Approximately one‐half of the United States population is covered by a dental benefit plan. One‐fifth of that group is covered under various types of managed care contracts, and this number is said to be increasing by 15% to 20% per year. However, dentists report that these plans have not had a major impact upon their practices. Only 6% of patients were covered by them, and only 2% of gross receipts were derived from them. Periodontists surveyed were divided in their opinions about how managed care has affected their practices. This paper discusses these changes, particularly with regard to income, referral patterns, treatment decisions, and ethical and legal liability. J Periodontol 1998;69:261–268.