Dealing with the Effects of Inflation

  • by Carrie Pallardy
  • Nov 21, 2022
A beleaguered supply chain and high levels of consumer demand are driving up costs. Inflation in the United States hit a 40-year high of 9.1% in June 2022.1 While inflation has somewhat receded in subsequent months, the economic pressure is being felt across the country by individuals and industries, including dentistry. According to an American Dental Association (ADA) Health Policy Institute survey, 35% of dentists polled are concerned about the impacts of inflation, overhead and rising costs.2 Even more dentists (69%) are concerned about staffing. In the wake of the COVID-19 pandemic, qualified hygienists and dental assistants are in high demand, and practices are paying more than ever in wages. 

While dentists are paying more to keep their practice doors open, inflation also puts stress on their patients. Will inflation mean consumers are more likely to put off dental care? Will dental practices be able to continue working with insurance companies as inflation drives up prices while reimbursements stay the same — or even decrease? Strategies to manage inflation are no secret, but weathering the current economic storm isn’t the only concern for dentists. Figuring out how to pay for supplies and staff while caring for patients takes a toll on mental health, which extends beyond dentists’ work lives.

Supply Costs 

During the height of the pandemic, the cost of personal protective equipment (PPE) — and the enormous effort required to source it — was a primary concern for dental practices. “Our $15 box of gloves jumped to $50 for a brief period of time,” said Jordan Weber, DDS, owner of Burlington Dental Center, Burlington, Kansas. The cost of PPE has started to drop, though not to pre-pandemic prices, and other costs are creeping up. 

Supply chain issues persist, and dentists are finding it difficult to source essential products for their practices. “Some offices have reported a shortage of restorative materials due to manufacturing being stopped or slowed,” said Richard A. Huot, DDS, FAGD, founder of dental management consulting group Beachside Dental Consultants. 

Many dental laboratories are notifying practices of blanket fee increases. For practices that have good relationships with labs, ending the partnerships over rising costs is impractical. Likewise, cutting costs on supplies that impact the quality of care is not a frontline strategy for dental practices. “You don’t try to cut costs on your composite and your impression materials,” said Weber. 

Products that do not affect patient care are the logical place to start for supply cost savings. In the past, dental practices may have ordered goods like office supplies and disposables without a second thought. Now, shopping around for those items could save money. 

Inflation tends to ebb and flow in cycles, but dental practices cannot expect prices to fall back completely to where they were before the pandemic or this period of inflation. “We’re anticipating an approximately 6%–7% increase in total practice overhead going forward, and we think most of that is what economists call structural, meaning permanent,” explained Roger Levin, DDS, CEO of dental management consulting firm Levin Group and AGD Impact Practice Management columnist. 

Higher overhead means less profit unless dental practices can adjust. Practices can take different approaches to managing their supply costs in the long term. Dental service organizations (DSOs) can leverage their group purchasing power and in-house laboratories to drive down costs. While smaller practices don’t have that strength in numbers, they can adopt these strategies in their own ways.

Independent practices can work together to increase their purchasing power. “There are Facebook groups and other private groups that have commingled together to improve their purchasing power, and I encourage dentists to look for those opportunities,” said Jennifer S. Bell, DDS, FAGD, FICD, co-founder and managing partner of Signature Family Dentistry, Raleigh, North Carolina. 

Even if practices are buying their supplies without the support of a group, they can find ways to cut supply costs. “Buying bulk, taking advantage of periodic specials and comparing prices among dental supply companies could prove useful,” said Huot. 

While bringing all laboratory services in-house may not be feasible for smaller practices, strategic investments in technology can lower costs in the long run. “If you were to bring your ability to make your own crowns in-house, then you could strategically reduce your costs for laboratory expenses,” said Bell.

Oaxaca, Ong & Jensen, a dental practice in Seal Beach, California, introduced CAD/CAM technology during the pandemic, which allowed the practice to complete crown and bridge cases in a single visit. Adopting that technology helped level the playing field for the practice, according to Howard E. Ong, DDS, MAGD, a partner in the practice. “Adopting technology where it applies and where you can afford it is tremendous,” he said. 

