How dentistry's practice models continue to evolve

Between 2022 and 2023, the proportion of dentists in practices with more than 100 locations increased while the percentage of dentists in solo practices fell. This new data were recently released from the ADA Health Policy Institute (HPI).

Additionally, the percentage of dentists affiliated with dental service organizations (DSOs) increased again, according to the data.

Changes in practice models in the U.S. were analyzed using the HPI Dental Office Database plus other resources. The analysis was based on all practicing dentists in the U.S. for which HPI could assign at least one practice location address. Of 203,631 practicing dentists in the U.S. in 2023, this analysis included 193,550 dentists.

In 2022, the proportion of dentists in practices with more than 100 locations was 9%, rising to 10% in 2023. During that same period, the percentage of dentists in solo practices declined from 36% to 35%, according to HPI.

The percentage of dentists practicing at solo practices has decreased for every career stage.

In 2022, nearly 13% of all dentists were affiliated with DSOs, increasing to nearly 14% in 2023. This percentage has ticked up every year since 2015, when approximately 7% of all dentists were affiliated with DSOs, according to HPI.

The largest increase, which is about 2%, was seen in clinicians who have been out of dental school for six to 10 years. In 2023, nearly 20% of these clinicians were affiliated with DSOs.

Affiliation increased by about 1% between 2022 and 2023 for dentists in all other career stages. In 2023, almost 29% of dentists out of school between zero and 5 years were affiliated with DSOs along with about 12% of those who had been out of school for 11 to 25 years, and approximately 8% of those who had been out of school at least 25 years, according to the results.

In 2023, DSO affiliation went up for every dental specialty, with orthodontists and oral and maxillofacial surgeons being the most likely to partner with them.

Furthermore, new dentists and women dentists were the most likely to partner with DSOs. Also, dentists in certain states were more likely to affiliate with DSOs. Nearly 25% of dentists in Colorado, Nevada, and Georgia were affiliated with DSOs, according to HPI.

Nevertheless, HPI noted that some methodological choices had to be made, which led the institute to believe the number of dentists affiliated with DSOs and larger groups was undercounted slightly.