DSO or OSO: What Every Dentist Should Know

By: Bruce Bryen

Once out of dental school, you begin looking at various choices regarding how to approach the job market.

  • Do you begin your career by working at a small, medium, or large dental practice?
  • Is the goal to own a dental practice in the future or to buy into a practice as a partner? 

Knowing which decision to make may develop into a lifelong process, especially if the idea is to be an owner/operator of a solo or partnership practice.

The reason for this statement is that DSOs (Dental Service Organizations) or OSOs (Orthodontic Service Organizations) really do not wish to be involved in a non-clinical approach to those joining it. 

A DSO or OSO has a staff of administrators and needs the clinical side of the practice where it can hire younger people out of school and train them with clinical points. As the younger practitioners get experience, there will be time for them to understand the administrative side of dentistry if they want to do so. 

Advantages of Joining a DSO or OSO


Starting salaries for the service organizations are good with fringe benefits. In addition, there is a benefit to working without the aggravation of the business side of dentistry administration and management

From the standpoint of compensation per hour, working only in the clinical side of the practice will be more lucrative to a new graduate than trying to learn the business side of the dental practice or practices involved with the service organization. The administrative and non-clinical side of the practice will have sufficient staffing and knowledge from those signed up by the DSO or OSO.

Less Complicated

This type of opportunity is designed to offer graduates a full-time clinical career without the encumbrance of learning about administration and running an office.  It appeals to many dental school graduates who want as little complication as possible from the beginning, to retirement. 

Of course, nothing is really easy, but for the graduate who wants fewer complications, the job with the DSO or the OSO sounds less complicated. However, for those who eventually want to own an office, this could be a setback based on the number of years working at the service organization where the new hire learns very little about the internal and non-clinical side of the office workings.

Disadvantage of Joining a DSO or OSO

Lack of Opportunities

For those who wish to own and manage a dental office, start out in a dental office with unlimited potential for learning how to deal with administrative, accounting, and legal issues. Each year of working as an associate will get you closer to being ready for the acquisition of a dental practice. 

In this case, a graduate can take a job at a small to a medium-sized office where there is plenty of opportunities to learn more about the clinical aspects, in addition to how the business side of a dental practice works. 

There are headaches along the way, but there are opportunities to learn about things not really concentrated upon in dental school such as the economics, hiring and firing of personnel, and other items that must be maintained. Unlike the DSO or OSO, you are not concentrating only on the clinical side of the practice.

You may change jobs or go to another small or medium-sized dental office, but you will have received training in administration for whomever you previously worked. You can use this knowledge in the new job and not be behind as the DSO-trained person who has not learned about the non-clinical aspect of a dental practice much or at all from past experience. 

You are now about two to three years ahead of the DSO or OSO-trained person in administrative matters if there is competition for the same job. Understanding this advantage, if you want to own your own practice, is a tremendous edge for a new graduate. In the case of the DSO-trained employee and the employee wanting to eventually own his or her own dental practice, each is learning, but only in specific aspects of the job.

Is a DSO or OSO Right For You?

In summary, working with a DSO or OSO while learning what you need to understand the overall details of operating a dental office will help a dentist to advance to practice ownership. 

The DSO will probably offer an initial higher compensation arrangement, but it will segregate the clinical side of the practice from the non-clinical side and ask for production from the employee. 

The small to the medium-sized dental practice will, by necessity, offer a lower base compensation range to start and probably even base a good part on the employee’s production.  An employee can learn the overall aspects of the clinical and administrative sides of dental practice. He or she will be prepared after a few years to be a buyer of a dental practice if they so desire.

The choice is ultimately up to the dental school graduate, and either way, it will lead to reasonable earnings and an excellent chance to build a good community reputation.

Frequently Asked Questions

What is a DSO in dental?

DSO stands for Dental Service Organizations or Dental Support Organizations.

What is an OSO in dental?

OSO in dentistry stands for Orthodontic Service Organizations.

Photo by RODNAE Productions

Bruce Bryen

Bruce Bryen

Bruce Bryen, CPA/CVA Dental Practice Valuation Analyst, Baratz & Associates, PA