The Dental Practice Squeeze: What the Numbers Say About 2026

You kept the schedule full, gave your team the raises they earned and paid the supply invoices as they came. Then the EOBs arrived, and reimbursement had not kept up with any of it. If running a practice feels harder than it did in 2021, even on busy days, you are not imagining it, and you are not alone.

Below are the latest numbers from the ADA Health Policy Institute (HPI), the Federal Reserve and ADEA, then what practices are doing about them and where a dental lab can help.

Quick Answer

The squeeze is real and measurable. Since January 2021, dental reimbursement across all payers rose 19% while inflation rose 27%, and supply prices and staff wages rose 23% each. A general dentist's average inflation-adjusted net income fell from $274,198 in 2010 to $215,320 in 2025. Insurance, staffing and overhead top dentists' worries for 2026. The practical responses: phase treatment, review each plan, protect recall and cut remakes.

How Big Is the Gap Between Reimbursement and Costs?

HPI tracks what dentists are paid per visit with a Bureau of Labor Statistics price index covering patients, private insurance, Medicaid and Medicare. From January 2021 to Q2 2026 it rose 19%. Over the same period inflation was 27%, prices for dental equipment and supplies rose 23%, and hourly earnings of dental office staff rose 23%. HPI's summary: "The fiscal squeeze continues."

The gap has not closed this year. From January through June 2026, the reimbursement index rose 1.1% against 1.8% inflation, while staff hourly earnings rose 2.2%.

What Has Happened to Dentists' Income?

The squeeze shows up in take-home pay. HPI puts the average net income of a general dentist at $215,320 in 2025, roughly flat against 2024 but well below the inflation-adjusted $274,198 of 2010.

The cause is arithmetic, not effort. Comparing 2016 to 2020 with 2021 to 2025, average revenue per general dentist rose 1.4% after inflation, expenses rose 4.9%, and net income fell 8.1%. Nonclinical time grew too.

For the patient side, see dental prices then and now.

What Worries Dentists Most in 2026?

Asked in late 2025 for their top three challenges for 2026, dentists put insurance first (55.3%), meaning low reimbursement and denials. Staffing (54.2%) and overhead (41.5%) followed, and 31.8% named keeping patient volume up.

Dropping networks is easier to plan than to do. In late 2024, 40.7% of owner dentists expected to drop some networks in 2025; by year end, 29.3% had. HPI noted that owners largely followed through on their other plans, but not this one. For 2026, 35.0% planned to drop some networks and 23.5% had by Q2, while 5.6% had joined one.

It is not all gloom. In Q2 2026, 50.2% of dentists were confident about the dental care sector and 25.2% were skeptical. The reason confident dentists gave most often: dentistry is always needed.

Why Is Hiring So Hard?

In Q2 2026, 36.8% of dentists had tried to recruit a hygienist in the previous three months, and 87.7% of them called it very or extremely challenging. For dental assistants the figures were 38.2% and 68.2%. The shortage lands on the dentist's schedule: in the ADA's 2024 Trend Report survey, 30% of dentists were doing more hygiene procedures than before the pandemic.

One sign of relief: dental office jobs grew 1.5% in the 12 months to Q2 2026 after two years of stagnation, possibly an early sign that staffing is easing, HPI says, though it is too soon to be sure.

Are Patients Putting Off Care Because of Cost?

Yes, more than any other care. In the Federal Reserve's survey covering 2025, 18% of U.S. adults skipped dental care they could not afford, against 15% who skipped seeing a doctor or specialist. HPI saw the same pattern in 2023: 12.7% of people went without needed dental care because of cost, against 5.2% for medical care.

Plan design adds to it. Dr. Bert Hughes of the ADA Council on Dental Benefit Programs noted in ADA News that many plans still promote the $1,000 annual maximum set some 40 years ago; National Association of Dental Plans figures cited there put 32.8% of in-network maximums between $1,000 and $1,500. CareQuest Institute estimates that about 32 million U.S. adults' dental needs will exceed their plan's maximum, and 46% of adults who reached it said it kept them from seeking more treatment.

How Is the Profession Changing?

DSO affiliation more than doubled, from 7.2% of dentists in 2015 to 16.1% in 2024, and reached 26.5% among dentists up to 10 years out of school. Practice ownership fell from 85% in 2005 to 73% in 2023, and about 1 in 3 dentists (34%) practice solo. HPI reads this as ownership delayed rather than abandoned: most dentists still become owners, just later.

