--- title: "DSO or private practice: what the data says about setting" description: "Compare DSO and private practice using ADA data: who works where by career stage, what dentists report about autonomy, and where pay data are missing." url: https://joncopeland.multisites.ai/blog/dso-vs-private-practice-data publisher: Copeland Consulting Services email: drcopeland@joncopelanddds.com contact: https://joncopeland.multisites.ai/contact --- # DSO or private practice: what the data says about setting ADA data show 16 percent of U.S. dentists were DSO-affiliated in 2024, and 27 percent of dentists under 10 years out. The sources reviewed here do not compare dentist pay by setting, and the ADA says it is still studying earnings. The ADA advises judging each practice on its own merits. Practice managementPublished October 26, 20264 min read Dentists who compare a DSO job with private practice often want one number: which pays more. This post shows what public data exist, and where they stop. It covers setting and career stage, what the ADA reports about autonomy, and questions to ask before signing. It does not take a side. It is general education, not career or legal advice. ## How many dentists work in each setting? A growing share work with a dental support organization (DSO), and a large share still work outside one. As of 2024, 16 percent of U.S. dentists were DSO-affiliated, according to the ADA Health Policy Institute (HPI). That leaves most dentists in other settings. Career stage changes the picture a lot. HPI reports 2024 figures for early and late career dentists: Measure (2024) Less than 10 years out At least 25 years out DSO-affiliated 27% 9% (more than 25 years out) Solo practice 15% 48% The early career DSO share was 24 percent in 2023. See [how many dentists work with a DSO](https://joncopeland.multisites.ai/blog/how-many-dentists-work-with-a-dso) for the full series, and [practice ownership trends](https://joncopeland.multisites.ai/blog/dental-practice-ownership-trends) for who owns. ## What does the data say about pay by setting? Nothing the sources here can support. None of the ADA, ADEA or peer-reviewed pages opened for this post compare dentist pay in a DSO with pay in private practice. HPI says it is still studying “whether there are differences across modalities in terms of career satisfaction, work-life balance, earnings and patient outcomes.” Two reasons make a simple comparison hard: 1. Pay models can vary inside any setting, for example [production-based pay](https://joncopeland.multisites.ai/glossary/production-based-pay) or [collections-based pay](https://joncopeland.multisites.ai/glossary/collections-based-pay). See [dental associate compensation models](https://joncopeland.multisites.ai/blog/dental-associate-compensation-models). 2. An owner’s pay and an employee’s pay are different things. An owner earns profit after expenses and carries risk. An employee earns a contract rate. Comparing the two takes care. If you are comparing offers, compare the written terms, not averages. [Dental associate contracts](https://joncopeland.multisites.ai/guides/dental-associate-contracts) lists the terms to check. ## Why is pay hard to compare? Pay in any setting has several parts. It can include a base, a share of production or collections, bonuses and benefits. An owner’s income is what remains after expenses. Two offers with the same headline number can pay very different amounts once the formula, the schedule and the expenses are applied. This is why the ADA’s career guidance pushes dentists toward the individual practice and the written terms. When someone quotes a pay gap between DSOs and private practices, ask which source it comes from, which year it covers and who was counted. ## What do dentists report about autonomy? Control is the common theme. An ADA career article describes qualitative research with dentists working in DSOs, done while its author worked at the ADA. Some loved the model and some were eager to leave. The shared complaint was control: “The surveyed dentists wanted more control over the materials used, their own time, and, in some cases, the treatment plan.” The same article adds a caution. It says the ADA would likely hear similar concerns from associates in independent practices, “or even in a completely different non-dental setting,” since some stem from being an employee. Those who start their own business “often do so because they want to control those standards and business practices.” The article also says some dentists choose DSOs because they do not want