Practicing dentistry

All dentists must go through the licensure process at least once during their professional careers. If you are considering moving to a new state, you may need to repeat the process to meet different requirements.

Your state dental board can provide specific information about licensure requirements, the dental practice laws that apply in your state and other licensure-related information. The ADA maintains a Dental Licensure Map that can help you find basic licensure information by state.

An interest area in general dentistry is a well-defined body of evidence-based scientific and clinical knowledge underlying general dentistry, but is a more focused, complex and distinct field identified by advanced knowledge, techniques and procedures.

Today’s rapidly emerging technologies and science are providing more sophisticated and complex solutions to problems encountered in general dentistry.

The advances are changing and enhancing the dental practice environment. Interest areas in general dentistry must meet the specified Criteria for Recognition of Interest Areas in General Dentistry (PDF) in order to be formally recognized by the American Dental Association.

Operative Dentistry, Cariology and Biomaterials has met the Criteria and is formally recognized by the American Dental Association. Operative Dentistry, Cariology and Biomaterials is that branch of general dentistry concerned with the advanced knowledge, expertise and clinical skills in operative dentistry, restorative dental materials, educational theory, techniques, and teaching skills. It includes scientific research and knowledge in the areas of cariology and advanced scientific clinical training in restorative materials and biomaterials.

For more information about interest areas in general dentistry, contact the ADA Council on Dental Education and Licensure at CDEL@ada.org or 312.440.2698.

The ADA believes that the public is best served when dentists focus on the general practice of dentistry. However, the recognition of specialties within dentistry offers benefits for patients and professionals alike. Accordingly, there are 12 recognized dental specialties within the dental profession.

The National Commission on Recognition of Dental Specialties and Certifying Boards is the official body that reviews and formally recognizes dental specialties and their certifying boards based on the ADA Requirements for Recognition of Dental Specialties and National Certifying Boards (PDF).

One dentist owner. This may include an employee dentist with or without a path to ownership. Could be a general dentist or specialist and is usually a single location. Solo ownership requires a commitment to business operations beyond clinical dentistry, including a dedication to non-clinical tasks such as HR, operations, cash flow, marketing, IT, equipment & materials, etc. It also requires relationship building to establish a patient base. Methods of entry include:

• Buy a practice – Identify and purchase an existing practice.
• Starting a practice from scratch – You are responsible for literally everything in your business.
• A dentist could join a practice as a partner owner with the goal of attaining full ownership, and be mentored on practice operations for a defined period of time.

Ownership
One dentist owner with option of employee dentist, may have path to ownership if owner had retirement plan

Brand or identity
Buy a practice OR start new one

Number of dentists
May have an employee dentist

Specialty collaboration, or potential to specialize
General dentist or specialist owner/ employee

Location
Most likely one location, can have more if rotates themselves or with employee dentist

Mentoring opportunity
If start as employee or partnership may experience clinical and operational mentorship, may seek consultant guidance or through association

Perks, employment opportunities
Complete charge of direction of time, hours, fees, purchasing etc

Residence
Limitations if want opportunity to move out of state, etc as need time to build practice and then sell.

Patient care
Requires relationship building to establish patient base

Facility/Program oversight and standards
Usually not accredited

Financial considerations
Full ownership, budget directs income, some use sale of practice as retirement, financial planning

A small group practice is typically two to five dentists in a single location or multiple locations. These are usually local and are not likely to be a DSO (example: endodontists/oral surgeons). They could be mix of general dentists and specialists, with full or part-time opportunities. Small groups may offer clinical mentorship. They often require relationship building to establish a patient base. Types of small group practice are:

• Owner(s) – Can be sole owner or build equity in group overall; shared operational decision making; also common vision/mission. 
• Associate (employee or independent contractor) – More than one mentor, opportunity to work in multiple practices, potential ownership track.
• May offer more practice location mobility than larger groups, and an opportunity to move around, invest in individual practice(s) or in the overall company, or move into management/leadership positions within the company. d. Some dentists have found it lucrative to buy a few older practices and bundle the patients and then flip to a DSO.

General Overview
May have more leadership or operational duties as owner vs employee dentists. Two to five dentists in a single location or multiple locations, usually local; usually not DSO or DMO supported

"Ownership"
One or more dentist owners, may have path to ownership

Brand or identity
Merger or new offices, Usually same brand practice name, philosophy, etc

Number of dentists
May have multiple dentist employees

Specialty collaboration. or potential to specialize
Common to specialty services or growing general practice groups with specialty. Allows for specialty services in house and specialist may have built in referrals.

