TOP OF MIND · ISSUE 01FROM THE EDITORS
FROM THE EDITORS
Dental care is being reorganized. Solo practices are giving way to groups, and a growing share of those groups answer to outside investors. The debate about what this means for patients is often loud and rarely precise.
In this first issue we put the question of ownership to three people who see it from different sides. They do not agree on everything. That is the point. What emerges is a clearer view of what ownership actually changes, for clinicians, for patients and for the long-term health of the profession.
IAn owner-operatorFounder and Chief Executive Officer, Piccadilly Dental Alliance03
IIA health economistIndependent researcher on dental markets04
IIIA new graduateAssociate dentist, three years out of dental school05
The bottom lineWhat the three perspectives share06
Ownership is not a label. It is a rule for who decides.
Top of Mind · Piccadilly Dental Alliance02
TOP OF MIND · ISSUE 01INTERVIEW I · AN OWNER-OPERATOR
i.INTERVIEW I
“Capital is a tool. The question is who holds it.”
GSGagandeep Sandha · Founder and Chief Executive Officer, Piccadilly Dental Alliance
Q1Why did you choose to build a group without outside investors?We wanted clinicians to keep the final word on care. Building our own offices was slower, but it meant every location shared our standards from its first day, and nobody outside the profession could overrule a clinical decision.
Q2Does ownership structure actually change what happens in the chair?It changes who wins the argument when growth targets and clinical judgment pull in different directions. In a dentist-owned group, the tie goes to the clinician — and patients feel that, even if they never see it.
Q3What would you tell a young dentist weighing their first offers?Ask who has the final word on your treatment plans, and who will teach you in your first five years. The salary matters. Those two answers matter more.
Q4What has ten years taught you that you did not expect?That independence is mostly about patience. Building our own offices meant slower years and harder choices. But every office we opened made the next one easier, because it carried the same culture from the start. That compounding is the real return on staying dentist-owned.
The salary matters. Who teaches you, and who decides your treatment, matters more.
Top of Mind · Piccadilly Dental Alliance03
TOP OF MIND · ISSUE 01INTERVIEW II · A HEALTH ECONOMIST
ii.INTERVIEW II
“Scale is not the problem. The question is whose clock it runs on.”
IIHealth economist and independent researcher on dental markets
Q1What has consolidation actually delivered for dentistry?Some real things. Groups can buy supplies and technology at better prices, take payroll and billing off a dentist’s desk, and offer careers that a single practice cannot. Those gains are genuine. What the evidence does not yet show clearly is that patients pay less or receive better care simply because a practice became part of something larger.
Q2Where has it fallen short?Where capital arrives with a fixed timeline. If an investor needs a return in five or seven years, the pressure eventually lands on the schedule: more patients per day, more procedures per visit. Clinicians feel it first, and turnover follows. Patients rarely see the ownership structure, but they notice when their dentist keeps changing.
Q3So does the type of owner matter more than the size of the group?In my view, yes. Two groups of the same size can behave very differently depending on who holds the capital and how long they intend to hold it. The useful question is not how big a group is, but whose time horizon governs its decisions.
Q4What should investors and policymakers watch?Clinician retention and continuity of care. They are slow-moving, hard to fake and closely tied to whether a model is sustainable. If a group keeps its dentists and its patients see the same faces year after year, that tells you more than any growth figure.
Two groups of the same size can behave very differently. Ownership decides which.
Top of Mind · Piccadilly Dental Alliance04
TOP OF MIND · ISSUE 01INTERVIEW III · A NEW GRADUATE
iii.INTERVIEW III
“We are not less ambitious. We want room to grow.”
IIIAssociate dentist, three years out of dental school
Q1What mattered most when you chose your first job?Who would teach me. In school you are supervised on every case, and then suddenly you are on your own. I wanted someone experienced down the hall who would look at a difficult case with me, and an office where nobody would tell me which treatment to recommend.
Q2Do you still want to own a practice one day?Yes, eventually. But not yet. I have a lot of debt, and I want to be a confident clinician before I take on payroll, leases and a team. Ownership is something I am working toward, not something I gave up on.
Q3What would make you leave an employer?Being pushed on production in a way that changes how I treat people. And a team that keeps turning over. When your assistant changes every few months, you spend your days training instead of improving.
Q4What do employers misunderstand about your generation?That wanting flexibility means wanting less responsibility. We want a lot of responsibility, for our patients and for our own growth. We just want to build a life alongside the career, not instead of it.
We want a lot of responsibility. We just want a life alongside it.
Top of Mind · Piccadilly Dental Alliance05
