--- title: "How many dentists work with a DSO? ADA data by year" description: "The ADA reports 16 percent of U.S. dentists were DSO-affiliated in 2024, up from 8.8 percent in 2017. See the series by year, career stage and practice size." url: https://joncopeland.multisites.ai/blog/how-many-dentists-work-with-a-dso publisher: Copeland Consulting Services email: drcopeland@joncopelanddds.com contact: https://joncopeland.multisites.ai/contact --- # How many dentists work with a DSO? ADA data by year The ADA Health Policy Institute reports that 16 percent of U.S. dentists were affiliated with a dental support organization as of 2024. The share was 8.8 percent in 2017, 10.4 percent in 2019 and 13 percent in 2022. Affiliation is highest among dentists in their first ten years after graduation. Practice managementPublished October 26, 20264 min read 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. Year Share of U.S. dentists affiliated with a DSO Source 2017 8.8% ADA News, 2023 2019 10.4% ADA News, 2023 2022 13% ADA News, 2023 and 2024 2024 16% HPI dental practice research page 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](https://joncopeland.multisites.ai/blog/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. Career stage (2022) Solo practitioners In practices with 10 or more locations 10 or fewer years out 17% 24% 11 to 25 years out 38% 12% More than 25 years out 50% 8% 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](https://joncopeland.multisites.ai/blog/dental-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](https://joncopeland.multisites.ai/glossary/dso), [dental support organization](https://joncopeland.multisites.ai/glossary/dental-support-organization), [group practice](https://joncopeland.multisites.ai/glossary/group-practice) and [solo practice](https://joncopeland.multisites.ai/glossary/solo-practice). For a side-by-side look at the models, read the [DSOs and private practice guide](https://joncopeland.multisites.ai/guides/dso-vs-private-practice-guide). ## 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 ### What percent of dentists are affiliated with a DSO? The ADA Health Policy Institute reports 16 percent as of 2024. Earlier HPI figures were 8.8 percent in 2017, 10.4 percent in 2019 and 13 percent in 2022. HPI counts a dentist as affiliated when an outside entity manages some or all of the practice's non-clinical functions. ### Are new dentists more likely to join a DSO? Yes. HPI reports that 27 percent of dentists less than 10 years out of dental school were DSO-affiliated in 2024, up from 24 percent in 2023. Only 9 percent of dentists more than 25 years out were affiliated. ### Is a DSO the same as a group practice? No. HPI treats practice size and DSO affiliation as separate ideas. A dentist can work alone in one location and still be affiliated with a DSO. A group practice can have many locations and no DSO. ## Terms on this page - [Dental support organization](https://joncopeland.multisites.ai/glossary/dental-support-organization) - [Practice ownership](https://joncopeland.multisites.ai/glossary/practice-ownership) - [Group practice](https://joncopeland.multisites.ai/glossary/group-practice) - [Solo practice](https://joncopeland.multisites.ai/glossary/solo-practice) - [ADA](https://joncopeland.multisites.ai/glossary/ada) - [DSO](https://joncopeland.multisites.ai/glossary/dso) ## Sources 1. [ADA News: More dentists affiliating with DSOs (2023)](https://adanews.ada.org/ada-news/2023/june/more-dentists-affiliating-with-dsos/) 2. [ADA News: More dentists affiliating with DSOs (definition)](https://adanews.ada.org/ada-news/2023/june/more-dentists-affiliating-with-dsos/) 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 Health Policy Institute: Dental Practice Research](https://www.ada.org/resources/research/health-policy-institute/dental-practice-research) 5. [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) 6. [ADA Health Policy Institute: Practice Ownership Trends in Dentistry (DSO share by career stage)](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/practice_ownership_trends_dentistry_new_look_old_data.pdf) 7. [ADA Health Policy Institute: Practice Ownership Trends in Dentistry (early career DSO share)](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/practice_ownership_trends_dentistry_new_look_old_data.pdf) 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 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) - [What is a dental support organization? DSO basicsA dental support organization, or DSO, is an outside entity that manages some or all of a dental practice's non-clinical work, such as billing, marketing and human resources. The ADA says DSO is about a business model, not practice size. DSOs differ widely in how much control dentists keep.](https://joncopeland.multisites.ai/blog/what-is-a-dental-support-organization) - [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 leadership: team skills, training programs and where to learn themDental leadership is the work of guiding a dental team, a practice or a part of the profession. Core skills include clear communication, delegation, feedback and hiring. Learn them through team routines, mentors, organized dentistry such as the ADA and state societies, and formal programs like the ADEA Leadership Institute.](https://joncopeland.multisites.ai/guides/dental-leadership) ## Talk with Dr. Copeland [Contact Dr. Copeland](https://joncopeland.multisites.ai/contact)[Email](mailto:drcopeland@joncopelanddds.com)