Dental insurance participation appears to be shifting.
According to an ADA economic report discussed by Shane Simmons, CEO and Visionary of Crimson Media, 29.3% of surveyed dentists dropped at least one dental insurance network during 2025.
That's nearly one in three.
There's an important distinction here. The report isn't saying nearly one-third of dentists went completely out of network or became fee-for-service practices. It means they dropped at least one insurance network during the year.
Still, the number caught Shane's attention because it lines up with something Crimson Media has been seeing among dental practices across the country.
More dentists are reconsidering which insurance plans make sense for their practices. Some are dropping one or two plans. Others are opening new practices completely out of network.
And according to the same report, that shift may continue.
More Dentists May Drop Insurance Networks in 2026
The ADA report surveyed 704 dentists about actions they took during 2025 and what they expected to do moving forward.
When asked about dropping some insurance networks in 2026, 14.6% said they were very likely to do so. Another 20.4% said they were somewhat likely.
Combined, that's 35%.
The finding also follows an earlier ADA report Shane referenced from July, when 31% of dentists said they were considering going out of network with an insurance plan during 2025.
The final figure for the year came remarkably close at 29.3%.
Crimson Media has seen a similar shift while working with dental practices.
Shane noted that it has become particularly noticeable over the past couple of years. Some established practices are beginning by dropping one of their lowest-reimbursing plans. Others are removing multiple plans over time.
The change isn't limited to established practices.
Some dental startups are choosing to open out of network from day one.
Why Are Dentists Reconsidering Insurance Participation?
Shane points to the economics of running a dental practice as one possible piece of the picture.
Equipment costs change. Payroll changes. Supplies and other operating expenses increase. Inflation affects the practice just as it affects patients.
Insurance reimbursement doesn't necessarily move at the same pace.
That can leave a dentist doing a large amount of dentistry without seeing the financial return needed to support the business and its team.
That doesn't mean dropping insurance is automatically the right move.
Shane is clear about that distinction in the episode. Plenty of practices participate with insurance and perform very well.
What the ADA numbers suggest is that more dentists are at least reconsidering the arrangement.
And once a practice drops an insurance network, another question becomes more important:
Why will a patient choose this practice if being in network is no longer the reason?
That's where marketing, brand reputation and the patient experience start carrying more weight.
Going Out of Network Changes the Patient Acquisition Equation
Insurance participation can be a significant reason a patient chooses a dentist.
Someone searches for an in-network provider, finds a nearby practice and schedules. The insurance relationship helped create the connection.
Take that advantage away and the practice may need to give patients other reasons to choose it.
Shane describes that as getting prospective patients to know, like and trust the dentist and team.
That doesn't happen from one advertisement.
Patients may encounter the dentist through search, social media, reviews, videos, referrals or community involvement before making an appointment. Over time, those interactions can build familiarity with the practice itself rather than relying primarily on an insurance directory.
This becomes particularly relevant for practices considering a move away from one or more plans.
A dental marketing strategy can help build that familiarity before the insurance relationship changes, rather than leaving the practice scrambling for new patient flow afterward.
Nearly 96% of Practices Are Accepting New Patients
The insurance numbers weren't the only part of the ADA report that stood out to Shane.
In Q4 2025, 95.7% of practices surveyed said they were accepting new patients.
At first glance, that sounds encouraging.
Then comes the more interesting number.
Among practices accepting new patients, the average wait for an initial appointment was 13.4 business days.
That's nearly three working weeks.
For an established patient or someone referred by a friend, that delay may not be a major problem. There's already some connection to the practice.
Someone searching online for a new dentist is different.
They may call another office.
Shane regularly discusses this with Crimson Media clients. Once new patient appointments are pushed beyond roughly 10 business days, practices can start running into conversion problems, particularly in competitive markets.
A prospective patient who doesn't know the dentist has little reason to wait several weeks if another well-reviewed practice can see them sooner.
More Marketing Won't Fix a Full Schedule
This is where the ADA report becomes particularly useful from a marketing perspective.
A practice might look at slowing new patient numbers and assume it needs more leads.
So the marketing budget goes up.
But what happens when the team can't schedule those leads for two or three weeks?
More demand doesn't create more room on the schedule.
The practice may simply pay to generate additional calls from people who eventually schedule somewhere else.
Longer delays can create another problem too.
The further away an appointment is, Shane notes, the greater the chance of a cancellation or no-show. The prospective patient has had more time to keep looking, forget about the appointment or change plans.
Before increasing acquisition spending, it makes sense to look at what's happening after the lead comes in.
How soon can a new patient actually be seen?
Are certain blocks being protected for new patients?
Can scheduling be adjusted?
Is the practice losing callers because the first available appointment is simply too far away?
Those questions connect marketing performance directly to operations.
Out-of-Network Practices Have to Give Patients a Reason to Stay
Getting someone through the door is only the beginning.
Shane has noticed another common trait among practices that successfully operate out of network or gradually reduce insurance participation: they've built loyalty.
That loyalty can come from several places.
The patient experience matters. So does the relationship patients build with the dentist and team. Reviews, referrals and a recognizable local brand reinforce it outside the office.
Over time, patients may become less likely to view the practice as simply "the dentist my insurance sent me to."
They have a relationship with the actual practice.
That can make a considerable difference when insurance participation changes.
A patient who feels little connection to the office may simply move to the next in-network provider. Someone who knows the team, trusts the dentist and has consistently had a good experience has a different decision to make.
Marketing contributes to that relationship too.
Crimson Media's approach to omnipresence marketing for dental practices is built around maintaining visibility across multiple touchpoints rather than depending on a single ad or channel to carry the entire patient relationship.
Insurance Changes Need More Than a Marketing Decision
The ADA numbers point to a broader change happening in dentistry.
Nearly one in three dentists surveyed dropped at least one insurance network during 2025. More than one-third indicated they were somewhat or very likely to drop a network in 2026.
At the same time, almost 96% of practices reported accepting new patients, yet those patients were waiting an average of 13.4 business days for an initial appointment.
Those numbers intersect.
A practice considering dropping an insurance plan needs to think about how patients will find it afterward. But generating demand isn't enough. The schedule needs room for those patients, the team needs to convert the opportunities coming in, and the experience needs to give patients a reason to return.
For some practices, remaining in network may continue to make sense. For others, dropping certain plans may be part of a larger shift in how the business operates.
Either way, the decision reaches beyond reimbursement rates.
It affects patient acquisition, scheduling, retention and how much weight the practice's own reputation carries in the community.
At Crimson Media Dental Marketing, Shane and the team work with dental practices on that patient acquisition side, including practices building a patient base that isn't dependent solely on insurance participation.