Hot Operations/Procurement topics were group purchasing and management organizations, the role of doctor leaders in DSOs, helping distributors and manufacturers understand the DSO space, dental leadership organizations, building relationships with vendors, company-wide communication and operations consistency, unlocking value in dental M&A, leading procurement as a group grows, simplifying the procurement and AP processes, and developing and leading a DSO hygiene department. 

Heidi Ardnt
Founder & CEO, Evolve Dental Advisors

The dental industry in 2025 is navigating a critical shift. With acquisitions slowing, the focus still remains on same-store growth—an area where many organizations struggle. Scaling through acquisition is no longer the primary driver of success; instead, DSOs must refine their operational playbooks, improve efficiencies, and elevate provider performance to drive organic growth.

One of the biggest challenges DSOs face is execution. Many groups have strong boardroom strategies but lack the ability to implement them effectively at the practice level. Without alignment between leadership, clinicians, and support teams, initiatives stall, leading to inconsistent results. The most successful organizations will be those that can bridge this gap, ensuring that business strategies translate into real improvements in patient care, provider productivity, and financial performance.

Technology is also playing a growing role in shaping the industry. AI-driven solutions are being adopted in areas like revenue cycle management, diagnostics, and patient engagement, offering DSOs opportunities to streamline workflows and improve decision-making. However, technology alone is not a silver bullet. Groups that integrate these tools strategically—focusing on efficiency without disrupting patient care—will see the greatest return on investment.

Beyond operations, DSOs must rethink how they develop and retain talent. The traditional playbook of rapid expansion and reactive management is no longer sustainable. Instead, organizations must build strong cultures, invest in leadership development, and create structured performance support to keep teams engaged and aligned.

The path forward for DSOs in 2025 is clear: those who refine their operational excellence, leverage technology wisely, and invest in their people will thrive. Those who continue to rely on acquisition-driven growth without a strong operational foundation will struggle to keep up in an increasingly competitive landscape.

April Cole
COO, Sage Dental

As the DSO market continues to expand, there is a growing emphasis across the industry on scaling operations and maintaining consistency across locations, all while adapting to local needs. During such a period of rapid growth, DSOs will need to prioritize improving communication and standardizing processes across practices to ensure seamless care.

The number of dentists affiliated with a DSO continues to rise each year as providers look for ways to streamline management and operational support, enabling them to have more time and capacity to focus on what’s most important: delivering direct high-quality patient care. Technology integration will play a key role in streamlining workflows, enhancing patient engagement, and improving care coordination. AI-driven solutions, from predictive analytics to automated administrative tasks, can also help ease the burden on clinicians and ensure resources are used more effectively. AI has the potential to enhance the patient experience by providing them with a range of more streamlined communication options, enhancing accessibility and convenience. As AI continues to advance, DSOs must be strategic in its implementation—leveraging AI to enhance efficiency and convenience while ensuring the human element remains central to the patient experience.

Sage Dental experienced significant growth in 2024, expanding into new markets such as Tennessee, Alabama, and South Carolina, bringing our total network to over 130 practices. In 2025, we’re aiming to continue this momentum and further our mission to provide high-quality, comprehensive dental care to even more communities.

As the market expands, streamlined communication and alignment between corporate leadership and local teams are becoming even more critical. A key trend is optimizing integration strategies for new practices, ensuring they align with broader organizational goals without disrupting patient care or team dynamics. The ability to balance structure with adaptability will define the next phase of growth for DSOs.

Marisa Dolce
VP of Hygiene, Advanced Dental Brands

The DSO industry is still growing, and I believe there are currently 350 DSOs/DPOs in the United States. Staffing costs are still an issue and a national shortage of hygienists continues to be a challenge. I don’t see that changing for 2025.

From a hygiene perspective, I can speak about the fact that DSOs have learned the value of employing hygiene leadership. I am active in a group of industry hygiene leaders and the group is continually growing. Hygiene leadership leads to the provision of improved patient care and drives revenue, and I am happy to see that recognition.

Advanced Dental Brands was acquired by H.I.G. Capital late in 2023 and is set on a growth trajectory. We have implemented AI and are in the process of software conversion and both will be game changers for the organization. I think that the utilization of AI will continue to grow and eventually become commonplace.  

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