New data: 17% of practicing dentists in the U.S. are affiliated with DSOs

Source: ADA

DentalGoodNews｜Recently, the 2025 Dentist Practice Patterns data report released by the American Dental Association Health Policy Institute (ADA HPI) shows that among U.S. practicing dentists included in the analysis, 17% are affiliated with Dental Service Organizations (DSOs). Data shows that DSO affiliation is more common among dentists in the early stages of their careers.

HPI stated that dentist affiliation with large group practices and DSOs continues to grow, and this trend is more pronounced among dentists early in their careers: by years since dental school graduation, among dentists who graduated no more than 10 years ago, this proportion is 27%; among dentists who graduated 11 to 25 years ago, 16% are affiliated with DSOs; within the group that graduated no more than 10 years ago, those who graduated 0 to 5 years ago account for 31%, and those who graduated 6 to 10 years ago account for 22%. However, these data reflect the cross-sectional distribution of different graduation cohorts in 2025 and cannot be used to conclude that the same dentist will gradually leave DSOs as years of practice increase.

Source: 2025 Dentist Practice Patterns Data Report

From the perspective of practice location size, in 2025, approximately 12% of surveyed dentists practice at organizations with 100 or more practice locations in the United States; 39% belong to the category of single-location practices with two or more dentists, and 33% belong to the category of single-location, single-dentist practices. It should be noted that practice location size and DSO affiliation are two independent statistical indicators.

According to HPI's definition, practice size is classified based on the number of affiliated practice locations, regardless of whether these locations are supported by a DSO. Therefore, large multi-location practices are not necessarily affiliated with DSOs, and single-location practices may also receive DSO support.

Source: 2025 Dentist Practice Patterns Data Report

DSO affiliation rates also vary by state. In 2025, the overall DSO affiliation rate for dentists in Nevada was 29%, a relatively high level among states; Alaska was 4%. Among dentists who graduated 0 to 5 years ago in Nevada, the DSO affiliation rate reached 52%. However, differences between career stages are not equally pronounced in all states. For example, in Delaware, DSO affiliation rates for dentists who graduated no more than 10 years ago, 11 to 25 years ago, and more than 25 years ago were 13%, 14%, and 13%, respectively, with relatively similar proportions across the three groups.

This analysis is based on the ADA HPI Dental Practice Database, supplemented by Fluent data. Of the 211,761 practicing dentists in the United States, HPI was able to match 198,110 dentists to at least one practice location, and therefore included them in the analysis. HPI noted that due to data matching and identification methods, the actual number of dentists affiliated with DSOs and large group practices may be slightly higher than the reported statistical results. HPI stated that the report data describe the distribution of different groups and cannot alone explain the reasons for the differences, nor is it sufficient to determine the impact on patient services.[1]