Thinking about dentistry and the concept of leadership may appear somewhat misplaced in the mind’s of many. However, as de Cervantes reminds us our teeth are more valuable than any diamond in terms of the essential role they play within our functioning lives. Yet is there leadership in the dental world – and why does it matter? Directing where a sector goes and which elements within an industry are chosen for future development are vitally important to that profession as a whole. Who, then, are the leaders in 21C dentistry?

Who Leads Dentistry In The 21C?

“A leader is one who knows the way, goes the way, and shows the way.“
– John C. Maxwell

There are leaders of dental associations, nationally and at the state level, these women and men front their organisations and are their spokespersons. They, perhaps, play more important roles than is realised internally and more generally. Why might this be so? Technology and AI, in particular, places dentistry at a crossroads in its historical journey. The tooth puller of ancient times has always had a strong relationship with his or her materials and surgical equipment. Now, however, the devices and machines are no longer mere servants but are on the threshold of taking over the complete operation. The human love affair with its technological innovations is facilitating the passing of the baton to artificial sentience. Machines (AI) with the ability to sense things better than their human counterparts. This evolution or revolution is more apparent in the dental world than in many others. The question, therefore, must be asked – who is overseeing this transition and the timing of it?

Is There An Absence Of Real Leadership Within The Dental Profession?

“The doctor / clinician leaves dental school armed with the tools to create beautiful smiles and relieve pain. The armamentarium in our toolbox is vast from simple to complex restorations, implants, surgery, root canal therapy, teeth whitening and straightening. As a practicing dentist and former assistant professor, I have been the recipient of all of the above. I know after more than 25 years in the industry that there is a lack of personal and professional leadership to drive more effectively the interpersonal relationships and culture of the offices we not only inhabit, but run on a day to day basis. 21st Century Leadership in Dentistry covers areas that are rarely discussed for lack of insight on its importance and in favor of the heavyweight clinical topics. Communication, Intentionality, office culture and a people over profit driven practice will be some of the topics addressed, depending on time permitted. Additional topics within the scope of leadership could include mission, value statements and legacy.”
– Yvette Weir, 2020. 

Who Are Australian Dentists?

Much of the dental world is made up of small businesses, with entrepreneurial health professionals establishing a clinic or clinics. In Australia, it is largely driven on a non-socialised private health insurance model outside of Medicare. This makes the business of dentistry expensive to run, relatively costly for consumers, but profitable if well run for dentists.

“Average Dental Practice Profit Margin: When determining if your dental practice is doing well, the profit margin should be a minimum of 40%, which is the average profitability of U.S. dental practices.”
– Thryv.com

In 2011, the average profit margin was listed at around 24.7%. So, things have been looking up over the last 13 years. To give you some comparison with other sectors, according to IBISWorld, a 45.9% profitability rate comes in 10th in the Top Ten in 2024. Mining fills the 4 of the places via Battery Material, Mineral Sand, Iron Ore, and Lithium and other non-metallic minerals in ascending order. Superannuation funds in Australia are number one with a 99% profit margin. Industry super funds are at number two at 94.1%. Retail super funds at number three at 91.7%. Financial asset investing has a 53.8% profit margin. Office property operators a 51.8% profitability rate. Online car classified ad sector at 48.7%. To give you another kind of perspective many restaurateurs operate at 1% or 2% profit margins. A well run dental clinic at 40% or higher tells you who is in the mug’s game and who is not.

The financial side of operating a dental practice, if well run, is likely to be lucrative. What about leadership, however, how does this come into it? Obviously, successful business people within communities and especially those helping people with their health are often well respected. Leadership roles have traditionally fallen to such figures within communities.

What Is The Dental Sector & Who Leads It?

“The Dental Board of Australia supports safe practice by publishing regulatory standards, codes and guidelines, updates and other resources for dental practitioners, employers, students and the public.”
– The Dental Board

The dental sector in Australia is linked together via the many strands making up this vibrant and dedicated industry. What one needs another provides and this goes around the business of fixing teeth and all the associated offshoots from the primary task.

“The dental industry comprises businesses that range in size from small family entities through to local operations of large, multinational therapeutic product suppliers. They share common aspirations for the growth of their business, the creation of jobs and the financial sustainability of the dental industry. Naturally, they are bound by a universal commitment to the supply of quality dental products and services. To excel, these businesses will benefit from a robust advocacy program by ADIA on behalf of those members to achieve a considered balance between economic growth that maximises patient safety.”
– Adia.org.au

Standards of dental care in Australia are of a very high level and we are fortunate to have such a situation. We pay for it, however, and I always say you get what you are willing to pay for in life. I suppose one of the questions that could be directed at the dental leadership in this country is whether we would have such great dentistry if we extended the availability of dental services to more people via making it affordable to them?

