Driven by rising operational costs, increased patient demand for convenience, and the need for financial security, many dentists in private practice have aligned themselves with dental service organizations (DSOs).
According to the American Dental Association (ADA), between 2005 and 2023, the percentage of dentists in private practice dropped from 84.7% to 72.5%.1 The trend is expected to accelerate as older providers retire, and younger dentists—who seem more predisposed to joining a DSO—enter the marketplace.
It’s probably not news to you that there is growing tension between these two business models. Private practices find themselves fighting off new competition, indeed, even fighting for their livelihood, not unlike many American businesses. The need to conserve cash assets is paramount.
That’s where bartering comes in.
Why more dentists are turning to bartering amid DSO competition
At a time when businesses (and individuals) have to stretch every dollar, bartering can be a strategic tool for saving cash while acquiring necessary resources without spending capital.
Barter is almost as old as civilization itself. Neighbors who knew each other would barter or trade for services or items they believed were at least of equal value. That system can still work within communities, but most often both parties do not have a “like in-kind need” for one another’s goods or services. In other words, it’s difficult to make a match both parties want.
In this digital age, though, it’s possible to find bartering partners across the city or across the country. Through third-party barter exchanges—where members pay a commission for goods or services traded—more complex trades are possible. These digital capabilities are one of the factors that are driving the resurgence in bartering.
How barter exchanges help dental practices conserve cash and grow
What can be bartered? Advertising, printing, public relations, website creation, and social media curation are popular in barter. In addition, people offer and seek services such as childcare, home repair, cleaning, landscaping, and computer repair, not to mention professional services of optometrists, CPAs, attorneys, and, yes, dentists. Restaurants and hotels are also interested in barter to fill empty tables and guest rooms with customers they may not otherwise attract.
Bartering in the dental industry involves the exchange of dental services for other goods or services instead of cash. It offers benefits such as increased revenue, a wider patient base, a way to market the practice and a method to provide costly care to patients who lack insurance.
The best way to manage bartering today is through a barter exchange, most of which operate locally or regionally. Here’s how a barter exchange works:
A business lists a product or service for trade through a barter exchange. When someone barters for those goods and services, the business receives a trade credit, or “barter dollars,” based on the dollar value of the good or service offered. It can then use those trade credits to “purchase” goods or services offered by other members.
As a result, small businesses and sole proprietorships can use these channels to market to new customers and build a valuable network. The barter exchanges offer arbitration in the case of a dispute, and they keep track of the bookkeeping. This is important because barter transactions are considered taxable income and must be reported to the IRS.
Dentists can thus obtain needed services or goods for their practice without spending cash.
Ethical and financial considerations of bartering in dentistry
There are some ethical considerations when it comes to bartering with patients. The Academy of General Dentistry (AGD) notes that bartering can create a dual relationship (dentist-patient and client-contractor), which may complicate the patient relationship.2
Bartering turns downtime into a valuable commodity, but it shouldn’t form the basis of a dental practice. Barter should only be 3% to 5% of a business’s annual revenue; therefore, a business owner shouldn’t spend more than a couple of hours a week on these ventures.
There are two more reasons to consider adding barter to your financial portfolio. They are less concrete but just as important.
Bartering encourages sustainability through the repurposing of goods and services, supporting the so-called “circular economy.” It also builds relationships and encourages collaboration among individuals and business owners who may not agree on anything else. Mutual respect and trust are building blocks not only of businesses, but of our entire economic system as well.
Editor's note: This article originally appeared in The Bottom Line with Dental Economics, the newsletter that will elevate your inbox with practical and innovative practice management and clinical content from experts across the field. Subscribe here.
References
- American Dental Association, Health Policy Institute. Practice Ownership Among Dentists in Private Practice Continues to Decline. Chicago, IL: American Dental Association; 2023. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/practice_ownership_among_dentists_continues_decline_2023.pdf. Accessed September 22, 2025.
- Academy of General Dentistry. “I’ll trade you one.” General Dentistry (AGD). November/December 2013. https://www.agd.org/docs/default-source/default-document-library/gendent_nd13_ethics.pdf