to run marketing, accounting or hiring, and because the model offers regulatory support. A DSO is not the only way to reach those goals, it says, but “the business model clearly resonates with those who see their needs served.” ## Does the DSO label tell you what the job is like? Not by itself. The ADA article says some large DSOs run offices with shared processes, branding and layout, while DSOs of 10 to 30 practices may let a dentist work as a solo practitioner with full operational autonomy. It concludes: “The reality is that every practice is unique, be it DSO, private practice, public health, or another modality.” The same applies on the independent side. Private practices differ in team culture, owner style and systems. ## What does the career-stage split suggest? The split suggests that new graduates choose group and DSO settings more often than older cohorts did. It does not say why. HPI’s ownership brief says young dentists “are practicing very differently than their predecessors,” and it lists possible factors without ranking them. See [dental school debt numbers](https://joncopeland.multisites.ai/blog/dental-school-debt-numbers) for one of those factors. It also does not say that these dentists will stay in the same setting. HPI says it is studying how long dentists remain in a modality. The ADA article notes that some DSOs see significant dentist turnover, and that some dentists enter DSOs late in a career as an “attractive off-ramp.” Settings change over a career. ## What should a dentist compare before signing? Compare the specific office, not the category. The ADA article says to ask whether you are comfortable with the quality of dentistry delivered and how the office fits your style. This table adds contract points to check with an attorney. Question Why it matters Where to read more Who sets treatment plans and materials? Control was the common complaint in ADA research [Clinical autonomy](https://joncopeland.multisites.ai/glossary/clinical-autonomy) How is pay calculated? Models differ in every setting [Associate compensation](https://joncopeland.multisites.ai/glossary/associate-compensation) What are the exit terms? Restrictions can affect your next job [Non-compete clause](https://joncopeland.multisites.ai/glossary/non-compete-clause) Employee or contractor? The label changes taxes and rights [Employee or independent contractor](https://joncopeland.multisites.ai/blog/dentist-employee-or-independent-contractor) What does the contract say overall? Terms are binding once signed [Employment agreement provisions](https://joncopeland.multisites.ai/blog/dentist-employment-agreement-provisions) The ADA article’s closing view is that “in the current market, there is room for corporate-owned dental service organizations and private practice owners,” and for everything in between. Read the [DSOs and private practice guide](https://joncopeland.multisites.ai/guides/dso-vs-private-practice-guide) for the models side by side. ## Next step Read the [DSOs and private practice guide](https://joncopeland.multisites.ai/guides/dso-vs-private-practice-guide) and the [dental practice ownership guide](https://joncopeland.multisites.ai/guides/dental-practice-ownership). Contact Dr. Copeland about [dental practice consulting](https://joncopeland.multisites.ai/contact?topic=consulting). ## Frequently asked questions ### Do dentists earn more in a DSO or private practice? The sources opened for this post do not compare pay by setting. The ADA Health Policy Institute says it is studying whether earnings differ across practice modalities. Pay depends on the contract, the pay model and the market, so read the written terms. ### How many new dentists plan to work in a DSO? An ADA career article cites ADEA data that 34 percent of dentists intend to work in DSOs immediately after graduating. HPI also reports that 27 percent of dentists under 10 years out were DSO-affiliated in 2024. ### What do dentists dislike about working as an employee in a corporate setting? An ADA career article says its member research found one common theme: control. Dentists wanted more say over materials, their own time and, in some cases, the treatment plan. The article notes that some of these concerns come from being an employee in any setting. ## Terms on this page - [Dental support organization](https://joncopeland.multisites.ai/glossary/dental-support-organization) - [Associate compensation](https://joncopeland.multisites.ai/glossary/associate-compensation) - [Independent contractor](https://joncopeland.multisites.ai/glossary/independent-contractor) - [Collections-based