Cultural alignment and working transparently throughout the entire process are two crucial factors that DSOs need to be looking at when weighing potential acquisitions and consolidation.
Dallas-based Smile Doctors made one of the industry’s largest acquisitions so far in 2025 when they acquired myOrthos, an orthodontic support organization with more than 70 practice locations across 13 states, in March.
Smile Doctors is the largest OSO in the U.S., and now supports more than 550 affiliated locations across 36 states.
J. Hedrick, the CEO of Smile Doctors, recently connected with Becker’s to share insights into the acquisition process, the benefits of acquiring myOrthos and how they navigated challenges.
Note: Responses were lightly edited for clarity and length.
Question: What was the thinking behind the acquisition of myOrthos, and what factors were you considering?
J. Hedrick: I think anytime you’re looking at a big acquisition, you try to figure out, how does it fit with your current platform, and is there cultural alignment? We spent a lot of time meeting with the myOrthos doctors, meeting with leadership to assess alignment from a cultural point of view, and so that was the biggest thing. We wanted to make sure that the way we viewed patient care at the pinnacle and having a doctor-driven organization was aligned with the myOrthos doctors and ethos.
Q: What does the myOrthos network bring to Smile Doctors, and what does it give you that you might not have had before?
JH: It gives us 80 more awesome doctors to take better care of our patients and expand our network. It fills in areas that we didn’t have. We were not very well represented in the Northeast, predominantly because myOrthos was well represented in the Northeast, and so it gave us the ability to expand our footprint. We really added a lot of concentration in states that we didn’t have much of a presence in, and it gives us a good foothold to continue to grow in new areas.
We always want to get better. And so when you bring in doctors who have done very well in a different way, perhaps we’ll be able to quickly learn from them, and I think they’ll be able to quickly see how our doctors do things and pick up some things there. Outside of the geographies that we didn’t have, it really is just bringing in a bunch of thought leaders, really thoughtful, patient focused providers and as quickly as possible, and meshing everyone together in the same organization so that we can learn and grow from each other.
Q: Were there any unexpected challenges that came up throughout the process and how did you navigate through them?
JH: Anytime you do something this big, there are unexpected challenges, or maybe there are expected challenges that you just don’t know what they’ll be. You know you’re going to have some hurdles, you just maybe don’t know exactly where you’re going to hit them. I really compliment the myOrthos legacy leadership and doctors. We worked together in a really transparent and open way. There were things where we had thought that this might not work for us, or this might be an issue that we need to address beforehand. We all wanted this to work, which is great. If you have the same objective in mind, it makes it a lot easier.
There’s always financial hurdles and different challenges and things that come up at all minutes, not just the last minute, but certainly sometimes in the last minute. The team just worked together with the problem solving mentality. I’m really pleased with the effort from both sides and getting to a deal that I think is mutually advantageous for everybody.
Q: What have been some takeaways that you’ve learned at Smile Doctors while going through this whole process?
JH: Gain alignment up front. Make sure there’s alignment between the goals of the organization, the goals of the individual teams and the goals of the employees. Really make sure that you create alignment and that there’s great, clear, transparent communication as much as you can all the way throughout the process. We were fortunate to be able to talk to the doctors early. If we did this again, I might even try to do it even earlier.
More planning is certainly better than less planning. We’ve learned that you can spend a lot of time on things that at the end of the day end up providing a little bit less importance. The things that really end up being incredibly important, like that alignment between the providers and the organization, and there are some things where you’d spend a little bit less time on.
