Happenings and Dental Hygiene Thought Leaders on DSO trends in 2024

DSOPro polled its 2023 Happenings and Dental Hygiene participants on what is impacting the future of DSOs.

We asked our 2023 featured industry leaders: Where is the DSO industry now? What will be different and where do you predict the industry is headed in 2024? Any thoughts on emerging technology?

Hot topics in the Happenings and Dental Hygiene categories in 2023 included coaching teams to improve diagnosis and case acceptance; training implant treatment protocols; creating marketing strategies; developing leadership and improving patient experience; targeting effectiveness over efficiency; reputation management; putting your HR in order; developing hygiene infrastructures; career opportunities for hygienists within DSOs; and supporting standards for clinical excellence.

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Steven Katz, DMD  
Founder, Smile Potential Dental Practice Coaching

Coaching Dental Practices and DSOs to Improve Diagnosis and Case Acceptance

Strategies for Team Retention

A lack of quality dental team members makes team retention a major focus for the coming year. Most practices are emerging in 2024 from a busy, but stressful year in 2023. Staffing challenges, declining reimbursements, and a generalized lack of team engagement in practice success, should be highlighting the need to focus on improving the quality of the patient and team experience to help generate opportunities for growth.

It has become a competitive market for quality team members. Team retention must be a priority because team acquisition has become difficult…and costly, with near bidding wars and “signing bonuses” on the table for some quality team members. There is always an easy opportunity for team members to increase their rate of pay by a few dollars per hour by switching offices, but the sharpest team members realize that there is a high value that should be put on the quality of the experience in their job. It is most important to feed into most team members’ craving for appreciation. It is the number one determinant of dental employee satisfaction.

It is also important to make sure that the team receives a clear message on what is expected of them. Team members crave strong leadership from the doctors and the practice management team. Team retention is helped if we can make team jobs interesting, and if there is room for their growth. Introducing advanced technology gives team members a feeling of greater worth when they are trained to use it effectively. This additionally points out the need to invest in the development of great team members. When you provide the team with the resources and training to help them perform their jobs well, and you give them the trust to grow and take ownership of decisions, the team becomes empowered, and the practices grow.

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Steve Saukaitis
Chief Executive Officer, Select Dental Management

Steve Select Dental

The dental industry is currently transitioning from the volatility of the past years toward a more stable model of consolidation and sustainable growth. For 2024, we foresee a trend toward organic growth, with an emphasis on enhancing employee and patient retention and improving operational workflows.

Select Dental Management is embracing strategic partnerships to advance both professional development and patient care. We’re also integrating artificial intelligence to support both clinical practices, such as radiograph evaluation and periodontal charting, and operational tasks such as insurance verification, ensuring efficiency, and precision.

Emerging technologies like AI, as well as 3D printing and advanced data analytics, will become more prevalent, offering improved patient experiences and predictive care models. Our commitment is to stay at the forefront of these innovations, continually elevating the quality of dental care and operational excellence.

Marisa Dolce, RDH
Vice President of Hygiene, Advanced Dental Brands

Marisa_headshotI joined the DSO industry in 2006 and at that time I thought to myself, “I think this may be the wave of the future.” I couldn’t have been more accurate. Even with higher interest rates in 2023, I believe there was growth in the industry. 2023 saw more small groups emerging as well as larger groups growing through acquisitions, albeit likely looking for higher margins. 

With interest rates having cooled a bit, it would make sense that the DSO industry continues to grow throughout 2024. Smaller groups create opportunities for growth through acquisition whether they become the acquirer or the acquiree. In addition, a percentage of new grad dentists and hygienists will continue to choose to practice with groups due to the advantages they provide, such as leadership, training, and capital. 

Aside from growth, I believe the implementation of AI systems will continue to progress and expand with the goal of streamlining and improving patient care. Diagnosis and treatment planning can be challenging for newer providers and these systems take the guesswork out of that process. There are groups already utilizing the technology with positive revenue growth. Although this technology is not perfect at this time, it is my belief that eventually its use will be standard. 

