The dental industry is moving fast, and leaders across the dental service organizations (DSO) landscape are paying close attention to the shifts taking place right now. Whether you’re building a platform, running a practice, advising on deals, or simply keeping an eye on where the market is heading, there’s a clear sense that the conversations happening today will shape the next phase of growth.
DSO CEO Roundtable: Meeting of the Minds
7 Pillars recently hosted a handful of DSO executives and a group of financial advisors from one of the top dental financial groups in the country to collaborate, share best practices, and find common ground. One of the nation’s leading investment bankers was also in the room, offering insight into the current state of the dental landscape and where the market is heading.
Here are three of the biggest takeaways from being in the room with the top minds of the dental M&A industry.
1. DSOs are focused on partner doctor succession.
DSOs continue to attract thousands of associate dentists each year, offering stability, resources, and career opportunities that many private practices often can’t match. Even so, recruiting and retaining top clinical talent remains a persistent challenge. This isn’t because DSOs are a less desirable option, but because of the inherent complexities of scaling a clinical workforce.
As a result, associate recruitment and retention have become a central focus for leadership teams across the DSO space.
“Across the DSO landscape, CEOs are aligned on one thing,” said Brett Pierce, Founding Partner at 7 Pillars and moderator of the roundtable event. “Associate recruitment and retention are the heartbeat of long-term success. This isn’t a competitive issue, it’s a collective one that directly influences how organizations invest in culture, mentorship, and clinical leadership.”
This shared focus is driving more intentional investments in onboarding, clinical development pathways, and leadership training. These are all areas that increasingly differentiate organizations who are competing for the same limited talent pool.
2. DSOs look for partners who reflect their specialty focus.
Over the past several years, DSOs have recognized a meaningful shift in provider preferences. Specialists increasingly seek environments built specifically around their discipline. Pediatric dentists want to practice alongside other pediatric dentists, oral surgeons prefer working with fellow surgeons, and orthodontists tend to thrive in ortho-centric settings where systems, workflows, and culture are tailored to their specialty.
This trend is driven by more than just preference. Specialty-focused environments allow for more consistent patient experiences, better utilization of clinical support teams, and the ability to implement systems that are purpose-built rather than generalized across multiple disciplines.
As a result, DSOs are becoming more intentional in how they grow by prioritizing partnerships with doctors who align with a defined specialty focus rather than building broadly across multiple service lines.
One DSO CEO in attendance reinforced this point saying, “When you align doctors by specialty, you create stronger clinical collaboration, more efficient operations, and a more compelling long-term platform.”
3. Underperforming DSOs will eventually fall off.
While the number of DSOs has grown significantly over the past decade, the industry is now entering a more mature phase, leaving unperforming platforms behind. The cream is rising to the top where performance, discipline, and differentiation matter more than ever.
In many ways, the consolidators are beginning to consolidate. Larger, well-capitalized DSOs with strong infrastructure, proven leadership, and consistent clinical models are increasingly separating themselves from the rest of the field. At the same time, smaller or underperforming organizations, particularly those that scaled too quickly without the necessary operational foundation, are now facing mounting pressure.
The next phase of the DSO evolution is likely to include increased consolidation among DSOs themselves. Stronger organizations will look to acquire or absorb weaker platforms to expand their capabilities.
This dynamic reinforces a broader industry reality that success is increasingly interconnected across stakeholders.
“Whether you’re an M&A advisor, a DSO CEO, a doctor within a DSO, or a financial advisor with clients who have partnered with one, we’re all in this together,” said Brett. “As consolidation accelerates, the success of the model becomes a shared responsibility across the entire ecosystem.”
7 Pillars looks forward to deepening their collaboration with these leaders as they continue to shape the future of the industry.
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For further education on DSOs, check out our blog post, Why Joining the Right DSO Matters, and subscribe to our podcast, The Advisor’s Table.