By Rachel W. Morrissey and Dr. Marko Vujicic
Results from the ADA Health Policy Institute’s quarterly Economic Outlook and Emerging Issues in Dentistry poll are in. This ongoing survey tracks dentists’ views on the U.S. economy, the dental sector, and their own practices. These findings present a snapshot of dentists’ priorities and concerns as they plan for the year ahead. Where available, results for DSO-affiliated dentist responses are highlighted.
In the Q4 2025 poll, dentists were asked to look ahead and identify their top three practice challenges for 2026. While the issues remain similar to those reported at the end of 2024, their ranking has shifted slightly. Insurance woes, specifically low reimbursement levels, emerged as the leading response, cited by more than half (55%) of responding dentists. Low reimbursement rates have long been a pain point, but the intensity of frustration appears to be growing. A similar share of dentists flagged low reimbursement as a major challenge last year, though it did not rank first at that time.
Staffing shortages, the top concern heading into 2025, now ranks a close second. More than half of dentists (54%) still report difficulties with recruitment and retention, but the pressure has eased somewhat compared to a year ago. Among practices currently hiring, challenges remain steep: 88% describe recruiting dental hygienists as “extremely” or “very” challenging, and 70% say the same for dental assistants.
Rising costs continue to round out the top three concerns. At the end of 2024, 45% of dentists anticipated cost pressures in 2025. One year later, that figure remains relatively unchanged at 42%, underscoring the persistent squeeze of inflation and climbing overhead expenses on practice finances. Patient volume is another key concern, with 32% of dentists predicting it will be an issue in 2026.
Dentists’ plans for the coming mirror their top challenges, with hiring at the forefront. Two in five practice owners (42%) expect to add staff in 2026. In response to insurance frustrations, 35% say they are very or somewhat likely to drop participation in certain networks. Fewer dentists plan to make major equipment purchases (24%) or invest in new software (17%), and less than 10% anticipate reducing staff.
A year ago, dentists expressed a generally positive economic outlook for 2025, showing confidence in the months ahead for the dental sector, their own practices, and the U.S. economy overall. In contrast, expectations for the first half of 2026 are more cautious. While a majority remain confident about their own practices (53%), fewer than half feel optimistic about the dental sector (41%), and confidence in the broader U.S. economy is even lower (33%). When asked to share reasons for their skepticism about the overall U.S. economic conditions, rising costs and inflation were cited by more than 80% of respondents.
Dentists affiliated with DSOs anticipate a stronger start to 2026, reporting confidence levels above the overall average across all three measures. Although fewer than half express confidence in the U.S. economy (41%), optimism is higher for the dental sector (57%) and especially for their own practices (70%).
As dentists prepare for 2026, their outlook reflects both resilience and caution. The persistent challenges of insurance reimbursement, workforce shortages and rising costs continue to shape practice strategies. While confidence in the broader economy and dental sector has softened since this time last year, most dentists remain optimistic about their own practices. HPI will continue to track economic confidence among dentists in 2026 and find out to what extent their concerns are realized.
We will continue to monitor these trends and share insights as more data become available. In the meantime, tune into the ADA Chief Economist’s take on future trends in the dental care market at the ADA’s Dental Sound Bite podcast.
