Protect Dentist Ownership of Dental Practices

Keep dentists in charge of patient care
A proposal in the NC General Assembly would allow non-dentists to own dental practices in North Carolina creating an opportunity for private equity and other investors to control and or influence clinical decisions and prioritize profits over patients.

What’s at Stake: Management Fees & Ownership
Under current law, Dental Management Companies (DMCs) can provide non-clinical services to dental practices, like administrative support, marketing, and staffing. In return, DMCs are paid management fees. However, these fees cannot be tied directly to a practice’s revenue or structured in a way that enables DMCs to keep all practice profits. This is to prevent DMCs from taking control over a practice, which is prohibited by the Dental Practice Act (DPA).

The NC Board of Dental Examiners, or “Board,” reviews management arrangement contracts between DMCs and dental practices to ensure the management fees do not exceed the practices’ profits. This protects the requirement that only NC-licensed dentists, who are accountable to the dental board, maintain ownership and control of the practice. The current system works efficiently and helps safeguard patient care by ensuring dentists remain in charge.

The Risks to Patient Care
The proposed language would allow management fees to be tied to a practice’s revenue, which could, in effect, lead to non-dentists controlling dental practices. It could also create an incentive for private equity backed DMCs to structure management fees in ways that maximize financial profit at the expense of patient care. Additionally, the proposal would prevent the Board from reviewing management arrangements, leaving the Board powerless if a DMC violates state law. Non-dentist ownership has been linked to issues like over-treatment, unnecessary procedures, and even fraud in other states. 

Why Current Regulations Work
Since 2012, the Board’s review process has been successful in ensuring that dentists maintain control over their practices while DMCs can operate legally. There are currently more than 80 DMCs operating in NC with more than 440 separate dental practice locations across the state. In addition, North Carolina operates in line with the national average of dentists affiliated with DSOs by state – 14%.

By keeping dentists in charge of dental practices, we ensure that patient care always comes first—before profits.