It is becoming more competitive, no question, but we need to look at it from a macroeconomic perspective.  The dentists still make close to a 40% margin and with the bankruptcy rate of under 2%, Canada is probably the best market in the world to be a dentist.  In the past dentists were able to be very successful with the "if you build they will come approach".  In the big cities the dentists need to approach the idea of opening their practice the same way as any other business owner.  In a more competitive industry there will be some dentists taking short cuts while others will work harder to provide a greater overall patient experience. At the end of the day, the dentist who takes care of their patients will do well.