Sustainability is a word we hear tossed around a lot in healthcare boardrooms, yet it’s often misunderstood. In the context of a private dental practice or a growing DSO, sustainability isn't just about keeping the lights on for another month. It’s about the heartbeat of the organization, the rhythm of patient care, the strength of the clinical culture, and the predictability of the bottom line.

At Arthur Marshall, we’ve spent years at the intersection of talent and healthcare strategy. We’ve seen general dentistry practices hit a ceiling because they keep referring specialty procedures out, and we’ve seen them grow when they create a smarter path to bring those services in-house. When you’re looking at untapped demand for oral surgery, endodontics, orthodontics, or periodontics, the pressure to make the "right" hire can feel enormous.

But here is the central question we must ask ourselves: How do you expand specialty care without taking on permanent-hire risk too early?

We believe the answer is a more strategic use of locum tenens in the dental space. Not as a Band-Aid. Not as a sign of instability. But as a deliberate way for a general dentistry practice to test, validate, and scale a specialty line before committing to a full-time specialist.

Locum Tenens as a Growth Strategy, Not Just a Coverage Strategy

Let’s be honest: when most people hear "locum tenens," they think emergency coverage. A last-minute fill. A short-term patch. And yes, it can be that.

But in dentistry, there’s another use case that deserves more attention.

A general practice may know it has growing demand for specialty production, but not enough consistent volume—yet—to justify a full-time endodontist, periodontist, oral surgeon, or orthodontist. That’s where a temporary specialist can become a strategic bridge. Instead of making a permanent hire too early, the practice brings in a specialist on a part-time or temp basis, captures revenue that would otherwise leave the building, and measures whether that service line has enough traction to scale.

That’s the point.

Used this way, locum tenens helps reduce the initial risk of expansion. You’re not locking yourself into a full-time compensation structure before the patient flow is proven. You’re building a runway first.

When Temporary Specialty Coverage Actually Improves Access

If you’re running a private dental practice, a group practice, or a DSO-backed platform, you already know this tension: patients need specialty care, but hiring full-time too early can create financial drag. At the same time, referring everything out creates leakage, slows treatment acceptance, and makes your practice less comprehensive in the eyes of patients.

So what’s the middle ground?

For many practices, it’s bringing in a specialist on a temporary basis while demand is still taking shape. Maybe your GP team is diagnosing enough endo cases to support one or two specialist days per month. Maybe one of your offices has enough oral surgery need to reduce outside referrals, but not enough to support a permanent surgeon five days a week. A locum specialist gives you access without overcommitment.

And for patients, that matters.

In dental settings, convenience and continuity are closely linked. If a patient can stay within the same practice for diagnosis, case presentation, and specialty treatment, case completion tends to improve. The specialist may be temporary, but the care pathway feels more connected. That’s a big deal for busy families and patients who value convenience, trust, and fewer scheduling handoffs.

Done right, temporary specialty staffing doesn’t weaken continuity. It can strengthen it by keeping more care in-house until the line of business is mature enough for a permanent specialist.

The Math of Testing a Specialty Line Before You Go All In

We aren't sounding alarms for drama, we’re looking at the economics. Let’s talk about the risk curve.

When a general dentistry practice refers specialty procedures out, it’s not just losing production on a single case. It may be losing downstream treatment, restorative follow-up, patient loyalty, and future referrals. But hiring a full-time specialist before the volume is there can create a different kind of problem—payroll pressure without enough chair demand to support it.

This is where locum tenens becomes a strategic financial tool.

A temporary specialist allows you to test real demand before making a permanent commitment. You can evaluate:

• procedure volume
• treatment acceptance rates
• scheduling consistency
• payer mix
• equipment and operatory utilization
• referral recapture from your existing patient base

That kind of trial period matters. It gives you actual production data instead of wishful forecasting.

And when the numbers support it, you move with confidence. You’re no longer guessing whether your practice can sustain a full-time periodontist or oral surgeon. You’ve already built the beginning of that line of business. In that model, locum tenens isn’t competing with permanent hiring—it’s preparing the ground for it.

