A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists.

Group Practice May Improve Access to Care

Although dental service organizations (DSOs) represent less than 10% of U.S. practices, this category is growing rapidly.


Although dental service organizations (DSOs) represent less than 10% of U.S. practices, this category is growing rapidly.1 According to the Association of Dental Support Organizations (formerly the Dental Group Practice Association), its members report a growth rate more than three times greater than the rest of the dental industry.2 While competition from such a rapidly expanding segment is concerning to many independent practices, this development raises other considerations, as well.

One is the extent to which DSO providers will remain in corporate practice. With the DSO model being relatively new, it’s still too early to discern whether significant numbers may eventually choose to practice in more traditional settings — whether driven by a desire for independence, or perhaps because student debt has been repaid to the point that starting an office becomes financially feasible.

Another consideration is that DSOs may help deliver care to underserved populations. Instead of being a threat to traditional practice — and in light of data from the federal Health Resources and Services Administration that identify 5594 “dental health professional shortage areas” in the United States3 — could the rise of DSOs improve access to care? A potential beneficiary might be the patient who relies on government-sponsored insurance, such as Medicaid or the Children’s Health Insurance Plan (CHIP). Because public plans tend to pay the lowest rates for care, these patients may have difficulty finding providers willing to accept their coverage. Busy and well-established private practices simply have less need to accept patients with low-paying plans. The result is that those who rely on these programs for care have fewer choices in dentists willing to treat them.

According to a report from the American Dental Association Health Policy Institute, DSO dentists are much more likely to participate in Medicaid or CHIP than non-DSO dentists. And this is true for every age category, from younger clinicians fresh out of dental school to more experienced providers who have been practicing for decades.1 Although the report does not explore reasons for the difference, it could be that DSOs — which are highly focused on efficient practice management — have found financially viable ways to provide care to patients with low-paying plans.

Whatever the reason, if DSOs are expanding — in part by picking up patients other practices find less desirable — this could go a long way toward improving access to care for underserved populations.


  1. American Dental Association Health Policy Institute. How Big Are Dental Service Organizations? Available at: ada.org/en/science-research/health-policyinstitute/publications/webinars/how-big-are-dental-service-organizations. Accessed August 15, 2017.
  2. Association of Dental Support Organizations. Strength in Numbers. Why Dental Service Organizations Are Here to Stay. Available at: dentalcarealliance.net/wpcontent/uploads/2012/01/infographic-why-dental-service-organizations-are-here-tostay-
    1000.png. Accessed August 15, 2017.
  3. Health Resources and Services Administration. Shortage Areas. Available at: datawarehouse.hrsa.gov/topics/shortageAreas.aspx. Accessed August 15, 2017.

From Decisions in Dentistry. September 2017;3(9):54.

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