How Trump’s One Big Beautiful Bill will reshape dentistry

Fraser Macdonald, Dental Tribune International

Thu. 14. August 2025

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CHICAGO, US: As one of President Donald Trump’s proudest accomplishments, the One Big Beautiful Bill Act (OBBB), enacted in July 2025, is a sweeping budget reconciliation law containing far-reaching provisions for dental professionals, students and patients. Tax reforms, student loan changes, adjustments in Medicaid funding—its effects will be felt across the profession for years to come.

As described in a recent American Dental Association (ADA) press release and corresponding document, the OBBB delivers a suite of tax benefits for dental practices, many of which were secured through persistent ADA advocacy. Chief among these is the full restoration of the pass-through entity tax deduction, protecting small-business dentists from an estimated 1.5–5.0% tax hike. Alongside it, a US$40,000 (€33,962^*) cap on the state and local tax deduction offers meaningful relief to practices organised as pass-through entities—roughly 90% of the industry—until 2030, after which it will be phased out.

The act also makes the 20% small business income deduction permanent, retroactively restores 100% bonus depreciation and increases expensing limits for depreciable business assets. These measures collectively give practices more scope to invest in new technology, infrastructure and software to create modern, competitive clinical environments.

Education and workforce measures are woven into the tax provisions. Post-secondary credentialing expenses now qualify as higher-education costs, benefiting dental students and their families, while amendments to employer-provided student loan repayment rules will exclude a portion of repayments from taxable income. These initiatives could strengthen workforce recruitment and retention, a point underscored in higher education advocacy circles.

The OBBB also overhauls federal student loan programmes from 1 July 2026, eliminating Graduate PLUS loans for new borrowers, introducing strict annual and lifetime borrowing caps, and reducing repayment options to two: a standard plan and a new income-based repayment assistance plan. Current borrowers will generally retain existing terms, but incoming dental students may face larger funding gaps.

On the Medicaid front, the OBBB introduces measures between 2026 and 2028 that could reshape state dental benefits. While paediatric dental coverage under the Early and Periodic Screening, Diagnostic and Treatment benefit remains untouched, changes in funding, new co-pay allowances of up to US$35 per visit and stricter eligibility rules could reduce adult dental services in some states—a shift already flagged by policy analysts.

Most major provisions are still pending, so dentists have time to adapt their financial planning and advocacy efforts. The ADA is advising its members to consult with tax professionals, financial aid offices and state dental societies to navigate this complex legislative change.

Editorial note:

^* Calculated on the OANDA platform for 4 July 2025.