How many dentists work with a DSO? ADA data by year

The share of U.S. dentists who work with a dental support organization (DSO) has risen for several years. This post lays out the ADA Health Policy Institute (HPI) numbers by year, by career stage and by practice size. It is data only. It does not say whether a DSO is a good or poor choice for any dentist.

What percent of dentists are affiliated with a DSO?

As of 2024, 16 percent. The HPI practice research page states: “As of 2024, more than one in ten dentists (16%) in the U.S. are affiliated with a dental support organization (DSO).”

The table shows the HPI series that the ADA has published.

HPI’s 2022 analysis covered 191,669 dentists out of 202,401 practicing dentists. These were the dentists for whom HPI could assign at least one practice location address. Treat the rates as estimates for that group.

How does HPI decide a dentist is DSO-affiliated?

HPI uses a business-model test, not a size test. A practice counts as affiliated “if some outside entity manages some or all of its non-clinical functions such as billing, marketing, human resources, etc.” HPI’s list of DSOs includes members of the Association of Dental Support Organizations and other entities that HPI primary research judged to be DSOs.

The ADA’s chief economist, who also leads HPI, put it this way: “DSO is not about the size of the practice, or the number of locations a practice has but rather about a particular type of business model.” A dentist can work alone in one office and still be DSO-supported. For a plain definition of the model, see what is a dental support organization.

Which dentists are most likely to work with a DSO?

Early career dentists. HPI reports DSO affiliation among dentists less than 10 years out of dental school as follows:

• 23 percent in 2022 (ADA News, 2023).
• 24 percent in 2023 (HPI brief).
• 27 percent in 2024 (HPI brief).

By comparison, HPI reports that only 9 percent of dentists who graduated more than 25 years ago were affiliated in 2024. The 2022 data split the early group further: 27 percent of dentists five or fewer years out and 18 percent of those six to 10 years out were DSO-affiliated.

Why does the denominator matter?

Every share depends on who is counted. HPI counts dentists for whom it can assign at least one practice location address. In the 2022 analysis, that was 191,669 of 202,401 practicing dentists, or about 95 percent. Dentists without a located practice are outside the count. If their settings differ from the rest, the true share could differ a little from the reported one.

The same care applies to comparisons across years. A change from 13 percent to 16 percent between 2022 and 2024 is large enough to notice, but the series also reflects HPI’s updated list of DSOs. Quote the year with every figure, and link the HPI page.

How does practice size compare by career stage?

Practice size is a separate measure. HPI’s 2022 numbers show the pattern by years since graduation.

HPI’s 2024 update shows the same direction. It reports 15 percent solo among dentists less than 10 years out, against 48 percent for those at least 25 years out, “with both values declining over time.”

Where do these numbers come from?

HPI publishes an annual report on practice modality. Its page says the report covers two things: dental practice size, defined by the number of locations, and DSO status, regardless of size. The data are broken down by dentist career stage, sex and specialty. State-level data by career stage are also available, so a reader in Missouri can look up the state figures on the HPI page.

HPI has posted 2022, 2023 and 2024 versions of the data. Its practice modality page says: “The latest data indicate that dentist affiliation with large group practices and DSOs continues to grow, especially among early career dentists.”

What do these numbers not tell us?

They count affiliation, not outcomes. HPI says its research continues on how long dentists stay in one practice modality. It also asks whether career satisfaction, work-life balance, earnings and patient outcomes differ across modalities, and what part private equity plays in consolidation. Those results are not in the figures above.

Three cautions apply:

1. The DSO list rests on HPI’s judgment, built from Association of Dental Support Organizations membership and HPI primary research. Another researcher could count differently.
2. Affiliation is not ownership. Some affiliated dentists own part of their practice, and some do not. See practice ownership trends.
3. The data count dentists, not patients or locations.

A rising share does not mean a settled outcome. Counts of this kind tell you where dentists work, not why they chose it, and not how they fared. Use them as one input next to contracts, site visits and conversations with people who work in the setting.

The glossary explains related terms: DSO, dental support organization, group practice and solo practice. For a side-by-side look at the models, read the DSOs and private practice guide.

Next step

Read the DSOs and private practice guide and the dental practice ownership guide. Contact Dr. Copeland about dental practice consulting.