Dentists are reaching practice ownership later than the generations before them. At five to nine years out of dental school, 21 percent of the 2016 to 2020 graduating cohort owned a practice. For the 2011 to 2015 cohort the figure was 33 percent. For cohorts graduating between 1996 and 2010 it ran from 63 to 70 percent.
Source: ADA Health Policy Institute, Practice Ownership Trends in Dentistry, June 2025, Table 1.
If you own a practice and plan to sell it to a younger dentist, that is a planning input. It is not a crisis. But it does test the assumption most exit plans rest on quietly. The assumption is that a ready buyer will be there when you are ready.
Read the ownership data with its limits attached
The same analysis shows the gap narrowing later in a career. At 15 to 19 years out, 81 percent of the 2006 to 2010 class owned a practice, against 89 percent of the 1991 to 1995 class. On its own, that looks like a delay rather than a disappearance.
One limitation matters more than any of the figures. No cohort graduating after 2010 has reached mid-career yet. For the newest cohorts, the later catch-up is an expectation, not a measurement. Nobody can say yet whether the most recent graduates will close the gap. They have not had the time to.
A second series runs alongside it. Among dentists in private practice, the share who own their practice fell from 84.7 percent in 2005 to 72.5 percent.
Source: ADA Health Policy Institute, practice ownership infographic, November 2023.
Three qualifications travel with that number. The denominator is dentists in private practice, not all dentists in the United States. The figures are snapshots of different dentists in different years, not one group followed over time. And the decline is concentrated among dentists under 45.
That last point is the one that touches succession directly. The shift shows up in the age band that supplies most first-time buyers.
What the class of 2025 actually intends
It would be easy to read all of this as young dentists losing interest in ownership. The published data does not say that. It reports where they intend to start.
Among 2025 dental school seniors planning to enter private practice immediately, 32 percent intended to join a DSO and 50 percent intended to join a non-DSO practice.
Source: ADEA, Dentists of Tomorrow 2025, Issue 10, January 2026.
Of the 2025 seniors planning to join a private practice, 77 percent expected to begin as associates.
Source: ADEA, Dentists of Tomorrow 2025, page 8.
The entry point has moved. Whether the destination has moved is not yet measurable. Most new dentists start employed. Student debt, clinical confidence, and financing all sit between graduation and a first purchase. Arrangements such as the DSO model also give a young dentist somewhere to work that does not require buying anything. Wanting to own and being ready to own are now separated by a longer stretch of time.
Where the early-career buyer pool sits
Affiliation is concentrated in the years that produce first-time buyers. In 2024, 26.5 percent of dentists up to 10 years out of dental school were DSO affiliated. At 11 to 25 years out the share was 14.4 percent. Beyond 25 years it was 9.1 percent. Among dentists less than five years out, 31 percent were affiliated. In four states, Nevada, Arizona, Colorado and Oklahoma, the share of dentists less than five years out reaches about half.
Source: ADA Health Policy Institute, Dentist Workforce, August 2025, slides 32 and 34.
Read that measure carefully before you draw a conclusion from it. Affiliation turns on who manages the non-clinical work. A practice can be counted as DSO affiliated without any equity changing hands. So the figures describe where younger dentists are working. They do not describe what those dentists have sold.
Geography matters as much as career stage. In 2024, DSO affiliation ranged from 2.3 percent of dentists in Hawaii to 26.9 percent in Colorado, with seven states sitting near 25 percent.
Source: ADA Health Policy Institute state data for 2024, and Dentist Workforce, August 2025, slide 33.
Your market is not the national average. A practice in a low-affiliation state faces a different buyer pool than one in a state near the top of that range. That is worth checking before you set a date.
What a later ownership curve does to your exit
The consequence is narrow and specific. At any given moment, fewer dentists early in their careers are positioned to buy. That follows directly from the cohort figures above. It does not mean your practice is unsellable. It means the matching problem is harder and slower than it was for the sellers you learned from.
Three things follow.
- Your timeline needs more runway. If the likely buyer reaches readiness later in their own career, the search takes longer. A two-year exit built on a five-year assumption creates pressure at exactly the wrong moment.
- Building a buyer beats waiting for one. An associate you hire at the start of a ten-year plan can be an owner by the end of it. A stranger introduced in the final year cannot.
- The clinical successor and the capital are two problems. A young dentist can be the right person to lead your patients and still not be positioned to finance the whole purchase alone.
Developing a successor takes years
Bringing an associate to the point of ownership is not a handshake at the end. It is production capacity and case acceptance. It is also comfort with the parts of the business most associates never touch: payroll, insurance contracts, hygiene scheduling, overhead. An associate can be an excellent clinician and have never seen a profit and loss statement for the practice they work in.
That gap closes slowly, and it closes through the systems you already have. Clean reporting, defined roles, and written processes make a practice easier to hand over. They are the same things that make it easier to run. It is worth judging the non-clinical support behind a practice on whether it produces that kind of clarity.
Starting earlier buys the one thing a late start cannot: room to be wrong. You can hire, train, and hire again if the fit is not there. A seller with two years left cannot do that twice.
Questions worth answering before you set a date
None of these require a decision today. They tell you how much runway you actually have.
- If you set a date five years out, who in the practice today could realistically be running it by then?
- Can an associate see the practice’s numbers, or only their own production?
- How much of collections depends on you personally, through referrals, case presentation, or specific procedures?
- Is your reporting clean enough that a buyer’s lender could read it without a rebuild?
- What does DSO affiliation look like in your own state, rather than nationally?
Where a partnership structure fits
One reason doctors look at a partnership model is that it separates the two problems above. The capital question and the clinical succession question stop sharing a deadline. Continuity for staff and patients no longer rests on one person. It no longer requires the right skills, the right timing, and the right balance sheet to arrive together in a single year.
That is a structural argument, not a promise. What any given arrangement does for you depends on how it is written. Every partnership is governed by its final transaction documents. What is described in a meeting and what appears in the signed documents are two different things, and only the second one governs. Most doctors have their own counsel read them closely before signing. That test matters on succession and continuity, and it applies to any partner you consider.
The honest version
None of this argues for hurry. The ownership data is directional. The newest cohorts are unfinished. One practice in one market can behave nothing like a national average. But the direction is clear enough to plan around, and planning early costs very little. Planning late costs you a compressed timeline and fewer choices.
If the exit you have in mind is inside ten years, the useful next step is a candid look at your own bench. Who is here today. What they can already run. What would have to be true for one of them to own this. A conversation about succession timing is a reasonable place to begin.