Dentists and DSOs are being confronted with new challenges this year as the industry faces increased operating costs, potential Medicaid cuts, stagnant insurance reimbursements and more.
Four dentists recently shared their top worries with Becker’s.
Editor’s note: These responses were lightly edited for length and clarity.
Murat Ayik, DDS. Woodhill Endodontics (Dallas): The increasing complexity of insurance reimbursements and administrative burdens can be challenging for independent practices. However, joining a DSO helps alleviate these pressures by providing business support, allowing dentists to focus on patient care rather than operational hurdles. Additionally, the rising costs of technology and equipment can be daunting, but DSOs offer access to state-of-the-art resources and group purchasing power, making it easier to stay at the forefront of dental advancements. These trends reinforce the importance of collaboration, and I see DSOs as a valuable solution to navigating the evolving landscape of dentistry.
The dental industry is evolving rapidly. One trend that some may find challenging is the increasing costs of running a private practice, from equipment investments to regulatory compliance. However, joining a DSO provides a solution by offering business support, financial stability and access to advanced technology without the heavy burden on individual practitioners. Another shift is the growing patient expectation for convenience and efficiency, which can be difficult for smaller practices to manage alone. With a DSO, dentists can leverage shared resources, streamlined operations and marketing expertise to enhance patient experience while maintaining high-quality care. Instead of worrying about these trends, I see them as an incentive to embrace collaboration and innovation in dentistry.
One trend is the increasing administrative and operational challenges for independent practices, which can take time away from patient care. However, joining a DSO helps alleviate these pressures by providing expert support in areas like billing, compliance and HR, allowing dentists to focus on what they do best: caring for patients. Another shift is the growing demand for cutting-edge technology and specialty services. Through a DSO, dentists gain access to state-of-the-art equipment and a network of specialists, ensuring they can meet patient expectations while staying competitive in a changing landscape. Rather than being a source of concern, these trends highlight the value of collaboration and strategic partnerships in modern dentistry.
Nichol Houston, DDS. Muzaffar Mirza DDS and Associates (Chicago, Ill.): The dental trends that are concerning me right now are the number of patients coming in with dentistry done internationally and locally (by unlicensed providers), and the current potential of Medicaid being discontinued.
I’ve seen multiple patients come in with failing, horrible dental work and wanting another solution. If they are traveling internationally or getting poor work done by unlicensed providers, they certainly are unlikely to be able to afford corrective treatment.
In regards to the current administration’s plan to discontinue offering Medicaid to an already underserved population that currently uses the emergency room for dental triage and sometimes dental services, what is going to happen if those patients no longer have benefits or providers to go to in an already strained system?
Anne Kossowan, DDS (New York City): Increasing costs of everything, from lab fees and the cost of materials, to increasing salaries to retain and hire good people. Patients understand increasing costs, but what is worrisome is that eventually only so much of the cost increase can be passed along to patients before there will be resistance to fees.
David Nguyen, DMD. CEO of URBN Dental (Houston): One of the most concerning trends in the dental industry right now is the commoditization of dental care driven by insurance constraints, DSOs focused on volume over quality, and the increasing influence of corporate consolidation without proper clinical oversight.
Key Concerns:
1. Insurance reimbursement decline: PPOs continue slashing reimbursements while increasing administrative burdens. Many practices are forced to increase volume at the expense of quality care, which erodes trust and patient experience.
2. Rising cost of clinical talent: Recruiting and retaining high-quality associates and specialists is becoming more challenging due to higher salary demands and limited availability of top-tier talent. The supply-demand imbalance could drive down clinical standards in some practices.
3. Private equity’s shift in focus: Investors are no longer just looking at top-line revenue growth; they are scrutinizing EBITDA efficiency, operational scalability and risk exposure. Many DSOs that grew too fast without financial discipline are now struggling.
4. Corporate dentistry’s one-size-fits-all approach: Many large DSOs are scaling with cookie-cutter models that prioritize uniformity over patient-centric, market-specific strategies. This creates a race to the bottom in terms of quality, pricing and patient retention.
5. Patient expectations and consumerism: Patients now expect a seamless, high-end experience comparable to hospitality and luxury retail. Practices that fail to deliver high-touch service, convenience and clear value differentiation will lose to competitors who do.
6. Artificial intelligence and technology disruption: While AI-driven diagnostics and automation are exciting, there’s a real risk of over-reliance on tech at the expense of clinical judgment and human connection, a critical element of case acceptance and long-term patient relationships.
The only way forward is to own the premium space, where we’re not competing on price but on expertise, experience and exclusivity. The future belongs to DSOs that can balance profitability with exceptional patient outcomes, leverage technology without losing the human element and build a brand that patients trust and value beyond insurance-driven decision-making.
Our strategy is clear:
- Selective insurance participation: Only working with plans that align with our clinical and financial model.
- Investing in top-tier talent: Paying for excellence, not just filling chairs.
- Luxury patient experience: Elevating every touchpoint from the first call to treatment completion.
- Operational efficiency at scale: Maintaining elite profitability while delivering superior care.
The DSOs that survive and thrive in this evolving landscape are the ones who understand the trends, adapt proactively and refuse to compromise on quality, and that’s exactly what we’re doing.
