The Case for Change

Why Dental Benefits Need to Change

Dental insurance was built to manage cost, not deliver care. Toothsome is building the alternative.

The Medical-Dental Disconnect

Oral health and systemic health are inseparable. The insurance infrastructure treats them as unrelated.

46%
of Americans skip dental care due to cost
ADA Oral Health & Well-Being Report
$1,500
annual maximum since 1973 — unchanged for 50+ years
NADP / HRA Division of Dentistry
12-14%
higher medical costs for diabetics without periodontal care
JADA / CareQuest Institute 2023

Three Converging Forces

The conditions for a direct dental care model have never been more favorable.

1
Employers Are Connecting the Dots

Benefits leaders see premiums rising while annual maximums stay flat. They are actively looking for alternatives that deliver real value.

2
Direct-Pay Infrastructure Is Mature

HRAs, real-time eligibility, and virtual card rails make it possible to deliver dental benefits without a carrier. The regulatory and technical infrastructure finally exists.

3
Providers Are Ready for Alternatives

Practices are leaving PPO networks in record numbers. Providers want fair payment at the chair without claims, pre-auths, or write-offs.

Direct Care Infrastructure

Toothsome connects employer benefit dollars directly to dental care, without insurance intermediaries. Employers fund dental wallets that employees control. No networks, no annual maximums, no claim denials. Founded by a board-certified oral and maxillofacial surgeon who saw this firsthand, Toothsome is direct dental care infrastructure: real-time provider payments, employer cost transparency, and patient access to the care their clinicians actually recommend.

"The system that exists was not built to deliver care. It was built to manage risk. We are building the one that should have existed all along."

Build With Us

Whether you are an employer looking for dental benefits that actually work, or a provider ready for a better model, we would like to hear from you.