A tight economy and increased competition has led to growing consolidation in the dental industry, with some DSOs being acquired by private equity firms and larger groups.
Many DSO executives predicted these acquisitions in recent years, with some expecting the success of certain DSOs to eventually fizzle out due to a lack of strategy and proper planning to drive continued growth.
“There has been such wild growth with consolidation in the last few years, that I believe we’ll start to see some small groups fail,” NextLevel Founder Gary Kadi told Becker’s. “This is already beginning to happen with groups that are failing to recapitalize. What started as highly successful practices are now struggling to scale because they didn’t have a plan in place and, almost more importantly, don’t have anyone to spot inefficiencies and proactively course correct.”
At the same time, some DSOs have opted to be bought out by investment firms to secure funding for future growth and success.
Greg White, DMD, president and CEO of Lexington, Ky.-based PepperPointe Partnerships, projected that the limited amount of funding available in the DSO field would lead larger DSOs that have access to capital to swallow smaller groups.
“It’s a combination of musical chairs and Russian dolls, you have X number of funding opportunities, and you have X number of DSOs that need the funding,” Dr. White told Becker’s. “As the number of DSOs that need funding outpace the money available, you’re going to see some folks that are not going to be able to have a chair when the music stops. That is going to precipitate the Russian doll phenomenon, which means the larger will eat the smaller.”
Here are 15 notable DSO acquisitions from the last five years:
2025
- Avenel, N.J.-based Eastern Dental Management was acquired by Branford Castle Partners, a private equity firm.
- Dallas-based Smile Doctors acquired myOrthos, an orthodontic support organization with more than 70 practice locations across 13 states.
2024
- New Hyde Park, N.Y.-based Dental365 acquired Legacy Dental Services Organization, a Boston-based DSO with four general dentistry practices and one facial pain practice. It also acquired Ephrata, Pa.-based DSO Dynamic Growth Dental.
2023
- Sarasota, Fla.-based DSO Dental Care Alliance was acquired by Mubadala Investment Co., a sovereign investor based in the United Arab Emirates.
2022
- New Hyde Park, N.Y.-based Dental365 and Premier Care Dental Management acquired Dental Care New Jersey, an eight location DSO.
- Sonrava Health completed its acquisition of Plymouth Meeting, Pa.-based DSO Mid-Atlantic Dental Partners.
- Blue Cloud Pediatric Surgery Centers was acquired by The Rise Fund, an investment company of private equity firm TPG.
- Tempe, Ariz.-based Gen4 Dental Partners acquired Grand Haven, Mich.-based DSO Smile One Services.
- Spark Dental Management acquired Children’s Dental Management along with its 35 locations and five dental surgery centers.
2021
- New Hyde Park, N.Y.-based Dental365 was acquired by private equity firm The Jordan Company through its Resolute Fund. Dental365 later went on to acquire Beacon Dental Health, a Boston-based DSO supporting 14 offices.
2020
- Effingham, Ill.-based Heartland Dental acquired Southfield, Mich.-based Tru Family Dental, a regional dental support organization consisting of 10 Illinois offices and 13 Michigan offices.
- Chicago-based Aspen Dental Management acquired ClearChoice Management Services.
- Private equity company Clairvest Equity Partners acquired 50 percent of Newark, N.J.-based The Childsmiles Group.