Location
Usually single location but if multiple usually regional

Mentoring opportunity
Clinical mentorship and operational decision making opportunities, internal study club, staff cross training

Perks, employment opportunities
Full/Part time

Residence
Considerations for ability to move depend if you are an owner (contract/penalty for sell out) vs Employee term based on employment contract.

Patient care
Requires relationship building to establish patient base

Facility/Program oversight and standards
Usually not accredited

Financial considerations
Ownership models impact equity in practice(s) or increase production model or salary. some use sale of equity/shares as retirement

An outside business entity that provides non-clinical business support. Could be a Dental Support Organization (DSO), Dental Management Organization (DMO) or Dental Partnership Organization (DPO). This is a good fit for dentists who don’t want to handle non-clinical functions like hiring, marketing, ordering products, etc. Requires relationship building to establish a patient base. Characteristics common to this type of group practice:

• A dentist may join as an associate (employee) and stay long enough to pay off student loans then look for a different career path.
• May receive education about group practice operations, clinical and leadership mentoring, and non-clinical support. Organization likely has solid structure and defined benefits. May receive robust mentoring from refined and well established programs, could have mobility across a large part of the U.S. Position is likely structured.
• May include specialists.
• May have service agreements with other doctor groups in different states as affiliates.
• DSOs are a good for those who don’t want to handle insurance contract negotiations and those who may eventually want to work part time.
• Provides opportunity for growth into leadership roles in operational support and clinical development, including purely administrative roles. (Large DSOs may provide more opportunity for growth into leadership roles for dentists than medium or smaller groups.)
• Opportunities for dentist to participate in various committees contributing to overall organizational initiatives, such as formulary development, quality assurance, continuing education, technology, lab updates, leadership, hygiene, etc.
• Could all operate under one brand, or each region/state has its own identity, or each practice has its own identity, etc.
• Could include multi-specialty practice.
• May be full or part-time.
• Commonly provide benefits.
• Mid-sized DSO: Up to 49 dentists, usually regional; may provide opportunities common to a growing organization; may be designed to stay mid-sized or be positioning itself to be acquired by a larger DSO
• Large DSO: 50-2,000+ dentists, usually multi-regional or national; may have more solid and established network and resources, a more robust mentorship program, and more comprehensive support and benefits

General overview
Business entity that provides non-clinical business support to dentists, Dentists leadership opportunities and operational duties depending on "ownership" definition

"Ownership"
One or more dentist owners or regional owners at the DSO allow for employment of dentists, employee dentists may also have option to purchase ESOP/stock of DSO and tiered purchase/buy in impacts production model (note that state laws on practice ownership vary)

Brand or identity
Can have same brand regionally, national or state wide or supported dentist keeps own practice name, may treat each location as own business entity for decision making, support therefore may have same brand but culture location specific

Number of dentists
Dentists are employees , Clinical and other operational, leadership roles within DSO

Specialty collaboration or potential to specialize
May include specialty within general

Location
Usually multi-regional or national Usually multi location, can be nationwide

Mentoring opportunity
Structured mentoring with Clinical Directors and nonclinical Operational Team, internal CE, leadership opportunities

Perks, employment opportunities
Commonly provide benefits. Full/ part time

Residence
Considerations for ability to move if stock or ESOP owner (contract/penalty for sell out) or if full time paid on production moving will require time to rebuild practice patient base, Employee term based on contract.

Patient care
Requires relationship building to establish patient base sometimes accredited

Financial considerations
Ownership models impact equity in practice(s) or increase production model or salary.. Some use sale of equity/shares as retirement.

An outside business entity that provides non-clinical business support. Could be a Dental Support Organization (DSO), Dental Management Organization (DMO) or Dental Partnership Organization (DPO). This is a good fit for dentists who don’t want to handle non-clinical functions like hiring, marketing, ordering products, etc. Requires relationship building to establish a patient base. Characteristics common to this type of group practice:

• A dentist may join as an associate (employee) and stay an employee or embark on an ownership track.
• Ownership could be in a single practice, all or a share of multiple practices, a share in the company, or even a share in the company’s real estate.
• May receive education about group practice operations, clinical and leadership mentoring, and non-clinical support. Organization likely has solid structure and defined benefits. May receive robust mentoring from refined and well established programs, could have mobility across a large part of the U.S. Position is likely structured.
• May include specialists.
• May have service agreements with other doctor groups in different states as affiliates.
• DSOs are a good for those who don’t want to handle insurance contract negotiations and those who may eventually want to work part time.
• Provides opportunity for growth into leadership roles in operational support and clinical development, including purely administrative roles. (Large DSOs may provide more opportunity for growth into leadership roles for dentists than medium or smaller groups.)
• Opportunities for dentist to participate in various committees contributing to overall organizational initiatives, such as formulary development, quality assurance, continuing education, technology, lab updates, leadership, hygiene, etc.
• Could all operate under one brand, or each region/state has its own identity, or each practice has its own identity, etc.
• Could include multi-specialty practice.
• May be full or part-time.
• Commonly provide benefits.
• Mid-sized DSO: Up to 49 dentists, usually regional; may provide opportunities common to a growing organization; may be designed to stay mid-sized or be positioning itself to be acquired by a larger DSO
• Large DSO: 50-2,000+ dentists, usually multi-regional or national; may have more solid and established network and resources, a more robust mentorship program, and more comprehensive support and benefits

General overview
Business entity that provides non-clinical business support to dentists, Dentists leadership opportunities and operational duties depending on “ownership” model.

"Ownership"
One or more dentist owners retain a higher ownership percentage of the business and have service agreement with DMO (note that state laws on practice ownership vary.)

Brand or identity
Can have same brand regionally, national or state wide or supported dentist keep own practice name, may treat each location as own business entity for decision making, support therefore may have same brand but culture location specific

Number of dentists
Dentist are employees of the dentist owner group supported by DMO, Clinical and other operational, leadership roles

Specialty collaboration or potential to specialize
May include specialty within general

Location
Usually multi location. Can span different states.

Mentoring opportunity
Structured mentoring with Clinical Directors, internal CE, leadership opportunities

Perks, employment opportunities
Commonly provide benefits. Full/ part time

Residence
Considerations to ability to move if partner or equity in dentist group (contract/penalty for sell out). Employee term based on contract.

Patient care
Requires relationship building to establish patient base

Facility/program oversight and standards
Sometimes accredited

Financial considerations
Ownership models impact equity in practice(s) or increase production model or salary. Some use sale of equity/shares as retirement.

A group of independent practices that share non clinical functions without external DSO or DMO support. “Hybrid”, culture location specific. Requires relationship building to establish patient base. Characteristics include:

• Hybrid of solo practice and DSO sometimes considered be “best of both worlds”.
• Difficult to set up correctly; significant legal support required; collaborative mentality.
• Practice owners maintain full ownership.
• May have numerous small med sized locations as one entity. May cross state lines.
• May included specialists.

General overview
Group of independent practices that share non clinical functions without external DSO or DMO support. “hybrid”, culture location specific

"Ownership"
Multiple dentist owners or regional owners.

Brand or identity
Can have same brand regionally, nation or state wide or supported dentist keep own practice name

Number of dentists
May have numerous small med sized locations as one entity

Specialty collaboration or potential to specialize
May include specialty within general

Location
Usually multi location. Can span different states

Mentoring opportunity
Clinical mentorship and operational decision making.

Perks, employment opportunities
Full/Part time

Residence
Considerations to ability to move if partner or equity in dentist group. Employee term based on contract.

Patient care
Requires relationship building to establish patient base

Facility/program oversight and standards
Usually not accredited

Financial considerations
Full ownership, budget directs income, some use sale of practice as retirement, financial planning.

A relatively new model that features a combination of physician and dentist practices; could include collaboration and patient record sharing between physicians and dentists. Characteristics include:

• Patient base based on insurance/location.
• Hospital system based.
• Part of health system with unified core values and mission.
• Dentists are employees.
• Opportunities for non-chairside health initiatives.
• One location or more locations, can span different states.
• May be full or part-time.
• Commonly provide benefits.

General overview
Integrated model within healthcare system, sharing services with medical, pharmacy, specialty, etc

"Ownership"
Hospital system based

Brand or identity
Part of health system with unified core values and mission

Number of dentists
Dentists are employees, and opportunities for non chairside health initiatives

Specialty collaboration or potential to specialize
General dentist work with specialists for ease of referral

Location
One location or more locations. Can span different states.

Mentoring opportunity
Mentoring interdisciplinary as access to colleagues, specialty, medical

Perks, employment opportunities
Commonly provide benefits, full/part time.