Staffing Costs 

Dental hygienists left the field in droves during the pandemic, and, as of August 2021, less than half had returned to their roles in dentistry.3 An ADA Health Policy Institute survey from May 2022 found that 40% of respondents were attempting to recruit dental hygienists. Additionally, 92% of respondents reported recruiting dental hygienists to be extremely challenging.4 Dental practices are feeling similar challenges when it comes to recruiting dental assistants. A total of 42% of the May 2022 ADA Health Policy Institute survey respondents were actively recruiting dental assistants, and 84% considered that effort to be extremely challenging.

The high demand for dental practice staff means wages are higher and staff retention is tough. In Bell’s area, some dental practices are offering $5,000 and $10,000 signing bonuses for hygienists and dental assistants. If practices can’t offer that to new employees or raise wages for current employees, staff can easily leave for a competitor who can. 

This environment for staffing can be the hardest on small practices that cannot keep up with what larger competitors can offer. “[DSOs] often offer more competitive benefit structures like 401(k) plans, health insurance, flex spending — a lot of the things that small business owners can’t afford to provide to three or four employees,” said Bell. 

While paying competitive wages goes a long way toward solving staffing woes, throwing money at the problem is not the only solution. “We need to be more strategic, more creative and more innovative because this problem will not be going away in the near future,” said Levin. He believes that dental practices need to take a long, hard look at staff retention strategies and practice culture. 

“People want to go to work today with a purpose,” he said. He recommended that dental practice owners look at their mission statement, if they have one, and make that pursuit clear to staff. Make the employee-employer relationship less transactional and more about a common goal of serving patients. 

Levin encouraged practice owners to treat staff members like customers — with respect. Offer regular and transparent communication. Recognize hard work. Surprise team members with small perks, like lunch or gift cards. Support team building outside of the practice environment. “It goes a long way toward building a powerful and deep relationship,” he said. 

The Patient Perspective 

Many general practices are just beginning to feel the effects of patients reacting to inflation. “Dentists typically feel economic changes about 18 months after the onset because we still fall somewhere between healthcare and commodity in the mindset of a consumer,” Bell explained. Dental practices can expect patients to continue tightening their budgets and prepare accordingly.

Minimizing the number of visits per person can help maximize patient value. Weber, who practices in a rural setting, points out that people are particularly cognizant of gas prices. Fewer trips to the dentist means more gas in the tank. Consolidating as much care as possible into a single visit can help ensure patients undergo treatment; they won’t have to worry about whether to skip a subsequent visit. 

For larger cases that require multiple visits, efficient scheduling practices can keep patients in the chair. “Schedule your large cases within seven to 10 days if possible. More and more patients will accept treatment on large cases,” Levin advised. “The longer they have to think about it, the longer they might decide to wait and see what happens with the economy.” 

Emphasizing preventive care can also be effective. “Preventive strategies seem to be really resonating with patients right now because of economic compression,” said Bell. 

Inflation may result in more patients delaying care because they cannot pay for it upfront. Offering financial solutions, like a healthcare credit card or an in-house membership plan, can help practices meet the needs of these patients. 

Insurance Outlook 

Raising prices is the usual response of any business facing inflation. “The typical insurance-driven dental practice just doesn’t have any ability to pass on any of the effects of inflation to the patient,” said Weber. 

Dental practices that work with insurance plans are in the tough position of attempting to negotiate reimbursement rates that have remained flat or even decreased. Some insurance companies will not negotiate on fees, while others are more open to it.

According to a 2019 study, more than half (50.2%) of adults aged 18–64 in the United States have dental coverage through private insurance.5 Severing ties with insurance companies without careful consideration can have a negative financial outcome for practices. Rather than ditching insurance companies out of frustration, Levin recommends completing a comprehensive insurance analysis. Understand how much revenue comes from each insurance plan, then determine if it is financially feasible to end any of those relationships. 

For the insurance companies you do plan to continue working with, it is still important to manage those relationships. “Raise your fees annually, and submit those fees to the insurer, requesting a higher profile or reimbursement of fees,” Levin said. 

Dental practices also have the option of hiring a third-party company to negotiate with insurers on their behalf. Bell has found that the company her practice uses is more intimately familiar with the inner workings of insurance companies than most dentists. These companies can analyze a practice’s fee schedules and network status and work with insurance companies to maximize reimbursement. 

