🦷 What private equity is doing to your dentist’s office

There’s a quiet takeover happening in dentistry—and it’s already impacting how patients are treated and how dentists practice.

Today’s newsletter breaks down why more dental offices are being bought by private equity firms, how that changes the kind of care you get, and what you can do to protect yourself and your health.

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Across the country, dental offices that appear to be owned by individual practitioners are increasingly being bought out—quietly—by large corporate entities called DSOs (Dental Service Organizations), often funded by private equity.

From the outside, nothing looks different. The sign out front still says “Family Dentistry.”

The same hygienist still greets you by name. But behind the scenes, a seismic shift has taken place—and it’s one that has profound implications for your care, your wallet, and the soul of dentistry itself.

DSOs promise efficiency, scale, and “improved patient outcomes.” But the reality can sometimes be the opposite. These organizations are not run by dentists. They’re owned by investors—and investors want returns.

And returns in dentistry come from more procedures, higher turnover, and less time per patient.

Suddenly, your hygiene appointment is over in 10 minutes, and you’re being pushed to crown a tooth with a tiny crack. Not because it’s best for you—but because the system rewards more procedures, not better care.

Historically, dentistry was a relationship-based practice. You trusted your dentist. They knew your family. Education about prevention was part of every visit—this was part of the dentist’s role, not just tooth carpentry. 

But in the early 2000s, private equity saw an opening. As dentists began to retire and student debt for new grads skyrocketed, corporate buyers stepped in.

Why build a practice when you can lock in a guaranteed salary and avoid a half-million in debt?

This mindset has contributed to the rapid growth of Dental Support Organizations (DSOs).

According to the American Dental Association’s Health Policy Institute, 13% of dentists nationwide were affiliated with a DSO in 2022, up from 10.4% in 2019 and 8.8% in 2017.

This trend is particularly pronounced among early-career dentists; 27% of those who graduated within the past five years and 18% of those who graduated six to ten years ago are affiliated with DSOs.

This model often leads to:

• Overtreatment: Unnecessary crowns, extractions, and root canals
• Burned-out clinicians: Dentists under productivity quotas, unable to push back
• Reduced trust: Patients treated like line items, not people
• Widening inequality: Vulnerable communities exploited for revenue

Dentists who speak up? They’re often pressured, punished, or pushed out.

What should you do about this?

If you’re reading this, you’re likely already thinking critically about your health. You understand that systems—especially those driven by money—don’t always have your best interest at heart.

DSOs are a symptom of a much larger problem in healthcare: when profit becomes the guiding principle, patient care becomes compromised. Preventive care keeps you healthier—and saves you money. But the DSO model doesn’t profit from prevention. It profits from procedures. That means your interests and theirs are often not aligned.

And while I’m not saying every DSO is evil, I am saying this:

You have a right to know who’s making decisions about your mouth.

How to Protect Yourself

• Ask your dentist directly: “Are you affiliated with a DSO or corporate group?” A good one won’t mind.
• Look for red flags: Frequent staff turnover, pushy treatment plans, minimal appointment time.
• Prioritize relationships: Functional, prevention-first care takes time and trust.
• Support independent practices: Especially ones focused on root-cause health, not insurance cycles. I maintain a directory of Functional Dentists on my website HERE.

This issue is about more than dental offices. It’s about a system that resists transparency, punishes dissent, and favors short-term gains over long-term wellness.

Whether it’s fluoride in your water, mouthwash in your bathroom, or a root canal you didn’t need—we’ve been told to trust authority at the cost of our own critical thinking.

It’s time we push back.

Because informed patients don’t just make better decisions—they help reshape the system.

P.S. If you’ve had an experience—good or bad—with a DSO or felt pressured into treatment, I’d love to hear about it. Hit reply and let me know.