10 years without a financial sponsor.

What we have learned about capital, culture and clinical judgment — and why the next decade belongs to groups that dentists own and lead.

To our clinicians, our teams, and the friends of Piccadilly Dental Alliance —

This year marks 10 years since a small group of dentists decided that the people who practice dentistry should also be the people who shape where it goes. It is a good moment to explain what we have learned, what we believe, and what we intend to do next.

i. The bet we made in 2016

We started with a frustration every dentist knows. Too much of a clinician’s day goes to things that are not dentistry — payroll, supply orders, staffing gaps, billing disputes. Our answer was not to hand the business to someone else. It was to build an organization of our own, owned by dentists, that could carry those burdens so our clinicians could focus on patients.

We made a second decision early that has defined us since: we would grow by building our own offices, not by acquiring other people’s. That choice made us slower in some years. It has also made us one organization, rather than a collection of practices that happen to share a logo.

ii. What ownership protects

Ownership structure is not an abstraction. It decides who has the final word when a treatment plan, a staffing model or a growth target is debated. In our case, that word belongs to clinicians. We believe that is the single most important safeguard for the quality of care — and, over time, for the value of the business itself.

“The people who practice dentistry should be the people who decide where it goes.”

None of this makes us opposed to capital. Capital is a tool, and good tools matter. But we have learned that the order of decisions matters more: the model has to work for patients and clinicians first. When it does, the economics follow.

iii. Why we build rather than buy

Every PDA office opens with the same systems, the same standards and a team we hired and trained. That consistency is visible to patients in the chair and to clinicians who move between our locations. It also gives us something rare: a clean record of how an office performs from its very first day. This year, for the first time, we are publishing that record as the PDA Index.

iv. The workforce question

The defining challenge for dentistry over the next decade will not be demand. It will be people. New graduates carry significant debt, want flexibility, and are wary of employers who treat clinical judgment as a production variable. We think they are right to be wary.

Our response is practical: mentorship from senior clinicians from day one, a visible path from associate to clinical leadership, and an operating team that removes the administrative weight that drives good dentists out of the profession.

v. Where dentistry goes next

Three forces will shape the years ahead. Consolidation will continue, and the question of who owns dental care will matter more, not less. Technology — digital imaging, AI-assisted diagnostics and better practice systems — will change what a single clinician can do in a day. And the link between oral health and overall health will draw dentistry closer to the rest of medicine.

Organizations built for the long term, with clinicians in charge, are best placed to adopt these changes carefully and to earn patients’ trust as they do.

vi. Our commitments for the next decade

10 years in, I am more convinced than when we started that dentists can build something lasting on their own terms. Thank you to every clinician and team member who has proven it.