At Arthur Marshall, we help practices think through both sides of that equation. Sometimes the right answer is a retained search for a permanent specialist today. Sometimes the smarter move is temporary specialty coverage now, followed by a permanent hire once the volume proves itself. The key is being intentional.

Temporary First. Permanent When the Timing Is Right.

You may already be feeling this shift: practices are getting more disciplined about how they scale. Not slower. Smarter.

Bringing in a temporary specialist first gives your team time to answer practical questions before you rush into a permanent offer:

• Is there enough monthly case volume to support this specialty?
• Which procedures are patients most likely to keep in-house?
• Does your current staff know how to schedule, assist, and present these cases well?
• Will this new specialty line fit your culture and workflow?

That learning period has value.

Because here’s the thing: a permanent specialist hire is still the long-term goal for many practices. Once demand is consistent, culture fit becomes even more important. At that point, you’re not just hiring for credentials. You’re hiring for someone who can build referral trust with your GPs, mentor the team, and help shape a sustainable specialty department inside the practice.

That’s a very different decision than "we think we might have enough cases."

And it’s a better one.

The Arthur Marshall Difference: Moving Beyond the Transaction

We’re not just watching the market: we’re building it. We know that the traditional "post and pray" method of recruitment is dead. If you’re just putting a job ad on a generic board, you’re competing with every other practice in the country for the same 5% of active job seekers.

Our approach is different. We are the only full-service retained recruitment firm that focuses on the long-term success of the placement. We don't just want to fill a seat; we want to fill it with someone who will still be there five years from now.

This is why we offer our 6-month guarantee.

We’re so confident in our ability to match the right provider to the right culture that we put our skin in the game. If the placement doesn't work out within the first six months, we do the search again. It’s that simple. We believe in the quality of our our services because we’ve seen the results across thousands of successful placements.

A Note for Growing Groups and DSOs

For our partners in larger group practices and DSOs, this strategy can be even more powerful. If you’re evaluating where to expand specialty access, a temporary specialist model can help you test one location, one region, or one service line before rolling out a broader permanent hiring plan.

That matters operationally—and financially.

You can identify which sites have the strongest patient demand, which teams are best equipped to support specialty days, and which service lines are most likely to become profitable. More importantly, you can make expansion decisions based on real production, collections, and utilization data instead of assumptions.

That’s the business case.

For private groups and DSO managers, temporary specialty coverage can help protect margins, reduce referral leakage, improve same-patient revenue capture, and build a stronger story around practice growth. In the right environment, it can also support valuation by showing a more mature, diversified service mix without forcing a premature full-time hire.

And once the volume is there, you’re in a much better position to recruit permanently. You’re no longer selling a concept. You’re offering a proven line of business, an established referral base, and a clearer path to long-term success.

Let’s Talk About Your Road Ahead

Choosing between temporary and permanent hiring isn’t always an either/or decision. In specialty dentistry, the smartest growth strategy is often both—just in the right order.

Locum tenens can help you open the door. A permanent specialist can help you build the room.

If your general dentistry practice is seeing enough specialty demand to start asking bigger questions, that’s usually the signal. You may not need to jump straight into a full-time hire. You may need a thoughtful interim step that lets you validate the opportunity, keep more care in-house, improve profitability, and scale with less risk.

We invite you to look at our success stories and see how we’ve helped practices grow with the right talent strategy. Whether you’re exploring temporary specialty coverage, planning for a permanent specialist, or trying to understand what your production data is really telling you, we can help.

Sustainability isn't something that happens by accident. It’s a choice. And in this case, it may be the choice to grow carefully first so you can grow confidently later—with a stronger business, a more valuable platform, and fewer expensive hiring mistakes.

If you’re ready to expand specialty care without overcommitting on day one, let’s talk. We’re here to help you find the right path—and the right person—when the timing is right.