The Disruptive Effects of AI on Dentistry

Derek Hill, CPA │ Derek Hill Advisory Group Inc. │ February 2026

Abstract

 Dentists will face two major but different challenges over the next three to five years. Challenge One will be the displacement of much of what they do, with AI and robots taking over the roles currently fulfilled by human administrative and dental assistants. The Second challenge relates to the eventuality that fee-for-service dentistry is likely to give way to a more OHIP-type government-controlled delivery system. These disruptions will likely change a dentist’s traditional cash flows and practice values. To what extent will these two challenges disrupt the profession of dentistry, and what should dentists do now to prepare for this disruption?

The Two Disruption Vectors

Vector One: AI and Automation Displacing Practice Operations

The operational disruption is already underway, though most dentists haven’t fully reckoned with its trajectory. Over the next three to five years, we’re likely to see progressive automation across several layers of the practice.

On the administrative side, the displacement will be substantial and relatively fast. For a deeper dive into this aspect of AI disruption, refer to my recent seven-article series in LinkedIn. AI scheduling systems, automated insurance verification and claims processing, patient communication bots, and treatment plan presentation tools are already functional and improving rapidly. A practice currently employing three or four administrative staff may need one or two within five years. That’s not speculation — the technology exists today and is being refined for dental-specific workflows. Companies like Dental Intelligence, Oryx, Pearl, and others are building exactly these tools.

Chairside, the timeline is longer, but the direction is clear. AI-assisted diagnostics — caries detection, Perio charting from radiographs, pathology screening — will increasingly reduce the cognitive load on both dentists and hygienists. Intraoral scanning tied to AI-driven treatment planning will compress what currently takes multiple appointments and specialist referrals. Robotic-assisted procedures are further out for general practice, probably beyond the five-year window for most clinical tasks, but autonomous hygiene delivery and certain restorative procedures are being actively developed.

The financial impact is double-edged. On one hand, reduced staffing costs could significantly improve EBITDA margins. A practice spending $350,000 to $450,000 annually on administrative and assisting staff could potentially reduce that by 40 to 60 percent over five years. On the other hand, this creates a massive capital expenditure requirement for technology adoption, and practices that don’t invest will find themselves competitively disadvantaged and less attractive to acquirers — including the DSOs that have been driving practice valuations upward.

For further references in this matter, review my seven-article series published recently in LinkedIn.  For the most part, this half of the coin is an exciting positive.

Vector Two: The Shift Toward Government-Controlled Delivery

The scary side of the coin is the disappearing job market. The popular talking heads place unemployment over the next 36 months between 10% and 80%.  Some think it will happen soon, and others not for a while.  Here is what is happening now, or at least what happened in 2024 and 2025, and this should give you pause.  In 2024, according to the US Bureau of Labor Statistics, the U.S. economy added 1.45 million jobs, averaging 121,000 per month.  In 2025, according to the US Bureau of Labor Statistics, and this is where it gets scary, revised data indicates that the U.S. economy added 181,000 jobs for the entire year, averaging only 15,000 jobs per month.  It is already happening – forget about the future.

The Canadian Dental Care Plan is already signaling the direction of travel. What began as coverage for uninsured populations could, under the economic pressures that AI-driven employment displacement will create, expand into something much more comprehensive. Here’s the logic chain:

As AI displaces workers across the broader economy — not just in dentistry but across all sectors — employer-sponsored dental benefits will erode. Fewer people in traditional employment means fewer people with private dental insurance. The tax base that funds public programs simultaneously shrinks. Government faces a choice: either expand public dental coverage to maintain population oral health or accept deteriorating dental outcomes with all their downstream healthcare costs. The politically viable path, especially in Canada, is the expansion of public coverage.

But government-controlled fee schedules are invariably lower than private fee-for-service rates. Ontario dentists currently billing at or near ODA suggested fee guide rates could see effective reimbursement drop by 25 to 40 percent if a significant portion of their patient base shifts to government-administered coverage. We’ve seen this pattern play out with OHIP for physicians, and there’s no reason to believe dentistry would be treated differently.

This is going to affect not just revenue and profit but also equity values. The practice valuation implications are serious. Current valuations for general practices in Ontario typically run in the range of 100 to 150 percent of gross revenues or 5.75 TO 6.25 times EBITDA for well-run practices. If revenues compress due to government fee schedules while the cost of technology adoption rises, we could see a significant contraction in practice values — potentially 20 to 35 percent from current levels — for practices that haven’t adapted.

