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Eight years ago, I walked into a dentist's office with a toothache and walked out with a treatment plan for eight cavities, a huge bill, and weeks of pain. After getting second and third opinions, I learned I needed just one filling, not eight.
That experience taught me what many Americans already know: traditional health care doesn't work for people facing sky-high living costs and unpredictable coverage.
Dental care used to be a standard part of American employee benefits packages. As health care premiums continue to rise and the American workforce transforms, with more freelancers, contractors, gig workers, and part-time employees than ever before, dental coverage is often the first benefit to be scaled back or eliminated entirely.
The result? Millions of working Americans, including many full-time employees, are left navigating an increasingly expensive and ineffective dental landscape.
The pain
The numbers tell a stark story: only 25% of gig workers have dental insurance, compared to 66% of full-time employees. Even those with employer coverage face mounting challenges: high deductibles, surprise bills, limited provider networks, and months-long wait times.
Our research shows that despite 75% of Americans planning to visit a dentist annually, only 35% actually do.
For HR professionals and benefits managers, this creates a painful dilemma: how to provide meaningful dental benefits when budgets are tight and the workforce is more diverse than ever.
The consequences extend far beyond individual workers. Reduced dental benefits mean employees have to make tough choices between rent, groceries, and health care. Dental care, which is often viewed as "cosmetic" or "optional," gets pushed to the bottom of the priority list until a toothache develops into an abscess that becomes an emergency room visit costing thousands of dollars and lost productivity.
In cities like New York or San Francisco, where housing costs consume most paychecks, dental care has become unaffordable for many, including freelancers, gig workers, small business employees, and young professionals.
For employers trying to compete for talent in these markets, inadequate dental coverage puts them at a significant disadvantage.
Dental care is real health care
The cruel irony is that preventive dental care is the most effective and affordable health care intervention we have.
Regular cleanings prevent expensive procedures that can bankrupt families. Yet shrinking benefits packages and rising costs make prevention inaccessible to those who need it most, affecting both workers without coverage and employers struggling to maintain competitive benefits.
New options
As traditional employer-sponsored dental benefits become harder to sustain and consumers look for more modern oral care providers, Americans are increasingly turning to alternative options.
Dental care options now include subscription-based models and annual membership plans, helping remove insurance hurdles for many patients.
Subscription-based "direct primary care" practices are starting to take off in the medical care sector.
Subscription-based and membership plan models are also gaining traction among individuals seeking affordable and effective preventive dental care.
When you remove financial barriers and insurance middlemen, people actually take care of their teeth.
I've seen this firsthand through my company, Wally Health. Our 25,000 members pay for an annual membership plan and average three to four cleanings per year, compared to the typical American who visits the dentist no more than once a year.
This subscription approach reduces dependence on traditional group insurance models and puts control back in the hands of employers and employees.
For benefits managers, subscription dental can work as a voluntary benefit that requires minimal administration.
For workers (particularly contractors, gig workers, and part-time staff), it offers predictable, affordable access without requiring full-time employment or navigating complex insurance networks.
Like HBO, but for teeth
Subscription models work because they align incentives properly. When providers receive consistent revenue for keeping patients healthy rather than treating them after problems develop, prevention becomes the top priority. Providers compete for outcomes instead of on their ability to navigate insurance bureaucracy.
Consumers readily pay recurring fees for Equinox, Netflix and Spotify. These services provide predictable value and convenient access. Adding preventive health care to a monthly subscription budget is just as intuitive and effective.
These models also make dental care costs transparent and affordable, allowing people to plan for them. People don't skip preventive appointments because they're afraid of surprise bills or unnecessary treatment recommendations.
For HR and benefits professionals navigating a tight labor market and budget constraints, subscription dental represents an innovative solution.
It addresses the coverage gap for non-traditional workers, offers predictable pricing for employers who want to subsidize or offer it as a voluntary benefit, and delivers measurable health outcomes that reduce downstream costs.
The American people deserve health care that works for them. Sometimes, the most radical solution is also the most obvious: Remove the barriers that prevent people from accessing the care they need and see the results.
Taking care of ourselves isn't so hard to swallow after all.
Tyler Burnett is the chief executive officer and co-founder of Wally Health, a direct dental care firm.
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