I recently joined Advanced Dental Brands (ADB) as Vice President of Hygiene. ADB is a New England based group with 45 practices and is on a growth trajectory. Because I have held national positions in two other large DSOs, I was hired in part for my experience at working to scale. At ADB I will not only implement a hygiene standard of care but will build an infrastructure of hygiene mentors and leaders as the company grows. It is very exciting to build once again something from the ground up!  

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Misty Mattingly, RDH  
Senior Vice President and Chief Dental Hygiene Officer, Sage Dental


The DSO industry experienced tremendous growth in 2023, fueled by advancements in technology and increased investment and acquisition activity. However, there are still challenges heading into 2024. The industry continues to grapple with the effects of staffing shortages caused by the decline of professionals entering dental and hygiene schools and older generations retiring from the field.

In fact, 34% of dental assistants and 31% of hygienists aim to leave dentistry in the next 5 years. To retain employees, DSOs will have to focus on elevating employee engagement while streamlining workflows and maintaining quality patient care. This includes the adoption of technology to enhance operational and clinical efficiency, such as voice-activated periodontal charting.

Dentistry has traditionally centered around reactive care, but now we’re experiencing a shift toward preventive health thanks to newer technologies that can efficiently detect early signs of periodontal disease and decay. AI-backed technology will also remain a primary focus. We saw a huge uptick of this technology in 2023 to help relieve administrative burden and enhance diagnostics, but we’ll really see the true impact this year. As it continues to evolve, AI will be particularly instrumental in creating more consistency in diagnostic accuracy throughout the field.

In addition to the continued focus on AI, we can expect to see a rise in more innovative products, such as solutions for enamel regeneration. Products like Curodont Repair Fluoride Plus provide solutions to non-invasively repair and rebuild enamel. That’s the kind of innovation we can expect to take center stage throughout the year.

Sage Dental’s main priority is organic portfolio growth. We achieved significant milestones in 2023, doubling our total portfolio since 2020. We’ll continue this momentum by embracing new technology and our unique, blended de novo/acquisition strategy.

Jennifer Turner, RDH, BSc  
Vice President of Dental Hygiene Operations, 123Dentist

Jennifer Turner Pic

In the dynamic landscape of the DSO space in 2024, the role of the dental hygienist is experiencing a notable evolution. Advanced technologies and collaborative approaches are transforming dental hygiene teams. Dental hygienists are increasingly leveraging cutting-edge tools for preventive care such as AI-assisted diagnostics and digital scanners, allowing for more accurate and efficient patient assessments along with elevated clinical conversations.

Despite these advancements, a persistent challenge in the DSO space is the shortage of dental hygienists. This shortage has led to an increased demand for their services, driving up hourly wages. While dental hygienists welcome the recognition of their essential role, many dentists are concerned with the financial implications of the wage surge. This has sparked a debate within the industry about how to address the shortage effectively without compromising the financial sustainability of dental practices.

I believe that it is crucial for dentists and dental hygienists to recognize the pivotal role metrics play in ensuring quality patient care. Embracing and understanding relevant metrics beyond overall hygiene production allows them to assess what procedures are being done and by whom, celebrate dental hygienists’ successes and for providing optimal patient care, identify areas for opportunity, and contribute to a comprehensive understanding of their impact individually and as a dental hygiene team, which many dental hygienists have not ever been privy to before.

Dentists and dental hygienists need to collaborate seamlessly to navigate the challenges and opportunities presented in the evolving landscape. Recognizing that each member of the team brings unique skills to the table, the industry is emphasizing the concept that “we are better together.” By fostering a culture of teamwork and embracing technological advancements, dental professionals can ensure that advancements in dental hygiene contribute to the overall success and efficiency of DSOs in 2024.

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