My View: A wake-up call from the future for dentists

What dentists can learn from the rapid decline of the American Medical Association and job satisfaction. Can it happen to us?

In 2017, U.S. News & World Report ranked dentistry as the #1 “Best Job” in America. That ranking wasn’t arbitrary — it reflected dentistry’s strong salary potential, job demand and future prospects, low unemployment rate, and enviable balance of stress levels with quality of life.

Since then, dentistry has only grown in popularity. Dental schools have never been more competitive to enter, attracting some of the nation’s brightest students who dream of a career that blends science, artistry, independence, and service. The profession enjoys a reputation as one of the most rewarding careers in healthcare.

Consider the numbers: In 1990, there were 5,123 applicants and 4,001 first-year enrollees, a 72.4% acceptance rate. By 2007, demand had skyrocketed, with 13,742 applicants competing for just 4,770 first-year seats, an acceptance rate of only 33.6%. Even in 2023, though applications dipped to 11,198, the expansion of dental schools still made for stiff competition. That year, 6,708 first-year students enrolled, with an acceptance rate of 58.6%. Meanwhile, the academic bar keeps rising: the average GPA of incoming dental students has climbed from 3.20 in 2000 to 3.66 in 2024.

For decades, dentistry has been one of the most respected professions in America. The work is rewarding, the hours are reasonable, and the financial stability is enviable. That reputation wasn’t an accident. It was built brick by brick by dentists who stood together through the American Dental Association and state dental associations, shaping laws, protecting independence, and ensuring patients had access to care.

But what happens if everything we cherish about dentistry gradually disappears? What happens when a profession lives off yesterday’s victories but forgets to protect tomorrow’s?

Why organized dentistry matters

How many times have you heard a colleague say, or maybe even thought to yourself, “Why should I join the ADA? What do they really do for me?”

It’s a fair question, but here’s the truth: organized dentistry is the reason we can still ask it.

• Without the ADA’s federal and state victories on insurance reform, carriers would operate with near-total impunity. Network leasing would let your patients’ plans be sold and resold without your knowledge, slashing reimbursement rates without recourse. “Non-covered services” laws, which today prevent insurers from dictating fees on procedures they don’t even pay for, wouldn’t exist. Dentists would have no shield from balance-billing nightmares or predatory insurer practices. Antitrust exemptions for dental insurers would remain untouched, allowing companies to collude openly and drive our fees into the ground.

• A colleague in private practice recently battled a large insurance carrier over unfair reimbursement policies. Only with the backing of organized dentistry, armed with legal resources and lobbying power, were those policies reversed.

• Years ago, a member faced legislation that would have sharply limited the procedures general dentists could perform. It was his state association, in partnership with the ADA, that stopped the bill. Without that intervention, his career would have been altered overnight.

These aren’t abstract victories; they are tangible protections for our practices, our patients, and our livelihoods. These wins weren’t free. They were earned through decades of dues, lobbying, grassroots organizing and countless hours of dentists volunteering. And, the fact is, no individual dentist could achieve these outcomes alone. 

Many see the benefits of organized dentistry’s advocacy as background noise, rights that “just exist.” They don’t realize those rights only exist because organized dentistry fought for them.  Without an organized voice representing us, dentists would be voiceless in the halls of power. Legislators would only hear from insurance lobbyists, corporate chains, or well-funded activist groups. Dentistry would be regulated, funded, and legislated by everyone except dentists.

But here’s the problem: association membership is shrinking, and our profession is silently eroding its own future. Each year, fewer dentists join organized dentistry, leaving the burden of advocacy to a smaller and smaller group. Some become disengaged, focusing only on frustrations while overlooking the victories. Others expect protection without contributing, and when organized dentistry loses a fight or takes a stance they disagree with, they walk away entirely.

When our collective voice grows weaker, policymakers and corporations step in to fill the vacuum.

