Hot Technology topics in 2024 included the importance of investing in technology and IT teams, a 20-year DSO veteran’s retrospective, improving diagnostics, communication, and workflow with AI technology (Diagnocat AI), employing sophisticated AI voice technology (Neurality AI), bridging the gap to successfully adopt emerging dental technologies with collaboration between The DSO Project and Cellerant Consulting Group, how Dental Innovation Alliance analyzes emerging technologies, how GoDental.ai can help improve insurance claim processing, and product reviews including DTX Studio Clinic, LightForce, BeVigilant OraFusion, and UptimeHealth.

Kentucky Morrow
Principal, Dental Innovation Alliance

The DSO industry stands at an inflection point. Over the last three years, the landscape has shifted dramatically as private equity-backed DSOs have adapted to a higher interest rate environment and increased competition for M&A transactions. Platforms have started changing hands with other opportunities on the horizon. New entrants and emerging DSOs have brought fresh perspectives and new strategies to the market.

This evolving financial backdrop, coupled with technological advancements, is positioning the industry for a wave of new innovation and technological adoption. Together with a continued focus on profitability and same-store sales growth, technology remains a key strategic resource for DSO executives.  

Staff recruitment, retention, and upskilling have been a focus area. Emerging technology solutions that provide tools to efficiently recruit staff have become essential tools for HR departments. Solutions like Cloud Dentistry, which provides both staffing functionality and software to help retain and leverage existing staff, will thrive as DSOs become more adaptable to understanding the relative strengths of each technology vendor compared to each other and traditional agencies.

In addition, expanding the skills of clinicians will remain a key focus area. Implant and orthodontic care have expanded beyond specialists to general practice dentists. Advances in treatment planning and support solutions have expanded the scope of care for enterprising clinicians. We expect next-generation orthodontic companies that are focused on patient preferences to thrive. In particular, Alta Smiles is one company we will be watching as their innovative approach enables general practitioner dentists to confidently take on orthodontic cases. This significantly expands same-store sales while also offering a unique solution that provides differentiation within their local market.

The DSO model will continue to thrive by embracing these tools, but success hinges on balancing the pace of adoption with driving utilization within the practice. At DIA, we believe the future isn’t just about doing more—it’s about doing better with less friction. For patients, this means faster, painless treatments. For DSOs, it’s about reducing administrative burdens and supporting their clinicians to achieve their full scope of practice. DIA’s investment thesis continues to revolve around solutions that align each stakeholder with these themes.

Jeromy R. Dixson, DMD, MBA
Co-Founder, Board Member, Chief Strategy Officer, Icon Dental Partners

DSO M&A: Open for Business in 2025

This year is poised for a remarkable resurgence in DSO M&A, driven by a more favorable interest rate environment, exceptional economic optimism tied to the incoming administration, and pent-up demand following a sluggish M&A market in 2023 and 2024. Private equity is expected to reenter the market with vigor as they recover from the deal malaise of the past two years, seeking to deploy their substantial capital reserves and make up for lost time.

DSOs with strong balance sheets, low leverage, and highly differentiated, doctor-friendly structures—such as ICON Dental Partners—are well-positioned for significant success. Conversely, over-leveraged legacy DSOs and poorly managed or outdated groups may continue to face challenges in achieving both organic and acquisitive growth goals.

While it is unlikely that average deal multiples will reach the peak levels seen in 2021 and 2022, 2025 is expected to mark a robust return to a more stable M&A market, supported by strong tailwinds in the current economic and industry landscape.

AI in DSOs

AI has played a mostly peripheral role in DSOs and dentistry to this point; however, 2025 may be the year its adoption into DSOs becomes mainstream. I expect that we will see broader use of AI-powered imaging software, alongside enhanced offerings from leading dental AI companies incorporating predictive analytics and other practice-level AI tools designed to optimize clinical efficiency.

In addition, AI-assisted solutions aimed at improving revenue cycle management, inventory management, and scheduling are likely to gain traction. This year, I also anticipate the emergence of several new AI software products focused on accessible, practice-level profitability enhancements. These innovations will help DSOs and dentists improve patient care while driving exceptional organic growth.

