A Running Argument · Est. 2026

Dentistry is fighting the wrong war.

Every conversation in the profession is about DSOs. Six out of seven US dentists are not in one. The actual threat opens at 11pm, accepts walk-ins, and never sends the patient back. This site is a running argument about the handoff between dentistry and medicine, who pays for the gap, and what to build instead.

About

Eric Chong is a founder and writer based in California. He runs original field research on the handoff between dentistry and medicine — the seam where insurance fails, hours are ceded, and patients quietly disappear. He builds the systems that close it.

Most of what shows up here are foundational thoughts on healthcare — the arguments worth defending, the reports worth running, and the work in progress.

BasedSan Jose, CA
BuildingNightLeak · MyTongueAI · checkmydenial
Writing onDentistry, medicine, the gap between
The Argument

The handoff nobody is defending.

The story the dental profession tells itself is that DSOs are the existential threat. Consolidation. Private equity. A corporate buyer on every corner. That story is convenient because it has a villain with a logo. The data says that villain is a sideshow. Sixteen percent of US dentists are DSO-affiliated. That number has not moved fast enough to justify the anxiety it generates.

The real loss is quieter. It happens at 7pm on a Tuesday when a patient's tooth starts throbbing and the office is closed. It happens in the emergency room, where 1.6 million Americans show up every year for a dental problem and leave with an antibiotic and a referral to a dentist they will never call. It happens in hospital credentialing offices, where the medical system decides which providers get the referral and which don't.

Dentistry didn't lose ground to a competitor. It ceded hours, access, and position while arguing about the wrong enemy. This site is where I document what that handoff looks like, what the data actually says, and what a sensible alternative would look like if someone bothered to build it.

Original Diagram · Handoff Map v1
How a paying patient quietly leaves the practice forever.
The five-step handoff diagram A horizontal flow diagram showing how a dental patient with a 8pm problem goes through five steps and never returns to dentistry. 01 02 03 04 05
01 Patient has a problem at 8pm.
02 Dental office is closed.
03 Patient goes to urgent care.
04 No referral back to a dentist.
05 Patient never returns to dentistry.
Repeat this loop 1.6 million times a year. That is not a DSO problem. That is a hours-and-access problem the profession has not named, much less defended.
The Receipts

Numbers the profession isn't citing.

If the DSO narrative is the wrong frame, the data has to make the real frame unignorable. These are the figures every dentist, hygienist, and office manager should have memorized. Sources logged with each.

FIG. 02 / GROWTH
+99%
Growth in US urgent care centers, 2014 to 2023. Nearly doubled in under a decade while dental office hours stayed flat.
Trilliant Health · Urgent Care Utilization Report · 2024
FIG. 03 / VOLUME
1.6M
Non-traumatic dental ER visits in the US per year. Roughly 79% are redirectable to a dental office that was open.
CareQuest Institute · Dental Care in Crisis · 2025
FIG. 04 / COST
$3.9B
Annual cost to the US healthcare system for those ER visits. Per-visit cost rose 29% from 2019 to 2022.
CareQuest Institute · 2025
FIG. 05 / TREND
+216%
Twenty-year increase in ER spending on non-traumatic dental conditions, inflation-adjusted. Still climbing.
Hugo FN et al. · JADA · 2022
FIG. 06 / FRAME
16.1%
Share of US dentists affiliated with a DSO as of 2024. The narrative does not match the numbers.
ADA Health Policy Institute · 2024
FIG. 07 / MATH
62%
Average overhead at a US dental practice. Fee-for-service does not fix the math. It moves the pressure.
ADA HPI · Economic Survey of Dental Practice · 2024
"Dentistry built itself into greatness through autonomy. In every decade since, when given the choice between rejoining medicine or entrenching isolation, the profession chose isolation. Against its own patients' interests. Against its own founding science." From the working draft · The Dental Deletion
Field Notes

What I'm hearing from the ground.

Every week I call between 30 and 150 dental practices. Most don't answer after hours. The ones that do, teach me something. I write it down here.

Week of April 14, 2026 · 34 practices · CA + AZ · 7–10pm PT Field Note №16

Of 34 practices called between 7 and 10pm Pacific on a Tuesday, 33 did not answer. One answered and rerouted the call to a scheduler for the following Monday. Zero had a path for a patient in active pain that night.

The one that did answer was a boutique practice in the Bay Area running a $250K-a-year rejuvenation model. Their front desk had a playbook. They are the only ones I have found who do.

The rest are ceding the patient. They do not know they are ceding the patient. They believe they are running a good practice — and by the metrics they were taught, they are. The metrics they were taught do not include the patient who called at 8:14pm and went somewhere else.

The Newsletter

One essay. One field note. One number that matters.

Sundays. No ads, no sponsorships, no PR. The argument as it develops. The data as it lands. The reports as they ship.

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Original data shared on request. Quote attribution: Eric Chong.