During the past year, the United States experienced a period of economic uncertainty that affected almost every industry, including dentistry. In 2024, there was a shift from discussing the state of the profession in terms of pandemic-related factors that were still in effect to discussing it in terms of understanding and accepting the new realities of practice, which included significant changes in patient expectations, staffing shortages, and more. Most of those new realities remained in effect through 2025; however, they were also challenged by new economic headwinds that further threatened practice profitability.
The current US administration adopted a more protectionist tone, proposing and implementing tariffs and other trade policies with the potential to affect parts of dentistry’s supply chain. Furthermore, although the rise in inflation that occurred during the previous administration had stalled, there was little improvement. And because tariff‑related cost increases, supply chain disruptions,
and the rising cost of overhead threatened to push inflation above target, it remained a risk. This cast a shadow of doubt, which not only affected the day-to-day financial decision-making of dental practices but also resulted in the Federal Reserve’s hesitancy to cut rates, keeping loan terms undesirable and stymieing growth.
In the face of this year’s tempest of economic uncertainty, dental practices weathered the storm by implementing a variety of strategies and systems to overcome obstacles to success. Many overhauled their approach to practice management, some offered new treatments and services, and others invested in new technologies. To help dentists appreciate where their practices stand when compared with those of their peers and what if any changes they could be making to help protect and grow them, Inside Dentistry is pleased to present the results of its annual Trends in Dentistry readership surveys, which shed light on the state of the profession in 2025 in the areas of practice management, clinical care, and purchasing and technology adoption.
Practice Management
When it comes to trends in practice management, many successful dentists have been taking action to streamline their front-office operations and implementing new practice management systems to realize efficiencies and subsequently improve production. “At the operational level, we have integrated AI-powered note-taking assistants, and this is clearly improving and reshaping our approach to practice management,” says Sonia Leziy, DDS, a board-certified periodontist with a private practice in Nanaimo, British Columbia, Canada. “This tool enhances our documentation accuracy, streamlines communication, and reduces administrative burden, allowing the clinical team to spend more meaningful time with patients. The growing intersection of technology and patient-centered care is one of the most exciting evolutions in practice efficiency today. In an industry plagued by staffing shortages, AI administrative assistants can help us better navigate ‘front-desk’ challenges.”
Marty Jablow, DMD, a private practitioner in Woodbridge, New Jersey, and chief development officer of Cellerant Consulting Group, agrees that AI is having a significant impact on practice management. “The use of AI to enhance the revenue cycle of dental offices will offer greater efficiency and may reduce or redirect the dental workforce,” he says. “This can have sweeping effects on the profitability of a dental office whether solo, group or DSO.”
Regarding practice type (ie, solo, group, or DSO), the percentage of respondents who reported being part of a DSO remained steady at approximately 9% from 2024 to 2025; however, the percentage of respondents who reported being part of a small group practice increased from 10% to 18%. This could indicate that dentists are looking to leverage the efficiencies of group practice without surrendering total control to a DSO. Although the percentage of respondents who indicated that they were not at all open to joining a DSO increased by 13% from 2023 to 2024 (49% to 62%), suggesting a cooling in dentists interest in joining these organizations, from 2024 to 2025, the percentage who indicated that they were not at all open to joining a DSO decreased by 5% (62% to 57%). Furthermore, the percentage who indicated that they were somewhat open to joining a DSO increased from 25% to 32%. Dentists’ opinions about DSOs can be strong, but the structure of DSOs is ever evolving. This data could indicate a positive shift in dentists’ interest in DSOs or merely a stabilization of the dramatic changes in interest that our survey data has shown over the past few years. Nonetheless, it’s seemingly only representative of interest because the percentage of Inside Dentistry survey respondents who have indicated that they are already affiliated with a DSO has remained steady in the 6% to 7% range for the past 4 years.
One of the most impactful realities of modern dental practice is the effect of staffing shortages, particularly shortages of dental hygienists. Although dentistry’s shutdown at the outset of the COVID-19 pandemic, which resulted in many hygienists leaving the profession, was certainly a factor, the root cause may lie in hygiene education. “Since 2020, the number of dental hygienists has been trending downward,” says John Flucke, DDS, a dental technology expert who maintains a private practice in Lee’s Summit, Missouri. “However, for as long as I’ve been in the profession, which is a while now, hygiene education has not graduated the proper numbers. Every doctor needs at least one good hygienist, and the US population continues to increase, which means that more people are going to need care.”
