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

What’s Keeping Dentists Awake At Night?

According to a survey by Bankers Healthcare Group, dentists are most worried about declining reimbursement and the impact of dental service organizations (DSOs) on the profession.


According to a survey by Bankers Healthcare Group, dentists are most worried about declining reimbursement and the impact of dental service organizations (DSOs) on the profession. Close to half are also worried about increasing competition.1 Are their concerns justified?

The Morgan Stanley research firm AlphaWise examined dental reimbursement rates and predicted that between May 2018 and May 2019, dentists will experience an overall decline in reimbursement rates. The drop will be steepest for solo practitioners, who are projected to be down by 8.7%, while group practices may see a slight 1.6% increase in reimbursement.2

Although still a minority share of the overall dental market, the number of DSOs and other large corporate practices is growing much more rapidly than small, independent practices, justifying the second worry of the surveyed dentists.2

But what about concerns over increasing competition? This is a bit murkier. The American Dental Association Health Policy Institute’s annual Survey of Dental Practice has found that wait times for patients to see a general practitioner — a proxy measure for dental competition — is continuing to trend upward.3 Rising wait times correlate with less-fierce competition, not more.In addition, data from the federal Health Resources and Services Administration (HRSA) indicate there are now nearly 58 million people living in designated “Dental Care Health Professional Shortage Areas.” The HRSA reports it would take more than 10,000 additional dental providers to meet the needs in these areas.4

It would appear competition may indeed be tough in the most desirable areas for dentists to live and work, but it is likely highly variable across communities — which points to untapped opportunity for clinicians willing to relocate.


  1. Declining Reimbursement Rates a Key Concern Among Dentists, Reports National Survey From Bankers Healthcare Group. Available at: http/​:/​​/​​www.multivu.com/​​players/​​English/​​8440251-bankers-healthcare-dentists-reimbursement-rates/​​. Accessed April 15, 2019.
  2. Morgan Stanley Research. Trends + 5 Key Forces Reshaping the U.S. Dental Market. Available at: https:/​​/​​www.ada.org/​​~/​​media/​​ADA/​​Science%20and%20Research/​​HPI/​​Files/​​HPIwebinar05222018.pdf?la=en. Accessed April 15, 2019.
  3. ADA Health Policy Institute. 2017 Survey of Dental Practice. Available at: https:/​​/​​www.ada.org/​​en/​​science-research/​​health-policy-institute/​​data-center/​​dental-practice. Accessed April 15, 2019.
  4. Bureau of Health Workforce, Health Resources and Services Administration, U.S. Department of Health & Human Services. Designated Health Professional Shortage Areas Statistics: Designated HPSA Quarterly Summary, as of December 31, 2018. Available at: https:/​​/​​ersrs.hrsa.gov/​​ReportServer?/​​HG_​W_​​Reports/​​BCD_​​HPSA/​​BCD_​​HPSA_​​SCR50_​​Qtr_​​Smry_​​HTML&rc:Toolbar=false. Accessed April 15, 2019.


From Decisions in Dentistry. May 2019;5(5):46.

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