State Dental Boards Appear to Ignore Supreme Court’s Antitrust Ruling

Ten years have passed since the United States Supreme Court ruled that state dental boards controlled by active market participants could be violating federal antitrust laws. Yet, a new report from the Pacific Legal Foundation (PLF) reveals that dental boards across the country have largely ignored the precedent set by North Carolina Board of Dental Examiners vs the Federal Trade Commission and may be risking legal consequences as a result.

The 2015 case stemmed from the North Carolina dental board’s aggressive crackdown on nondentists offering tooth-whitening services. The board, primarily composed of licensed dentists, sent cease-and-desist letters to more than 40 individuals and businesses, claiming they were illegally practicing dentistry. The Supreme Court’s 6-3 ruling found that such actions violated federal antitrust laws, as the board was acting to limit competition rather than protect public health.

Despite this landmark decision, PLF’s new report highlights that state dental boards remain overwhelmingly controlled by practicing dentists and dental hygienists — individuals who have a vested financial interest in restricting competition. In fact, the report found that in all 50 states, at least 60% of board seats are occupied by active market participants, with an average of 85% nationwide. No state has moved to reduce this dominance, and some — like Georgia, Michigan, and North Dakota — have even increased the number of dental professionals on their boards.

The report warns that unless states reform their licensing boards — either by reducing the number of market participants in decision-making roles or increasing legislative and executive oversight — they could face costly legal battles. Some experts suggest introducing more public representatives to dental boards or shifting regulatory power to state agencies to ensure fairer oversight. Click here to read more.