Foreshadowing from medicine

If this sounds alarmist, just look at medicine. In the 1960s, nearly 75% of U.S. physicians were members of the American Medical Association. Over the past several decades, the AMA saw its membership plummet. As a result, physicians lost much of their influence over healthcare policy. Today, many doctors work in environments where insurance companies, government agencies, and corporate interests dictate how medicine is practiced.

As AMA membership fell below 15%, Medicare physician payments dropped 33% (adjusted for inflation since 2001). Those numbers aren’t just statistics; they represent lost opportunities, rising burnout, overregulation and the steady erosion of a once-independent profession. Many physicians were driven out of private practice, taking with them a profound loss of autonomy. This isn’t science fiction. It’s exactly what happens when a profession stops standing together.

Physicians are still respected, but their ability to shape their own destiny has been gutted. Dentistry is not immune. If we follow the same path, we risk losing control over our profession. Decisions about how we practice, how we are reimbursed, and how patients view our role in healthcare could soon be made for us, not with us.

A warning from the future

Imagine opening your practice in 2040. You’re no longer in control of your fees; insurance companies dictate them. Your autonomy in patient care is diminished; government regulations and corporate dental chains set the parameters. Patients see you not as an independent professional, but as a cog in a system that values volume over relationships.

The future of dentistry will not be decided by the loudest lobbyist in Washington or the biggest corporations. It will be decided by whether dentists themselves believe the profession is worth protecting.

A call to arms

The future of our profession depends on what we do now. Our prosperity was earned, not granted. Organized dentistry is our shield and our voice. Without strong membership, our ability to influence policy, protect patient relationships, and preserve professional autonomy will slip away.

Some of you may already feel disenfranchised, trapped by debt, overwhelmed by corporate pressures, or worn down by bureaucracy. But if you think it’s difficult now, imagine a future of even higher burnout, financial strain, and loss of control.

So, the real question isn’t, “What does the ADA do for me?” The real question is: What happens if I don’t join?

The hard truth is that if too many dentists choose to free ride on yesterday’s victories, tomorrow’s dentists will not inherit the same profession.

This is our call to arms. Join. Renew. Most importantly, encourage your colleagues. When one of them asks, “What does the ADA do for me?” Speak up! Remind them that organized dentistry doesn’t exist just for one of us, but for all of us. The future of your profession depends on you being an advocate for organized dentistry to those who choose to denigrate its importance to all of us.

Our profession that we worked so hard to become a part of is changing rapidly, not always for the better, but it will be exponentially worse if we lose our collective voice. By investing in organized dentistry, we preserve not only our careers but the very identity of our profession.

The strength of dentistry tomorrow depends on the choices we make today.

Dr. Bulnes was born and raised in Tampa, attended the University of South Florida to attain his undergraduate degree in chemistry and earned his DMD from Southern Illinois University in 2000. He then obtained his Advanced Education in General Dentistry in 2001 from Southern Illinois University. He is a Trustee to the Florida Dental Association and presently serves Florida as their representative to the American Dental Association Council on Governmental Affairs. 

Dr. Wilson received his DMD degree with high honors from the University of Florida College of Dentistry.  Following dental school, he completed a one-year fellowship in Oral Maxillofacial Surgery and a one-year Advanced Education in General Dentistry residency.  Dr. Wilson obtained his Certificate in Periodontics from the University of Florida College of Dentistry.  Following his residency, he opened Tampa Bay Periodontics and Implant Dentistry.  Dr. Wilson is a Diplomate of the American Board of Periodontology and a Fellow of the American College of Dentists and the International College of Dentists.  Dr. Wilson currently serves as Secretary-Treasurer of the American Academy of Periodontology Foundation, Editor for Florida’s West Coast District Dental Association as well as Immediate Past President of the Hillsborough County Dental Association.

This article was reprinted with permission. It was originally published in the Fall 2025 issue of Check Up, a newsletter from the West Coast District Dental Association, a component of the Florida Dental Association.