If you’ve been in private practice for more than a few years, you’ve probably felt it — working just as hard, maybe harder, and taking less home. You’re not imagining it.

The ADA’s U.S. Dentist Workforce — 2025 Update confirms what many owners have suspected: dentist income is declining, and the independent solo practice is under real pressure. The data is sobering. But for the right practices, it’s also an opening.

What the ADA Data Shows

• Inflation-adjusted net income for general dentists has dropped from ~$267,000 in 2010 to just over $207,000 in 2024.
• Practice expenses are rising faster than revenues, squeezing profitability at every career stage.
• Practice ownership has fallen from 85% in 2005 to 73% in 2023 — the lowest on record.
• Dentists are working more hours and earning less. Owner dentists average five more hours per week than associates.

Insurance reimbursements have not kept pace with the cost of delivering care. Administrative burdens — pre-authorizations, downcoding, write-offs — consume more time and resources every year with less return. Practices built around a high volume of insurance-driven patients often find themselves on a treadmill: busier office, lower net income.

A Different Reality for Our Clients

Practices that are not primarily reliant on insurance are experiencing a markedly different financial reality. Many of our clients do accept insurance — but insurance doesn’t drive their practice. Their scheduling, treatment planning, and patient communication are built around health, not fee schedules.

The result: in many cases, our clients are seeing income growth in the same environment where the broader profession is contracting. Dollar-per-hour production increases. Case acceptance improves. And as more dentists move into DSOs and group settings, something is disappearing — the personalized, owner-operated practice where the dentist truly knows the patient. Patients who value that experience have fewer places to find it, which means less competition for those who position themselves correctly.

That’s the opportunity inside the problem.

What It Takes

Building a practice that operates outside the insurance squeeze requires two things: the right marketing and the right systems. Marketing must speak to patients who prioritize their health and can act on it — not to insurance plans or discounts. Once the right patients are coming through the door, the systems have to convert them consistently. When both are in place, 90%+ scheduling and case acceptance are achievable. We’ve helped practices get there for over 35 years.