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The dental chair felt like something to get through, not a place where meaningful health conversations happened.
A few fillings and a root canal later, my perspective has changed. Not just because the experience wasn’t nearly as dramatic as I’d imagined -- but because, over the years, I’ve spent a great deal of time interviewing dentists across a wide range of treatment topics. Those conversations led me to a realization that’s much more strategic than nostalgic: dentistry represents far more potential than most life sciences companies -- particularly in pharma and biotech-- currently appreciate.
In fact, the dental office may be one of the most underutilized access points in American healthcare.
That idea matters for anyone in pharma, biotech, (or medtech) who sells into primary care. Not because dentists are going to “become PCPs,” and not because every dental practice wants a new identity. But because in specific communities -- and within specific dentist segments -- there is a plausible, scalable opportunity to expand basic primary care services through the dental setting. And if that happens, it changes the map of where prevention, screening, and even certain therapies can be initiated.
The catch is reimbursement. Without it, this remains a well-meaning pilot project hobby. With it, dentistry becomes a new front door for healthcare -- particularly for patients who rarely see a PCP.
In commercial strategy, we often talk about “unmet need” as if the only barrier is a better molecule, device, or diagnostic. In primary care, the unmet need is frequently more mundane: people can’t get appointments, don’t have a consistent provider, or don’t trust the system enough to engage until something breaks.
Dentists, on the other hand, see a lot of people -- often at regular, predictable intervals. Many patients who are inconsistent with medical visits will still show up for cleanings, tooth pain, or cosmetic care. And dentists already do a version of medical intake: health histories, medication reviews, vitals in some practices, and head/neck evaluation as part of routine exams.
The academic literature has been making the case for years. Gambhir’s review frames the dental office as a “portal” for screening and prevention: diabetes risk, hypertension, tobacco and alcohol counseling, oral/head and neck cancer observation, sleep apnea screening pathways, and more. Gordon and colleagues go further, arguing that “oral health primary care provider” competencies could fit within existing educational standards for interested programs; while acknowledging that scope-of-practice and market barriers (especially billing) are the limiting factors.
Here’s the commercial translation: dentistry is already an anatomically focused primary care platform with repeat visits, established patient relationships, and procedural confidence (including injections). The missing pieces are: (1) segment targeting, (2) workflow design, (3) data connectivity, and (4) reimbursement.
If you spend enough time talking with dentists, as I have, you quickly realize there is no single “dentistry market.” There isn’t a unified appetite for expanded scope, and there certainly isn’t consensus about becoming more involved in primary care.
At minimum, I would think about three broad segments.
These clinicians are deeply committed to dentistry as a distinct profession. They take pride in clinical excellence within established boundaries.
They worry, reasonably so, about liability creep, workflow dilution, payer complexity, and being treated as low-cost substitutes for physicians. For them, expanding into primary care feels less like opportunity and more like distraction.
Importantly, this group often shapes professional culture at the local and state level. If they feel threatened, they will push back -- and they will do so effectively.
This group is commercially and clinically practical. If something is clearly adjacent to oral health, fits into the existing workflow, and reimburses appropriately, they’re open.
Think tobacco cessation tied to periodontal outcomes. Blood pressure checks as part of procedural safety. Diabetes risk identification that improves gum disease management. Oral cancer screening protocols. Sleep apnea pathways.
This is also the segment where you increasingly see services like therapeutic Botox for TMJ or bruxism; and, in some markets, cosmetic facial aesthetics. These dentists are not trying to become dermatologists. They are responding to patient demand, leveraging injection expertise, and expanding revenue within the orofacial domain.
They don’t want a new identity. They want sensible, well-defined expansions that make clinical and economic sense.
Then there are the dentists who are philosophically comfortable talking about whole-person health. They see the mouth as inseparable from the body and are intrigued by chair-side screening, vaccination administration (where permitted), salivary diagnostics, and deeper integration with medical teams.
Many are already operating inside Dental Service Organizations (DSOs), community clinics, academic centers, or integrated delivery systems where collaboration is more natural. They are often early adopters of new models; and are more willing to navigate reimbursement experimentation if the long-term upside is clear.
Strategically, the second and third segments are where life sciences companies can play. But this only works if the first segment’s concerns are respected. Professional identity matters in dentistry. So does autonomy.
The lesson for pharma, biotech, and medtech isn’t “convince all dentists to become PCPs.” It’s far more nuanced: activate the willing segments with tightly defined, reimbursable use cases, without triggering the profession’s defensive reflex.
Next, let’s separate the feasible from the fanciful.
Feasible, high-value, low-drama opportunities:
Less feasible (or high-risk) expansions:
A practical north star: dentistry can expand primary care capacity by increasing the number of touchpoints for prevention and early detection, not by replacing medical homes.
If done well, there are real advantages:
More detection in high-friction communities. Rural areas, underserved urban neighborhoods, and populations with poor PCP continuity stand to benefit the most. If a dental visit becomes a routine place where hypertension flags are caught or diabetes risk is surfaced, the system gains through earlier potential interventions.
