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The dental industry is undergoing a major shift, and one of the most important questions for dentists today is: who owns dentistry?
With the growing presence of Dental Service Organizations (DSOs), changing career preferences, and increasing financial pressures on new graduates, the structure of dental ownership is evolving faster than ever.
Using insights from the ADA Health Policy Institute 2024 study, this blog explores ownership trends, practice models, and what they mean for dentists at every stage of their careers.
Despite all the buzz around DSOs, independent ownership still plays a dominant role in dentistry.
According to the latest data:
This means that while DSOs are growing, private practice continues to be the backbone of the dental industry.
However, the real shift is not in total ownership numbers but in who is choosing which path.
One of the clearest insights from the report is the difference in ownership patterns across career stages.
Many dentists begin their careers in DSOs but gradually move toward private ownership as they gain experience, confidence, and financial stability.
This trend highlights an important pattern: DSOs are often an entry point, not a long-term destination
Solo practice has traditionally been the gold standard in dentistry, but that is changing, especially among younger professionals.
This financial burden pushes many new dentists toward stable employment models instead of immediate ownership.
Starting a practice involves:
For new graduates, these responsibilities can feel overwhelming.
DSOs provide:
This makes them attractive for dentists who want to focus on clinical work early in their careers.
The report also provides a clear breakdown of how practices are distributed across the industry.
Nearly three-quarters of all practices operate from a single location.
Even though large DSOs exist and are expanding, the majority of dental care is still delivered through local, independently managed offices.
While many dentists aim to expand into multiple locations, the data shows that very few succeed at larger scales.
There is a sharp drop from:
Managing multiple practices is not just about growth it requires a complete shift in how the business operates.
Many dentists underestimate these challenges, which is why expansion often leads to stress, inefficiency, or even scaling back.
Not all dental specialties are equally involved with DSOs. Some are far more attractive due to profitability and scalability.
Specialties with:
They are more likely to attract DSO investment.
The study also shows a slight variation between male and female dentists:
While the difference is small, it suggests that structured work environments may appeal more to certain lifestyle preferences, such as flexibility or work-life balance.
Student debt is not just a financial issue; it is influencing how dentists think about their careers.
Even with income-driven repayment programs available, many dentists still feel the need for:
This mindset leads to:
Choosing employment over ownership
Prioritizing short-term security over long-term growth
At its core, the difference between private practice and DSOs lies in control and structure.
Each model serves a purpose, but they offer very different career experiences.
The dental industry is not moving toward a single model. Instead, it is becoming more diverse.
Dentists who understand these shifts will be better positioned to:
The question of who owns dentistry today is complex, but the data provides clarity.
Ultimately, dentistry is evolving into a multi-path profession, where success depends on choosing the right model based on individual goals, risk tolerance, and long-term vision.Partner with PracticeCFO to make smarter financial and ownership decisions. Our team helps dentists grow profits, manage risk, and build lasting wealth through expert guidance and proven strategies. Listen to Episode 146 of The Dental Boardroom Podcast: https://podcasts.apple.com/us/podcast/146-who-owns-dentistry/id1518344747?i=1000757102884
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