Over the past two decades, DSOs have become a driving force in modern dentistry by providing non-clinical, administrative support that allows dentists to focus on delivering high-quality care. Today, that momentum continues, not through unchecked expansion, but through disciplined, sustained growth that reflects the model’s long-term strength.
As CEO of the Association of Dental Support Organizations, I see firsthand how our members are navigating the changing landscape, not by retreating, but by adapting in ways that position them for continued growth and impact. Recent commentary in Becker’s suggesting the “DSO boom may be over” reflects a misunderstanding of this shift.
Some have suggested growth may slow due to limited practice supply and increased selectivity. But the data tells a different story. Precedence Research estimates the DSO market reached $155.65 billion in 2025 and will grow to approximately $302.54 billion by 2035. The market is also highly diverse and remains unconsolidated. Three of the largest DSOs combined make up just 6% of market share and there is significant growth on the horizon.
More dentists are also choosing to partner with a DSO. According to data from Stax, DSO affiliation doubled from 11% in 2015 to 22% in 2024. Stax estimates that this number will grow to 27% by 2027, and that is a conservative estimate. DSOs also continue to be a popular option among graduating dental school students. In the American Dental Education Association’s Dentists of Tomorrow 2025 report, 32% of seniors said they plan to join a DSO after graduation.
Recent milestones among ADSO members reinforce this trajectory. In 2025, Heartland Dental expanded to more than 1,900 supported practices and completed 11.5 million patient visits. Many DSO’s have advanced innovation through next-generation digital tools and AI-driven diagnostic and staffing solutions, while continuing to invest in clinical education for current practitioners and the next generation of dentists. ADSO members of all types and sizes continue to thrive, particularly specialty DSOs. In 2025, ADSO member Specialized Dental Partners added more than 20 supported practices and 80 doctors to its network. Of course, as with any industry, not all organizations are successful. But any financial woes facing certain DSOs are a reflection of their own unique challenges, not a systemic industry problem.
DSOs also operate in an increasingly complex policy environment. While appropriate oversight plays an important role in maintaining high standards of care, some policymakers continue to misunderstand the DSO model, at times incorrectly conflating it with unrelated concerns in other areas of healthcare. That misunderstanding carries real consequences. Policies that restrict how dental practices operate or how patients obtain care risk limiting access, particularly in underserved communities. Ensuring policymakers understand the distinct, non-clinical role DSOs play is critical to preserving both innovation and access to care.
ADSO’s government relations efforts are a key part of that work. Our team is actively working with lawmakers to ensure oversight supports, rather than constrains, access to care. That engagement is producing real results in states like Maine, Indiana and Colorado, and will continue in the months ahead as ADSO members convene in Washington for our annual D.C. Fly-in to further educate federal lawmakers on the DSO model.
Another common misconception is that DSOs interfere with clinical decision-making. They do not. Clinical decisions are made by dentists, full stop. Corporate practice of dentistry laws in nearly every state prohibit non-dentist entities from owning practices or directing clinical care, and DSOs operate strictly within those boundaries, providing only administrative and business support to dentist-owned practices.
DSO-affiliated providers maintain the same clinical autonomy as those in independent practices, while benefitting from the operational support that allows them to more fully prioritize patient care. When dentists don’t have to worry about handling facility maintenance or marketing, it gives them more time to focus on what they do best: practicing dentistry.
Indeed, as Elevate Dental Partners’ Matt Hendrick tells Becker’s, “Dental practices succeed because of trusted doctor-patient relationships, experienced clinical teams and consistent standards of care.” Recent research shows that the operational support DSOs provide can improve patients’ overall experience and oral health outcomes — with a 2024 study by dental analytics firm Fluent finding that DSO-affiliated providers outperform solo practices in key metrics such as treatment outcomes and patient retention. Fluent also found patients are increasingly choosing DSO-supported practices over solo practices. In 2024, 51% of patients received care from a DSO-supported practice, up from 40% in 2022.
The future of the DSO model will be defined by how it continues to evolve, through new technologies, changing patient expectations and growing demand for access to care. The question isn’t whether DSOs will endure, but how far they can go in helping solve dentistry’s most pressing challenges.
As that future takes shape, ADSO and its members remain focused on what has driven the model’s success from the start: supporting providers and expanding access to high-quality, affordable care.
At the Becker's 5th Annual Future of Dentistry Roundtable, taking place September 14-15 in Chicago, dental leaders and executives will gain insights into emerging technologies, practice growth strategies and the evolving landscape of dental care delivery, with a focus on innovation, patient experience and operational excellence. Apply for complimentary registration now.
