HPI: Younger dentists still become practice owners, just later in careers

While the percentage of early-career dentists who are practice owners has declined significantly over time, new data from the ADA Health Policy Institute shows recent dental school graduates are still becoming owners — just later in their careers.

In its research brief “Practice Ownership Trends in Dentistry: A New Look at Old Data,” released in June, HPI examines practice ownership rates at various career intervals for dentists who graduated from dental school between 1991 and 2020.

Practice ownership rates at the earliest career stage — defined as three to seven years out of dental school for the most recent group of graduates and five to nine years for all other groups — are much lower for dentists who graduated between 2011 and 2020 than those who graduated in the 1990s or 2000s. At this stage, 21% of 2016-20 graduates and 33% of 2011-15 graduates owned practices. In contrast, 63%-70% of dentists who graduated from dental school in 2010 or earlier owned practices at this point in their careers.

This difference continues 10-14 years out of dental school, with more recent graduating cohorts showing successively lower ownership rates. While the ownership rates for dentists who graduated between 1991 and 2005 were all more than 80%, the rate for 2006-10 graduates was 72% and the rate for 2011-15 graduates was 58%.

However, this trend seems to diminish as dentists reach 15-19 years out of dental school. At this stage, the likelihood of owning a practice is not that different across generations. For example, 81% of 2006-10 graduates were practice owners compared with 89% of 1991-95 graduates.

“Our analysis suggests that the trend of declining practice ownership among younger dentists is primarily an early-career phenomenon,” said Marko Vujicic, Ph.D., ADA chief economist and vice president of HPI. “That is, practice ownership appears to be significantly delayed for newer graduates, but eventually the vast majority of dentists become practice owners. Where ‘eventually’ used to be very early in a dentist’s career for older generations of dentist, now it is pushed back much further into the mid- and late-career stages. In a nutshell, most roads still, eventually, lead to practice ownership.”

In its brief, HPI lists many factors that could potentially affect early-career ownership rates, including dentists’ demographics, increased educational debt and shifting preferences about work-life balance.

HPI’s analysis indicates the year 2011 was a turning point in dental practice ownership patterns, but it’s unclear why. It’s possible that expansions in dental school enrollment around this timeframe, including the opening of 15 new dental schools since 2011, drew dental students into the profession with different ownership expectations and aspirations.

Across all career stages, women are less likely to be practice owners than men, especially early in their careers when their ownership rates are about 16 percentage points lower. However, the overall decline in early-career ownership is apparent among men as well.

For more on these findings, visit ADA.org/HPI.