Private equity groups have begun to play a much larger role in dentistry over the years as the industry continues to consolidate and practice owners face growing financial pressures.
Several DSOs gained private equity funding in 2025 to fuel future growth and network expansion, including Blue Cloud Pediatric Surgery Centers and Motor City Dental Partners. Investors specifically targeted oral surgery MSOs due to the field’s growth opportunities and history of success. They’ve also begun to turn their attention more toward smaller DSOs.
Additionally, the percentage of dentists affiliated with private equity has nearly doubled over the course of six years. Amid this growth, private equity investors are seeing more challenges as states consider legislation to limit their power. California recently passed a bill that expands the attorney general’s powers to take action against corporate entities that interfere with medical and dental practices, including patient care decisions and coding and billing procedures. Pennsylvania also passed legislation to expand the attorney general’s authority to review and potentially block healthcare mergers and acquisitions.
Four dentists recently spoke with Becker’s to discuss their predictions for private equity’s role in the dental field this year.
Note: Responses were lightly edited for clarity and length.
Gary Boyajian, DDS. Owner of Nationwide Dental Practice Brokers: I think private equity will always be involved in dentistry to some extent because over the past few years interest rates have risen, therefore private equity is more selective in their choice of dental practice, and many of them are insisting on a five-year minimum that the doctor must stay on as an employee. The five-year request is challenging, and I’m getting some resistance from
dental sellers. Secondly, it’s become apparent that certain smaller DSOs one year post closing and beyond are having some trouble delivering on their promises of release of the holdback monies, and this is circulating among the dentists in a somewhat negative way.
In addition, very few DSOs are giving more than 65%-70% cash at close. This is creating some apprehension among the dentists who are sellers, so I’m noticing some pushback there. In summary, private equity will play a role, but I don’t believe that role will increase higher than the present level of activity.
I feel there will always be opportunities for private equity DSOs to purchase a dental practice and maintain a presence in the dental ownership space. Private equity offers a higher sale price than the average private dental buyer. They provide great employment opportunities with excellent benefits and the opportunity for extra bonus payments upon recapitalization that the DSOs do every three to five years. Therefore, the private equity DSO certainly provides a great opportunity going forward with dentists who have larger practices and a willingness to stay on as an employee.
Trent Glaser, DDS. Powers Dental Group (Colorado Springs, Colo.): PE groups will continue to be a major player in dentistry in 2026. They will continue to exploit dentistry by taking advantage of what our education was lacking: business management. They will continue to acquire practices and be an opportunity for long-term practitioners as an exit strategy.
I believe PE groups that allow their practitioners to still maintain full autonomy like MB2, which is more of a partnership than a true DSO, will be the model that stands out in the future.
The biggest hurdle with all the PE groups I see is trying to incorporate new dentists or associates into the mix. The new dentists didn’t get to transact through original ownership. How quickly can you get them acclimated to be your new practice owners? How can you make them as profitable as possible without watching them leave to open their own offices? Is there going to be a PE group that sees this and begins to incorporate and attract young dentists through dental school scholarships or paybacks, similar to what Kaiser Permanente does for their physicians?
All in all, they face the same challenges all dentists face: very low and almost unchanging insurance reimbursements, increasing staff salaries and increasing supply costs.
Krista Kappus, DDS. Fitch Mountain Dental (Healdsburg, Calif.): I believe private equity will continue to consolidate dentistry, with smaller firms merging into larger, more established organizations. As these entities gain influence, they are likely to increasingly dictate treatment options, material selection and operational decisions. Over time, this consolidation may also contribute to reduced job opportunities and downward pressure on salaries across the profession.
Robert Trager, DDS. Dentist at JFK Airport (New York City): Since interest rates have fallen over the past year and will probably continue, there will be much more money available for PE firms to invest and M&A. There will be scrutiny in accruing high dental practices that will allow ROI. One can see what has been happening to the medical profession where one cannot find a solo practitioner at least in the New York area. Just about every primary care provider and/or specialist is connected to Langone or Northwell hospitals. Within 10 years, due to retirements and debt-ridden graduates, there will be about 15% of solo dental practitioners left. Most dental graduates will be working for a dental corporation. If they ever anticipate going into a solo or small group practice, they will not have the business skills of management, advertising, insurance, marketing and other indices that will make for a successful business acumen. You will be nothing but a statistic to be reviewed as a production capability for overall success. My suggestion to those who would like to have their own solo practice is to learn as much as possible in the environment you are in to be able to run a successful solo practice.
