PE Roll-up Tracker · 2026

Who is buying dental practices?

Quick Answer
Dentistry is consolidating into dental support organizations (DSOs): 16.1% of US dentists were DSO-affiliated in 2024, double the 2017 rate and more than 25% among dentists within a decade of school. Private equity is the engine — there are roughly 130 PE-backed DSOs, and dental logged 120+ PE add-on acquisitions in 2024, the most of any healthcare category. The largest are Heartland Dental (KKR), Aspen Dental (Leonard Green + Ares), MB2 Dental (Charlesbank + Warburg Pincus) and Smile Brands (Gryphon), with PE also rolling up specialties — orthodontics via Smile Doctors and oral surgery via U.S. Oral Surgery Management. Not every big DSO is PE-owned: Pacific Dental Services is founder-owned. Dental practices typically sell for about 5x-7x EBITDA, scaling to 10x+ for platforms.

Why dentistry is consolidating

16.1%
of US dentists are DSO-affiliated (2024) — double the 2017 rate, and >25% among new dentists (ADA HPI)
202,485
US dentists across ~135,000 dental offices — still about 1 in 3 in solo practice (ADA HPI / Census)
120+
PE add-on dental acquisitions in 2024 — the most of any healthcare category (Lincoln International)
  • Consolidation is generational: DSO affiliation rose from 8.8% of US dentists in 2017 to 16.1% in 2024, more than 25% of dentists within 10 years of dental school are now DSO-affiliated, and the share of dentists who own their practice fell from 84.7% in 2005 to 72.5% (ADA Health Policy Institute).
  • Dental is private equity’s busiest healthcare roll-up: roughly 130 PE-backed DSOs operate today, and US dental recorded 120+ PE add-on acquisitions in 2024 — the highest volume of any healthcare-services category (Lincoln International; ADA HPI).
  • The runway is large: there are about 202,485 dentists across roughly 135,000 dental offices, and even after a decade of DSO growth ~84% of dentists remain unaffiliated and about one in three still practice solo — a deeply fragmented base (ADA Health Policy Institute; US Census).
  • Recession-resistant, needs-based demand, a durable mix of cash-pay and insurance revenue, and a wave of debt-laden younger dentists who would rather affiliate than buy a practice make dental an attractive, repeatable roll-up (Lincoln International; ADA HPI).

The platforms consolidating dental care

The named groups acquiring US dental businesses, with their current owner and a source for each. Most grow through individual partnerships that are not separately disclosed; where a platform publishes named deals, recent ones are listed.

Heartland Dental

Private equity
Owner
KKR
Headquarters
Effingham, IL
Scale
1,900+ supported practices, 3,000+ affiliated dentists across 39 states + DC — the largest US DSO
Recent acquisitions
Smile Design Dentistry (60 Florida practices, 2025); 75 de novo practices opened (2025)

KKR is the majority owner of the largest US DSO. As with every DSO, Heartland owns the non-clinical support business while affiliated dentists own the clinical practices.

Aspen Dental Management

Private equity
Owner
Leonard Green & Partners + Ares Management (~80%); American Securities (~20%)
Headquarters
Chicago, IL
Scale
1,100+ branded offices across 40+ states

Leonard Green and Ares hold a roughly 80% majority, with American Securities and management owning the rest. Aspen grows largely through de novo offices rather than acquisitions.

MB2 Dental

Private equity
Owner
Charlesbank Capital Partners + KKR + Warburg Pincus
Headquarters
Carrollton, TX
Scale
800+ affiliated practices, 700+ doctor-partners

A November 2024 recapitalization added Warburg Pincus alongside existing investors Charlesbank and KKR. MB2 calls itself a “dental partnership organization” — affiliating dentists co-invest and retain equity.

Smile Brands

Private equity
Owner
Gryphon Investors
Headquarters
Irvine, CA
Scale
~650 offices across roughly 30 states
Recent acquisitions
Midwest Dental (brought the combined company to ~650 offices)

A PE-to-PE repeat: Gryphon Investors previously owned Smile Brands, sold it, and re-acquired it in 2024.