Residence
Employment terms depend on contract to allow to change residence.

Patient care
Patient base based on insurance/location

Facility/program oversight and standards
Accredited

Financial considerations
Employee budgeting determines financial planning opportunities, non-owner but may have 401k.

A traveling dentist is usually an employee of a mobile dentistry service, temp agency or self-employed, which provides great flexibility.

• Provides services in a number of different practices locally or regionally; probably as an independent contractor.
• Locum tenens (temps) are usually employed by a temp service or brokers to help fill in for emergency leave, maternity leave etc. Great fit for dentists who don’t want to stay in one place or just searching for the right fit.
• Could also be a public practice.
• Location varies by assignment (fill in for medical leave, or addition of hours) locations may be in dental clinic or services brought to patients (schools, nursing homes).
• May have multiple dentist employees as part of temp agency, or solo as contractor.
• Commonly provide benefits, as locum tenens may have more flexibility with location and hours, whereas a contractor is self-employed.

General overview
Usually employee of mobile dentistry service or temp agency or self-employed, providing great flexibility.

"Ownership"
Location varies by assignment (fill in for medical leave, or addition of hours.) Locations may be in dental clinic or services brought to patients (schools, nursing homes.)

Specialty collaboration or potential to specialize
May have multiple dentist employees as part of temp agency, or solo as contractor.

Perks, employment opportunities
Commonly provide benefits, as locum tenens may have more flexibility with location and hours, contractor is self-employed.

Patient care
Varies depending on assignment

Facility/program oversight and standards
Not accredited

Financial considerations
Dentist's own budgeting determines financial planning opportunities.

Part of the dental safety net, these centers serve locations or populations with limited access to care. They may be located in urban or rural areas. An FQHC is often an integrated medical facility, where a patient has a single chart encompassing all care, including medical, dental, and behavioral health. FQHC's are included under Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services.

• Could offer full-time or part-time positions.
• May offer loan repayment assistance.
• Urban and rural areas serve locations or populations with limited access to care.
• Federally funded.
• Dentists are employees of the FQHC.
• General dentists coordinate care with expanded function dental assistants, dental therapist, hygienists, depending on state regulations.
• The patient base is determined by local needs.

General overview
Health Resources and Services Administration is agency of US Dept of HHS, community health clinics often an integrated medical facility.

"Ownership"
Federal funded

Brand or identity
Federal funded

Number of dentists
Dentists are employees

Specialty collaboration or potential to specialize
General Dentists coordinate care with expanded function dental assistants, dental therapist, hygienists, depending on state regulations

Location
Facilities are located nationwide

Mentoring opportunities
Mentoring interdisciplinary as access colleagues, specialty, medical.

Perks, employment opportunities
Student loan reimbursement. Part time options

Residence
Employment terms depend on contract to allow to change residence.

Patient care
Patient base based on needs.

Facility/program oversight and standards
Accredited

Financial considerations
Employee budgeting determines financial planning opportunities. Dentist is a non-owner, but may have 401k and loan repayment.

General overview
Agency of the US Department of Veterans Affairs

"Ownership"
Usually integrated within the VA hospital system

Brand or identity
Federally funded

Number of dentists
Dentists are employees, residents. The VA is an option for dentists even if they have no affiliation with military (civilian service.)

Specialty collaboration or potential to specialize
Collaborate with medical, and opportunities to specialize. Opportunity for paid Advanced Education in General Dentistry (AEGD). to learn more about specialties.

Location
Nationwide

Mentoring opportunities
Mentoring as also part of residency option, interdisciplinary as the dentist has access to dental colleagues, specialists, and medical.

Perks, employment opportunities
Student loan reimbursement and part time available.

Residence
Employment terms depend on contract to allow to change residence.

Patient care
Patient base determined by assignment.

Facility/program oversight and standards
Accredited

Financial considerations
Employee budgeting determines financial planning opportunities. Dentist is a non-owner but may have 401k or loan repayment options.

• Serving the health care needs of over 1 million active military personnel, and their families. Army, Navy, and Air Force actively recruit dental professionals. (The Marine Corps uses Navy doctors and dentists).
• Allows the practitioner to fully focus on dentistry, not administrative or business operations.
• International and national.
• Can join before dental school through scholarship program or commissioned after dental school, an option even if have no affiliation with military.
• Offers travel (may be great for someone who doesn’t want to commit to same location for 20 years), can be deployed overseas.
• Patient base determine by assignment.

