Creating dentistry's future
Richard J. Rosato, D.M.D., to become 162nd ADA president
It’s fall 2023. Richard J. Rosato, D.M.D., is ending his four-year term on the ADA Board of Trustees, ready to devote all of his time to his family and oral and maxillofacial surgery practices. But, and it may be cliché to say, these were truly unprecedented times.
The trauma of COVID was still in the air. Dentists were still struggling to find people to join their teams. Science had become political, and health care was under attack. And within organized dentistry, there was a need to bolster partnerships with the state and local dental societies.
“We needed to listen to our peers and ask, ‘How can we come together?’ Especially during a time where there seemed to be a lack of acknowledgement for science within oral health. This is a time for us to be together if there ever was. Our profession is under attack,” Dr. Rosato said during an interview. “That was a huge reason why I went to my wife, Laurie, and she said, ‘What’s going on? You haven’t slept well in three days.’ I said, ‘I need to run.’ And I’ll always remember her response. She said, ‘Well, it’s about time. We’ve all been waiting.’”
So, he did. And he won. The first person to successfully run a campaign for ADA president-elect while not being a current member of the Board of Trustees. Dr. Rosato will be installed as the 162nd ADA president Oct. 27 at the House of Delegates meeting in Washington, D.C.
As he assumes office, Dr. Rosato is still in unprecedented times. Oral health is still under attack as federal and state politicians question the science behind community water fluoridation, some ending it in their state altogether. And the ADA is in a budget transition as it tries to rebuild its reserve funds after years of deficit spending. But Dr. Rosato also has some robust goals he wants to accomplish: enforcing clinical autonomy, patient wellness and looking ahead to what the delivery of oral health care will look like in 25 years.
Road to oral surgery
Dr. Rosato, 56, was born in Revere, Massachusetts, to Italian immigrants, growing up in his grandmother’s house until eighth grade. The Rosato family moved to Danvers, Massachusetts, so he could play high school hockey.
He attended Saint Anselm College for his undergraduate, majoring in chemistry, with a goal of being a pediatrician. Dr. Rosato is one of four children, and his younger sister is severely disabled with epilepsy, which is why he wanted to go into medicine: to help patients like her. But after meeting his wife, a general dentist, she introduced him to everything dentistry could offer and how it was becoming more and more integrated into medicine.
Why oral surgery?
“I would say the best way I could describe it is when every single class I took in dental school that still had that medicine link like gross anatomy or neuroanatomy, I fell in love with those classes,” Dr. Rosato said. “So I knew there was a calling to a medical-dental integrated type specialty and that was oral surgery.”
Dr. Rosato headed to Tufts University for dental school and did his oral surgery residency in Chicago at the University of Illinois Chicago, before moving to Rhode Island for a short period then settling in New Hampshire. That’s where his passion for organized dentistry started.
Advocating for children
The New Hampshire state legislature had introduced a bill in 2001 to lower the age that an insurance carrier would have to pay for general anesthesia from 8 years old to 4, meaning insurance carriers would be able to stop offering anesthesia coverage once children in the state reached 5 years old.
“I remember thinking, we can’t let this happen. So many of these children need care. Their parents can’t afford to pay for general anesthesia in a hospital setting,” Dr. Rosato said. “So I called the New Hampshire Dental Society and asked how I could help.”
Dr. Rosato testified before the state legislature and a week later he found out they were successful: State lawmakers decided to keep the age as is. “I saw firsthand what advocacy, what being involved can do to help shape the future for our patients and for the dentists who are providing the care,” Dr. Rosato said.
His testimony kicked off a series of leadership positions within the New Hampshire Dental Society: serving on the government affairs council, chairing other councils and ultimately being elected as president in 2009. He got to know volunteer dental leaders at the national level and was appointed to the ADA Council on Ethics, Bylaws and Judicial Affairs in 2011. He was elected by his district to serve as trustee and joined the Board of Trustees in 2019.
Rebuilding trust
Coming into 2025 as president-elect, Dr. Rosato was still facing those unprecedented times, just in a different way. The ADA Board of Trustees announced in August it approved a new 2025 budget that reduces core expenses by more than $20 million, amid months of discussions over how to rebuild reserves following years of deficit spending and investments.
The changes include cuts to numerous ADA programs, a reduction in staff, changes to various outreach strategies, and reductions in staff and volunteer expenses. These decisions come after the ADA spent $142 million from its reserve funds between March 2022 and March 2025 to invest in various companies, purchase and implement a new association management system and support advocacy efforts.
Some members have criticized ADA leaders for their financial management and lack of transparency. Current ADA President Brett Kessler, D.D.S., Dr. Rosato and the board are trying to change that. The board has authored an open letter to the membership detailing the spending and pledging to make thoughtful, data-driven decisions that prioritize sustainable progress for the organization. It’ll be Dr. Rosato’s job to lead the board to transform the words into actions.
“This has been building for a few years now. Membership is dropping, and being a membership organization, we needed to find other means of revenue to stay vital and valid so that we can represent the profession in times like these,” Dr. Rosato said. “Because of that, we’ve had to invest in things that are outside the norm to try to deliver more nondues revenue. And there’s a certain percentage of the membership who is upset about that. My year will be about basing decisions on facts and being appropriately transparent so everybody understands what’s going on and rebuilding trust.”
His other priorities as president include updating the ADA Code of Ethics to include a statement on clinical autonomy.
“I want it to reflect what it means in the relationship between the patient and the doctor and the decisions they make together,” Dr. Rosato said. “We’re hearing a lot that insurance companies interfere with that; different practice models interfere with that. So we want all of those groups to understand that when a dentist is in the operatory talking with the patient, that that relationship is sanctified and protected.”
His second area of focus will be patient wellness. Dr. Kessler has long been an advocate for provider wellness, but Dr. Rosato wants to add patients to that focus. “People are struggling incredibly in our country,” Dr. Rosato said. “We’ve developed this aura of isolationism as Americans, and I remember just feeling the calling that I want us to take our wellness initiatives for dentists and ask how dentists can be a part of solving the mental health crisis for our patients.”
He said it can be as simple as including a question on patient forms asking how they view the world: against you or with you? Depending on the answer and any follow-up conversations, the dentist can make an appropriate referral to a mental health professional. “I think dentistry can be a big part of mental health screenings since we see our patients twice a year,” he said.
Looking to 2050
As you can probably tell, Dr. Rosato’s brain never stops. To try to slow the gears, he meditates each morning when he wakes up. Exercise also helps; he lifts weights three to four times a week, golfs or goes for walks on the beach near his home in New Hampshire. He loves hockey and is a passionate Boston Bruins fan.
Dr. Rosato and his wife, Laurie Rosato, D.M.D., have three children: Richard Jr., 26, who’s in his last year of medical school at Dartmouth College; Colin, 22, a business student at Wake Forest; and Madison, 21, is an international relations major at Tufts University.
Dr. Rosato’s term is sure to be a busy one as he works to navigate a slimmed-down budget, advocate for oral health nationwide and plan for the future. The Board adopted a resolution this year to create a task force to explore the feasibility of developing a new “Future of Dentistry” report. Digging deeper into that mission is one of the tent poles of Dr. Rosato’s goals in 2025-26: to look at what various aspects of dentistry will look like in 25 years. What will the workforce look like? What will the delivery of dentistry look like? How will artificial intelligence play a role?
“There’s a saying, ‘The best way to predict your future is to create it,’” Dr. Rosato said. “Together, that’s what our ADA can do.”
