COVER STORY
Sales/Use Tax Audits: The Biggest Win for Missouri Dentists this Year
S
ales and use tax are regulated by the Missouri Department of Revenue (DOR). In general, dentists are ren- dering services not subject to sales
tax; however, tangible personal property purchased by dentists and used or consumed in the practice of their professions is subject to use tax when purchased.
The exemption section states, “also exempt from sales tax are items specifi ed in section 1862(A)(12) of the Social Security Act of 1965. Exempt items included in this class are those used in connection with the treatment, re- moval or replacement of teeth or structures directly supporting teeth. Dental equipment or supplies are not exempt. The exempt items include:
• Dentures • Inlays • Bridge work • Fillings • Crowns • Braces, or • Artifi cial dentistry and dental recon- structions made, manufactured or fabricated from molds or impressions made by dentists of the mouths of their particular patients and sold to dentists for insertion in the patient’s mouth as the direct support of, substitution for, or part of the patient’s teeth.”
These specifi cations are outlined in more easily understood Taxability Information Guides, or “Tax Matrices” provided by the DOR. For the dental profession, two matrices exist: one for Dental Supply Companies and one for Dentists and Orthodontists.
ISSUE BEING CONSIDERED
Much had remained unchanged, or perhaps unnoticed, about this tax law until August 2024 when the MDA was alerted to some
20 focus | FALL 2025 | ISSUE 3
My experience with the MDA in regards to this audit was fantastic ... Having that ally throughout this process gave me relief. Knowing that there was still someone working for me when I wasn’t able to be on the phone or working constantly to resolve this issue.
Missouri dentists receiving audit inquiries specifi cally on clear aligners used to treat malocclusion.
The audit inquiries brought to light that the DOR had changed its interpretation of the existing matrix without notifi cation to the dental profession and began audits under the new interpretation, which was incorrect.
In summary, the question being considered was, “Are dental straighteners/aligners are subject to sales tax or are they exempt?” If not exempt, who should be charging and paying the tax? Should the manufacturers of the appliance (such as Invisalign) charge the dentist sales tax? Should the dentist charge the patient sales tax?
The MDA position to DOR for clear aligners specifi cally, was that like traditional braces, clear aligners are a treatment plan for maloc- clusion and therefore should be an “exempt item” included in the class with those “used in connection with treatment.”
MDA ADVOCACY
MDA action on this issue began in early fall 2024, once we were aware of the audit inquiries. We consulted our lobby and legal teams for advice. A call was secured between DOR staff , MDA staff and MDA president, Dr. Jon Copeland, to discuss the audits and an understanding of their application of the tax to better advocate for members.
The DOR responded they would review the matrices and the concerns of the MDA and provide feedback. A signifi cant amount of time passed with MDA awaiting more com- ments on the matrices. In part, this was due to elections and the changing of state staff that resulted in the issue being pushed back.
In April 2025, the DOR published new tax matrices, but the language still did not refl ect the requested changes of the MDA. The DOR stated: “The Department has reviewed the statutes and regulations and still has mouth guards,
— Dr. Jason Sparks, Kansas City
SCAN CODE FOR ADDITIONAL RESOURCES
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