Findings from the 2025 Dental Economics-Levin Group Annual Practice Survey

Every year for the past 20 years, Levin Group and Dental Economics have collected data from practices all over the United States to determine the most interesting and revealing trends in our profession. Over those 20 years, dentistry has experienced recessions, recoveries, pandemics, and staffing shortages—yet it has still maintained its place as one of the most desirable and rewarding professions.  

Like many businesses and industries, the speed of change is accelerating exponentially as technological advances (both clinical and administrative) and AI are rapidly adopted into most dental practices. How are dentists faring in this environment? Is production affected? Are costs impacting profitability? How quickly are we adopting AI? Let’s find out.  

Who responded to the survey?

General dentists make up the majority of the profession, so we have always included them in our survey. 87% of respondents are owners or partners in an independent private practice, 3% are associates, and approximately 10% are employed by DSOs or large group practices. We asked the respondents to consider 2025 practice statistics when responding to questions about practice performance but to consider their current attitudes when answering questions about the direction, trends, and expectations for practice performance. 

Interestingly, 52.3% of respondents are in solo practice. And the average age of a respondent to the Dental Economics – Levin Group annual survey this year was 55. Our group is slightly older than the average age of 49, identified in ADA data. 

What’s going on with production? 

As every dentist knows, production is the single most important factor in dental practice success. Historically in our survey, production per doctor has grown over 20 years at a modest compound annual growth rate of 2.3%, but that includes some very challenging years between 2008 and 2010 (the Great Recession) and the very difficult pandemic era. Even with modest production growth, practice growth experienced strong growth over that period until 2022 when overhead started accelerating significantly faster than production, eating into profit (and doctor income). The good news is that things seem to be settling down. 

The average production per doctor in our survey (including hygiene) was $1,001,807 versus $1,004,178 last year—statistically flat. If 25% of doctor production stems from hygiene, the average general dentist made $751,355 of direct production. Specific factors holding production down will be discussed later in the article. 

The good news is that 72% of practices did report higher production in 2025, but only 8% reported an increase greater than 15%. 

Overhead is still taking its toll on income 

Overhead continues to impact dental practice success and is accelerating faster than practice production. 58% of practices reported higher overhead in 2025 compared to 2024. Only 15% said their overhead was lower and the remaining 27% reported it stayed the same. When we asked how much higher overhead had grown, the average was 4.5%, but 27% stated that it was over 10% higher. If practice production is flat (as it was this year in the survey) and overhead increases any amount, practice profitability declines. 

There is a bit of good news on the overhead front this year. The pace of overhead growth may be slowing. The average increase (4.5%) is down from 5.1% in 2024.  

According to the American Dental Association Health Policy Institute, prices for dental equipment and supplies increased by 5% between January and September of 2025.¹ That lines up well with the overhead increases the doctors responding to this survey experienced. Unsurprisingly, 55% of practices reported that rising overhead was their biggest challenge right now. 

Predicting the future–optimism or pessimism? 

As we typically see in this annual survey, dentists tend to be optimistic about the approaching year. When asked about their expectations, 92% stated that they expected to do the same or better in 2026 compared to 2025. Most expect their total revenue to increase by 5% or higher this year. But are dentists taking any steps to ensure the revenue growth they expect, or are they simply hoping for a better situation? 

Dental practice owners need to be proactive about identifying their strengths, weaknesses, opportunities, and threats so they can set the appropriate goals and strategies to achieve them. 

Speaking of threats … when asked to identify the biggest challenges facing their practices right now, the top six answers were: 

1. Declining dental insurance reimbursements (56%) The majority of practices have some level of insurance participation, making it a key factor in overall practice economic success. Right now, insurance companies are either keeping reimbursement levels the same ordecreasing them. 

2. Rising overhead (55%) The combination of declining reimbursements and increasing overhead is not a good recipe for higher profitability. 

3. Difficulty hiring clinical team members (53%) There is a crisis-level shortage of trained clinical staff, and we believe this will continue for quite some time.  

4. Patient concerns about finances/the overall economy (50%) This is a huge increase from last year’s survey. The concern that an increasing number of patients are either not presenting to the practice, not accepting treatment, or are postponing major treatment has grown considerably. 17.5% of practices reported an increase in the use of third-party financing in 2025. This is higher than last year and correlates well with Levin Group’s observation of our clients who also are reporting more patients who decide not to initiate treatment due to financial concerns. Many economists suggest we are in a “K-shaped recovery” right now, where patients on the lower (descending) part of the K are being hit by inflation and are having difficulty in affording dental care. Third-party financing creates an opportunity for practices to remain strong and patients to have optimal care regardless of prevailing broader economic conditions. 

5. Not enough new patients (31%) It should come as no surprise that practice owners pay attention to this metric. Adding more new patients is the traditional remedy for all dental practice challenges. New patients are a key driver of revenue and Levin Group recommends that 40% of doctor production come from new patients. 