From 2024 to 2025, the percentage of respondents who reported employing one hygienist dropped slightly from 25% to 23% and the percentage of respondents who reported employing two to three hygienists dropped from 41% to 34%; however, the percentage of respondents who reported employing four or more hygienists increased from 11% to 20%. The decreases in those who employ fewer hygienists are likely evidence of the effects of the hygienist shortage, whereas the increase in those who employ four or more hygienists may suggest that building a robust hygiene program with flexibility for hygienists enables practitioners to better attract and retain them.
“It’s important to factor in that many hygienists work part time,” says Flucke. “The last statistics I saw on this stated that roughly 60% of hygienists work full time. That means that a single doctor will often need to find two hygienists to equal a full-time equivalent. Therefore, what the profession needs is a ratio of approximately two hygienists graduating for every one doctor. This shortage needs to be addressed. Dentistry is approaching a point where oral health could be compromised due to an insufficient number of quality dental hygienists.”
One indicator of a practice’s success is its rate of acceptance for complex treatment plan proposals. Approximately 46% of the respondents to this year’s survey reported that the majority of their complex treatment plan proposals are accepted by patients, which is down from 54% last year—a decrease of 8%. This is significant because the decrease from 57% in 2023 to 54% in 2024 represented the first time that this number fell below 57% since Inside Dentistry’s surveys began in 2019. Clearly, patients are accepting less treatment, but why? Tightening budgets from years of persistent inflation is a likely cause.
Helping patients pay for treatment is essential to boosting case acceptance rates, so Inside Dentistry’s surveys ask practices about their available payment options. From 2024 to 2025, although the percentages of respondents who indicated that they accept alternative plans (eg, dental discount plans, membership plans, etc) remained the same (47%), the percentage who indicated that they accept private insurance decreased slightly by 4% (89% to 85%), and the percentage who indicated that they accept healthcare financing (eg, CareCredit, Sunbit, etc) increased by 6% (63% to 69%). These changes are likely reflective of the stagnation of insurance reimbursement rates and the recent rise in availability and popularity of healthcare financing options for dental care. “Financing options are vitally important to making good dentistry affordable,” says Richard P. Gangwisch, DDS, a clinical assistant professor at the Dental College of Georgia at Augusta University who practices in a Heartland Dental-supported office in Lilburn, Georgia. “We can’t gain case acceptance if our patients don’t have the means to pay for it. There are more options available now, so even patients who do not have good credit ratings can get help.”
When it comes to the marketing channels that practices utilize, the largest percentage of respondents (72%) reported using practice websites. Interestingly, from 2024 to 2025, the percentage of respondents who reported using social media decreased from 51% to 46%, and the percentage of those who reported using email decreased from 40% to 37%, but there were slight increases in the percentages of those who reported using print advertisements (18% to 21%) and direct mail (16% to 20%). Print may still be a valuable way to reach certain patients in our increasingly digital world, but successful practices realize that establishing genuine relationships with patients is the best marketing tool. “Independent specialty practices are redefining growth through collaboration, education, and authentic patient connection,” says Leziy. “In a marketplace dominated by corporate consolidation, there’s renewed value in the personalized, relationship-based model of care. Our focus has been on cultivating strong referral partnerships while also expanding our direct-to-patient engagement through educational content, digital outreach, and community involvement. This dual-channel approach—referral-based and direct-to-patient—strengthens trust and the visibility of our practice.”
Clinical Care
In recent years, there has been little change in the number of restorative procedures that respondents report performing, with approximately 75% of this year’s respondents reporting that they perform 1 to 100 direct restorative procedures and place 1 to 30 crowns per month. The stats have also remained relatively unchanged for endodontics. Approximately 65% of this year’s respondents reported that they perform standard root canals, with 55% indicating that they perform 1 to 25 endodontic procedures per month. The percentage of those who report that they do not perform endodontic procedures has continued to hover between 30% and 33% for the past 3 years.
