Who Is Buying Dental Practices in 2026?
Most owners can name three buyers. The ones with national advertising.
Two of those three do not primarily buy existing practices at all.
That gap between who owners think is buying and who is actually buying is worth real money, because the buyer most likely to pay the most for your practice is frequently one you have never heard of.
Key takeaways
- The buyer pool is far deeper than the household names. The Association of Dental Support Organizations alone counts 80-plus DSO member companies, and roughly 130 private equity-backed DSOs operate in the US.
- Two of the three largest DSOs grow mainly by opening new offices, not buying yours. Knowing which is which saves wasted conversations.
- Regional platforms frequently outbid national ones inside their own footprint. Filling in a market they already run is worth more to them.
- Doctor-partnership organizations are the fastest-growing category and often the best structural fit for an owner who wants to keep equity and autonomy.
- The buyer who calls you is not the market. They are one participant, pricing without competition.
Who is buying dental practices in 2026? Buyers fall into four groups: national DSO platforms, large multi-region acquirers, regional platforms concentrated in one geography, and doctor-partnership organizations. Roughly 30 to 35 organizations actively acquire independent general practices at scale, alongside individual dentists and existing local groups.
The four kinds of buyers
A DSO is a dental support organization. It is the management company that owns the non-clinical side of a practice and handles everything outside the operatory, while a licensed dentist retains ownership of the clinical entity.
That structure exists because of the corporate practice of dentistry doctrine, which restricts non-dentist ownership of clinical practices in many states.
1. National platforms. The biggest names.
They operate across most of the country and carry the most capital. Heartland Dental supports roughly 1,900-plus offices across 39 states and DC and is majority-owned by KKR alongside Ontario Teachers’ Pension Plan.
Smile Brands operates around 600 practices in 29 states under Gryphon Investors. Sonrava Health supports around 600 across 21 states, backed by New Mountain Capital.
2. Large multi-region acquirers. Not national.
Still very large. These groups operate across many states and acquire steadily.
MB2 Dental supports 800-plus practices under a doctor-partnership model with backing from Warburg Pincus and Charlesbank. Dental Care Alliance runs roughly 400 practices across 24 states.
Others in this tier include North American Dental Group, Great Expressions Dental Centers, Mortenson Dental Partners, 42 North Dental, Affordable Care, and Guardian Dentistry Partners, which recently agreed a majority acquisition of Select Dental Management and its 38 locations.
3. Regional platforms. Concentrated in one geography, and frequently the most motivated buyer inside it.
This is the tier owners overlook most, and it is the one that most often surprises them on price.
A group with thirty practices in your state gains something specific by adding yours: density, shared staffing, referral efficiency, marketing that covers more offices for the same spend. A national buyer adding a location three states from anything else they run gains none of that.
The names here include Sage Dental across Florida and Georgia, backed by Linden Capital, and DECA Dental anchored in Texas. CORDENTAL operates through the Midwest and Southeast with backing from NMS Capital.
Dental365 has been affiliating steadily through the Northeast, ProSmile across New Jersey, New York and Pennsylvania, and Riccobene through the Carolinas. Jefferson Dental, Espire, Marquee and Coast Dental each hold their own regions.
None of them advertise nationally. Most owners have never heard of the one operating in their own state.
4. Doctor-partnership organizations. The fastest-growing category in dentistry.
Sometimes called a DPO — a dental partnership organization, where the selling doctor retains meaningful ownership and the local practice brand usually survives rather than being converted to a house banner. Imagen Dental Partners has been among the most active acquirers of the past two years.
Others include SALT Dental Partners, Rising Tide, Providence Dental Partners, Dentive, Gen4 and Elevate.
And alongside all of these: individual dentists and existing local groups. Still real buyers. Still the right answer for some practices.
Just constrained by lending capacity in a way funded groups are not.
Three owners, three completely different buyers
Lists are abstract. What this actually looks like is easier to see through three owners I have watched go through it, each of whom ended up somewhere they would not have predicted at the start.
The first was a solo owner in a mid-sized Midwestern city. Strong practice, one location, hygiene running a little over 30% of collections, two associates carrying most of the restorative. She assumed the national group that had been writing to her for two years was the answer, because they were the only name she recognised.
They were not. A regional platform operating about forty practices across her state and the one next to it wanted her market badly.
They had two offices within twenty minutes and no presence in her town at all. Adding her closed a gap on their map.
The national buyer was adding a dot. The regional buyer was completing a picture.
That difference showed up in the number, and it showed up more in the terms, because the regional group cared about keeping her team intact for reasons that were operational rather than sentimental.
The second was a two-doctor practice where the owner did not actually want to leave. He was 57. He wanted the risk off the table and the administration off his desk, and he wanted to keep cutting teeth.