Western Dental / Sonrava Health

Private equity
Owner
New Mountain Capital
Headquarters
Orange, CA
Scale
580+ offices across 20 states, 1,400+ dentists

New Mountain has held Western Dental (rebranded Sonrava Health) since 2012 — one of the longest holds in the sector; a 2024 sale process did not complete.

Dental Care Alliance

Private equity
Owner
Harvest Partners + Mubadala Investment Company
Headquarters
Sarasota, FL
Scale
400+ affiliated practices, 900+ dentists across ~24 states

Recapitalized in December 2022 by Harvest Partners and Abu Dhabi sovereign fund Mubadala. Harvest also co-owns Affordable Care — two separate dental platforms.

North American Dental Group

Strategic / family-owned
Owner
Jacobs Holding AG
Headquarters
Pittsburgh, PA
Scale
~250 affiliated practices across 15 states

Owned since 2019 by Jacobs Holding AG, a Swiss long-term family holding company (not a fund-structured PE firm), as part of a transatlantic dental group.

Affordable Care (Affordable Dentures & Implants)

Private equity
Owner
Harvest Partners + PSP Investments (Berkshire Partners, minority)
Headquarters
Raleigh, NC
Scale
350+ affiliated practices across ~40 states (dentures and implants)

Control passed from Berkshire Partners to Harvest Partners and PSP Investments in 2021 (Berkshire rolled over a minority stake). A dentures-and-implants specialist rather than general dentistry.

DECA Dental Group / Ideal Dental

Private equity
Owner
Blackstone (Tactical Opportunities)
Headquarters
Carrollton, TX
Scale
~200 locations across 9 states

Blackstone made a strategic investment in August 2024 (prior owner Blue Sea Capital exited); founder Dr. Sulman Ahmed retains a meaningful stake. Runs a dentist joint-venture model under the Ideal Dental brand.

Sage Dental

Private equity
Owner
Linden Capital Partners
Headquarters
Boca Raton, FL
Scale
140+ supported offices across Florida and Georgia
Recent acquisitions
The Dental Group, Fort Lauderdale (Aug 2025)

A regional (Florida and Georgia) DSO; Linden Capital has backed Sage since 2012.

Dental365

Private equity
Owner
The Jordan Company
Headquarters
Melville, NY
Scale
A Northeast multispecialty group (NY, CT, NJ, PA, OH and beyond)

The Jordan Company acquired Dental365 in 2021 from Regal Healthcare Capital Partners; founder Dr. Scott Asnis continues to lead.

Smile Doctors

Private equity
Owner
Thomas H. Lee Partners + Linden Capital Partners
Headquarters
Dallas, TX
Scale
580+ affiliated orthodontic locations across 36 states — the largest US orthodontics platform
Recent acquisitions
myOrthos (70+ locations across 13 states, 2023)

Linden Capital has backed Smile Doctors since 2017; Thomas H. Lee Partners joined as an equal partner in 2022. Affiliated orthodontists retain a stake.

U.S. Oral Surgery Management (USOSM)

Private equity
Owner
Oak Hill Capital
Headquarters
Irving, TX
Scale
A national oral & maxillofacial surgery platform

Oak Hill Capital acquired a controlling stake from RiverGlade Capital in 2021; the surgeon partners retain ownership.

Paradigm Oral Health

Private equity
Owner
BlackRock Long Term Private Capital
Headquarters
Lincoln, NE
Scale
~75 facilities, 100+ surgeon partners (oral & maxillofacial surgery)

BlackRock Long Term Private Capital took a majority stake in September 2022, acquiring it from InTandem Capital Partners.

Specialized Dental Partners

Private equity
Owner
Quad-C Management
Headquarters
Dallas–Fort Worth, TX
Scale
A surgical-specialty platform (endodontics, oral surgery, periodontics)

Quad-C invested in 2021; the platform was renamed from U.S. Endo Partners to Specialized Dental Partners in 2023 as it expanded beyond endodontics.

Rodeo Dental & Orthodontics

Private equity
Owner
Bain Capital Double Impact
Headquarters
Fort Worth, TX
Scale
General, orthodontic and specialty care, serving largely underserved and Medicaid communities

Bain Capital Double Impact (the firm’s impact-investing arm) recapitalized Rodeo Dental in 2019 alongside management.