Rahul Sharma
CEO and Founder, Neurality Health AI

The Evolution of AI in DSO Operations: A 2025 Perspective

As we kick off 2025, the DSO industry stands at a fascinating crossroads of technology and healthcare delivery. The past year has marked a significant shift from basic automation to truly intelligent operational systems, with over 60% of mid-sized DSOs now incorporating some form of AI into their daily workflows.¹

We’re seeing two major trends emerging that will reshape the DSO landscape. First, the integration of multimodal AI systems will become standard practice. These systems will seamlessly switch between voice, chat, and text interactions, providing a more natural and efficient experience for both staff and patients. Second, we’re witnessing the rise of predictive analytics in practice management, with AI systems capable of forecasting patient scheduling patterns and optimizing resource allocation months in advance.^2,3

At Neurality AI, we’re proud to be at the forefront of this transformation. The launch of our integrated Voice & Chat AI platform in late 2024 has already demonstrated significant ROI for dental practices across the country. The average ROI for our customers using inbound Voice AI can range from $15k to $30k per month, for just overflow and after-hours calls. Looking ahead, our outbound marketing module will introduce adaptive campaigns that drive even more value using conversational, human-centered AI.

Another exciting trend is in the revenue cycle management space. Voice AI technology is transforming how practices handle insurance verification, claims processing, and patient collections. These AI systems can now conduct real-time eligibility checks, manage pre-authorizations, and even negotiate with insurance providers—tasks that traditionally consumed hours of staff time.

The key to success in this evolving landscape will be choosing solutions that prioritize human-centered design while delivering concrete operational benefits. The DSOs that thrive will be those that embrace AI not just as a tool for efficiency, but as a means to enhance the human elements of dental care delivery.

Resources: 1. Dental Practice Management Software Market Report 2025, DentTech Analytics; 2. Global Dental Software Market Forecast 2026, HealthTech Insights; 3. Khoury P. Embracing evolution: how dental leaders navigate the shift from traditional to digital practices. Dental Economics July 18, 2024. https://www.dentaleconomics.com/science-tech/article/55093146/embracing-evolution-how-dental-leaders-navigate-the-shift-from-traditional-to-digital-practices. Accessed February 6, 2025.

Michelle Hambidge
Communications Director, Sunset Technologies

The DSO industry is evolving rapidly, driven by consolidation, increased emphasis on operational efficiency, and the growing importance of technology integration. In 2024, many DSOs focused on scalability, compliance, and enhanced patient care, leveraging technology to streamline operations and reduce downtime. The transition from fragmented systems to unified platforms was a key trend, enabling practices to achieve peak performance.

In 2025, the DSO industry will prioritize enhanced security and uptime as the cornerstone of operational success. New requirements from the U.S. Department of Health and Human Services regarding HIPAA compliance will push organizations to strengthen their data protection and reporting practices. This regulatory focus will drive DSOs to invest in advanced compliance tools and robust risk mitigation strategies. We also anticipate an increased reliance on AI-driven tools for patient engagement, data analysis, and cybersecurity. These shifts position IT solutions as essential for maintaining stability, meeting compliance standards, and fostering growth in a competitive landscape.

Sunset Technologies continues to innovate in IT solutions for dental practices and DSOs, emphasizing uptime, performance, and security. In 2024, we expanded our capabilities through strategic acquisitions, making us the largest dental-focused MSP in the United States. Moving into 2025, we are enhancing our service offerings with advanced compliance tools and integrating AI technologies to optimize dental operations.

AI and cloud-based platforms will dominate in 2025, enabling DSOs to streamline workflows, enhance patient care, and mitigate risks. The shift toward predictive analytics in cybersecurity and performance monitoring will be pivotal for maintaining uptime and operational efficiency. Sunset remains at the forefront of these innovations, partnering with DSOs to navigate these advancements and secure their technology environments.

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