A conventional full sale would have solved two of those three. What fitted was a doctor-partnership organization, where he sold a majority stake, kept a real ownership position, kept the practice name on the door, and handed over everything he disliked.
He is still practising four days a week. He describes it, without irony, as the first time in a decade he has enjoyed the job.
The third had three locations and assumed he was too small to interest anyone serious. He was wrong by a wide margin. Three locations with a functioning management layer is not a practice, it is a small platform, and it attracted a different tier of buyer entirely, including one group that had never contacted him because he was not on their outreach list.
None of the three had run a structured competitive process before we started, and none could have named their eventual buyer at the outset. Nothing about those outcomes was predictable from the practice alone.
What they had in common is that none of the three ended up with the buyer who had been sending them letters.
The two big names that probably will not buy your practice
This is the part that surprises owners most. It surprises them late, too, usually after months of waiting for a call that was never coming.
Of the three largest DSOs in the country, only Heartland Dental grows primarily through acquiring existing practices. Heartland’s growth is driven largely by affiliation, supplemented by de novo openings.
Aspen Dental grows largely through opening new offices rather than acquisitions. PDS Health does the same — it has stated plans to open more than 100 de novo locations, and it opened 10 in a single month in mid-2026.
None of that is a criticism. Building new offices is a legitimate strategy, and for those two it has worked extremely well.
But if you are an owner assuming that the three biggest names are your three most likely buyers, two of them are not in that conversation at all.
How to think about which buyer is right
Bigger is not automatically better. The highest number is not automatically the best deal.
Both of those take owners a while to believe.
Scale and stability favour the national platforms. More infrastructure, more capital, more established integration processes.
Price inside a specific market frequently favours a regional platform. A group that already runs 30 practices in your state gains density and referral efficiency by adding yours that a national buyer does not get.
That shows up in what they will pay.
Autonomy and retained equity frequently favour a doctor-partnership organization. If you want to keep practising on your own terms, keep your practice name, and hold a real ownership stake, that model is built for it.
Legacy and continuity sometimes favour an individual buyer or your own associate, if the financing works.
The honest answer is that you cannot know which of these fits best until more than one of them has told you what they would actually do. Which is the whole argument for not answering the first letter with a number.
How to find out who would actually want your practice
Owners ask me this constantly. The honest answer is that you cannot work it out from a list.
Be sceptical of anyone who says otherwise.
What determines it is specific. Where you are.
What the groups near you are missing. Whether your production runs through associates or through you.
How your payer mix compares to what a particular buyer’s model assumes. Whether anyone has just raised capital and needs to deploy it.
That last one matters more than owners realise. A group that closed a recapitalisation three months ago behaves very differently from one near the end of its investment period.
Same organisation. Different appetite.
You cannot read that off a website.
Here is what you can do yourself, and it is worth an afternoon.
Look at who has been acquiring within a hundred miles of you over the past two years. Trade coverage reports most affiliations.
The pattern in your own region tells you more than any national ranking does.
Then notice which groups have offices near you but not in your town. That gap is what makes you valuable.
Then be honest about what you are. A single location where you produce most of the dentistry is a tuck-in.
Three locations with someone else running the day-to-day is a small platform. Different buyers entirely.
Owners routinely misjudge which one they are.
What you cannot do from the outside is find out what any of them would pay. That only emerges one way.
More than one of them has to put a number on paper, knowing the others are doing the same.
Why so many buyers, and why now
The demand is structural. This is not a fashion that passes.
Practice ownership among US dentists fell from 84.7% in 2005 to 72.5% in 2023.
DSO affiliation climbed from 8.8% of dentists in 2017 to 16.1% in 2024, and among dentists less than 10 years out of school it is 27%, against 9% for those more than 25 years out.
Meanwhile the retirement curve keeps advancing. Average dentist retirement age reached 68.7 in 2024, up from 64.7 in 2001.
So you have a generation of owners approaching an exit, a younger generation less inclined to buy practices outright, and a large pool of well-capitalized organizations positioned in between.
Becker’s Dental Review tracked more than 200 DSO affiliations in 2025, with California, Florida, Pennsylvania and Texas the most active states, and 69% of DSOs reported in 2026 that their sponsors expect increased acquisition activity.
That is why your phone rings. What it does not tell you is what the practice is actually worth, or how long a proper sale takes.
It is not about you. It is arithmetic, and the arithmetic is not going to change soon.
The one question worth asking any buyer
If a group does approach you, there is a single question that tells you more than any other, and almost nobody asks it.
Ask to speak to two dentists who sold to them more than two years ago.
Not last year. Two years, because that is long enough for the integration to have happened and the honeymoon to be over.
A buyer confident in how they treat sellers will make that call happen quickly. One that hesitates, offers a curated single reference, or explains why it is difficult has told you something useful.
