With the continued shift in the dental landscape and the rise of dental service organizations (DSOs), it can feel like every practice owner is “selling out.”
The DSO path has gained momentum largely because of the strong financial offers many doctors are receiving. But a successful transition isn’t defined by multiples alone. It’s about partnership alignment in working alongside a group whose culture, decision-making, and long-term vision complement your own.
Understanding the Landscape
Dentistry remains one of the largest and most fragmented healthcare sectors in the United States. Unlike pharmacies or hospital systems, it has historically resisted corporatization, leaving thousands of independently owned practices.
According to the American Dental Association’s Health Policy Institute, there are roughly 160,000 general dentists in the U.S., representing a market value north of $180 billion. While consolidation is accelerating across both general and specialty dentistry, private equity-backed DSOs still control only 20-25% of the market. Private practice is far from gone, but buyer demand and private equity interest continue to grow.
The Consolidation of Consolidators
The DSO movement began in general dentistry but has now expanded meaningfully into specialty platforms as well. Many groups focus on acquiring general practices within a defined geography, whether it’s a few neighboring states or a specific region, while a smaller percentage function at a national scale.
DSO buyers especially focus on the practice’s geography, practice size, payer mix, and long-term growth potential, which all directly influence valuation and deal structure.
A notable recent trend is the consolidation of consolidators. In 2025, Heartland Dental acquired SMILE Design’s 50-60 locations, reflecting the growing number of DSO-to-DSO transactions as larger platforms strengthen scale and capital position.
The Personal Side of Selecting the Right Group
The corporate route can be the right fit for your practice transition. But today’s market requires deeper evaluation, especially as consolidation accelerates.
Not all DSOs are built the same. Leadership, financial stability, and integration capability can affect a doctor’s day-to-day experience. How a group absorbs and supports acquired practices influences culture, clinical autonomy, resources, and long-term support. Choosing the right group isn’t just a business decision. It’s a personal one.
The Best Deal is More Than a Number
Some advisory firms promise the highest price. But focusing solely on valuation is like promising the biggest cake in the world without considering whether it tastes good. Size alone doesn’t determine quality.
The best deal considers:
- Structure and how the deal is built
- Culture and daily work environment
- Strategic alignment with your long-term goals
- Day-to-day partnership experience after the transaction
- Risk and timing relative to your personal situation
Most DSOs require doctors to remain in the practice for up to five years post-transaction. You’re not just choosing a buyer, you’re choosing a partner. When your professional future is tied to that relationship, fit matters as much as price.
“Five years is a long time to be in an unhappy marriage. A DSO partnership is a real commitment. Alignment determines whether those years energize you or exhaust you.” — Brian Christensen, CFA, Chief Development Officer at 7 Pillars
We advise owners to speak directly with doctors currently partnered with a DSO. Ask real questions and understand what life truly looks like after the transition.
Choosing the Right Partner for Your Next Chapter
Maximizing value matters, but true value extends beyond the headline number. It includes structure, equity participation, timing, risk, and alignment with your long-term goals.
At 7 Pillars, we guide practice owners through every dimension of the process so they can make confident, informed decisions. Selling your practice isn’t simply a financial event, it’s a defining moment that impacts your future and legacy.
Whether you’re considering a strategic partnership or simply exploring what your practice may be worth, now is the time to start the conversation.