DSO activity continues to make a comeback this year with the support of private equity investors and rising patient demand.
Barry Lyon, DDS, director of provider recruiting and onboarding at Dental Care Alliance, recently spoke with Becker’s about current trends in dental M&A.
Editor’s note: This Q&A is part of a weekly series featuring Dr. Lyon focused on topics in the dental industry and DSO field. The views expressed are those of Dr. Lyon and do not necessarily reflect those of Dental Care Alliance.
This response was lightly edited for clarity and length.
Dr. Barry Lyon:
DSO M&A activity boomed in 2021 and early 2022 before slowing down in 2023, 2024 and into early 2025. The increased costs of capital, enhanced due diligence and unrealistic seller expectations accounted for the slow down. However, M&A activity has rebounded in 2026 with a flourish.
Dental services consistently rank among the top healthcare subsectors by transaction volume, with M&A activity in this sector accounting for more than 100 transactions annually for the past several years. This activity has been driven largely by add-on acquisitions by established platforms, while private equity-back DSOs continue to invest in the market with confidence.
Multi-state DSOs are acquiring smaller regional groups, often paying 5x-9x EBITDA for profitable practices. Pediatric dental practices remain particularly attractive due to predictable patient flow and strong reimbursement margins. DSOs are placing emphasis on integration, retaining dentists, streamlining operations and standardizing clinical processes to ensure growth doesn’t compromise care quality. From pediatrics to orthodontics, DSOs are aggressively expanding their footprints, backed by private equity and strategic investors.
M&A activity is expected to remain strong over the next several years due to an increase in PE investment, an aging dentist population seeking exit strategies and rising patient demand. With valuation opportunities being strong, it may be the best time for private practice owners to make hay while the sun shines.
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