Most dental practices already clear the mandate — the real question is whether the plan you have still fits the practice you run. An owner-dentist throttled by top-heavy and ADP/ACP testing, or capped by a SIMPLE IRA's lower limits, can usually do substantially better with a safe harbor 401(k), and mature practices can add a cash balance layer on top. The fix starts with a fee and design review of whatever you were sold, which we do as a fiduciary, not a product broker.
Why this industry is different
The mandate treats every employer alike. The payroll realities underneath don't cooperate:
- The owner wants to max personal deferrals but a small, lower-paid census means top-heavy status and failed ADP/ACP tests keep clawing contributions back.
- Hygienist and assistant turnover is high enough that eligibility and vesting design genuinely matter — and rarely got any thought at setup.
- The practice outgrew its SIMPLE IRA years ago, but nobody has revisited it — and a SIMPLE's limits sit well below a 401(k)'s $24,500.
- The plan was sold, not designed — placed by a product broker years ago, never benchmarked for fees, never reviewed for design.
- Nobody is the named fiduciary. Which means, by default, the owner is — personally.
What actually works
The standard fix is a safe harbor 401(k): the safe harbor contribution exempts the plan from ADP/ACP testing and satisfies the top-heavy minimum in most designs, so the owner can defer the full $24,500 for 2026 (plus the $8,000 age-50 catch-up) without the December testing surprise. A cross-tested profit sharing formula can then direct a larger share of employer contributions to the owner, within the nondiscrimination rules. For an established practice with strong, steady income, a cash balance plan layered on top may allow six-figure annual pre-tax contributions — the actual amount depends on age, compensation and the census, and is actuarially determined, not promised.
If you are on a SIMPLE IRA now, timing matters: SECURE 2.0 permits a mid-year SIMPLE-to-safe-harbor-401(k) conversion, but the mechanics have traps. We map the transition before anything is signed.
The SECURE 2.0 credits frequently cover most of the first three years' administration for employers under 50 staff — the formula, worked honestly — and if after the arithmetic CalSavers is still the right answer for your shop, we'll say so: the full comparison · run your own numbers.
On the numbers. Census County Business Patterns does not publish a clean dental-office count for LA County; dental practices sit inside the county's 26,872 ambulatory health care establishments (NAICS 621) alongside physician and allied-health offices — see the health care sector page for the full picture.
By county
This guide is statewide. The county pages go local — where the industry physically clusters, which cities it sits in, and the municipal rules that stack on top of the state mandate.
Where this industry clusters near us
Dental Practices questions
Can I put away more than $24,500?
Often, yes. The $24,500 is only the employee-deferral limit; employer profit sharing on top can bring total defined-contribution additions well beyond it, and a cash balance plan can add a further actuarially-determined layer for an owner in their 40s, 50s or 60s. How much depends on your age, compensation and staff census — it is arithmetic we run for your specific numbers, not a figure anyone should quote you in advance.
Why do I keep getting refunds back from my 401(k)?
Failed ADP/ACP testing: your deferrals are capped relative to what staff defer, and the excess is returned. A safe harbor design removes that test entirely in exchange for a required employer contribution — usually the single highest-value design change for an owner-dentist.
We're a small office — is a 401(k) overkill versus CalSavers?
CalSavers routes contributions to a Roth IRA, with Roth income limits (roughly $168,000 single / $252,000 married MAGI for 2026) that most practice owners exceed — so the state program satisfies your mandate but does little for you personally. For a 4–15 person office the comparison usually turns on what the owner wants to save, and the SECURE 2.0 credits may offset much of a small plan's cost in its first three years.
My associate is paid on production. Does that complicate the plan?
It affects the compensation definition and, if the associate is an owner or becomes one, the contribution allocations. It is handled routinely in dental plan design — but it has to be handled, not defaulted.
A plan designed around dental practices — not around the average employer
We design around the census you actually have — turnover, seasonality, pay structure and all. Fifteen minutes, no charge, and a straight answer.