Choosing where to get dental implants is one of the largest healthcare purchases most people ever make, and the first fork in the road is a quiet one: do you go to a national chain with a familiar name and a TV budget, or to an independent practice in your neighborhood? The marketing on both sides makes the choice sound obvious. The data tells a more specific story.
Dental Implant Directory maintains a database of more than 19,000 implant providers across all 50 states, including the Google rating and review count for each one. This study analyzed the 18,520 active practices with a Google rating to answer a question nobody in the industry has published numbers on: do patients actually rate chains and independents differently?
Here is what the data shows, brand by brand, state by state, and city by city.
Are chain dental clinics rated lower than independent implant practices?
On average, yes. Independent implant practices average 4.76 stars on Google. The five largest dental chains in the dataset combine for a lower average, dragged down primarily by the biggest name in the category. The gap between independent practices and Aspen Dental, the largest chain in the dataset, is 0.44 stars, which is a wide margin in a category where more than half of all providers score 4.9 or above.
Corporate dentistry is also a smaller share of the implant market than its advertising suggests. Chain locations make up roughly 8 percent of the 18,945 active providers in the directory. The other 92 percent are independent practices, local groups, and specialty clinics.
How does each major implant chain score on Google?
The dataset includes 1,548 locations belonging to the five most recognizable implant and denture chains. They do not perform alike, and the differences are large enough to matter to a patient choosing between them.
Aspen Dental: 4.32 stars across 967 locations
Aspen Dental is the largest chain in the dataset and the lowest rated. Its 4.32 average sits nearly half a star below the independent average of 4.76. Aspen locations do generate high review volume, averaging 690 reviews per location, roughly double the independent average, so the rating reflects a large sample of patient experiences rather than a handful of complaints.
Affordable Dentures & Implants: 4.55 stars across 417 locations
Affordable Dentures & Implants scores 4.55, better than Aspen but still 0.21 stars below the independent average. Like Aspen, its locations collect reviews at high volume, averaging 680 per location.
ClearChoice: 4.75 stars across 108 locations
ClearChoice, the chain most narrowly focused on full-arch implant treatment, essentially matches the independent average at 4.75. Its review volume, 275 per location, is closer to typical independent levels. One ownership note: ClearChoice and Aspen Dental have shared a parent company, The Aspen Group, since a 2020 acquisition. The two are analyzed separately here because patients encounter them as separate brands, and the results justify it. The same parent company operates the lowest rated major brand in this study and one that matches the independent average, which suggests the operating model matters more than the ownership.
Nuvia: 4.95 stars across 52 locations
Nuvia is the outlier in the entire dataset. Its 52 locations average 4.95 stars and 1,372 reviews per location. For comparison, the median independent practice has 217 reviews. That is more than six times the review volume of a typical independent practice, at a nearly perfect average. Whatever Nuvia's process for collecting patient feedback is, it operates at a scale no other brand in the dataset approaches.
Where are corporate implant chains most common?
Chain dentistry is a regional phenomenon, not a national one. In parts of the Southeast, Midwest, and Mid-Atlantic, chains hold a meaningful share of the implant market. Across most of the West, they barely register.
Indiana has the highest chain share in the dataset, with about 17 percent of implant providers belonging to a national brand. Georgia follows at roughly 16 percent, with Maryland and Ohio close behind at about 16 percent each. Florida sits near 13 percent, North Carolina near 13 percent, and Texas near 10 percent.
The West Coast is a different market entirely. In California, chains account for under 2 percent of the state's 1,953 listed providers, the largest state total in the directory. Washington sits under 4 percent, Oregon and Utah near 3 percent, and Montana at 1 percent. Alaska has no chain implant locations in the dataset at all.
For patients, this means the chain vs. independent question is mostly a question of geography. A patient in Atlanta or Indianapolis will encounter chains constantly while searching. A patient in San Francisco may never see one.
Which cities have the highest rated dental implant providers?
Among the 25 US cities with the most listed implant providers, average ratings cluster tightly, but the spread between the top and bottom of the table is still visible to any patient comparing their options.
