There is no shortage of opportunity for dental practice ownership even though the dental industry is undergoing a significant transformation. The undertones of corporate dentistry within the industry, along with the changes in the patient landscapes, and the rest makes ownership scary and confusing to the common dentist today.

This post will attempt to explore key statistics offered by ADA surveys from 2020 to 2024 that examine the size of practices in the industry, incomes, and gross billings for dentistry. We compare and contrast the increase affiliation with Dental Support Organizations (DSOs), and the latest trends.

For dental associates considering dental practice ownership – understanding these dynamics is important in order to navigate the current industry’s environment. These figures can help you make informed decisions about your career path toward private practice ownership. As always NEXT LEVEL CONSULTANTS can help you get into practice ownership when you’re ready.

The Size of Dental Practices Across the Country

• Single Location, Multiple Dentists: 
  • The largest segment in the industry today.
  • 39% of dentists, work in practices with one location and two or more dentists.
• Solo Practitioners: 
  • 34% of dentists are in solo practices with one location and one dentist.
• Larger Practices (DSOs): 
  • Only 16% of dentists are part of very large practices (10 to 100+ locations).
• Smaller Multi-location Practice:
  • 10% of dentists are a part of practices with 2 to 9 locations.

The Rise of the DSO Affiliation

Dental Support Organizations (DSOs) continue to play an increasingly sizeable role in the dental industry, driven by the dramatic shift in the economics of private practice. The nostalgic “good old days” of a solo dentist effortlessly working four days a week with low overhead and guaranteed above-average income are fundamentally over.

Dental practice ownership today requires sophisticated business acumen to navigate rising practice expenses which have surpassed a $500,000 average for owners in 2023. A phenomenon called “Margin Compression” a decrease in the profit margin despite practices seeing higher or even slightly increased gross revenues. This financial stressors has made DSO affiliation, particularly attractive to younger dentists (27% – 10 years out of school are affiliated).

• Overall DSO Affiliation: 
  • About 16% of all dentists in the industry are affiliated with a DSO.
• Early Career:
  • Dentists up to 10 years out of dental school show the highest DSO affiliation at 27%.
• Mid-Career:
  • Those 11 to 25 years out have 14% DSO affiliation.
• Late Career:
  • Dentists more than 25 years out have 9% DSO affiliation.
  • This trend suggests that newer dentists are more likely to join DSOs.
• Female Dentists:
  • 18% of female dentists are affiliated with a DSO.
• Male Dentists:
  • 15% of male dentists are affiliated with a DSO.

In Contrast Practice Owner’s Income Trends Snapshot (2023 data)

The long-term trend in the data from 2000 to 2023 shows a consistent increase in income across all categories, with a notable acceleration in growth during the post-pandemic period (2020 onwards).

But with that post-pandemic, general practitioner dentists are facing a more challenging economic environment. Patients are experiencing longer wait times for appointments yet dentists are working extended hours, which points to the phenomenon known as “margin compression.” 

Margin compression means that while dentists might be working more, the profit margins on their services are shrinking, making it harder to maintain or increase their net income. This trend highlights the increasing pressures within the dental industry as a whole.

Looking at the data from 2020 to 2023 for Median Net Income

• Employed Individuals: 
  • Experienced a growth of 29.74%.
• Solo Practitioners: 
  • Saw an increase of 16.62%.
• All Owners: 
  • Showed a growth of 13.56%.
• Non Solo Practitioners: 
  • Had a growth of 12.56%.

Gross Billings for Ownership in Private Practice (2023 data)

Type of Dentist	Average Gross Billings	Median Gross Billings
General Practitioners
– Solo Ownership	$968,920	$896,370
– Non Solo Ownership	$734,560	$679,000
Specialists
– Solo Ownership	$1,127,620	$977,610
– Non Solo Ownership	$1,188,440	$1,029,350
All Dentists
– Solo Ownership	$1,007,790	$903,440
– Non Solo Ownership	$848,370	$729,630

General Practitioner “Solo Ownership”

The traditional solo general practice faces continued financial pressure due to rising overhead costs. While gross billings have increased across the board (e.g., all dentists’ average gross billings per practice hour increased by 6% from 2022 to 2023), the cost of running a practice is rising at a faster pace for solo owners. This is why we see a case for dentists joining multi-dentist groups or DSOs to achieve scale.

