In this episode of the Dental Boardroom Podcast, Wes Read continues his analysis of the ADA Health Policy Institute 2024 study, focusing on one of the biggest shifts in modern dentistry who actually owns the industry today.

This episode dives deep into the rise of Dental Service Organizations (DSOs) and compares them with traditional private practice models. Wes breaks down real data on ownership trends, career stages, and practice sizes, and shares practical insights from years of advising dentists.

Beyond the numbers, he explores the hidden challenges of scaling multi-location practices, the financial trade-offs of choosing employment over ownership, and the reality behind DSO deal structures.

The episode closes with a strong perspective on the future of DSOs, why many may struggle in the long term, and why private practice ownership remains the most powerful path to autonomy, control, and wealth in dentistry.

1) Ownership Trends Are Shifting

Younger dentists are moving away from solo ownership.

The majority of older dentists still prefer private practice.

2) DSOs Are Growing, but Not Dominating

Only a small percentage of dentists are DSO-affiliated.

Most practices are still single-location setups.

3) Scaling Is Harder Than It Looks

Expanding beyond one location adds significant complexity.

Many dentists struggle in the “in-between” growth phase.

4) Stability vs. Wealth Trade-Off

DSOs offer more predictable income.

Private ownership offers significantly higher long-term earnings.

5) Small Income Gap = Massive Lifetime Impact

Even a $50K annual difference can lead to millions lost over time.

6) DSO Deals Can Be Misleading

Higher valuations often come with strings attached.

Earn-outs and equity rollovers carry uncertainty.

7) Early Players Win in DSOs

The biggest gains go to early adopters.

Late entrants typically see limited upside.

8) Private Equity Plays a Short-Term Game

The focus is often on scaling and reselling, not long-term operations.

9) Future Risk for DSOs

Talent retention and performance consistency are major challenges.

Many DSOs may struggle as original owners exit.

10) Private Practice Still Wins (for Most)

Greater control, autonomy, and wealth-building potential.

The best path for long-term financial success in dentistry.

1. The current breakdown of DSOs vs. private practice ownership in dentistry
2. Why solo practice is declining among early-career dentists
3. How student debt is influencing career decisions and risk tolerance
4. The real challenges of scaling from one to multiple locations
5. How DSOs are structured and how their deals actually work
6. The difference in income and long-term wealth between owners and employees
7. Why many dentists may be leaving money on the table by choosing DSOs
8. The role of private equity in shaping the dental industry
9. Predictions on the future of DSOs and potential market shifts