# 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](https://ddsintel.com/deal-sourcing)). By DDSIntel Editorial Team. Source: DDSIntel, https://ddsintel.com/deal-sourcing/off-market-dental-practices. Published 2026-10-26; data as of 2026-10-25. ## Key numbers - **135** DSOs and private equity groups were active buyers in 2026, more than (TUSK Practice Sales, Q3 2026 dental market report, 2026; https://www.prnewswire.com/news-releases/tusk-practice-sales-assesses-the-state-of-the-dental-industry-in-its-q3-2026-dental-market-report-302823046.html) - **175** practice locations were reported sold in the first half of 2026, at least (TUSK Practice Sales, Q3 2026 Dental Market Report (PR Newswire), H1 2026; https://www.prnewswire.com/news-releases/tusk-practice-sales-assesses-the-state-of-the-dental-industry-in-its-q3-2026-dental-market-report-302823046.html) - **15.2%** of professionally active U.S. dentists were 65 or older (ADA Health Policy Institute, 2025; https://www.ada.org/resources/research/health-policy-institute/dentist-workforce) - **72.5%** of U.S. dentists were private practice owners (ADA Health Policy Institute, 2023; https://www.ada.org/resources/research/health-policy-institute/dental-practice-research) ## 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](https://ddsintel.com/deal-sourcing) 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](https://ddsintel.com/glossary/pre-market) gives the exact definition, and [listing data versus signal data](https://ddsintel.com/deal-sourcing/listing-data-vs-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](https://ddsintel.com/data/dentist-retirement-statistics)), a point that matters to [associates planning a buy-in](https://ddsintel.com/deal-sourcing/associate-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](https://ddsintel.com/deal-sourcing/public-record-checks-before-loi) and [owner outreach and consent](https://ddsintel.com/deal-sourcing/owner-outreach-consent). For the signal side, read [what dental transition signals are](https://ddsintel.com/signals). ## Frequently asked questions ### Are off-market practices cheaper? Not by rule. Published multiples describe all sales; see [how practices are valued](https://ddsintel.com/deal-sourcing/how-dental-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](https://ddsintel.com/deal-sourcing/working-with-brokers-buyer). ### 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). https://pr.timesenterprise.com/article/TUSK-Practice-Sales-Assesses-the-State-of-the-Dental-Industry-in-Its-Q3-2026-Dental-Market-Report/6a514c9516e7610b3c53e15d 2. ADA Health Policy Institute. Dental practice research. https://www.ada.org/resources/research/health-policy-institute/dental-practice-research 3. ADA Health Policy Institute. The dentist workforce. https://www.ada.org/resources/research/health-policy-institute/dentist-workforce --- DDSIntel is a dental transition intelligence platform that detects pre-market dental practice transition signals for brokers, DSOs, lenders and the firms that serve them.