Specialist Ownership

Specialists, who already command higher gross billings per hour, further optimize their profits through “Non Solo” arrangements. The higher gross billings for “Non Solo” specialists suggest a more successful model of intra- or inter-specialty collaboration, which can boost referrals and overall practice productivity.

Annual Net Income of Dentists in Private Practice (2023)

Type of Dentist	Average Net Income	Median Net Income
General Practitioners
– Solo Ownership	$204,900	$172,040
– Non Solo Ownership	$263,450	$230,070
– Employed	$177,110	$168,390
Specialists
– Solo Ownership	$322,330	$279,630
– Non Solo Ownership	$470,020	$385,470
All Dentists
– Solo Ownership	$227,750	$179,970
– Non Solo Ownership	$307,810	$247,670
– Employed	$183,910	$169,720

When looking at the data the Average Net Income is higher than the Median Net Income. This confirms that there are high-earning outliers (owner-dentists making substantially more than the norm) that are pulling the average up.

Dental Industry Income Trends Analysis

• Employed Individuals Experienced the Highest Growth Rate:
  • Employed individuals saw the most significant percentage increase in income.
  • A rise of approximately 23.88%
  • From an average $125,726.42 Pre-pandemic to $155,755.83 post-pandemic.
• Non Solo Owners Showed Strong Growth:
  • Non Solo ownership also experienced substantial income growth.
  • 17.67% increase.
  • Average income rose from $240,451.50 before the pandemic to $282,930.00 after.
• All Owners and Solo Practitioners Also Saw Increases:
  • ‘All owners’ which includes specialists observed a 16.43% increase.
  • Moving from $219,201.50 pre-pandemic to $255,226.25 post-pandemic.
  • Solo practitioners had an 11.16% increase.
  • Average income rose from $200,875.00 to $223,286.25.

All data pulled from Source: American Dental Association, Health Policy Institute, 2024 Survey of Dental Practice.			
Copyright © 2024 American Dental Association.		

Overall, all analyzed income categories demonstrated positive growth in the post-pandemic era, indicating a recovery or even an acceleration of income for these groups.

Becoming a Practice Owner Provides Dentists the Ability to Raise Their Income While Having More Control

Despite the rising challenges with students graduating with more debt along with a continued rise in corporate competition, practice ownership remains the single best long-term career choice for young dentists. The initial comfort and administrative relief offered by a DSO or associateship cannot match the profound and lasting advantages of owning your practice.

Based on the data provided a practice owner earns $51,110 more per year than an employed associate, simply by being the one who keeps the net profits. The most significant figure here is; Over a 30-year career, this difference alone can accumulate to over $1.5 million in pre-tax income that an associate does not realize. So the sooner you become an owner the better. Again NEXT LEVEL CONSULTANTS can help any dentists who is considering practice ownership.

Beyond the financial advantages, practice ownership offers the singular reward of complete autonomy, a benefit fundamentally unattainable in any associateship model. As an owner, you are the Chief Visionary Officer and Executor of the clinical environment! This freedom allows you to build a true love and passion for the work you do; hand-picking your team to cultivate a distinct office culture, investing in technology that reflects your commitment to clinical excellence, and controlling the pace and quality of every procedure.

Practice ownership is the only vehicle that fully converts your training, values, and vision into a cohesive, enduring professional entity. This path, though, is not without its initial challenges. While the administrative burden of ownership is real, it is entirely manageable.

With proper planning, strong mentorship or consultants, the initial hurdles are easily overcome. The long-term investment of effort is a worthwhile trade-off for securing that freedom, income, and legacy that only ownership can provide.