How DSOs Can Survive and Thrive in the New Dental Gig Economy

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Back in January, the American Dental Association surveyed 1,883 dentists as part of its “Economic Outlook and Emerging Issues in Dentistry” poll. Out of 1,780 responses, 91 were from DSO-affiliated practices. 

Although not a large sample size, the findings were troubling but unsurprising.  Over half of the DSO-affiliated dental practices said they could not fill their appointment schedule 100 percent due to vacant staff positions. Specifically, DSO-affiliated respondents estimated that their chairs were 78.5 percent full.  Which is not optimal for profitability or the patient’s experience of accessing care.

The current state of the dental job market is generally the result of the COVID-19 pandemic. Post-pandemic, many dental team members – especially hygienists – began re-evaluating their careers and recalibrating their work/life balance. 

It’s been estimated that after soul-searching, a whopping 50% of hygienists left the clinical workforce. Many willing to return to work would only do so after certain terms and conditions regarding salary, flexibility, company culture, and other factors were met.  

These are the new rules of dental employment established by an empowered workforce. Moreover, many candidates in the post-pandemic dental workforce no longer feel that full-time employment is the only career path. More are taking on temporary assignments before committing to a single employer. This may be especially true for dental professionals who have never worked for a DSO.

DSOs need to embrace the dental gig economy to help fill their chairs, boost their bottom lines, and provide their patients with convenient, responsive care. 

The solution: Cloud Dentistry – a digital employment app that connects dental offices with dental professions via its on-demand booking and messaging features. can help DSOs survive and thrive in this new job marketplace. Here’s how:

  • Enabling more options for DSOs to meet more candidates in a much more reliable, quicker means. This is  a prect example of  “the more, the merrier.” It’s a true numbers game out there. 
  • Using Cloud Dentistry enables DSOs to find, schedule and manage payments for a fleet of back-up W2 RDHs “on-call” ready to come in for staff relief. 
  • DSOs can highly benefit from the savings of admin HR and recruitment man-hours. Cloud Dentistry has proven to reduce teams as big as six to one full-time recruiter, allowing the rest of the team members to focus on other HR processes. 

Another challenge facing DSOs is the high rate of associate churn. Some anecdotal estimates state that the average tenure of a DSO associate is 18 months. This may be due to newly-graduated dentists using DSO employment as a steppingstone to own a practice, former private practice dentists not being able to adjust to the DSO business model, etc.

Whatever the reason for associate churn, DSOs must prepare  by having an updated bullpen of candidates that they can tap into when needed. Cloud Dentistry makes this easy.

First of all, most graduating students have a prejudice against meeting DSOs in traditional ways, such as over lunch n’ learn presentations at their campuses. They are more receptive to conducting their own search on an agnostic platform such as Cloud Dentistry.

One hygienist who was exploring DSO employment opportunities told me, “ I was dreading showing up to another boring lunch n’ learn pitch from another DSO offering a sign-on bonus, but CLOUD Dentistry was so informative, and your platform doesn’t get in the middle, which allowed me to work out my own arrangements with the DSO.

Not only do many graduating students have misgivings about what they regard as “being poached” by a DSO, they also have a bias towards working through an employment agency or recruiter. 

Both typically have a middle-man markup fees that inflate the employee’s rate and/or require the signing of a contract that has to be making the employee/employer relationship more challenging to nurture. 

One of the most common contract “gotchas” is a buyout fee which must be paid if the temporary employee decides to enter full-time employment with the DSO. 

Cloud Dentistry does not take commissions or levy buyout fees – these policies are win-wins for candidates and DSOs alike.  It should be noted that many silent quitters may ghost a DSO if they feel that the 30-40% markup most staffing agencies take is too egregious. This disincentivizes the employee to continue. 


In today’s post-covid world, DSOs are faced with a job market commanded by the job-seekers of the workforce. It’s a sellers’ market. Job candidates will not tolerate being handcuffed from making their full earning potential, when they can do better by negotiating directly for themselves and retaining the difference in compensation that the staffing agency received. “If the DSO has the budget to pay a recruiter, they have the budget to pay me more if I negotiate independently,” may be what they are thinking.

The best advice I have for DSOs challenged with recruiting and retaining qualified team members, is to connect with candidates directly by using a no commission, no-buy-out dental employment marketplace such as Cloud Dentistry. In invite you to try it with one location and compare it to traditional efforts such as job fairs and lunch and learns.

If you are ready to see how Cloud Dentistry can be your hiring solution, the next step is easy! You can create a free account to see the available professionals in your area simply by visiting to sign up. 

About the Author: Darius Somekhian is The Head of Strageic Partnerships for Cloud Dentistry, a digital marketplace for dental practices & professionals to connect for work hire. He is also the co-founder of Pair Dental, the agency which pioneered the traveling  in-house dental specialists model. Contact Darius at