Some DSOs have grown by aggregating practices and revenue without ever becoming true operating companies. Now, the doctors who trusted them with their practices are bearing the cost, according to Dylan Bates, CEO of SALT Dental Partners.
Mr. Bates recently spoke with Becker’s about the company’s growth strategy, which has included 13 partnerships so far in 2026, and the challenges facing DSOs as investors raise the bar.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How would you describe SALT’s growth this year? Is it at the pace that you expected at the beginning of 2026?
Dylan Bates: I would say we’ve had a really solid year. We’ve been growing across multiple channels of growth. We’ve had a strong organic growth year. We’ve done 13 partnerships this year to date, with a couple more under letter of intent, so we’ve been very active on the new partner front. I’d say our growth has been in line with what we expected. We don’t necessarily set out with a hard target. We’re very thoughtful and we have a high bar in terms of what we try to look for in new partners, so sometimes you’ll have a spurt of activity, and then other times we’re being very thoughtful about the integration. It’s one thing to get the partnership done; it’s another thing to do it well, and to be high touch with our new partners. We’ve had a great year of growth, but we’ve also been very methodical and disciplined around partner selection.
Q: SALT has expanded in several states this year, including two new states. What can you attribute this growth to?
DB: Just really blue chip practices and doctors that were interested in the SALT story. We were introduced in a couple of those new state situations by existing partner doctors. We’ve got a great, really tight relationship with our partner doctors, and they have friends and trusted colleagues from the past, very reputable groups that they’ve encouraged us to talk to. Ultimately, those tend to be the best partners because our existing partners handpick people who they would want to do business with and who they trust and respect, and so forth. That’s led to some of our growth and expansion into new markets.
Q: What does the company plan to focus on during the remainder of 2026?
DB: We’ve had a lot of success and are very focused on adding service lines where it makes sense … We have a strategic growth function and department within SALT that are dedicated professionals, led by our Chief Strategy Officer Josh Yelsey, and we’ve had a lot of success opening new service lines when we have significant density of one or two of the other services. We partner with doctors across pedo, ortho and oral surgery, so the disciplines play very nice together. Throughout the rest of the year, we’ve got a few strategic growth projects slated, as well as a couple new partner brands that are under letter of intent that we will close before year end.
Q: What goals does the company have set for 2027 in terms of organic and inorganic growth, team development, technology, etc.?
DB: We’ve got a lot going in all those areas … We really focus inward on having the right team and the right talent pointed toward the right initiatives. I think like is attracting like, so our new partner growth will continue and stay on pace, or even accelerate to a certain extent, because of our industry reputation. We have momentum in that lane, in terms of our new partnership growth, so I think that will continue. And whenever we do new partnerships, it can unlock the strategic growth dynamic I mentioned earlier. So, when we go into markets where we partner with a blue chip pediatric dental practice that has significant opportunities for us to provide convenience and care for orthodontic care, as an example, we look for those opportunities. We’re excited about next year. We think we’ve got the best team in the business. We’ve got great leaders. We’ve got great partners, great doctors, and a lot of great momentum, so we’re very excited about what the future holds.
Q: What trends are you following right now?
DB: There have been some groups that have been a little more quiet than we’ve historically seen. I think appropriately so, most and all DSOs that are paying attention to the changing landscape are really focusing inward and focusing on organic growth and their teams and just being a really sound business and discipline and attention to detail in all of their functions. In the past, there have been groups that have really grown via new partner growth, but maybe the integration wasn’t ideal, and they became kind of an aggregation of a number of brands and a number of practices, but are they really becoming an operating company? I think that’s what we’re paying attention to and what we’re very well aware of.
To really stand out and have a business and a company that’s here for the long haul and built to last, it takes all of that. It takes a great team, a great vision, a lot of collaboration and partnership with our partners. When you approach it that way, and you have a big long-term vision of being the best, and you do things with discipline and be methodical and build with intention, good things happen. The investor community definitely has a high bar these days, so they look for companies to truly operate and behave like an integrated, well-oiled machine, and that’s what we feel like we’re doing a pretty darn good job of.
Q: What do you predict will be the biggest challenges for DSOs and DPOs next year?
DB: Organic growth is mission critical in being an integrated operating company. Gone are the days where you can just aggregate revenue and EBITDA and make it for the long haul. That train is at the end of the line. It’s unfortunate that there have been quite a few groups that have lost their way, become over-leveled, and have real challenges. We take a very close eye on that because many of those doctors that joined a DSO that ultimately becomes upside down — it’s their practice, it’s their brand, and if they’ve trusted that DSO and the leadership with their practice and with a lot of rollover equity, and that equity is now impaired or diminished or gone to zero. I hate to see stories like that. There’s too much of that in dentistry, and we know how that happens. We’ve seen it numerous times.
I have a very seasoned management team that have been in various multi-site healthcare, private equity-backed environments, and that perspective and that experience is so foundational to how we look at things. We know where the pitfalls are. We invest ahead of the curve. We build things with intention. We build things the right way, and it is unfortunate that we’ve seen quite a few groups lose their way and become upside down. The number of doctors that are in the crosshairs of that is disappointing to see, and it’s unfortunate. We’re definitively keeping that front of mind how we intentionally build SALT.
