Photo by Ales Krivec on Unsplash
2008 De Cmas P01 5f57a8e22d08c

Rural dentistry: Where the grass is always greener

Sept. 1, 2020
While more and more professionals opt to practice in an urban or suburban setting, rural dentist Jonathan Mason, DMD, makes a compelling case for ditching the daily grind of city life in favor of greener surroundings.

Did you get into dentistry for the lifestyle the profession often affords? Fancy car, large home, country club membership, stress, heart attacks, divorce? That’s right; the “keeping up with the Joneses” mentality of dentists in America often results in stress and anxiety, leading to unhappy lives, marriages, and families. Why not choose a lifestyle that will allow you to be active, enjoy the outdoors, have kids who aren’t on their iPads all day, and still make as much money as the typical city dentist, but put twice as much away for retirement? Being a dentist in a rural community gives you the ability to practice the way you want to practice while maintaining your sanity and enjoying your personal life.

Urban migration

The majority of our population is flocking to the cities, which means the majority of dentists are doing the same. Urban and suburban practices today are heavily driven by insurance and intense competition to get the most Google reviews, on top of suffering through a long daily commute to get to a stressful day. When everyone runs in one direction, sometimes it pays off to consider running the other way. Escape the urban life for mountains, oceans, lakes, and the life of your dreams: the ultimate adventure. 

Big fish, small pond

Rural communities in America offer a host of advantages over their urban counterparts. Cost of living is always lower, there’s a great need for care from those who have the means and those who don’t, and most everyone is pleased to have a proficient caregiver in their community. You get to be a big fish in a small pond with no shortage of respect from the community and people looking out for you and your family. Traffic, smog, and pollution are all absent in rural America, leading to less stress and healthier living. Instead of escaping to the country on the weekend, you can live a less stressful life with the same income and visit urban areas as needed. 

While a better lifestyle is a great start, the real advantage comes in having the freedom to practice dentistry on your own terms. Rural patients tend to have less dental insurance since they work for smaller companies or own their own businesses and aren’t offered the large plans that corporations tend to carry for their employees. Being reimbursed a proper fee for the work you are doing as a dentist is fair, and not being beholden to insurance companies is something many dentists dream about. 

Expand your capabilities

One of the fastest ways to grow a practice is to increase the number of procedures you offer. Everyone who completes dental school can do fillings, crowns, and dentures—important skills to maintain your baseline income—but many of us get bored with the same old procedures every day and want to increase our skills. Whether it’s endo, extractions, implants, aligner therapy, sedation, gingival grafts, conventional orthodontics, etc., you can acquire all of these skills through continuing education to expand the service offerings of your practice. Can you do this in urban dentistry? Of course, but the motivation may not be as strong.

When there are specialists of every kind within five minutes of your office, you’re more likely to refer most of the specialized procedures out the door. They’ll wine and dine you, and probably discourage you from doing “specialty” work as a general dentist, which is easy to accept since making a referral doesn’t result in a huge inconvenience to your patients. Now, what if your patients had to travel 45 minutes to get to an oral surgeon or endodontist? Between the consults, appointments, and follow-ups, your patients will travel several hours just for their extractions. Due to patient demand, you will be motivated to go out and get the proper CE to start doing extractions. Maybe you even have a mentor who can coach you through more difficult extractions, root canals, etc. Adding these services not only greatly benefits the bottom line of your practice, but greatly benefits your patients since they don’t have to be inconvenienced by driving all over the state to have a procedure completed.

Of course, there will always be procedures that require a specialist. Starting out with easier cases and not getting in over your head is key, and proper continuing education will be very beneficial on your journey. 

Another option you may have is to bring a specialist into your practice a couple of days a month, depending on the demand. This is something done all over the country, but works really well when specialists are otherwise far away. Many people will raise concern over upsetting their referrals by doing too much, but in reality, most specialists are busy enough that they’re happy to handle the harder and larger cases while not worrying about the smaller things. 

As people flee more congested urban areas, rural communities will be actively looking for new dentists to care for their families. [. . . ] I urge you to take this opportunity to explore rural dentistry.

No shortage of demand

As I write this, I am 39 years old, I get my teeth cleaned twice a year, and have had two fillings in my entire life. I am not what you’d consider a profitable patient, and neither are many people my age. The aging patient population is most in need of significant dentistry. Teeth that had overprepped amalgams are breaking cusps and need crowns, crowns need endo, and failing root canals necessitate implants. Baby boomers, now into their 60s and 70s, are retiring to the country with past dental work failing, and smart dentists are there to rehabilitate them. 

Just as the patient population is aging, so are dentists. There are many practices with a dentist over 65 who wants to sell and retire but can’t find a replacement dentist willing to move to the country and take over. This makes the value of rural practices dramatically less than city practices. An urban practice near New York or Boston may sell for 125% of collections, a typical suburban practice is close to 85%, and rural practices may be closer to 60%. I purchased mine for 42% of the prior year’s collections, more than doubled the practice revenue in three years, and paid off the practice loan in four years. You may find a rural practice that needs a little facelift, but the patients are extremely loyal and eager to be treated by a younger dentist with a modern education and steady hand.

The hook

Everything in this article is representative only of my experience, and it all took place before March 15, 2020, when COVID-19 closed my practice and almost all of the practices in the US. Now, more than ever, people are afraid to go back to the cities, and the truth is, they don’t need to. Rural America is wired for high-speed internet and most people are realizing they can reliably work from home. There is new technology that allows data to travel over radio antennas to reach the most remote areas of the country. 

As people flee more congested urban areas, rural communities will be actively looking for new dentists to care for their families. Dentistry is sure to come back strong since we’re already ahead of the curve on infection control, so I urge you to take this opportunity to explore rural dentistry. The grass really is greener on the other side. 

Jonathan Mason, DMD, is a 2002 graduate of Hamilton College and a 2006 graduate of University of Connecticut School of Dental Medicine. He maintains Mason Dental, a private practice in Manchester, Vermont. In 2013, he was named a Top 40 Under 40 by Benco Dental. He is the cofounder and chief clinical officer of Select Dental Management, an emerging dental support organization in the Northeast.
About the Author

Jonathan Mason, DMD

JONATHAN MASON, DMD, is a 2002 graduate of Hamilton College and a 2006 graduate of UCONN School of Dental Medicine. He maintains a private practice in Manchester, VT. In 2013, he was named a Top 40 Under 40 by Benco Dental. He is the cofounder and chief clinical officer of Select Dental Management, an emerging DSO in the Northeast.

Updated September 8, 2020

Sponsored Recommendations

Clinical Study: OraCare Reduced Probing Depths 4450% Better than Brushing Alone

Good oral hygiene is essential to preserving gum health. In this study the improvements seen were statistically superior at reducing pocket depth than brushing alone (control ...

Clincial Study: OraCare Proven to Improve Gingival Health by 604% in just a 6 Week Period

A new clinical study reveals how OraCare showed improvement in the whole mouth as bleeding, plaque reduction, interproximal sites, and probing depths were all evaluated. All areas...

Chlorine Dioxide Efficacy Against Pathogens and How it Compares to Chlorhexidine

Explore our library of studies to learn about the historical application of chlorine dioxide, efficacy against pathogens, how it compares to chlorhexidine and more.

Enhancing Your Practice Growth with Chairside Milling

When practice growth and predictability matter...Get more output with less input discover chairside milling.