# How do DSOs acquire dental practices? DSOs grow through platform acquisitions of groups, add-on acquisitions of single practices and new de novo offices. Levin Associates counted 54 dental deals in Q2 2026, the most of any specialty it tracked, and TUSK Practice Sales reported at least 175 practice locations sold in the first half. By DDSIntel Editorial. Source: DDSIntel, https://ddsintel.com/dso/how-dsos-acquire-practices. Published 2026-10-26; data as of 2026-10-25. ## Key numbers - **54** dental deals were counted by Levin Associates in Q2 2026 (Levin Associates, Q2 2026; https://www.levinassociates.com/healthcare-ma-deal-volume-drops-in-q226-according-to-acquisition-data-from-levinpro-hc/) - **175** or more practice locations were reported sold in the first half of 2026 (TUSK Practice Sales, Q3 2026 dental market report, 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) - **135** or more DSOs and private equity groups were in the buyer universe (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) - **60%** % is the low end of cash at close in DSO offers, up to 85% or more (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) ## What are platform, add-on and de novo growth? A platform acquisition buys a group large enough to anchor a region or a whole DSO. An add-on brings a single practice or small group onto an existing platform. A de novo opens a new office instead of buying one. Most individual owners meet a DSO through an add-on. See the [consolidation overview](https://ddsintel.com/dso). ## How many dental deals happen, and why do counts disagree? Levin Associates counted 54 dental transactions in Q2 2026, the most of any specialty it tracked. TUSK reported at least 175 practice locations sold in the first half. One counts deals and the other counts locations, and a single platform deal can add many locations, so always cite the unit. ## Where do DSO deal announcements come from? From DSO press releases, trade-press roundups, filings by public companies and adviser announcements. Each has gaps, since many small add-ons are never announced and roundups are often dated only by month. Announcement counts are therefore a floor, which is why independent trackers should be cited by name. DDSIntel’s [news feed](https://ddsintel.com/news) carries deal announcements as the cited source names the companies, and describes acquired independent practices only generically. The same floor logic applies to affiliation counts, explained in [how many dental practices DSOs own](https://ddsintel.com/dso/why-dso-counts-differ). ## How does an add-on deal work for the seller? The buyer values the practice on earnings, typically adjusted EBITDA, and offers a mix of cash at close and other consideration. TUSK described DSO offers with 60% to 85% or more paid as cash at close. Terms such as the seller’s role afterward vary, so counsel and a CPA should review the offer. Compare the buyer types in [who buys dental practices](https://ddsintel.com/dso/dso-or-private-buyer), and the investor side in [private equity in dentistry](https://ddsintel.com/dso/private-equity-in-dentistry). Signals that often precede a sale are covered on the [signals hub](https://ddsintel.com/signals), and sales figures sit in the [data hub](https://ddsintel.com/data). ## Frequently asked questions ### What is an add-on acquisition in dentistry? The purchase or affiliation of a single practice or small group onto an existing DSO platform. ### What is a de novo dental office? A newly built office opened by a DSO or group instead of an acquired practice. ### How many dental acquisitions were there in Q2 2026? Levin Associates counted 54 dental transactions in Q2 2026, the most of any specialty it tracked. ### Why do dental deal counts differ between sources? They count different units: transactions (Levin) versus practice locations sold (TUSK). A single deal can include many locations. ### Does DDSIntel name the practices DSOs acquire? No. Companies may be named as the cited source names them; acquired independent practices are described generically. ## Sources 1. Levin Associates. Healthcare M&A deal volume drops in Q2 2026. https://www.levinassociates.com/healthcare-ma-deal-volume-drops-in-q226-according-to-acquisition-data-from-levinpro-hc/ 2. 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 3. ADA Health Policy Institute. Dental practice research (DSO affiliation and practice ownership). https://www.ada.org/resources/research/health-policy-institute/dental-practice-research --- 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.