Why fewer young dentists own practices

Fraser Macdonald, Dental Tribune International

Wed. 16 July 2025

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CHICAGO, US: Fewer young dentists are buying practices early in their careers—but that does not mean they are abandoning the idea of ownership altogether. According to recent research from the American Dental Association (ADA), the traditional model of early-career practice ownership is shifting as new generations face different economic realities and career expectations. Still, for most, ownership remains a long-term goal.

In its recent study, the ADA Health Policy Institute found that just 21% of dentists who graduated between 2016 and 2020 owned a practice within five to nine years of graduation. That is a sharp decline from 33% ownership among 2011–2015 graduates, and over 60% for those who graduated before 2010. Yet by 15–19 years into practice, ownership levels rise to over 80% across all cohorts, suggesting that today’s early-career dentists may be charting a longer path but one that still leads to practice ownership for most.

Why are younger dentists waiting longer? The reasons appear to be multifactorial. While educational debt is frequently cited, the ADA notes that inflation-adjusted debt levels have remained stable. Instead, dentists may be prioritising financial stability, clinical experience or lifestyle preferences before assuming the responsibilities of ownership. The growing presence of dental support organisations offering salaried employment may also provide an appealing alternative to immediate ownership.

In a related 2020 survey of US paediatric dentistry residents, researchers found strong interest in ownership among these future specialists. Over 61% of respondents reported being “extremely” or “very” interested in owning a practice, and nearly 50% expected to do so within five years of graduation.

However, educational debt was a significant concern. Residents with debt exceeding US$400,000 (€367,005^*) were far less comfortable assuming additional business loans. More influential than debt, however, was confidence in practice management. Those who felt well prepared to run a business were over 40% more likely to express high interest in ownership, pointing to the value of including robust business training in dental education.

Besides being influenced by age and specialisation, practice ownership may have strongly gendered dimensions. The ADA study highlighted ongoing gender disparities: early-career male dentists are 16 percentage points more likely to be practice owners than their female counterparts. Though the gap narrows with age, it does not disappear entirely. Also, a 2016 study of dentists in the Canadian province of Ontario found that men were more likely to be practice owners—but when age, work preferences and family responsibilities were considered, the gender gap disappeared. However, these family responsibilities were themselves gendered: female dentists who made career sacrifices for family were less likely to own practices, whereas those with partner support were more likely to pursue ownership. The study reinforces the importance of broader social and educational support in narrowing ownership disparities.

These studies collectively demonstrate that, while the path to dental practice ownership is evolving—delayed by debt, shaped by gender roles and influenced by training and organisational models—it remains a strong aspiration among dentists. Addressing business education gaps and supporting work–life balance may be key to ensuring that the next generation is both willing and ready to lead practices of their own.

Editorial note:

^* Calculated on the OANDA platform for 1 May 2020.