Why Are Dentists Going Private in the U.S.?

A few years ago, I sat across from my long-time dentist and asked why he was suddenly no longer accepting my dental insurance. What he told me opened my eyes to a broader shift happening across the country. More and more dentists are leaving the traditional insurance-based model and going private — and it's not just about money. I’ve since talked to multiple professionals in the field and learned firsthand what’s really driving this change. Let me share with you what I’ve discovered.

1. The Administrative Burden of Insurance

One of the biggest complaints I’ve heard from dentists is the overwhelming amount of paperwork and bureaucracy involved with insurance companies. A friend of mine, Dr. Lena — who practiced in Boston for over 15 years — told me she used to spend nearly 20% of her time handling claims, denials, and coding issues. That’s time she wasn’t spending with patients.

1.1. Delayed Payments and Denied Claims

Even after jumping through all the hoops, many dentists face delayed reimbursements or outright denials. Dr. Lena shared that some insurance providers would delay payments for months over minor clerical errors. Eventually, she decided to leave the insurance system entirely and open a private practice where she could focus on dentistry, not paperwork.

2. More Control Over Treatment Plans

In private practice, dentists have the freedom to provide the treatments they believe are best — without needing approval from an insurance company. This is something I didn’t realize until my own dentist explained it to me. He once recommended a crown for one of my molars, but insurance would only cover a filling. He knew the crown would last longer and protect my tooth better, but he was forced to offer a suboptimal option to fit my coverage. It frustrated him as much as it frustrated me.

2.1. Personalized Care Without Compromise

Once he went private, the conversations changed. It became about what was best for my health, not what an insurance adjuster thought was cost-effective. Many dentists I’ve spoken with say this shift has reignited their passion for their work — they get to treat people, not policies.

3. Higher Patient Satisfaction and Time Per Visit

Private dentists can often spend more time with each patient. One hygienist I interviewed mentioned that, under the insurance model, appointments were scheduled every 15 minutes. There was barely time for a thorough cleaning, let alone a genuine conversation. But in the private model, 30–60 minute appointments are the norm, and patients feel heard and understood.

3.1. Building Real Relationships

I’ve noticed the difference myself. My current dentist, who runs a small private clinic, remembers personal details from our conversations and always explains my treatment options in depth. It feels less like a transaction and more like a partnership. That kind of care is hard to deliver when you’re rushing to meet insurance quotas.

4. Financial Sustainability for Dentists

Many patients assume dentists go private to make more money — and while that's partially true, it's more nuanced. Insurance reimbursements haven’t kept pace with rising costs. Overhead expenses — staff, equipment, rent — continue to climb, but payments from insurance companies often remain stagnant or decline.

4.1. Avoiding Burnout

One young dentist told me that his father, also a dentist, discouraged him from accepting insurance at all. "It’s a fast path to burnout," he said. "You end up overworking, underpaid, and exhausted." By opening a private clinic with membership plans and transparent pricing, he was able to maintain financial stability while keeping his stress levels manageable.

5. Freedom to Innovate and Upgrade

Another upside to going private is the ability to invest in better technology and techniques. Without waiting for insurance approval, private dentists can bring in cutting-edge tools — from 3D imaging to laser dentistry — that improve results and patient comfort.

5.1. Offering Modern Solutions

When I had a dental implant last year, my private dentist used digital impressions instead of those gooey mouth molds I hated as a kid. It was faster, cleaner, and more accurate. That kind of innovation often starts in private clinics before insurance-based practices can afford or get approval to use it.

6. Patients Are More Open to Membership Models

Something that surprised me was how many people — myself included — are now willing to pay a monthly fee for dental care in place of traditional insurance. These membership models often include cleanings, X-rays, and discounts on treatments. For many, it’s more cost-effective and much simpler than dealing with premiums and deductibles.

6.1. Clear Pricing Builds Trust

When I joined a dental membership plan, I knew exactly what I was paying and what I was getting. No surprise bills. No "your insurance doesn’t cover that." It made me trust the clinic more because they were transparent from the start. This is becoming a trend that benefits both patients and dentists alike.

7. Shifting Patient Expectations and Preferences

Lastly, patients today expect more from their healthcare providers — convenience, communication, and a higher standard of care. Private practices are often better equipped to meet these expectations. From online booking to text reminders and shorter wait times, these small changes have a big impact on patient loyalty.

7.1. Why This Shift Matters

As patients, we might not always understand why our dentists make certain decisions, but what I’ve learned is this: when dentists choose to go private, it’s usually because they care more — not less — about their patients. They’re reclaiming their profession and putting the focus back where it belongs: on care, not coding.