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The purpose of the quantitative longitudinal study was to analyze income and overhead trends in U.S. dental practices from 2000 to 2024, to better understand the financial factors that influence long-term sustainability. The study is important because it addresses a gap in existing literature by providing a theory-driven evaluation of financial patterns across multiple economic cycles. The sample consisted of national aggregated data representing general dentists and specialists in the United States over a twenty-four-year timeframe. Instrumentation included standardized annual data reports and financial variable tables capturing gross billings, net income, and categorized overhead expenses. Data collection was conducted through the extraction of longitudinal records from secondary professional and governmental databases. Statistical analysis procedures involved trend analysis and descriptive modeling to evaluate the relationship between revenue growth and operational costs. The results indicated that while nominal gross revenues increased over the study period, inflation-adjusted net income remained stagnant due to a significant and sustained rise in operating overhead. It was concluded that rising nondiscretionary costs have compressed profit margins, suggesting that traditional volume-based growth strategies are insufficient for maintaining long-term financial viability. Recommendations for further research include conducting regional sensitivity analyses, category-level expense analysis, and investigating the impact of specific third-party payer reimbursement models on practice sustainability.