Dentistry remains one of the strongest and most resilient sectors in healthcare. But for independent practice owners, a healthy dental market doesn’t necessarily mean practice ownership is getting easier.
That was the focus of our recent webinar, “Sell Out or Partner Up? What Every Independent Dentist Needs to Know About the Market.”
Imagen President and CFO David Diekmann opened with an overview of the forces reshaping dentistry today. Doug Clarke then shared how Imagen is responding to those changes and helping partner doctors grow their practices and build long-term wealth. Finally, Imagen partner doctors joined the conversation to share why they chose partnership and what the experience has actually looked like.
Here are the biggest takeaways.
Dentistry Is Still Strong… But the Market Is Shifting
The underlying demand for dentistry remains strong.
The U.S. dental market is now worth more than $200 billion and growing approximately 3% annually. At the same time, only about 16% of U.S. dentists are affiliated with a dental group, suggesting consolidation is still relatively early.
What’s notable is where the growth is happening.
Organized dentistry is growing faster than the overall market, while independent practices are seeing more modest growth.
That doesn’t mean independent dentistry is going away. It does, however, mean the environment around independent practice owners is changing, and the advantages of scale are becoming more significant.
Strong Demand Doesn’t Eliminate the Pressures of Ownership
One of the most important distinctions from the webinar was the difference between demand for dentistry and the economics of owning a dental practice.
Patients aren’t the problem. In many markets, practices have more demand than they have capacity to serve.
The challenge is delivering that care profitably.
Costs for labor, supplies, labs, insurance, technology, and other practice expenses are rising faster than reimbursement. Left unaddressed, that gap puts direct pressure on practice margins.
Labor remains another significant constraint. David noted that approximately 90% of dentists describe hiring a hygienist as very or extremely difficult.
For practice owners, those challenges compound. Recruiting, compensation, payer negotiations, purchasing, finance, HR, technology, and succession planning all compete for the same limited resource: the doctor’s time.
That’s why staying independent shouldn’t necessarily be viewed as the default or “neutral” option. It means choosing to continue navigating those pressures independently.
The Question Has Changed
Traditionally, dentists approaching a transition saw two choices: remain independent or sell the practice and walk away.
Today, the conversation is more nuanced.
Some doctors want to keep growing. Some want more time away from the business. Others are thinking about succession but aren’t ready to retire.
And as David discussed during the webinar, finding an individual buyer for a successful practice can itself become challenging, particularly as younger dentists enter the profession carrying significant student debt.
So, the question becomes less about whether to “stay or sell” and more about:
How can I keep building what I’ve created without carrying the business alone?
Imagen’s Approach: Grow the Practice and the Doctor’s Wealth
Following the market overview, Doug Clarke explained how Imagen has built its model around that question.
Imagen has analyzed more than 4,000 dental practices, looking across financial performance, production, technology, procedural mix, and other factors that distinguish growing practices from those that plateau. Today, that experience also comes from operating more than 130 partner practices.
The goal isn’t simply to acquire practices. It’s to help partner doctors make their practices stronger.
Doug shared that Imagen practices are currently growing an average of 10.3% annually, compared with approximately 3.5% across the broader dental industry, while Imagen’s highest-performing practices are growing approximately 15% annually.
But growth is only one part of the model.
Imagen is designed to help doctors build wealth through multiple channels rather than relying solely on clinical production and the eventual sale of a practice.
Partner doctors participate through:
- Clinical production, earning from the dentistry they continue to perform
- Practice profitability, retaining a 40% ownership interest and participating in free cash flow
- Imagen equity, giving doctors ownership in the broader organization and the opportunity to participate in value created across the partnership
- Real estate income, when applicable, for doctors who continue to own their practice property
The idea is diversification: doctors can continue earning from their clinical work while also participating in the performance of their individual practice and the growth of the larger organization.
That alignment is an important part of Imagen’s approach. When the practice grows and becomes more profitable, the doctor continues to participate in that value rather than simply receiving a check at closing and walking away.
Why Our Partner Doctors Chose Partnership
The numbers help explain what’s happening in dentistry. But they don’t answer the question most prospective partners really want to ask: What’s it actually like to do this?
That’s why the partner roundtable remains such an important part of our webinar series.
The doctors on our panel came to Imagen at very different stages of their careers and for different reasons.
For some, the goal was more time back. Less time managing the business and more time for patients, family, and life outside the practice.
For others, it was a better path forward. Partnership offered a way to begin succession planning without forcing an immediate exit from dentistry.
And for others, it was about support to keep growing and having access to additional resources, expertise, and infrastructure without having to manage every part of that growth alone.
Different circumstances led them to the same realization:
Partnership could give them support without requiring them to give up the parts of ownership they valued most.
What Changed After Partnership and What Stayed the Same
That distinction came through clearly during the partner discussion.
Some things were intentionally designed to stay the same:
- Clinical decision-making
- Practice identity
- Patient relationships
- Team culture
Imagen’s model is built around maintaining clinical autonomy. Doctors continue deciding how they diagnose, treat, and care for their patients.
What changed was the support around them.
Partner doctors described having less administrative burden, greater operational support, access to a community of other dentists, and more time to focus on patients, their teams, and their lives outside the practice.
The practice still felt like theirs.
They just weren’t carrying all of it alone.
So… Sell Out or Partner Up?
The dental market isn’t sending one simple signal.
Demand remains strong. Dentistry continues to grow. And independent practice ownership still offers tremendous opportunity.
But costs are rising, labor remains constrained, consolidation is continuing, and the business of dentistry is becoming more complex.
That makes the decision about your practice’s future less about choosing between independence and selling out and more about determining what kind of ownership model supports the future you actually want.
For the partner doctors we heard from, partnership offered a way to keep what mattered while gaining the resources, financial opportunities, and support to build what came next.
Want to hear their experiences firsthand?
Learn more from our webinar series and connect with Imagen Dental Partners to hear what partnership could look like for your practice.
