The number of dentists in the U.S. that own practices have diminished over the past few years, for a variety of reasons.
The American Dental Association reported that only 72.5% of all private practice dentists are owners in 2023. In 2005, 84.7% of dentists were owners.
Money and time are a major hurdle for dentists when it comes to owning a practice, according to one dentist.
"With ownership comes regulations, HR and payroll, legal, practice management, accounting, maintenance and marketing, not to mention the price tag for real estate, equipment and financing costs these days," said Joseph Oleske III, DMD, a partner at Simply Beautiful Smiles in New Jersey.
Robert Trager, DDS, a dentist in New York City, said that many young dentists are shying away from ownership because they do not have the right collection of skills to successfully run a practice.
"Because of technology and being pampered by their parents, dental school and society, many do not have the confidence and ability to navigate ownership," he said. "Many lack the management, financial, interpersonal relationships and marketing skills to own and run a dental practice."
Huge student loan balances are making it almost impossible for new dentists to financially afford to open their own practice, especially for the first few years out of dental school. According to the ADA, dentists in unaffiliated private practice that are less than 10 years out of dental school have an average of $274,370 in educational debt.
This student loan debt is a major pitfall, said Avinash Bidra, DDS, who is a program director, maxillofacial prosthodontist and clinical professor in the Department of Reconstructive Sciences at UCONN Health in Farmington, Conn.
"The biggest reason for fewer dentists owning their practices is due to changing demographics, in which younger dentists with a significant student loan debt (almost 10 times higher than the retiring dentist had about 30 years ago) are afraid to take on another financial challenge at this stage in their lives," he said.
The emergence of DSOs in the industry has also contributed to the decrease in owner-dentists, as it provides an alternative to private practice ownership. In 2022, 13% of all dentists in the U.S. were affiliated with a DSO, and 32 states had an affiliation rate of 10% or more, according to the ADA.
As the challenges continue to mount for dentists, the number that turn to DSOs instead of practice ownership will likely continue to rise.