pay](https://joncopeland.multisites.ai/glossary/collections-based-pay) - [Employment agreement](https://joncopeland.multisites.ai/glossary/employment-agreement) - [Production-based pay](https://joncopeland.multisites.ai/glossary/production-based-pay) - [Dental school debt](https://joncopeland.multisites.ai/glossary/dental-school-debt) - [Non-compete clause](https://joncopeland.multisites.ai/glossary/non-compete-clause) - [Practice ownership](https://joncopeland.multisites.ai/glossary/practice-ownership) - [Clinical autonomy](https://joncopeland.multisites.ai/glossary/clinical-autonomy) ## Sources 1. [ADA Health Policy Institute: Dental Practice Research](https://www.ada.org/resources/research/health-policy-institute/dental-practice-research) 2. [ADA Health Policy Institute: Practice Ownership Trends in Dentistry (June 2025)](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/practice_ownership_trends_dentistry_new_look_old_data.pdf) 3. [ADA News: Practice modality by the numbers (2024)](https://adanews.ada.org/new-dentist/2024/web-exclusives/practice-modality-by-the-numbers/) 4. [ADA: To DSO or Not to DSO, That Is the Question](https://www.ada.org/resources/careers/career-planning/articles/to-dso-or-not-to-dso-that-is-the-question) 5. [ADA: To DSO or Not to DSO (new graduates)](https://www.ada.org/resources/careers/career-planning/articles/to-dso-or-not-to-dso-that-is-the-question) 6. [ADA: To DSO or Not to DSO (autonomy)](https://www.ada.org/resources/careers/career-planning/articles/to-dso-or-not-to-dso-that-is-the-question) Written by Copeland Consulting Services and checked against the sources above on October 26, 2026. Rules, data and guidance change, so check the linked page before you act on it. ## Keep reading - [DSOs and private practice: models, data and questions to askA dental support organization (DSO) manages some or all of a practice's nonclinical work, such as billing, marketing and human resources. ADA data show 16.1% of U.S. dentists were DSO-affiliated in 2024, and 27% of those under 10 years out of school. Each model has trade-offs.](https://joncopeland.multisites.ai/guides/dso-vs-private-practice-guide) - [Dental practice ownership: buying, starting, valuing, selling, associates and DSOsDentists reach ownership by starting a practice, buying one, buying in as a partner, or working as an associate or for a DSO first. ADA data show 73 percent of dentists owned a practice in 2023, down from 85 percent in 2005. Each path needs an attorney, a CPA and often a lender or broker.](https://joncopeland.multisites.ai/guides/dental-practice-ownership) - [Dental associate contracts: terms, pay models and red flags to ask aboutA dental associate contract sets pay, status, duties, term, termination, insurance and limits on work after you leave. The ADA publishes a guide to key provisions and a compensation explainer. Pay models differ in what they count, so read the formula. Have an attorney in your state review any contract before you sign.](https://joncopeland.multisites.ai/guides/dental-associate-contracts) - [Dental practice ownership trends: who owns practices nowThe ADA Health Policy Institute reports that 73 percent of U.S. dentists were practice owners in 2023, down from 85 percent in 2005. The drop is largest early in careers. Ownership rates among older cohorts catch up later, so the ADA describes the change as delayed ownership rather than the end of it.](https://joncopeland.multisites.ai/blog/dental-practice-ownership-trends) - [Dental associate compensation models explainedThe ADA lists four common models for dentist pay: straight salary, salary-plus, straight commission, and net profit. Commission models depend on whether pay is figured on total production, adjusted production, or collections. The same crown can produce very different pay under each base. Ask for a written formula and run sample numbers.](https://joncopeland.multisites.ai/blog/dental-associate-compensation-models) - [Dental school debt: the numbers for the class of 2025ADEA reports that dental graduates with debt owed an average of $297,800 in 2025, down from $312,700 in 2024. Of 2025 respondents, 82 percent graduated with education debt. Students covered about 65 percent of costs with loans. Federal Grad PLUS loans end for students starting on or after July 1, 2026.](https://joncopeland.multisites.ai/blog/dental-school-debt-numbers) ## Talk with Dr. Copeland [Contact Dr. Copeland](https://joncopeland.multisites.ai/contact)[Email](mailto:drcopeland@joncopelanddds.com)