Better chronic disease outcomes through earlier action. Diabetes, CVD risk, and tobacco-related morbidity are not problems we solve with awareness campaigns alone. Screening plus a credible referral or follow-up pathway can shift outcomes -- especially when paired with data and care navigation.
A tangible bridge between oral health and systemic health. The “mouth-body divide” is still real in how patients think and how payers reimburse. Dentists can be the clinicians who make the integration feel concrete, not theoretical.
Now the uncomfortable parts.
Reimbursement complexity is the choke point. Medical and dental coding live in different worlds. Dental offices are not staffed for medical billing complexity, denials management, or prior auth workflows. Even when reimbursement exists in theory, it often fails in practice. Without straightforward payment models, this becomes uncompensated labor.
Scope-of-practice variability creates fragmentation. State-by-state rules differ, and they change slowly. Vaccination authority is a perfect example: expanded in many places during COVID, but not uniformly embedded afterward. National strategies must assume patchwork adoption.
Time is not free in a dental chair. Dentistry is productivity-driven. Every added step competes with procedures that keep the lights on. If the workflow adds five minutes without revenue, it won’t last.
Professional identity and liability concerns are real. Dentists I've spoken to fret about being held to medical standards without medical infrastructure, and about malpractice exposure if a screening result isn’t acted upon perfectly. Those fears won’t be “educated away.” These apprehensions must be designed around.
From a commercial standpoint, here’s the opportunity: activate the willing segments with infrastructure, evidence, and reimbursement enablement-- without triggering the profession’s "immune response."
1) Treat dentistry as a channel strategy, not a novelty. Start with segmentation: which specialties, practice types (solo vs DSO), and geographies have the right patient mix and openness? Layer in community health need data. Then prioritize use cases (e.g., hypertension identification and referral, diabetes risk flags, oral cancer screening workflows, vaccination administration where legal).
2) Build “protocol + pathway” packages, not vague integration messaging. Dentists don’t need a manifesto. They need a laminated workflow: who does what, when, how it’s documented, what happens next, and what referral network receives the patient. The easier you make it operationally, the more it spreads.
3) Invest in reimbursement design, i.e., codes, contracts, and value models. This is where life sciences can be unusually helpful. Convene payer discussions. Support pilots that measure outcomes and cost offsets. Help create billing playbooks and training for front office staff. Partner with DSOs and integrated systems to implement value-based arrangements that reward prevention and early detection.
If you want a blunt consultant line: the business model has to work at the front desk, not just in a white paper.
4) Enable connectivity and measurement. The dental-medical data gap is a practical barrier. Medtech and digital health partners can help with interoperable documentation, referral tracking, and closed-loop outcomes. Pharma and biotech can support real-world evidence designs that answer payer questions:
5) Be disciplined about brand adjacency. This can benefit brands -- but it has to be credible. For example:
But if the activation feels like “selling through dentists,” it will backfire. The framing must be access, prevention, and coordinated care.
If I were advising a company to pilot this, I’d start with two wedges that balance impact and feasibility:
Wedge 1: Hypertension and diabetes risk identification + referral closure. Simple measurements, high prevalence, meaningful downstream impact, and strong relevance to chronic disease portfolios.
Wedge 2: Vaccination administration in aligned states/systems. Where permitted, this is operationally straightforward. The keys are training, documentation, adverse event protocols, and payer alignment.
In both cases, the win condition isn’t “dentists did the thing.” The win condition is closed-loop follow-through: patients get to the next step of care, and outcomes can be measured.
Dentists don’t need to become PCPs to make a difference in primary care capacity. They just need permission, payment, and practical pathways to do what many are already positioned to do: identify risk earlier, educate credibly, and connect patients into the broader system.
For life sciences companies chasing primary care audiences, that creates a new strategic question: what if the next meaningful share shift in prevention and early detection doesn’t happen in the physician’s office -- but in the dental chair?
The answer won’t be universal. It will be segmented, local, and operational. And it will live or die on reimbursement.
But if you’re looking for growth levers that don’t rely solely on “more reps” or “more digital,” this could be one of the rare ideas that changes access itself. And access, in primary care, is the game.
Gambhir RS. Primary Care in Dentistry – An Untapped Potential. Journal of Family Medicine and Primary Care. 2015;4(1):13–18. (Comprehensive review outlining screening, prevention, and curriculum implications.)
Gordon SC, Kaste LM, Mouradian WE, et al. Dentists as Primary Care Providers: Expert Opinion on Predoctoral Competencies. Frontiers in Dental Medicine. 2021. (Proposes the “Oral Health Primary Care Provider” model and evaluates competency feasibility within CODA standards.)
Myers-Wright N, Lamster IB. A New Model of Integrated Oral Health and Primary Care. American Journal of Public Health. 2016. (Conceptual framework for medical-dental integration.)