The highest rated large implant markets in the dataset:
- Dallas, TX: 4.89 average across 38 providers
- Houston, TX: 4.86 average across 68 providers, the most of any US city in the directory
- New York, NY: 4.85 average across 54 providers
- Austin, TX: 4.84 average across 42 providers
- Seattle, WA: 4.84 average across 40 providers
The lowest rated markets among the top 25:
- Wichita, KS: 4.58 average across 44 providers
- Bakersfield, CA: 4.66 average across 37 providers
- Fort Wayne, IN: 4.67 average across 38 providers
- Omaha, NE: 4.69 average across 37 providers
- Indianapolis, IN: 4.71 average across 36 providers
Texas is the standout state at the metro level. Dallas, Houston, and Austin all land in the top five, and San Antonio's 54 providers average 4.80. Patients researching providers in these cities can compare every listed practice on the Houston provider directory and the Dallas provider directory.
Should you avoid chain dental clinics for implants?
The data does not support a blanket verdict, and patients should not read this study as one. The chain average is pulled down almost entirely by the two largest denture-and-implant brands. ClearChoice matches the independent average, and Nuvia exceeds it. Judging a specific clinic by its corporate parent is exactly the kind of shortcut this data warns against.
Chains also solve real problems for real patients. They advertise financing aggressively, they are often easier to get into quickly, and they publish starting prices in a market where most independent practices quote only after a consultation. For patients whose main barrier is cost or scheduling, those are not small things.
What the numbers do say is that the familiar name is not a quality guarantee. A patient choosing a chain location should evaluate it the same way they would evaluate an unknown independent practice: check the specific location's rating and reviews, ask who will actually place the implant, and confirm the surgeon's credentials rather than the brand's. The 4.32 average across Aspen's 967 locations contains locations patients rate highly and locations they clearly do not, and the brand name tells you nothing about which one is near you.
Do Google ratings actually help you choose an implant provider?
Less than most patients assume, and the distribution explains why. Of the 18,520 rated practices in this study, 55 percent score 4.9 stars or higher. Only 4 percent score below 4.0. When more than half the market holds a near-perfect score, the star number alone cannot separate an excellent surgeon from an average one.
That compression is exactly why the chain findings are notable. A brand averaging 4.32 across nearly a thousand locations is not suffering from a few unlucky reviews. It is underperforming a market where a 4.9 is ordinary.
Review volume separates providers more than the star average does. The median independent implant practice in the dataset has 217 Google reviews. Aspen Dental and Affordable Dentures & Implants locations average around 680 to 690, and Nuvia locations average 1,372. High volume at a chain reflects corporate systems that ask every patient for a review. At an independent practice, several hundred reviews usually accumulated one patient at a time over years, which makes the same star average harder to manufacture and, arguably, more informative.
For an individual practice, the useful signal is rarely the star average. It is the content and recency of the reviews, the volume relative to nearby competitors, and how the practice responds to problems. Ratings are one input among several, and they work best alongside credential checks and consultation questions. A full walkthrough of that process is in the guide on how to choose a dental implant provider.
How was this study conducted?
Dental Implant Directory analyzed its database of 19,016 US dental implant providers in August 2026. Of the 18,945 active listings, 18,520 had a Google Business Profile rating, and those practices form the study population. Ratings and review counts come from Google Business Profile data refreshed on a rolling basis.
Chain locations were identified by brand name across five national brands: Aspen Dental, Affordable Dentures & Implants, ClearChoice, Nuvia, and Smile Brands. Aspen Dental and ClearChoice share a parent company, The Aspen Group, but are treated as separate brands because they operate and market separately. All other practices were classified as independent, which includes local multi-office groups. State and city figures reflect providers listed in the directory rather than a census of every dentist in the United States, and the analysis deliberately excludes per-capita comparisons for that reason. Averages are simple means of location ratings, unweighted by review count.
Journalists and researchers are welcome to cite this data with attribution and a link to this page. Requests for custom breakdowns by state, metro, or brand can be sent through the Dental Implant Directory contact page.
The Bottom Line
Independent practices outrate the largest dental chains on Google, and the biggest chain in the country trails the independent average by nearly half a star. At the same time, ratings across the industry are so compressed that the star number alone should never pick your surgeon. Use the data to narrow the field, then verify credentials, ask hard questions at the consultation, and read the reviews rather than counting them. And when you are ready, find qualified providers near you at Dental Implant Directory.
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Ready to find a qualified provider?
Search our independent directory of dental implant providers organized by specialty, location, and credentials.