It costs you nothing and it is the most reliable signal available to you.
What this means for you practically
Three things follow from the size of the buyer pool.
First, the buyer who contacted you is one of many. They approached you because you were on a list, at a moment convenient to them. That is not the same as being the best fit or the best price.
Second, you almost certainly do not know your best buyer’s name. Which is separate from the question of what your practice is worth in the first place. The organizations most likely to pay a premium for a specific practice are often regional or partnership groups without national advertising budgets.
Third, none of this helps unless more than one of them is actually bidding. A deep buyer pool that never competes for your practice produces exactly the same outcome as a shallow one.
That last point is what the Elite Selling System exists to fix.
We hand-select and vet every buyer who gets to bid on your practice, the way a doorman with a velvet rope lets in only the right people, then run a private competitive window inside that vetted group. The point is not volume of buyers.
It is the right buyers, aware of each other.
If you want to know which of these organizations would realistically compete for your practice, and what that changes about the number, start with a free, confidential practice value estimate.
Our fee varies depending on the value of the practice and is success-based. If we do not get you a result, we do not get paid.
Frequently asked questions
How many DSOs are actually buying dental practices?
The Association of Dental Support Organizations counts more than 80 DSO member companies, and roughly 130 private equity-backed DSOs operate in the US. Of those, somewhere around 30 to 35 actively acquire independent general practices at meaningful scale.
Does Heartland Dental buy existing practices?
Yes. Heartland’s growth is driven largely by acquiring and affiliating existing practices, alongside a smaller number of new office openings each year.
It is the largest DSO in the country by supported office count.
Does Aspen Dental buy existing dental practices?
Aspen Dental grows primarily by opening new offices rather than acquiring existing ones. Owners looking for an acquirer are generally better served looking at organizations whose growth model is acquisition-led.
Does PDS Health buy existing practices?
PDS Health, formerly Pacific Dental Services, also grows primarily through de novo openings, with public plans to open more than 100 new locations. Acquisition of existing independent practices is not its main growth channel.
Will a regional DSO pay less than a national one?
Not necessarily, and often the opposite. A regional platform gaining density in a market it already operates in can extract more value from your practice than a national buyer adding a scattered location, and that frequently shows up in a higher offer.
What is a DPO, and how is it different from a DSO?
A dental partnership organization keeps the selling doctor as a meaningful owner and usually preserves the local practice brand, rather than converting it to a house banner. It suits owners who want liquidity without fully leaving.
Should I just respond to the group that contacted me?
You can, but you will be negotiating with a buyer who has no competitive pressure. Before responding with a number, it is worth understanding which other organizations would realistically want your practice and what they would pay.
Do individual dentists still buy practices?
Yes, and for some practices it is the right outcome. The constraint is lending: an individual buyer is limited by what a bank will advance, which generally sits below what a capitalized group can pay.
Sources
Buyer types and DSO scale
- Association of Dental Support Organizations. “About ADSO.” theadso.org
- Becker’s Dental Review. “The largest DSOs headed into 2026.” beckersdental.com
- Becker’s Dental Review. “52 DSOs to know: 2026.” beckersdental.com
- Becker’s Dental Review. “Dentistry’s biggest players.” beckersdental.com
- Becker’s Dental Review. “What the 3 largest DSOs have been up to.” beckersdental.com
- Becker’s Dental Review. “The big trends driving DSO growth in 2026.” beckersdental.com
- Group Dentistry Now. “DSO Deal Roundup — July 2026.” groupdentistrynow.com
- Group Dentistry Now. “DSO Deal Roundup — June 2026.” groupdentistrynow.com
Deal activity and geography
- Becker’s Dental Review. “200+ DSO affiliations in 2025: State-by-state breakdown.” beckersdental.com
- Becker’s Dental Review. “5 states with the most DSO activity in 2025.” beckersdental.com
- Becker’s Dental Review. “69% of DSOs plan to boost acquisitions in 2026: Report.” beckersdental.com
- Becker’s Dental Review. “16% of US dentists affiliated with a DSO: State-by-state breakdown.” beckersdental.com
Ownership trends and structure
- ADA Health Policy Institute. “Practice Ownership Trends in Dentistry.” ada.org
- ADA News. “More dentists affiliating with DSOs.” adanews.ada.org
- ADA Health Policy Institute. “Dentist Retirements Increase.” ada.org
- US House Committee on Oversight. “Survey of State Laws Governing the Corporate Practice of Dentistry.” oversight.house.gov
- Congressional Research Service. “Private Equity Investments in Health Care: Selected Enforcement Issues.” congress.gov
Melani Seymour, co-founder of Transitions Elite, helps veterinary practice owners take action now to maximize value and secure their future.
With over 15 years of experience guiding thousands of owners, she knows exactly what it takes to achieve the best outcome.