New dentists start further behind: 82% of 2025 graduates in ADEA's survey had education debt, averaging $297,800.

What Is the Squeeze Doing to Dentists?

In the ADA's 2024 Trend Report survey of 560 member dentists, 82% reported some type of major stress in their career, led by insurance reimbursement (55%) and the workforce shortage (54%). Among those with major stress, 58% were considering changing careers or retiring early. That is what a fiscal squeeze feels like from the operatory, not a personal failing.

What Are Practices Doing About It?

Phasing treatment around benefits and budgets

Splitting a plan across benefit years and the patient's budget keeps care moving instead of stalled. Treat what is urgent first, protect the rest with provisionals where needed, and book the next phase before the patient leaves. ADA News also suggests encouraging patients to raise low maximums with their employer's HR department.

Reviewing each plan

Judge every PPO on its own: fee schedule against your real costs, the patients it brings and how much of the schedule it fills. Some plans are worth renegotiating, some worth keeping for volume, and some cost more than they bring. Plan any exit carefully; in 2025 many owners who intended to leave did not.

Protecting the hygiene schedule

With hygienists this hard to hire, an empty hygiene hour is expensive. Prebook the next recall before the patient leaves, confirm by text, keep a short-notice list and track who is overdue.

Making restorations predictable

A remake costs a second appointment and unpaid chair time. In a U.S. study of 3,750 single crowns, 3.8% were remade, but rates ranged from 0% to 42% by dentist, and 58% of dentists rejected none. Remakes follow habits and systems, which can be fixed; see our article on crown remakes.

Using the digital workflow

In the same research network, 99.5% of crowns made from digital scans were clinically acceptable, against 94.0% to 95.8% for tray impressions. If you own a scanner, send every case digitally. If not, read whether an intraoral scanner is worth it.

Where Can a Dental Lab Take Work Off Your Plate?

• Fewer remakes: a lab that reviews each scan before production catches an unclear margin while you can still rescan, not at the seat appointment.
• Clear communication: one call about a margin or shade before design beats an adjustment after.
• Reliable turnaround: when the lab hits its dates, you stop rescheduling seats. Put the seat date on the Rx and call ahead for a rush.
• Less running around: case pickup or shipping labels keep your team off errands. See how to send a case.

How Elegant Dental Laboratory Helps

• Full-service dental lab at 2308 McDonald Ave, Brooklyn, NY: a 7,000 sq. ft. facility with more than 35 technicians, founded in 2007 by Gary Fingerman.
• Every case made in house, with no outsourcing.
• 5 business day standard turnaround on most restorative cases, with rush options available.
• Digital scans reviewed before production. Submit a digital case.
• Case pickup by our own drivers for practices in the New York area (call to confirm availability) and UPS shipping labels for practices anywhere. Pickup and delivery.
• Up to a 7-year warranty on final restorations and up to 20 years on screw-retained implant abutments. See policies and warranties.

Get started or call 877-335-5221. Still comparing labs? Read How to Choose a Dental Lab.

Related Guides

• The Dental Hygienist Shortage Is Not Temporary: What the Data Say in 2026
• Dental Insurance Then and Now: From a 1954 Union Plan to the $1,500 Maximum
• CDT Codes for Dental Lab Work: 2026 Cheat Sheet for Crowns, Bridges, Implants and Dentures

FAQ

How much have dental reimbursements increased since 2021?

The price index HPI tracks for what dentists are paid per visit, across all payers, rose 19% from January 2021 to Q2 2026, while inflation was 27%.

Is dentist income going down?

Over the long run, yes. A general dentist's average net income was $215,320 in 2025, roughly flat against 2024 but well below an inflation-adjusted $274,198 in 2010.

What are dentists' biggest challenges in 2026?

Insurance (55.3%), staffing (54.2%) and overhead costs (41.5%), according to HPI's late-2025 poll.

How many dentists are dropping insurance networks?

In 2025, 29.3% of owner dentists dropped some networks, fewer than the 40.7% who planned to. By Q2 2026, 23.5% had done so this year.

Why do patients delay dental treatment?

Mostly cost: 18% of U.S. adults skipped dental care they could not afford in 2025. Among adults who reached their annual maximum, 46% said it kept them from seeking more treatment.

Reviewed by Gary Fingerman, founder and CEO of Elegant Dental Laboratory, Brooklyn, New York (founded 2007). Last reviewed: September 28, 2026.