Gen4 Dental Partners

Private equity
Owner
Thurston Group
Headquarters
Tempe, AZ
Scale
~110 offices across 14 states (platform formed 2021)

A younger Thurston Group platform (formed 2021); not to be confused with TPG, which a common listicle wrongly names as the owner.

Frequently asked

Who are the largest dental DSOs in the US?

By scale: Heartland Dental (KKR), Aspen Dental (Leonard Green + Ares), MB2 Dental (Charlesbank + KKR + Warburg Pincus), Smile Brands (Gryphon), Western Dental / Sonrava Health (New Mountain) and Dental Care Alliance (Harvest Partners + Mubadala). Private equity is also rolling up specialties — Smile Doctors (Thomas H. Lee + Linden) in orthodontics and U.S. Oral Surgery Management (Oak Hill) in oral surgery.

How can private equity own a dental practice?

Through the dental support organization (DSO) structure. Because most states bar non-dentists from owning a clinical practice (the “corporate practice of dentistry” doctrine), the practice splits in two: a licensed dentist owns the clinical professional corporation, and a separate management company — the DSO, which is what private equity invests in — owns the non-clinical business and provides support under a management services agreement.

What multiple do dental practices sell for?

It depends heavily on size. M&A advisers report single-location practices selling for roughly 5x-7x EBITDA, with larger multi-location groups and platform-grade businesses commanding about 10x or more. Single-doctor tuck-ins are often valued lower, around 3x-6x. Private-equity-backed DSOs pay up for scale and recurring patient bases.

How do I sell my dental practice to a DSO?

DealSeam works confidentially with dental-practice owners to understand their options and, where there is a fit, introduces them to qualified buyers — with the buyer paying the success fee, so sellers pay nothing. DealSeam is not a traditional business broker.

Methodology & sources

Platforms were identified from dental-industry M&A coverage (Group Dentistry Now, DrBicuspid, Becker’s Dental, and dental-sector reports from Lincoln International) and then each one’s current owner, headquarters and scale were verified against a primary public source — the PE sponsor’s portfolio or news page, the DSO’s own press release, or a dated trade-press report. Every entry uses the dental “support organization” structure: because most states’ corporate-practice-of-dentistry laws bar non-dentists from owning a clinical practice, the PE-backed DSO owns the non-clinical management business (real estate, billing, HR, marketing, equipment) under a management services agreement, while a licensed dentist owns the clinical professional corporation — so “KKR owns Heartland” means KKR owns the support company, not the practice of dentistry. Ownership churns, so several widely-repeated facts were corrected: Affordable Care’s control passed from Berkshire Partners to Harvest Partners and PSP in 2021 (Berkshire is now a minority); Dental365 is owned by The Jordan Company (not Bain); Gen4 Dental Partners is a Thurston Group platform (not TPG); and U.S. Endo Partners is the same entity as Specialized Dental Partners (renamed in 2023). Great Expressions Dental Centers was excluded because its current owner could not be confirmed against a primary source after multiple ownership changes. North American Dental Group’s owner, Jacobs Holding, is a Swiss family holding company rather than a PE fund, and is labeled accordingly. Not every large DSO is private equity: Pacific Dental Services (~1,000 supported practices) is founder-owned, Mortenson Dental Partners is employee-owned through an ESOP, and PepperPointe Partnerships is a dentist-owned partnership that explicitly markets itself as the alternative to PE. Revenue and EBITDA are private and intentionally omitted; the multiple band shown is industry-typical, not any single deal’s multiple. Market-size, affiliation and deal-count figures are sourced externally (ADA Health Policy Institute, US Census, Lincoln International). Last updated June 2026.

Market sources

Last updated June 2026. Ownership in this sector changes frequently; figures reflect the most recent public sources available and are not investment, legal, or tax advice.

Thinking about selling your dental practice?

DealSeam works confidentially with owners to understand their options and, where there's a fit, introduces them to qualified buyers — at no cost to sellers.