“Low-income people, racial or ethnic minorities, pregnant women, seniors, people with special needs, people in rural areas – they all have a much harder time accessing a dentist than other groups of Americans.”
– Bernie Sanders 

The situation In Australia is similar in that many ordinary folk cannot afford to go to the dentist. Subsidised dental care is available but the waiting lists are long and there is simply not enough of it to meet the needs of the population in many areas. Dental associations want to see more subsidised dental care made available to more needy Australians like the elderly, in particular.

The Greens recently got a figure of $11.6 billion per year as the cost of providing free dental care to all Australians if it was totally subsidised by the federal government.

“CANBERRA, Australia: Official statistics show that in Australia up to 60% of dental care is paid out of pocket, whereas many other kinds of healthcare are publicly funded. This lack of governmental financial support has produced an understandable reluctance by the public to seek dental care owing to the costs, leading to delayed care as well as a range of oral health complications.

ADA President Dr Scott Davis remarked that the issue of oral health in Australia has “been kicked down the road year after year after year. What we want is for disadvantaged Australians to have a fair go. For nearly half the population, access to dental care is very difficult indeed.””
– Dental Tribune

Good Teeth For All Or Sketchy Nuclear Submarines, Maybe?

A relevant expenditure comparison is the $368 billion nuclear submarine deal agreed to by the last 2 federal governments. This will run over the next 30 years or so, and in the fine print there are no guarantees of Australia actually receiving any submarines. What experience has taught us, though is, that you can bank on the final bill costing far more than budgeted – this is a given in government projects and especially defence ones.

“The program is forecast to cost $268bn to $368bn between now and the mid 2050s, most of it beyond the first four-year budget period, and will depend on help from the US and the UK.”
– The Guardian 

National security, as a category, allows ‘pie in the sky’ defence projects to blow out and largely avoid normal levels of public scrutiny and accountability. We will blithely spend enormous amounts of money on things like weapons, which are never tested in battle or used for purpose, whilst putting the nation’s oral health in the too hard and too expensive basket. Submarines in Australia have been a black hole sucking billions from the public purse for little to show in terms of defending our borders.

“No man is good enough to govern another man without that other’s consent.”
—Abraham Lincoln

Are we lacking leadership in the dental world? Does it matter? Wonderful new innovations are happening in dentistry. Whether these can be shared with the world and not just the few who can afford them is the question facing the cutting edge of dental care everywhere.

AI is not automatically going to make better oral health cheaper for the world. There is a long way to go yet before that happens or it may never happen. Ai is making dental care better through the technology that is making its way into dental surgeries already. Going to the dentist in Australia, however, is becoming more and more expensive. Will the dental leadership in this country pay attention to the fact that the growing divide between the rich and poor is delineated down dental care lines in many ways? Will we see a backlash against sectors that have watched their services become further and further out of financial reach of the working poor?

Several years of high inflation and sticky high inflation in the services’ sector have made more Australians economically aware of the inequality within the nation. Coles and Woolworths and their pseudo-duopoly have come in for sustained attacks from multiple sources recently. The Coles profit margin is around 26% and is higher than similar supermarket chains elsewhere in the UK and US. Is the fact that many dental clinics operate on a 40%+ profit margin going to be a cause for concern and public opprobrium in the near future? Most dentists in Australia do a sterling job and work hard for their success but will health care remain an appreciated privatised sector if half the population cannot afford to access it? These are real questions facing the leadership of the dental sector in the 21C.

Once again, I will emphasise that we in Australia are fortunate to have such a high quality oral healthcare sector. However, if half the population cannot afford to regularly access these top line services, then dental care will become a lightning rod for disgruntled folk and potential civil unrest. The embrace of AI and technological advances in this sector needs to be monitored by the national and state bodies in terms of the impact upon prices for dental services. If the industry prices itself out of the general market to such an extent there could be very real problems emerging. Leadership is called for, leadership in the dental world, to navigate the opportunities and challenges of the present and the future. It will be interesting to see what eventuates over the next few years.

Disclaimer: The material posted is for informational purposes only and is not intended to substitute for professional medical advice, diagnosis or treatment. Results vary with each patient. Any dental procedure carries risks and benefits. If you have any specific questions about any dental and/or medical matter, you should consult your dentist, physician or other professional healthcare providers.

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