Regarding periodontal treatments, the most frequently performed procedure indicated by respondents in 2025 was full-mouth debridement, which was followed by gingivectomy and then crown lengthening. Leziy explains that regenerative and minimally invasive strategies are reshaping approaches to periodontal and peri-implant disease management. “Minimally invasive surgical techniques supported by suitable tools/instruments and biostimulation have improved outcomes and our ability to preserve native tissue,” she says. “Furthermore, laser-assisted, minimally invasive alternatives to conventional surgical therapy are offering patients improved comfort and faster recovery while maintaining long-term periodontal stability. Collectively, these innovations reflect a paradigm shift toward biologically driven, patient-centered interventions aimed at regeneration rather than resection.”
The Inside Dentistry survey data continues to reflect that more and more dentists are placing implants, with the percentage of respondents who reported that they do not place implants decreasing from 49% in 2023 to 47% in 2024 and to 42% in 2025. Furthermore, the data indicates that the dentists who place implants are placing more of them. From 2024 to 2025, the percentage of respondents who reported that they place 6 to 10 implants per month increased from 10% to 15%, and the percentage who indicated that they place 11 to 15 implants per month increased from 2% to 5%. “Digital workflows and bioactive technologies are transforming both diagnostics and treatment execution,” notes Leziy. “From AI-assisted treatment planning systems to electrolytic implant decontamination, technology continues to advance the precision, efficiency, and predictability of implant treatment.”
With regard to practices’ in-house laboratory capabilities, the percentage of respondents who reported that they mill their own restorations decreased from 14% in 2023 to 12% in 2024 and remained at 12% in 2025; however, the percentage of respondents who reported that they 3D print models, surgical guides, and night guards increased significantly to 14% in 2025 after dipping from 9% to 6% from 2023 to 2024. “We will continue to see an increase in the use of 3D-printed appliances, surgical guides, and restorations,” predicts Jablow. “The adoption of 3D printers will continue to increase, particularly among the younger dentists, and 3D printed restorations will continue on their quick adoption path with better dental resins.” As evidence of that, the percentage of respondents who indicated that they 3D print permanent restorations in-house, which increased from 2% to 4% from 2023 to 2024, further increased to 7% in 2025.
Flucke believes that in-office fabrication of routine restorations and appliances will see a significant change in the near future. “The current evolution of artificial intelligence into the design process for in-office 3D printing and milling is simplifying creation in incredible ways,” he says. “In the last 5 years, design programs have made a quantum leap. Designing in-house or sending IOS files to a digital dental laboratory to design and then fabricating in the dental office streamlines delivery and patient satisfaction, making waiting days or sometimes weeks for a crown, denture, or occlusal guard a thing of the past. These restorations and appliances can be turned around quickly, sometimes during the same appointment, with the quality and fit that the profession strives for. That being said, I don’t think the profession of dental lab technician will ever be lost to history. What I see is more and more of the routine ‘everyday’ cases moving into the dental office; the difficult cases will still need to be handled by highly skilled professionals.”
Today’s patients have greater expectations when it comes to the delivery of care and their comfort, and dental anxiety related to fear of pain or injections is as pervasive as ever. From 2023 to 2024, the percentage of respondents who reported that their practices offer sedation dentistry decreased slightly from 26% to 24%, but in 2025, it increased to 32%, possibly reflecting patient preferences. “Sedation dentistry can be a great practice builder,” says Gangwisch. “Dentophobes who have had a good experience due to sedation can be great referral sources. Similarly, providing treatment for obstructive sleep apnea can be a great help in expanding the types of services that practices provide. You are a hero to those patients who are able to stop continuous positive airway pressure therapy.” In 2025, 37% of the survey respondents indicated that they treat patients for obstructive sleep apnea.
Purchasing and Technology Adoption
Although some practices prefer to work with a lot of distributors or dealers, in 2025, the majority of survey respondents (52%) continue to report that they work with one to three. The percentage of respondents who reported that they participate in a group purchasing organization or buying groups in 2025 was 24%, a number that has remained essentially unchanged for the past few years, hovering around 25%. Regarding sources for purchasing products, the most used source continues to be dealer websites. From 2024 to 2025, the percentage of respondents who reported using dealer websites increased from 80% to 83%, which is up from 77% in 2023. The use of manufacturer websites comes in close second, but from 2024 to 2025, the percentage of respondents who reported using those saw a decrease from 74% to 59%, possibly indicating a preference among dentists for dealers.
