make predictions on that, but that, that I internally got a little bit wrong.

But let's look ahead. A lot of exciting things we're digging into. So given some of the top concerns we saw around insurance and the issue that it's frustrating for both providers -- and we didn't talk today -- but it's frustrating for patients, as well. And we know even those people with insurance report significant financial barriers to care.

Anyway, bottom line, We're going to look to start evaluating some of the important reforms. Listeners may have heard of something called medical loss ratio or dental loss ratio. These are important policy reforms. The biggest one being in Massachusetts where there's regulations on basically how much an insurance company can keep as profit versus how much they have to pay out from their revenue in terms of care.

So it's another accountability measure for the insurers. We're going to invest a little bit more to see, look, what's that done to patients? What's that done to access, et cetera. We will continue to monitor the usual trends in terms of dental spending, what's been growing, what hasn't. Which, by the way, is fascinating. If you look last month, we released the latest data from CMS on dental spending. We didn't talk about it here. Dental spending grew by 4 million. This is actually 2023 data. Don't worry about the year. The biggest thing was all that growth is in the public space, Medicare and Medicaid, especially Medicare.

So the private dental spending from insurance and out of pocket has been totally flat and slightly down, and it's on a downward trend. So this is a whole other topic about dental spending becoming, 

Ioannidou: [00:34:00] And a big one. 

Vujicic: [00:34:01] you know, the public programs are really fueling the growth in the dental economy. But anyways, we're gonna look a little bit more on what are some good practices in Medicaid.

We didn't talk to too much today. We do a lot of research that's very policymaker focused. So, you know, a state Medicaid department is interested. Okay, what do we know about best practices for how to run a Medicaid program? And the idea is a whole advocacy group just focused on that. And we arm them a little bit with research. So we're going to do more there.

Finally, we really want to look at, obviously, there's a lot of discussions with the new administration, you know, a lot of wild cards in healthcare, a lot of unknowns, but frankly, a lot of opportunities to really re-engage oral health. You know, we had a lot of discussions around fluoride, and as this episode comes out, who knows if we're still having them.

But the point is, people were talking about oral health at the highest levels. And I think we have an opportunity, really, to inject a broader, broader discussion about, hey, how do we address America's oral health challenges? And why was only half the population going?

So we're going to continue to get real, almost real time data in terms of how some of these policy changes that are coming are affecting both the profession and the public because again, that's part of our role, right, is to really get the data and get the evidence and the facts. So the ADA can kind of help guide the path of oral health in America using those facts. 

Wright: [00:35:33] It was so good. 

Ioannidou: [00:35:35] This is great. Thank you. Thank you so much, Marko. Thank you for sharing this information. You got me excited. 

Wright: [00:35:42] Every single time. Every time. I'm telling you. 

Vujicic: [00:35:46] Yes. Okay. 

Announcer: [00:35:51] On the next Dental Sound Bites. 

Wright: [00:35:53] A dentist's guide to the law. Answers to the top legal questions every dentist should know. 

Ioannidou: [00:35:58] Practical resources to help you, your team, and your practice stay compliant and protected.

Ioannidou: This is great. This is amazing. I love it. And we cover so much, but I wonder if there is anything else to, to add that we haven't covered? 

Vujicic: [00:36:20] No, just again, just a lot more topics we could talk about. You're both amazing. You know, I love chatting with you. 

Wright: [00:36:27] We get so excited. 

Vujicic: [00:36:29] Hopefully we do this again soon. 

Wright: [00:36:31] Yeah. We're going to have to do a part two. 

Ioannidou: [00:36:32] Oh my God. Yeah. We have to, I mean, before we started, I went to your, the Health Policy Institute website, and I was so excited about the live data you have on Tableau about the mobility of dentists from one state to the other. And this made me, made me think, I have some ideas. We have to talk.

Vujicic: [00:36:51] People are going to Texas. People are going to Idaho. Yeah, it's a whole other discussion. 

Ioannidou: [00:36:57] Exactly. So, yeah, that's great. Thank you. Thank you, Marko. Thank you so much. 

Wright: [00:37:02] Yeah, we're so glad you were here. 

Vujicic: [00:37:04] Thank you so much for having me on. 

Wright: [00:37:06] Yeah, we're so, we're always welcome to come back.

So can you tell our listeners where they can find all of the HPI's great work and how they can get in contact with you once again? 

Vujicic: [00:37:16] Sure. Yeah. Uh, ADA.org/HPI And if you prefer email hpi@ada.org. And again, Marko Vujicic on LinkedIn. I believe I'm the only one. Those are three ways. 

Ioannidou: [00:37:32] Yes, you are. You are the one and only one and only. 

So, and we will have all the resources and the information that we mention in the show notes, on theADA. org slash podcast. And don't forget, if you like this episode, share it with a friend. Do it. Share, share, right? And be sure to subscribe to the podcast wherever you listen, so you can get the latest episodes.

Wright: [00:38:00] Yes. And you can also rate it, write a review and follow us on social media. All right. Thank you so much for being here again. 

Vujicic: [00:38:08] Thank you. 

Ioannidou: [00:38:09] Bye. 

Wright: [00:38:10] Bye.

Announcer: [00:38:13] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show, resources and more on the ADA member app and online at ada. org slash podcast.