Small dental practices face uncertain future

Decrease in independent practices could spell trouble

INDEPENDENT DENTISTS who work in rural areas and suburbs across Massachusetts are in a vulnerable spot. The dental practice landscape is changing, and the small, private practices that are an essential part of the fabric of these communities may soon disappear.

The threat has nothing to do with attracting patients. While COVID-19 posed significant challenges, solo practices are rebounding quickly. Most dentists say they are now back to business as usual, and data from the American Dental Association supports this observation.

Instead, there’s simply no one to replace retiring dentists.

In the past, many younger dentists looked to suburbs and smaller towns to buy a practice from a retiring dentist. Today, many of those same young people prefer to live in the city.

Making matters worse, dental school graduates now enter the workforce with more debt than ever before, making it unaffordable for them to open or buy their own practices.

And today’s younger dentists have a new option to launch their career: dental service organizations, where a non-dentist-owned organization purchases the practice, running the business’s operations, and the dentist runs the clinical aspect of the practice. This model has grown tremendously in recent years. The approach can be attractive to younger dentists, as it provides a steady salary without the hassles and headaches of practice ownership.

This reality creates an ugly choice for retiring dentists in solo or small-group practices. They can either work until their health forces them to stop. They can close the practice and walk away, leaving long-term patients in a lurch. Or they can sell to a dental service organization.

When practice owners choose the third option, it puts the future of independent dentistry at risk. To independent-minded doctors, the growth of dental service organizations signals a seismic shift in how dental practices operate. Ultimately, it could lead to a dramatic decrease in the number of dentists who run their own businesses.

That matters because smaller-town practices often provide the most significant opportunities for young dentists. With lower overhead and less competition, young dentists can make a great living — often on a part-time schedule. While many younger dentists opt for dental service organizations, small practices with one or two doctors can provide fantastic opportunities for motivated dentists who want to control their own destinies. This flexibility is also great for dentists raising families.

And small towns need dentists. Not everyone wants to drive to Boston or Worcester for routine dental care, especially if it might mean taking the kids out of school. In fact, when communities are left without a dentist, many people skip that routine, preventive care. Down the road, they then need more extensive care that can be more painful and expensive. Preventative dental checkups can also help identify conditions like oral cancer — which is treatable if detected early.

What’s more, small-town dentists are also integral to their communities. They sponsor baseball teams and invite Scout troops or school groups to tour their offices and learn about good dental health. Some offer low-cost or pro-bono care for those who can’t afford it.

Meet the Author

Bree Simmers

Director of marketing and operations, ADA Practice Transitions
That’s why we need to do more to foster independent practice sustainability. This requires innovation and education. For example, platforms like ADA Practice Transitions (ADAPT) provide a wealth of information and offer a service built around matching dentists around a shared practice approach, and promoting the benefits of practice ownership, particularly in small towns and rural communities.

These types of programs go a long way in supporting dentist-owned practices. We must ensure independent dentists not only survive but thrive well into the future – so our communities can, too.

Bree Simmers is director of marketing and operations at ADA Practice Transitions.