Private Equity Conversations with Fexingo · 2026-06-19 · 9 min
Dental Support Organizations, or DSOs, have become one of private equity's most active consolidation targets. In this episode, Lucas and Luna break down the business model: PE firms acquire individual dental practices, bundle them under a centralized management platform, and aim for scale efficiencies without changing the clinical care. They focus on the case of Heartland Dental, one of the largest DSOs in the US, which now supports over 1,700 affiliated practices. The hosts discuss the typical deal structure - PE buys the non-clinical assets, the dentist retains equity in the practice - and the financial logic behind rolling up fragmented local dentistry. They also touch on the tension between corporate efficiency and clinical autonomy, and what this means for patients. Specific numbers: Heartland Dental was acquired by KKR in 2019 at a valuation of roughly $2.8 billion. The broader DSO market has grown from about 5% of US dentists in 2010 to nearly 15% today, representing roughly $15 billion in annual revenue.
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