The Compounding Effect & What Dentists Should Do Now

What makes this particularly challenging is that these two vectors compound each other. AI displaces employment broadly, which erodes private insurance coverage, which accelerates the shift toward government payment, which compresses revenues, which makes technology investment harder to justify, which leaves practices less competitive. It’s a reinforcing cycle, and dentists who wait until both forces are fully manifest will find themselves with far fewer options.

There are several concrete steps that are worth serious consideration.

First, maximize current practice value while the window is open. The next two to three years represent what may be the peak valuation environment for dental practices in Canada. Private equity and DSO activity remain strong, fee-for-service revenues are still robust, and the full impact of either disruption has not landed yet. Dentists within five to ten years of retirement should be accelerating their exit planning, not delaying it. Every dollar of EBITDA improvement you help them capture now. Perio enhancement, hygiene optimization, patient reactivation will have an outsized impact on practice value if the practice is sold before the disruption cycle compresses multiples.

Second, begin strategic technology adoption immediately, but deliberately. This doesn’t mean buying every AI tool on the market. It means identifying the highest-ROI automation opportunities — typically administrative functions first — and implementing them in a way that genuinely reduces overhead rather than simply adding cost. The practices that will thrive are those that use AI to operate with leaner teams and higher margins, creating a buffer against future revenue compression.

Third, diversify revenue streams away from reliance on insurance fees. This includes building out services that are less likely to be captured by government fee schedules — cosmetic dentistry, implants, orthodontics, sleep medicine, and facial aesthetics. These discretionary and specialty services will likely remain in the private-pay domain even if basic and preventive dentistry shifts toward public coverage. Practices with 30 to 40 percent of revenue from elective or specialty services will be far more resilient than those running predominantly on hygiene, restorative, and preventive care.

Fourth, invest in patient relationships and data. In a world where AI handles much of clinical detection and administrative workflow, the dentist’s irreplaceable value lies in the patient relationship, clinical judgment in complex cases, and the trust that drives case acceptance for higher-value treatment. Practices should be deepening patient engagement now — not through more recall postcards, but through genuine relationship-building that creates loyalty beyond what any government system, corporate competitor or robot can replicate.

Fifth, watch the policy environment closely and engage with it. Dentists and their professional associations need to be active participants in shaping how public dental coverage evolves, rather than passive recipients of policy decisions. The difference between a well-designed public-private hybrid system and a poorly designed government takeover of dental delivery could be the difference between a profession that adapts successfully and one that gets hollowed out. This is particularly important given the almost total lack of attention to these matters by our current politicians. 

The Bottom Line

The dentists who will navigate this well are those who treat the next two to three years as a strategic preparation window rather than business as usual. The combination of AI operational disruption and potential shifts in the payment model represents the most significant structural change in Canadian dentistry (as well as society in general) since the establishment of the current fee-for-service model. It’s not a question of whether disruption is coming — it’s a question of whether individual practitioners will be positioned on the right side of it.

References and Further Reading

This paper synthesizes ideas from multiple traditions and thinkers. Readers interested in exploring these concepts further may consult:

On technological unemployment and AI impacts: The work of Erik Brynjolfsson and Andrew McAfee, particularly “The Second Machine Age” and “Machine, Platform, Crowd.” Carl Benedikt Frey’s “The Technology Trap” provides historical context. Daron Acemoglu’s research on automation and labor markets offers rigorous economic analysis.

On economic pluralism and alternative ownership models: Mariana Mazzucato’s work on mission-oriented economics and the entrepreneurial state. Elinor Ostrom’s research on commons governance was recognized with a Nobel Prize in Economics. Gar Alperovitz’s writings on community wealth building and democratic ownership.

On wealth concentration and democracy: Thomas Piketty’s “Capital in the Twenty-First Century” and subsequent works. Martin Gilens and Benjamin Page’s research on political influence. Ganesh Sitaraman’s “The Crisis of the Middle-Class Constitution.”

On institutional design for the AI age: The AI governance work of the Future of Humanity Institute, Partnership on AI, and similar organizations. Policy proposals from the Brookings Institution, the Roosevelt Institute, and the Berggruen Institute.

Derek Hill Advisory Group Inc.

For more information on this topic, see Derek’s brief “When Your Patients Lose Their Jobs”  and “Navigating The Great Disruption: A MOSAIC Economic Strategy for the Age of Artificial Intelligence and Robotics“ If you would like a Preparedness Assessment of your practice, reach out to Derek Hill at derek@derekhill.ca (Derek Hill Advisory Group Inc.).  Check back for more detailed presentations on the AI Revolution, its impact on society, and current thought remedies to the disruption.