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What is an off-market dental practice?

An off-market dental practice is one whose owner has not listed it for sale, and a transition there happens through a private conversation rather than a broker’s process. Buyers compete for them too: TUSK Practice Sales counted more than 135 DSOs and private equity groups active in 2026 (TUSK Practice Sales; see the deal-sourcing guide).

By DDSIntel Editorial· Published · Data as of

Key numbers

Where do off-market dental practice deals come from?

Most come from existing relationships: an owner approaches a colleague, an associate, a supplier’s representative or an adviser, or a buyer reaches out and the owner is ready to talk. A broker can also run a quiet sale to selected buyers. In each case the practice never appears on a public listing site.

The deal-sourcing guide sets out the full buy-side process from territory to diligence.

How is off-market different from pre-market?

Off-market describes a practice not offered for sale. A pre-market dental practice is narrower: it shows public-record transition signals but has not engaged a broker or listed. DDSIntel measures the second in aggregate. Neither term says the owner wants to sell, and observed signals never imply that.

The glossary entry for pre-market dental practices gives the exact definition, and listing data versus signal data compares the two ways of finding them.

Why would an owner sell off-market?

Confidentiality and choosing the successor are common reasons. About 72.5% of U.S. dentists owned a private practice in 2023, so many owners face the question eventually. A private sale avoids telling staff and patients before a deal is certain, which a public listing cannot guarantee.

Ownership has been falling: it was 84.7% in 2005 (ADA Health Policy Institute), a point that matters to associates planning a buy-in.

What are the risks of buying off-market?

With no broker package, the buyer must build the financial picture, confirm licenses and entity standing, and negotiate unaided. Pricing is harder to benchmark without competing bids. Have a CPA and counsel review the books and contract, and run the public-record checks before any letter of intent.

See public-record checks before an LOI and owner outreach and consent. For the signal side, read what dental transition signals are.

Frequently asked questions

Are off-market practices cheaper?

Not by rule. Published multiples describe all sales; see how practices are valued.

Can I get a list of off-market practices?

No public list exists. DDSIntel publishes aggregate signal counts by state and region, never practice-level lists.

Do brokers handle off-market sales?

Some run confidential processes with selected buyers. See working with brokers.

Is approaching an owner directly allowed?

Yes, within marketing, privacy and professional rules. Have counsel review how and when you reach out.

Sources

  1. TUSK Practice Sales. TUSK Practice Sales Assesses the State of the Dental Industry in Its Q3 2026 Dental Market Report (July 10, 2026). pr.timesenterprise.com.
  2. ADA Health Policy Institute. Dental practice research. ada.org.
  3. ADA Health Policy Institute. The dentist workforce. ada.org.

Questions or corrections: request a correction. Markdown version: /deal-sourcing/off-market-dental-practices.md.