“The real victory is that a permanent change to the tax matrix protects every active dentist in the state.” Vicki Wilbers, Executive Director
retainers, dental straighteners, and align- ers as taxable when a dentist or orthodon- tist purchases these items. Dental items placed permanently in a patient’s mouth are exempt. Anytime a dentist or ortho- dontist purchases something from the pur- chase area of the matrix that is marked as taxable and they don’t pay sales tax they should accrue consumer’s use tax.”
The MDA reached out again to DOR to request a meeting to address this. In June 2025, MDA staff, Dr. Copeland and the MDA legal team met with the DOR to address the matrices again. It was a posi- tive meeting, with DOR stating it would update the tax matrices again to make some items exempt as well as to provide clarification on some items discussed dur- ing the meeting.
On July 15, 2025, the MDA received notice of the DOR updates to the dental tax matrices. MDA legal counsel reviewed the updates to ensure our requests were accurately addressed. A week later, MDA formally accepted the changes to the matrices for Dentists & Orthodontists and Dental Supply Companies.
The updated matrices reflect that the following items are tax exempt when sold by a dentist or orthodontist and when purchased by a dentist or orthodontist: • Wires, retainers, dental straighteners and aligners
• Custom fitted trays designed for the delivery of prescribed medication
• Prescribed mouth guards • Occlusal splints
DOR has also added a general reference to the sales tax exemption in Section 144.030.2(18) of the Missouri Revised Statutes, which will be helpful in alerting members and reminding the Department that section may apply if future disputes arise.
“We are grateful for the positive interac- tion with the DOR and their responsive- ness to our concerns,” said Vicki Wilbers, MDA Executive Director. “The MDA
values its relationships with state agencies and we are glad we could work collabora- tively with DOR on a commonsense result for the dental profession.”
PRACTICAL APPLICATION
The MDA’s work with DOR has advanced the matrices to modern dentistry and re- moved the confusion that existed on what different procedures entail. These im- provements allow for practices and supply companies to have a clear and consistent document to reference when determining taxable implications.
“We really feel this is the biggest win for Missouri dentists (and their bottom lines) this year,” said Wilbers. Because of MDA advocacy, one dentist avoided a tax consequence and another recovered a five-figure refund from DOR. But the real victory is that a permanent change to the tax matrix protects every active dentist in the state.”
“We all could have been facing an audit, explaining our clinical process to the state and paying thousands in unneces- sary taxes,” said Dr. Copeland. “Thanks to MDA advocacy, we won’t have this worry. Without it, items used every day in our treatment plans would still be considered taxable.”
“The MDA invested significant time, energy and a five-figure legal expense, plus critical lobbying support, to achieve this,” said Wilbers. “Members expect this kind of advocacy and they should. This issue is just one example of how we advocate every day for issues like this, because in the end we know it directly affected two members, but ultimately, it could have affected every member. This is why the MDA matters. This is why belonging is critical. No one cares more, or fights harder, for you.”
REFERENCES
1. 12 CSR 10-110.013 Drugs and Medical Equipment (page 3) - Sales/Use Tax Exemptions
2.
https://dor.mo.gov/taxation/business/docu- ments/Dental-Supply-Companies.pdf
3.
https://dor.mo.gov/taxation/business/docu- ments/Dentists-Orthodontists.pdf
Additional Tax
fter sending members an email about this tax win, we received some addi- tional questions and provide clarification following. If you still have questions about this issue, please contact the MDA.
A
QUESTION: What is the main change from what [the tax matrix] used to be? Is it the addition of splints and retainers? In short, the Department of Revenue (DOR) changed its interpretation of the existing matrix and began audits under the new interpretation, which was incorrect. To ensure clarity and protection of dentists, the MDA met with DOR to advocate for updating the matrix with an understanding of modern dental procedures. The major change MDA advo- cated for was that the following items are tax exempt when sold by a dentist or ortho- dontist and when purchased by a dentist or orthodontist: • Wires, retainers, dental straighteners and aligners
• Custom fitted trays designed for the delivery of prescribed medication
• Prescribed mouth guards • Occlusal splints
QUESTION: It looks like sales tax should not be charged on composite and other items that are permanently placed in the mouth. Has this always been the case? Yes, but it often is not adhered to (suddenly) or when those within DOR are unfamiliar with the modern methods for providing care. Missouri Revised Statute 144.030 provides specific exemptions from the state’s sales and use taxes.
On January 1, 1980, the specific Federal law section incorporated by Missouri statute read:
“where such expenses are for services in connection with the care, treatment, fill- ing, removal, or replacement of teeth or structures directly supporting teeth, ex- cept that payment may be made under part A in the case of inpatient hospital services in connection with the provi-
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