Here are seven statistics and trends showing how the DSO landscape is evolving in 2026:
1. DSOs accounted for 30 of 51 dental transactions that took place during the third quarter, including 16 transactions made by private equity-backed DSOs.
2. Dental consolidation has made its way up the food chain this year as some of the biggest organizations have gone shopping for other DSOs, from a Canadian company’s entry into the U.S. market to a three-way merger that created one of the country’s largest networks.
3. DSOs that are looking to buy are scrutinizing practices’ financials, operations and projections more intensely, as the supply of “premium” practices is tight, according to a report from TUSK Practice Sales. The top reasons why DSOs are walking away from deals include provider risk and clinical continuity, declining financial performance and reimbursement exposure.
4. DSOs are facing a new challenge this year that could threaten their operations and ability to grow: increased scrutiny and oversight from providers and legislators. Several states have introduced legislation to limit corporate entities’ ownership of dental practices and their influence on clinical decision-making. Driving these initiatives is increased scrutiny from clinicians, patients and legislators seeking to protect patient care and clinical autonomy.
5. DSO affiliation among U.S. dentists has more than doubled since 2015 — from 7.2% to 16.1% — as practice ownership has dropped to a 20-year low of 73%, according to TUSK Practice Sales’ Q4 2026 Dental Market Report.
6. Park Dental Partners remains the only publicly traded U.S. DSO after its December 2025 IPO. TUSK expects that DSOs preparing for recapitalization or an IPO will actively seek to partner with high-performing practices to strengthen their EBITDA before going to market, creating near-term acquisition opportunities for well-run practices.
7. More than 20 PE-backed dental platforms are seven or more years into their hold periods — setting up a wave of DSO recapitalizations, secondary sales and potential IPOs that is expected to reshape the acquisition landscape over the next 12 months.