Back to Basics 

Dental practices can approach inflation from many angles. They can invest in technology to keep more cases in-house. They can leverage different strategies to cut costs. They can invest in staff retention. They can take a hard look at optimizing reimbursement rates. All of these strategies can help practices manage their overhead and stay profitable, but guiding a practice through economic pressure begins with the fundamentals. “The quality of the practice systems is directly proportional to the level of practice success,” said Levin. 

First, evaluate the practice scheduling system. Are there patient no-shows? How many patients have been scheduled for their next appointment? Practices that know those numbers can improve them. Set aside time each day for front desk staff to reach out to patients via phone, email and text to confirm appointments and schedule overdue appointments. Building a scheduling system that gets more patients into the office means the practice is bringing in more revenue. 

A practice’s systems are only as good as the people who run them. Staffing challenges are not going away, and practices cannot afford turnover. But they can invest in the staff that they do have. The majority of dental office managers have no management training or experience, according to Levin. “If we give these people training, guidance and systems to work with, they will take enormous pressure off the dentist, who can get back to being the dentist and focusing on patient care, customer service and practice production,” he said. 

It can be easy to become overwhelmed by the impact of inflation. What should a practice do first? Ong agreed that the basics are the place to start. “If you don’t know the basics, start learning how to run a business, how to treat team members, how to lead patients and how to establish a culture,” he said. 

Mental Health 

The ins and outs of running a business during an inflationary period aren’t the only concerns for dentists. Surging prices are also impacting mental health. An overwhelming 87% of Americans consider inflation to be a significant source of stress, according to a poll conducted by the American Psychological Association.6 

Mental health concerns like anxiety and depression, already on the rise during the pandemic, are being compounded by inflation. An ADA survey of dentist health and well-being found that anxiety among dentists more than tripled in 2021 compared to 2003; 16% of survey respondents had anxiety and 13% had depression.7 

With seemingly never-ending stress from a number of factors — the cost of supplies, paying and retaining staff, battling insurers, caring for patients with their own financial concerns — dental provider burnout is also a concern in dentistry. A survey conducted by CareQuest Institute for Oral Health found that 71% of dental providers are experiencing increased burnout since the start of the pandemic.8

Anxiety, depression and burnout are common, but living with them is unsustainable in the long term. “If you look back to generations ago in the dental community, there was a lot of taboo around reaching out and getting support,” said Bell. Even though the culture surrounding mental health has changed, not all dentists are able to recognize when they need help or how to find the right kind of support. 

“Dentists are very self-sufficient; they tend to be somewhat perfectionistic, and they might not want to acknowledge that they’re having any kind of struggle,” said Lisa J. Heaton, PhD, a psychologist and science writer for CareQuest Institute for Oral Health. The ins and outs of running a business during an inflationary period aren’t the only concerns for dentists. 

Constant stress caused by the effects of inflation can easily erode basic self-care. Things like eating a healthy diet, maintaining a good sleep schedule and exercising can plummet to the bottom of the priority list. Concentrating on self-care is an important element of mental health, but it isn’t always enough. When mental health begins to impact how you function in daily life, it could be time to explore available resources. 

Health insurance typically covers visits to mental healthcare providers. Online therapy services have the convenience of remote visits and flexible scheduling. Organizations like the ADA and AGD offer mental health resources. “If you don’t help yourself, you’re not able to help your patients and the people who rely on you,” Heaton stressed. 

While inflation and how it affects mental health are very real concerns, Levin has a bright outlook for the future of the industry. “We will always have uncertainty. Uncertainty is a recession. Uncertainty is a pandemic. Uncertainty is a staffing shortage. Uncertainty is what the insurance reimbursements will be next month or next year. Uncertainty is the emergence of competition,” he said. “But with everything that I see, I think dentists have a fantastic opportunity at an outstanding career.” 

Carrie Pallardy is a freelance writer and editor based in Chicago. To comment on this article, email

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8. “Burnout Among Dental Professionals Before and During a Public Health Crisis: Causes, Consequences, and Next Steps." CareQuest Institute for Oral Health, July 2022, Accessed 1 Sept. 2022