Wherever dentists are getting their products, they recognize the importance of evidence in selecting them. From 2023 to 2025, the percentage of respondents who reported that clinical research is very important when deciding to adopt a new product has slightly increased by 2% to 3% each year (79% to 84%), while the percentage who report that it is somewhat important has commensurably decreased, demonstrating that most dentists understand the value of research in purchasing decisions and that position is only strengthening.
One of the ways that practices can both increase efficiency and expand their service offerings to patients is by implementing new technology. From 2023 to 2024, the percentage of respondents who reported that they spend 10% or less of their yearly practice budgets on purchasing new technology increased from 48% to 58%, while all of the greater spend categories saw decreases. This could indicate that the economy had practices tightening their purse strings. However, from 2024 to 2025, the percentage of respondents who reported that they spend 10% or less decreased from 58% back to 49%, with a significant corresponding increase of 13% in the percentage who reported spending 15% of their yearly budget (22% to 35%). This could indicate that more dentists are recognizing the value of investing in technology as a means to differentiate their practices.
“From my point of view, all dental technologies have two big advantages in common: increased speed and improved control,” says Flucke. “Prepping with electric handpieces provides both of those, and so does in-office milling, 3D printing, and the use of AI. Dentists have always been ‘quality first’ individuals, as they should be, and I think that’s why the profession has been faster to adopt intraoral scanning than in-office fabrication. When dentists learned that digital impressions were as accurate as analog impressions, and faster, that product category grew rapidly.”
In 2022 and 2023 the percentage of respondents who reported using digital impression systems plateaued around 50% after previously undergoing dramatic year on year increases from 37% in 2020. However, from 2023 to 2024, the data indicated that the percentage of respondents who reported using digital impression systems increased from 48% to 57%—an increase of almost 10%. And in 2025, this increase continued with the percentage of respondents who reported using digital impression systems reaching 64%. The use of other digital dentistry technologies is on the rise as well. Digital radiography is reaching a saturation point, with the percentage of respondents who reported using digital radiography sensors increasing from 75% in 2023 to 80% in 2024 and to 87% in 2025. The change in data from 2024 to 2025 also demonstrated increases in the percentages of respondents who reported using cone-beam computed tomography (CBCT) (31% to 38%) and lasers (36% to 46%).
“Intraoral scanners are now awesome not only for fixed restorative applications but also for removables,” says Gangwisch. “Digital dentures are significantly reducing chair time, and quality two-visit dentures are now a reality. In addition, intraoral cameras can be an immense help in attaining case acceptance, and they are dirt cheap. AI-powered caries detection is also now available to help with case acceptance. The patient view, which colors caries red, helps patients visualize their issues to better understand the need for treatment.”
Relatedly, the surveys ask participants if they have explored using AI-powered products, such as caries detection software, in their clinical workflows. From 2024 to 2025, the percentage of respondents who indicated that they are monitoring the developments and considering it increased from 19% to 31%, and the percentage of respondents who indicated that they do not feel that AI is a fit for their practice decreased from 15% to 7%. Taken together, these data seem to reflect that interest/trust in AI and its potential benefits is increasing with education. “AI and machine learning will transform the entire dental industry,” says Jablow. “From assisting in patient acquisition and the revenue cycle to improving diagnosis and providing clinical decision-making support, AI will streamline everything to do with dentistry. Nonetheless, we need to be very careful to remember that AI is just a tool to assist us and to never assume that it is 100% accurate.”
Flucke agrees that the profession will see tremendous growth in the use of AI systems. “We are going to see much smarter systems in many areas that will allow computers to do what they do best while freeing up doctors and their teams to deal with their patients human being to human being,” he says. “Dentistry is built on relationships, and being able to spend more time face to face will be a good thing.”
According to Leziy, the growing influence of AI represents an inflection point in how we deliver and manage care. “The convergence of biologics, digital design, and intelligent systems is enabling a new standard of personalized, evidence-based, and efficient dentistry,” she says, “one in which technology enhances, rather than replaces, the clinician’s expertise.”
Figures and Images
