By Aijaz Alam
How many dentists own a practice, and how many work for DSOs?
16.1% of US dentists were affiliated with a dental support organization (DSO) in 2024, per the American Dental Association's Health Policy Institute, up from 7.2% in 2015. Among dentists in private practice, 72.5% owned their practice in 2023, down from 84.7% in 2005. A third of US dentists (33.6%) still worked in a solo practice in 2024.
- 16.1%US dentists affiliated with a DSOADA HPI, 2024; 7.2% in 2015
- 72.5%Dentists in private practice who own their practiceADA HPI, 2023; 84.7% in 2005
- 26.5%Dentists up to 10 years out of school affiliated with a DSOADA HPI, 2024; 9.1% of those more than 25 years out
- 33.6%Dentists in solo practice (one location, one dentist)ADA HPI, 2024
The numbers
The full breakdown
DSO affiliation, solo practice and the largest groups, by career stage and sex, 2024
| Group | Affiliated with a DSO | Solo practice | Practice with 100+ locations |
|---|---|---|---|
| All dentists | 16.1% | 33.6% | 10.8% |
| Up to 10 years out of dental school | 26.5% | 14.9% | 18.2% |
| 11 to 25 years out | 14.4% | 35.1% | 9.7% |
| More than 25 years out | 9.1% | 47.6% | 5.8% |
| Female dentists | 17.6% | 28.0% | 12.1% |
| Male dentists | 14.8% | 37.4% | 9.7% |
ADA HPI data file for 2024, sheet 'Summary - US Data'. Shares of dentists HPI could match to a practice location: 198,117 of 212,459 practicing US dentists. Solo practice is HPI's '1 location & 1 dentist' group and leaves out solo offices tied to a DSO. A practice with 100+ locations may or may not be DSO-affiliated.
US dentists by size of their practice, 2024
| Practice size | Share of dentists |
|---|---|
| 100 or more locations | 10.8% |
| 50-99 locations | 2.7% |
| 10-49 locations | 3.8% |
| 2-9 locations | 9.9% |
| 1 location, 2 or more dentists | 39.1% |
| 1 location, 1 dentist (solo practice) | 33.6% |
Size is the number of locations in the practice across the US, whether owned directly or linked through other arrangements, regardless of DSO affiliation. Shares add to 100% before rounding.
DSO affiliation and solo practice by practice area, 2024
| Practice area | Affiliated with a DSO | Solo practice |
|---|---|---|
| General practice | 15.5% | 34.9% |
| Endodontics | 20.8% | 26.9% |
| Oral and maxillofacial surgery | 21.8% | 23.4% |
| Orthodontics | 22.8% | 38.4% |
| Pediatric dentistry | 15.0% | 21.8% |
| Periodontics | 14.3% | 30.0% |
| Prosthodontics | 11.1% | 32.7% |
| Other specialties | 10.5% | 24.1% |
Same ADA HPI 2024 file and sheet, columns GP to Other.
Dentists in private practice who own it, 2005 and 2023
| Group | 2005 | 2023 |
|---|---|---|
| All dentists in private practice | 84.7% | 72.5% |
| Female dentists | 68.1% | 59.9% |
| Male dentists | 88.5% | 79.9% |
ADA HPI infographic 'Practice Ownership Among Dentists Continues to Decline' (November 2023), from the Distribution of Dentists survey, the Survey of Dental Graduates and the Survey of Dentist Practice Choices, weighted for nonresponse. The base is dentists in private practice, not all dentists.
Over time
US dentists affiliated with a DSO, 2015 to 2024
| Year | All dentists | Up to 10 years out of school | Solo practice, all dentists |
|---|---|---|---|
| 2015 | 7.2% | Not published | Not published |
| 2016 | 8.1% | Not published | Not published |
| 2017 | 8.5% | Not published | Not published |
| 2019 | 10.0% | Not published | Not published |
| 2020 | 10.7% | Not published | Not published |
| 2021 | 11.1% | Not published | Not published |
| 2022 | 12.7% | 22.7% | 36.5% |
| 2023 | 13.8% | 24.1% | 35.2% |
| 2024 | 16.1% | 26.5% | 33.6% |
2015-2021: chart labels on slide 31 of the ADA HPI report 'The U.S. Dentist Workforce - 2025 update' (HPI analysis of the ADA dentist office database; the chart has no 2018 point). 2022-2024: the ADA HPI practice size and DSO data files for each year, which also give the career-stage and solo columns. HPI says its method slightly undercounts DSO affiliation.
