Andrew Smith

The world of dentistry has changed in myriad ways, including the career options new dentists have following graduation. Inheriting your parent’s dental practice, or starting your own private practice, is no longer the only choice, or even the desired choice, for today’s generation of dentists. Instead, you can choose among a career in private practice, research, public health, academia, the military or as a practitioner in a supported dental office, known as a DSO or dental supported organization.

The trend toward DSOs is accelerating. According to an ADEA study, in 2020, 30 percent of dental school seniors indicated they were planning to join a DSO up from 12 percent in 2015. The trend is confirmed by the ADA Health Policy Institute (HPI) whose research shows traditional solo practices are becoming less common as dentists gravitate toward group practices, a shift that is likely to continue. According to the HPI article, about two in three dentists were in solo practice in 1999. That proportion decreased to one in two in 2019; among dentists under 35, one in four was in solo practice that year. The DSO market share varies significantly across age groups. One in five dentists under 35 were affiliated with a DSO in 2019, according to HPI’s most current data.

Why has there been such a dramatic increase in the percentage of dental students planning to join a DSO? Every choice is an individual choice, but there are common themes. New dentists are graduating with sizeable debt, making investment in a private practice unrealistic or undesirable. Today’s generation of dentists seems to prefer focusing on clinical practice versus previous generations that combined patient care with small business ownership. Another factor is the desire for lateral and upward movement within an individual’s dental career, with flexibility within in the dental field gaining importance. Whatever the theme, DSOs are filling a growing need for today’s and tomorrow’s dentists.

Is a DSO right for you? Here are several points to consider.

A primer on DSOs. More commonly known as DSOs, dental support organizations are entities that dental practice owners contract with to manage the administrative, marketing and/or business sides of that dental practice. Simply put, a DSO provides a variety of non-clinical services to dentists including facility maintenance, IT and software support, supply procurement, accounting and marketing, to name a few. By handling back-office administration, the DSO frees the dentists to concentrate on clinical care. If you are a practice owner, and choose to affiliate with a DSO, you can choose the services you wish the DSO to provide. If you are a dentist affiliating with a DSO as a clinician, you can explore various DSO options and select the DSO that provides the right balance of business support for you.

DSOs come in different shapes and colors. The saying goes, “If you’ve seen one DSO, you’ve seen one DSO,” and the saying is true. Opportunities within DSOs range from large organizations with practice locations across the country, to smaller, regional organizations, to specialty DSOs whose dentists focus on orthodontics, oral surgery, or other specialty. DSOs may be locally or nationally branded, and are operate under various business models to provide infrastructure, recruitment tools, advanced technology, and administrative support functions.

Camaraderie and mentorship. You’re new to dentistry and likely are looking to hone your clinical skills.  DSOs provide the clinical mentorship you need to help bring clinical care from theory into practice. DSOs also provide robust training curricula for continuing education and offer a peer network through which you can share best practices and develop a professional support group. DSOs are inherently structured to provide dentists at any stage of their career access to peer support and mentoring. The ability to learn from each other is good for the profession — no matter where that learning happens.

Interested in innovation? DSOs have access to state-of-the-art tools and products including AI for diagnosis and treatment planning, computer-aided design and manufacturing of materials to aid in providing the highest quality patient care.

Paths to leadership. You may want to focus solely on patient care throughout your career, or perhaps you plan to transition into a clinical director or administrative role, or wish to gain an equity stake in the practice. DSOs offer a variety of career paths, from clinical operations to practice ownership to positions within executive management.

Education and training. DSOs typically invest in continuous R&D, so you can stay abreast of new protocols, equipment, treatments and practice management tools and techniques.

Diversity and inclusion. In a March 2022 ADA News article, ADA President Cesar Sabates, DDS, said, “Diversity and Inclusion are two core values of the ADA, and that extends to practice modalities.” Dr. Sabates went on to say, “As dentists, we want to provide the best care to our patients. When we unite on the common ground of our passion and purpose, we are primed to build our profession’s future together.”