6. Difficulty hiring office/administrative team members (22%)This is actually an improvement from last year’s survey, which could be the result of more automation being used for administrative tasks. 

This data regarding the challenges facing our profession aligns very well with that reported recently by the ADA Health Policy Institute. The ADA HPI found that insurance reimbursements were identified as major challenges by 55.3% of respondents, rising overhead by 41.5%, and staffing issues by 54.2%.¹ 

Is dental insurance helping or hurting practice performance? 

The news is not great. Since 2021, the reimbursement rates paid by dental insurance companies have not kept up with the inflation rate of the overall US economy—and that’s not the worst of it. Dental insurance providers, which have presented a huge challenge for practices for decades, are now taking steps to make things even more challenging. 

Slightly more than half (50.5%) of respondents reported that one or more of their plans lowered reimbursements in 2025. That is a significant increase over 2024. This trend seems to be gaining steam and insurance companies appear more emboldened to lower reimbursements. With only 10% of practices reporting that they are fully fee-for-service and do not participate in any insurance plans, this creates a problem for almost every dental practice. When insurance companies do not raise reimbursements, then higher overhead expenses (staff compensation, supplies, new technologies, general inflation, etc.) create a decrease in profitability for the practice, and lower income for the doctor. 

Anecdotally, new client practices have told us they want to eliminate insurance participation and go fully fee-for-service. After analyzing their situation, we are frequently compelled to inform them of the difficulty and danger of taking that approach. When a practice has 57% of its patients covered by dental insurance (as was the average in this year’s survey) it is difficult, challenging, and dangerous to eliminate all insurance, and in most cases, we advise the client not to go down this path without careful advanced planning. Instead, we advise them toidentify one (maybe two) plans that they want to exit, but to be very careful not to exit all plans at once without a strategy to replace the lost patients. Typically, when a practice exits an insurance plan, it can expect to lose approximately 50% of those insurance patients. 

Have staffing shortages gotten any better? 

More than 89% of the dentists responding believe there is a shortage of dental staff available for hire. 58% of practices are seeking to hire at least one team member and 76% of practices have at least one open position to fill right now, which is a huge increase from last year’s survey. 

In my opinion, this dental staffing crisis will not be resolved for at least 10 years. Employment in America combined with lost personnel from COVID and more people working from home will prevent dentistry from reaching full employment for some time. 

We then asked dentists what they were doing to address the current staff challenges. They responded as follows. Some practices chose more than one strategy. It is interesting to note that the top three are focused on increasing total compensation costs, which significantly contributes to the increase in total overhead that was discussed earlier. 

1. Increasing base compensation for staff (49%) 

2. Providing more bonuses for staff (32%) 

3. Offering more/better employee benefits (27%) 

4. Adding technology for productivity enhancement 23%) 

6. Utilizing a staffing agency (25%) 

7. Reducing office hours (8%) 

Clearly staffing challenges are reshaping dentistry. In this environment it is important that practice leaders focus on things like cross training, so that when you do lose a team member you are able to continue carrying out the basic functions. There are also new technologiescoming online that may enable practices to operate effectively with fewer team members. Technologies such as… 

The rapid adoption of AI 

43% of practices report they are using AI to support the practice, clinically and administratively. This is an astoundingly rapid adoption of new technology for a profession known to take thing slowly and deliberately as it regards new technology. 

When we asked dentists to describe their specific areas of AI adoption, here is what they said: 

Clearly AI is coming, for many different reasons.  

First, clinical improvement and clinical support. Maybe you don’t need AI to read a radiograph, but it makes it faster, easier, and provides more detailed information, all of which allows dentists to be more efficient and helps convince the patient to accept treatment. In some ways,AI is already more effective than clinicians when it comes to identifying and diagnosing certain conditions. 

Second, it makes many administrative tasks much easier, especially insurance processing. 

Third, and this was mentioned in the staffing section above, eventually we will see practices replacing certain administrative functions in the practice with AI. This is already occurring in places like hotels and restaurants. Tasks such as answering phones, filing insurance, writing insurance narratives and appeals, etc., will be handled by AI, some not requiring human oversight. 

We expect to see giant leaps in AI adoption in the coming year, and we will look forward to reporting this to you in next year’s survey. 

Summing it all up 

A couple of the trends have stepped to the forefront this year. Staffing is still in a crisis and will remain there for a number of years. Practices should act now to increase team satisfaction and longevity. Dental insurance companies are not only holding the line and not increasing reimbursements, but in many cases, they are lowering them. Practices must become as productive and efficient as possible and continue to grow so that they outpace the higher overhead. Finally, the newest big jump is in AI. This is an exciting area that will make practices clinically better and far superior in overall performance.  

Although several of these trends present challenges, there is a huge opportunity for practices to increase production and practice income. It is a matter of implementing the right systems, training your team, and continuing to improve the practice every year. 

Reference

1. The state of the US dental economy. American Dental Association Health Policy Institute. February 3, 2026. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/state_us_dental_economy_q42025.pdf

Editor's note: This article appeared in the May 2026 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.