General overview
Dentist provides for the oral health care needs of over 1 million active military personnel, and their families. Allows full focus on dentistry, not administrative or business operations.

"Ownership"
International and national

Brand or identity
Army, Navy, and Air Force actively recruit dental professionals. (The Marine Corps uses Navy doctors and dentists.)

Number of dentists
Can join before dental school through scholarship program or commissioned after dental school, and option even if have no affiliation with military.

Specialty collaboration or potential to specialize
Collaborate with medical, and opportunities to specialize. Opportunity for paid Advanced Education in General Dentistry (AEGD) to learn more specialty.

Location
International and national

Mentoring opportunity
Mentoring interdisciplinary as access to colleagues, specialty, and medical.

Perks, employment opportunities
Health Professions and Scholarship Program, tuition reimbursement, retirement path, full time as active duty or part time as reservist.

Residence
Allows for travel (great for someone who doesn't want to commit to same place for 20 years). Can be deployed.

Patient care
Patient base determined by assignment

Facility/program oversight and standards
Accredited

Financial considerations
Retirement planning opportunities. Dentist is a non-owner but may have 401k, loan repayment, or pension at a younger age.

U.S. Public Health Service Commissioned Corps are uniformed dental officers, serving in the Indian Health Service, U.S. Coast Guard, Federal Bureau of Prisons, and the National Health Service Corps. While their uniforms are derived from the uniforms of the U.S. Navy, the Commissioned Corps is under the Department of Health and Human Services, overseen by the Surgeon General, rather than under the Department of Defense.

• Allows the practitioner to fully focus on dentistry, not administrative or business operations.
• International and national in scope
• Can join before dental school through scholarship program or commissioned after dental school, an option even if the dentist has no affiliation with military.
• Offers travel (may be great for someone who doesn’t want to commit to same location for 20 years), and can be deployed overseas.
• Patient base is determined by assignment.

General overview
Uniformed officers, serving in Indian Health Service, U.S. Coast Guard, Federal Bureau of Prisons and Immigration and Customs Enforcement allows full focus on dentistry, not administrative or business operations.

"Ownership"
Can be global

Brand or identity
As a branch of the U.S. Department of Health and Human Services, Surgeon General, USPHS Commissioned Corps, the dental officers embody the core values of their service: leadership, service, integrity, and excellence.

Number of dentists
Dentists serve terms. This is an option even if the dentist has no affiliation with military (civilian service).

Specialty collaboration or potential to specialize
Collaborate with medical, and opportunities to specialize

Location
International and national

Mentoring opportunity
Mentoring interdisciplinary as the dentist has access to dental colleagues, specialty, and medical.

Perks, employment opportunities
Many benefits, including tuition reimbursement, loan assistance, tax free housing, or pension.

Residence
Can be deployed to a public health crisis. Location depends on agencies.

Patient care
Patient base determined by assignment.

Facility/program oversight and standards
Accredited

Financial considerations
Retirement planning opportunities. dentist is a non-owner but may have a 401k or pension at a younger age.

Faculty - May involve a career that combines teaching, research, community service, and patient care in a dental school, hygiene, or assisting program.

• Faculty: Full-time / Part-time
• Part-time faculty often also practice dentistry part-time
• Dean/Leadership role at a school
• Traditional classroom instruction combined with stewardship over students in school operated dental clinic (patients typically sourced from underserved populations).
• Provides an opportunity to give back to the profession.

Use the ADA’s interactive Practice Location Map for Dentists (member login required) tool to get location-based demographic information. Find data on the distribution of active dentists, population median income, as well as the number of federally qualified health centers with dental services in each state.

Every associateship and every dental practice is different. But generally, hiring organizations are looking for:

• Dentists whose philosophy is similar to theirs
• A strong resume detailing experience and accomplishments
• Interest in getting involved with the community, which helps build the practice
• A willingness to take on duties such as emergency coverage, paperwork, practice management and the like
• A good listener who will tune into what patients and colleagues are saying
• Someone who is enthusiastic about joining the practice
• Good references —both professional and personal
• An interview that affirms the candidate’s qualifications, skills and value to the team

The ADA offers hiring resources for dentists, including:

• Fact sheet: Business Services Agreements with DSOs: What Every Dentist Should Know
• Research: Structure of Dental Practices in the U.S.

Check out the ADA job board for openings across the country.