Dentists graduating from dental school typically have two choices following commencement — joining a DSO or entering private practice.
Among the factors that play into a dentist’s decision are where they want to live, the number of hours they want to work and whether they want to handle the business side of running a practice.
With the average dental student loan debt for new graduates now above $300,000, according to data from the ADA, that decision is crucial for their future.
These four dentists recently connected with Becker’s to share their advice for new graduates on how they should approach joining the workforce.
Note: Responses have been lightly edited for clarity and length.
Question: If you were advising a graduating dental student today (who likely has significant student loan debt) would you tell them to buy a practice, join a DSO or pursue another route, and why?
Mark Harris, DDS. Owner of Mark E. Harris D.D.S. (Riverside, Calif.): If only the question were that simple. The dental student should sit down and look at what their ultimate outcome is. They should break things up into one-year, five-year, 10-year and 30-year windows. They need to prioritize a number of things that will determine which route is right for them.
Do they want to live in a metropolitan area? Suburbs? Underserved area? How much freedom do they want to prescribe the exact care they were taught? Will they be OK with a business person making treatment plans? Do they want to work 40 hours a week or do they want to work part-time and never have to work weekends? Do they want to make more money on the front end of their career versus building equity value in a business? Do they need to provide healthcare benefits for themself and family? These answers will be different for every dentist.
Peter Lucchese, DDS. Owner of Dr. Peter Lucchese (Fishkill, N.Y.): I feel all newly graduated dental students have so much to learn. They all need to become a full-time associate in private practice or full-time in a DSO for a minimum of five years and make sure they have medical benefits and start a retirement plan, regardless of their choice. As an associate, they should be a sponge with their mentors and become proficient in dentistry and develop their soft skills and learn how to interact with patients and staff.
Paul Mabe, DDS. Owner of Naples (Fla.) Family Dentist: If I were advising a graduating dental student today who is carrying significant student loan debt, I would encourage them to strongly consider purchasing a private practice rather than joining a DSO, assuming they have an interest in ownership and are willing to learn the business side of dentistry.
My recommendation would be to identify a respected dentist who is approaching retirement and has built a strong reputation, loyal patient base and goodwill within the community, and who is willing to mentor the next generation through a structured transition. Ideally, I would look for a practice in an area where the dentist and their spouse genuinely want to live long-term, while avoiding markets that are heavily saturated with providers. Many smaller communities and mid-sized metropolitan areas offer excellent opportunities for growth and favorable dentist-to-population ratios.
I would target a profitable practice producing approximately $600,000 to $800,000 annually with room for expansion. One of the greatest opportunities for a young dentist is finding a practice where the owner has slowed down clinically or is no longer offering certain services. Procedures such as implant placement, bone grafting, orthodontics, surgical extractions and other advanced treatments can often be added to the practice relatively quickly. Today, high-quality continuing education and online training resources make it easier and more affordable than ever to acquire new clinical skills, often producing a substantial return on investment in a short period of time.
When combined with excellent patient care, community involvement and sound business management, it is not unreasonable to achieve double-digit annual growth for several years following an acquisition. A practice that begins in the $600,000 to $800,000 range can often grow into a $1.2 million to $1.5 million practice within five to seven years, and in some cases even exceed those numbers.
I would also structure the transition to move quickly and efficiently. Ideally, the new dentist would work alongside the senior doctor for about six months, learning the practice systems, culture and patient relationships. Ownership would then transfer, and the retiring doctor would remain for an additional six months as an associate to help ensure continuity and facilitate introductions. This creates a smooth one-year transition while allowing the new owner to begin implementing their vision without unnecessary delays.
The financial advantages of ownership can be significant. In addition to generating income, the dentist is building equity in the practice, potentially acquiring the real estate and creating an asset that may later be sold for a profit. A well-run practice can provide the cash flow necessary to aggressively reduce student loan debt while simultaneously building long-term wealth. Ownership also gives young dentists greater control over their clinical philosophy, patient experience, schedule, team culture and long-term financial future — factors that often become increasingly important as their career progresses.
While DSOs can offer valuable experience and mentorship for some graduates, I believe private practice ownership remains one of the most powerful wealth-building and career-building opportunities in dentistry. For dentists willing to invest in both their clinical and business development, ownership provides a level of autonomy, financial upside and professional fulfillment that is difficult to match.
Barry Sporer DMD. Dentist and Partner of MB2 Dental (Dallas): If I were to advise a dentist graduating today, I would recommend starting with a DSO as an excellent way to gain rapid clinical experience. Ultimately, however, most dentists want a true equity interest in a practice — and that is where a dental partnership organization comes in.
Solo practice is simply no longer economically practical. Joining a DPO as a partner allows a young dentist to benefit from built-in mentorship. Furthermore, if you choose the right DPO, you retain the clinical independence of private practice — making all your own diagnostic and treatment decisions — while leveraging the back-office management support and vendor purchasing power that only a larger organization can provide.
At the Becker's 5th Annual Future of Dentistry Roundtable, taking place September 14-15 in Chicago, dental leaders and executives will gain insights into emerging technologies, practice growth strategies and the evolving landscape of dental care delivery, with a focus on innovation, patient experience and operational excellence. Apply for complimentary registration now.