By Alayna Schoblaske, DMD

When I was younger, I knew I wanted to be a dentist. I also thought that would mean one specific thing – that I was working in a solo private practice. Now that I have been a dentist for nearly nine years, though, I know that there are dozens of different ways to be a dentist. As you consider what career path you will choose, it’s important to know your options as well as some factors to consider where and how to practice.

Practice Settings

There are at least seven types of practice: private practice, dental education and research, hospital dentistry, dental support organizations, community dentistry, hospital dentistry, uniformed dental services, and public health/health policy. It is important to note that many dentists choose to combine these settings, for example working in a private practice three days per week and teaching at a dental school one day per week. You don’t have to choose just one!

• Private practice – Working in a privately-owned practice where the owner dentist(s) make all the clinical and operational decisions. Some dentists are the owner, while others work as an employee or associate.
• Dental education and research – Working in a dental school or research institute (such as National Institutes of Health or Forsyth) to teach dental students and/or conduct dental research. This may include giving lectures, overseeing simulation clinics, and/or supervising patient care done by students.
• Hospital dentistry – Working in a hospital setting to see patients, most commonly medically or behaviorally complex patients in the operating room. This may overlap with an academic position, or some dentists that work in other settings may occasionally see their patients in the operating room (eg., once per week or once per month).
• Dental support organizations – Working in a clinic where dentists perform clinical care while a contracted entity manages the operational and business aspects of the practice. This is sometimes also referred to as corporate dentistry.
• Community dentistry – Working in community clinics (eg., Indian Health Services or federally-qualified health centers) that serve under-resourced and/or marginalized communities. These clinics often provide social services alongside dental care.
• Uniformed dental services – Working in clinics run by the United States Army, Navy, Air Force, and Public Health Service. One of the most unique aspects of these jobs is that dentists are commissioned, or assigned, to their practice location instead of choosing.
• Public health / health policy – Working for governmental and/or health policy organizations to set public health policy and administer governmental dental programs at a local, state, or national level.

Each practice setting has its own advantages and disadvantages, and there are many variances within clinics of each setting (for example, one FQHC may be very different from another).

Practice Size

Once you have chosen what sort of setting you want to practice in, you may have to decide how many colleagues you have. While some settings – dental schools, for example – necessarily have a large number of dentists working for them, others exist in multiple sizes: solo practice, small group practice, and large group and/or multi-site practice.

• Solo practice – One dentist working in and managing a single-site practice.
• Small group practice – Two to three dentists working in and managing a practice, usually at one location or site.
• Large group practice – Four or more dentists working in the same practice. Some or all may have ownership or decision-making authority. The dentists may work at the same site, or there may be multiple sites.

Generally, as practice size increases, the cost to operate (overhead) decreases along with each dentist’s responsibility to the operation of the practice (eg., being on call for patients, managing equipment repairs, etc.). Of course, with more dentists, each individual dentist’s influence also decreases. If you like to call the shots, you may prefer solo practice, and if you like being part of a larger team, you may prefer small or large group practice.

Factors to Consider

• Do you want to live in the same city where you practice?
• What is your practice philosophy? Do you want to be in setting with lots of technology, or that does a lot of a certain type of procedure?
• What type of schedule do you want? Is this schedule available in the practice setting and size you are considering? (Generally, owner dentists have more control over their schedule.)
• Do you want or require certain benefits (health insurance, retirement matching, etc.)? (Generally, larger practices can offer more robust benefits.)

Author Bio: Dr. Alayna Schoblaske is a general dentist and dental director at a federally-qualified health center in southern Oregon. She is Editor for the Oregon Dental Association, and an active volunteer with the American Dental Association. She is passionate about education and equity, still does Wordle every day, and enjoys getting outside with her husband, Sean, and son, Conner.