Publications like this one are expected to produce predictions at least once a year. We would rather publish the questions, partly because they are more useful and mostly because we do not know the answers and would prefer to say so.
Here is what we expect to spend 2027 reporting on.
1. Does the shared-services model survive its first difficult exit?
Arrangements like Front Range Dental Collective work because every member currently wants to be in them. None has yet been tested by a member leaving under strain, at a bad moment, with a shared vendor contract in the middle. That test will be more informative than anything the model has demonstrated so far.
2. Where do diagnostic thresholds settle?
Detection software is configurable, and someone sets the default. So far that someone has usually been the vendor. Whether the profession develops its own view — through associations, through malpractice carriers, or through practices simply comparing notes — is unresolved and consequential.
3. Does anyone fix the interoperability problem?
The proprietary layer in scanner output is the product, which is precisely why it will not be opened voluntarily. The interesting question is whether a large enough buyer — a group, an insurer, a state — ever makes it a condition.
If hygiene capacity recovers, do those intervals snap back? The clinical case says no. The revenue model says yes.
4. Do extended recall intervals survive the staffing recovery?
Practices that stretched low-risk patients to nine or twelve months because they could not staff hygiene have generally not observed harm. If hygiene capacity recovers, do those intervals snap back? The clinical case says no. The revenue model says yes.
5. What happens to the practices that cannot be sold?
Multiple compression has stranded a cohort of owners whose retirement plan was an exit at 2021 prices. Some will work longer. Some will close. What happens to their patients, in markets where they were the only practice, is a question nobody is currently responsible for.
6. Does loss-ratio regulation reach dental benefits anywhere?
Six states are considering it. Legislative staff mostly expect it to fail this session. Legislative staff have been wrong before, and the first state to pass one will change the conversation everywhere else.
7. Do the curriculum redesigns produce measurably different dentists?
Several programs have committed to comparing cohorts, which is more rigor than curriculum reform usually gets. The results will start arriving in 2027 and will be contested immediately.
8. Does anyone treat access as a logistics problem?
Dr. Theo Adeyemi’s work keeps finding that the binding constraint is transportation, scheduling, and hourly employment rather than the supply of dentists. Almost every program funded to address access is a supply program. That mismatch is either about to be noticed or about to persist for another decade.
9. What is a practice’s data worth, and to whom?
Practices are generating large volumes of imaging and outcome data that is valuable for model training and that nobody has priced. The agreements governing it are, at present, buried in software terms of service that almost no owner has read.
10. Does any of this change what happens in the chair?
The honest answer is that most of it will not, for most patients, in 2027. The visit is remarkably durable. That durability is either the profession’s great strength or the reason it changes so slowly, and we expect to keep arguing about which.