Why sources differ
Same question, different answers
| Number | When | Who measured | Why it differs |
|---|---|---|---|
| 16.1% | 2024 | ADA HPI practice data | Dentists matched to a practice location whose practice has outside management of non-clinical work; HPI says this slightly undercounts |
| 72.5% | 2023 | ADA HPI ownership surveys | Owners as a share of dentists in private practice, from weighted surveys; not all dentists |
| 33.6% | 2024 | ADA HPI practice data | Dentists in a one-location, one-dentist practice not tied to a DSO |
| 12% | 2025 | BLS Occupational Outlook Handbook | Self-employed workers' share of dentist jobs; a job measure, not practice ownership |
Practice ownership and DSO figures answer different questions, so they do not add up to 100%. The ADA Health Policy Institute's 72.5% is a share of dentists in private practice who own their practice, from weighted surveys, for 2023. Its 16.1% is a share of all practicing dentists it could match to a practice location in 2024, counting those whose practice has an outside organization running non-clinical work such as billing, marketing or HR. A dentist can own a practice and still be DSO-affiliated, so the two shares overlap. HPI also says its DSO figure is a slight undercount, because it chose a method that avoids overcounting. The Bureau of Labor Statistics figure of 12% self-employed is about jobs, not ownership, and BLS does not say how incorporated practice owners are counted. Other consolidation figures you may see often count practices or revenue rather than dentists, so check the base before comparing. Quote each figure with its own base and year.
What it means
How to use these numbers
Most US dentists still own their practice or work in a small independent one, but the trend is clear. DSO affiliation more than doubled from 7.2% of dentists in 2015 to 16.1% in 2024, and private-practice ownership fell from 84.7% in 2005 to 72.5% in 2023.
The change is led by new dentists. 26.5% of dentists up to 10 years out of dental school were DSO-affiliated in 2024, against 9.1% of those more than 25 years out, and only 14.9% of new dentists work in solo practice. HPI's 2025 workforce report says ownership looks delayed rather than lost: more recent graduates reach ownership later in their careers.
For independent practices, this means more local competition from groups with central marketing teams, since marketing is one of the non-clinical jobs a DSO can run. It also means recruiting: a solo owner hiring an associate competes with DSO offers.
For anyone selling to dental practices, the buyer is changing too. About 27% of dentists work in practices with two or more locations, where buying decisions are more likely to be made centrally.
Method and sources
How it was measured
Method
- Publisher
- American Dental Association, Health Policy Institute
- Sample
- DSO and practice size: HPI Dental Office Database supplemented with Fluent data; 198,117 of 212,459 practicing US dentists matched to a location (2024). Ownership: HPI Distribution of Dentists survey, Survey of Dental Graduates and Survey of Dentist Practice Choices, weighted for nonresponse.
- Definition
- DSO-affiliated: an outside entity manages some or all of the practice's non-clinical functions (billing, marketing, HR and similar); includes ADSO members and other entities HPI judged to be DSOs. Solo practice: one location and one dentist, not tied to a DSO. Owner: a dentist in private practice who owns it.
- Released
- 2024 practice size and DSO file (copyright 2025); ownership infographic, November 2023; 'The U.S. Dentist Workforce - 2025 update' (data as of August 2025)
- Checked at source
- 31 Oct 2026: ADA HPI xlsx files for 2022, 2023 and 2024, the ownership infographic PDF, the 2025 workforce report PDF and the HPI dental practice research page; BLS Dentists page
- Next release
- HPI updates the practice size and DSO file about once a year; a 2025 data year file is the next expected
- Last changed
- 30 Oct 2026
- Data files
- CSV · JSON (stable links)
Sources
- Health Policy Institute research and data, American Dental Association, Health Policy Institute Industry body
- Occupational Outlook Handbook, US Bureau of Labor Statistics Official data
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FAQ
More questions people ask
Are new dentists joining DSOs?
Yes. 26.5% of dentists up to 10 years out of dental school were DSO-affiliated in 2024, up from 22.7% in 2022, against 9.1% of dentists more than 25 years out (ADA HPI).
Do female dentists own practices less often than male dentists?
Yes. Among dentists in private practice, 59.9% of women owned their practice in 2023, against 79.9% of men. Both shares were higher in 2005 (68.1% and 88.5%).
Which dental specialty has the most DSO dentists?
Orthodontics, at 22.8% in 2024, followed by oral and maxillofacial surgery (21.8%) and endodontics (20.8%). Prosthodontics was lowest of the named specialties at 11.1%.
What is a DSO?
A dental support organization is an outside company that manages some or all of a practice's non-clinical work, such as billing, marketing and HR. The ADA counts ADSO members and other firms it judges to be DSOs.
Every number on this page was checked at its original source (American Dental Association, Health Policy Institute, US Bureau of Labor Statistics). Free to cite with a link to this page.