60.6% confident in their practice, 26% not busy enough, 87.7% say hiring hygienists is very hard: HPI's Q2 2026 dentist poll

What it says#

HPI's Economic Outlook and Emerging Issues in Dentistry survey is a quarterly poll of a standing panel of dentists. Invitations go out online in the second half of the last month of each quarter; each wave repeats a core set of questions on the economic outlook and adds new ones on whatever issue is current. For Q2 2026, invitations went to 2,432 panel dentists on June 15, 589 responded (24.3% after removing undeliverable addresses) and 552 of them work in private practice, including large group and DSO practices; the published results are theirs. HPI's page carries an archive of monthly and quarterly reports from January 2022 through Q4 2025 and a note that as of Q1 2026 the panel's results are published only through its State of the U.S. Dental Economy reports, so the Q2 2026 deck, 50 slides with a special section on AI, is the current edition.

Confidence: in Q2 2026, 60.6% of dentists were somewhat or very confident about the economic conditions of their own practice over the next six months, 50.2% about the dental care sector and 39.7% about the U.S. economy. All three rose from Q1 2026 (55.1%, 44.4% and 32.5%) and all three remain below the Q4 2024 peak (67.5%, 62.6% and 56.3%), which HPI describes as a surge and crash in late 2024 and early 2025 followed by a slight recovery. Among dentists confident about the sector, the top reasons were that dentistry is always needed (39.6%), strong demand and busyness (22.6%), a positive economic outlook in general (17.0%), patient demand exceeding the supply of dentists (8.0%) and patient awareness of oral health (8.0%). Among the 25.2% who were skeptical: low reimbursement and insurance pressures (34.7%), patients unwilling or unable to prioritize dental care (24.6%), rising practice costs and inflation (21.2%), a U.S. economic downturn (21.2%) and the rise of corporate dentistry and DSOs (11.0%). HPI sets this against the University of Michigan consumer sentiment index, which it says is at a historical low.

Busyness: over the last three months, 12% of dentists were too busy to treat all patients requesting care, 21% treated everyone but were overworked, 41% treated everyone and were not overworked, and 26% were not busy enough and could have treated more patients. The not-busy-enough share was 32% in Q1 2026, 33% in Q4 2025 and 35% in Q3 2025, and 24% in Q2 2024 when the series shown begins. Among owners accepting new patients, the average wait for an initial appointment was 13.9 business days, up from 12.4 in Q1 2026 and below the 14.7-day peak of Q2 2024.

Staffing: 36.8% of dentists had recruited a dental hygienist in the last three months, and 87.7% of them said it was very or extremely challenging; that share has stayed between 87.7% and 91.7% in every quarter since Q1 2024. For dental assistants, 38.2% had recruited and 68.2% found it very or extremely challenging, down from 77.2% in Q1 2024. BLS data on the same deck put jobs in dental offices up 1.5% over the 12 months to June 2026 after two years of stagnation.

Plans against actions: in Q4 2025 owners were asked how likely they were to do various things in 2026, and in Q2 2026 whether they had. Add staff: 42.3% likely, 39.4% had. Drop out of some insurance networks: 35.0% likely, 23.5% had. Make major equipment purchases: 24.4% likely, 15.8% had. Invest in new software: 16.9% likely, 17.5% had. Reduce staff: 8.6%, 6.5%. Join networks: 3.2%, 5.6%. HPI's reading is that dentists are moving toward their plans and have already passed their intentions on software and on joining networks.

The government data HPI adds for context: consumer dental spending was up 1% over the 12 months to May 2026, an annualized $216 billion in 2026 dollars against $195 billion in January 2020, and over ten years dental spending rose 24% while physician services rose 46% and health care 39%. Since January 2021, prices for dental equipment and supplies and hourly earnings of dental office staff are each up 23%, inflation 27%, and the reimbursement index across all payers 19%; from January through June 2026, supplies rose 0.2%, staff earnings 2.2%, inflation 1.8% and reimbursement 1.1%. HPI calls this the fiscal squeeze and says it continues. On AI, 43.3% of dentists use it for at least one task, most often imaging and diagnostics, 26.4% plan to and 30.3% do not intend to; four in five have no interest in AI for treatment recommendations.

Who it applies to#

The poll describes practicing dentists who volunteered for HPI's panel, and the published figures are the private-practice subset, so an owner is reading about owners like them. HPI states the skew plainly: this quarter's respondents leaned toward ADA members, general practitioners, practice owners, solo or small-group practices, mid- to late-career, white and urban dentists. The recruiting figures apply to the dentists who tried to hire in the quarter, not to all practices; the wait-time figure to owners accepting new patients. Specialists and public health dentists, who once had their own report, are not broken out since Q1 2026. For a multi-location owner, the busyness split and the plans-versus-actions slide are the useful comparisons: whether your schedule and your capital decisions are ahead of or behind the profession's.

What changed#

Against Q1 2026, as the Q2 2026 deck states it: confidence rose in all three measures; dentists were busier, with the not-busy-enough share down from 32% to 26% and the treated-all-not-overworked share up from 37% to 41%; the new-patient wait rose from 12.4 to 13.9 days; hygienist recruiting eased slightly (37.6% recruiting and 90.5% very or extremely challenged in Q1, 36.8% and 87.7% in Q2) while assistant recruiting rose from 36.7% to 38.2% with difficulty down from 69.8% to 68.2%; and dental office employment resumed growth. HPI's caution is that busier dentists and a 1% rise in spending do not square, and it offers three readings: aggregate spending may not map to busyness, traffic may be rising for low-value services, or dentists may be working harder for the same revenue. The publication itself changed at the start of 2026: no more standalone main and specialist reports, one deck per quarter.

Where the source is#

The HPI page Economic Outlook and Emerging Issues in Dentistry describes the panel, invites dentists to join it, links the past panel questions spreadsheet and archives every main report, specialist report and slide deck from January 2022 through Q4 2025. Since Q1 2026 the results are published only in The State of the U.S. Dental Economy, whose page hosts the quarterly decks; the Q2 2026 update is the source of every figure on this page, with its data sources and methods on slides 37 to 50. The decks are free PDFs and copyright the American Dental Association; the poll data behind them are unpublished HPI data.