Many DSOs leaders are feeling optimistic about the opportunities for continued growth, whether it be through acquisitions, de novo offices or same-store growth.
Three leaders recently joined Becker’s “Dental + DSO Virtual Event” to discuss what’s next for the DSO field.
Editor’s note: Responses were lightly edited for length and clarity.
Question: How would you describe the current state of the DSO market? Are we still in a growth phase, or is consolidation slowing down?
Jeremy Jonckheere. Vice President of Strategic Payer Partnerships at PDS Health (Henderson, Nev.): A hundred percent a growth phase. No question. Nobody is more than a couple percent of the market. I would point out that it’s not just consolidation driving the market at this stage. It’s expansion through same-store growth. It’s de novos that are gathering market share. So, the growth is coming from a number of different areas. If consolidation is still happening, it might be happening a little bit at a smaller scale, and if it is slowing down, it’s probably less about appetite and more about the valuation or the labor force. The scale just has to make sense for the systems, the policies [and] the administration. The big number that I look at when I’m thinking about all of this is that about one-third of all new graduating dentists are going to join a DSO coming out of school. Beyond that, about one-third of all dentists are thinking of retiring in the next three to six years. Those two numbers alone say the industry is just going to continue to grow like crazy.
Zach Cherry. Vice President of Operations at Heartland Dental (Effingham, Ill.): The market’s growing, which is fantastic. At Heartland, we’re just focusing on more strategic, value-driven growth. It just means we’re thoughtful about folks we affiliate with. We focus more on the partnerships that align from a cultural standpoint and a clinical standpoint, and not just geography. There are still a lot of opportunities to scoop up. Both our de novos and our affiliations have been on a consistent and strong growth trajectory year over year, and so we’re going to continue to grow. We feel super optimistic about that because we know communities need care. We just want to be selective.
Q: Many DSOs have begun to be more selective and strategic about who they affiliate with in recent years. What do you think has led to this shift?
ZC: I think there’s an excitement around growth. I love seeing us going to communities we haven’t been in before, and we know that there are a lot of patients that have needs, but again, it’s always good to pause and slow down and say, do these folks who we’re meeting match our values? At Heartland, we have super strong core values that we eat, sleep and breathe, and we want to make sure the folks we’re adding to the family match up to those.
Jeffrey DeBellis. COO at MAX Surgical Specialty Management (Hackensack, N.J.): There is some evidence and some historical news about some of [the] enterprise organizations that have stalled or run into a little bit of difficulty on the heels of maybe being too exuberant in the use of capital in acquiring partners. Our approach at MAX has been very different from the start. When we defined our strategy, we were very specific about establishing a strong geographical presence in the Northeast. That’s not because we’re not interested in partnering with great partners in other places, but we feel very strongly at our size that we need to be committed to being able to provide exemplary service and be close to the partners we value.
Relative to just the larger growth discussion, I think everybody has experienced some challenges in the first half of 2025 as a product of the economic environment, but I have been speaking to a lot of people here on the investor side or even just peers in the industry who feel really strongly that we’re looking down the runway of some exciting stuff happening in the next 12 months across the entire dental profession, from either large consolidations or continued M&A activity, or reinvestment in places where brands can expand. I think our entire team and our investment group is really optimistic about what lies ahead, but I think it’s cautious optimism based on learning from other people’s mistakes over the past five years.
