The dental market is shifting again. The frantic, gold-rush phase of DSO acquisitions is giving way to something more selective, more strategic, and far less forgiving.

In 2026, simply having a good practice will not guarantee a premium offer. Buyers are sharpening their pencils. Capital is tightening. Competition among sellers is increasing.

The practices that thrive will be the ones that approach their sale strategically. The ones that stumble will be those that treat it like a routine transaction. Next year will separate the strategists from the sellers.

For the past decade, DSOs have been in rapid expansion mode.

Fueled by private equity capital, they were racing to acquire as many profitable practices as possible. Multiples rose quickly, and strong practices often found themselves fielding multiple offers with minimal positioning.

That era is ending. The market is maturing. DSOs have filled many of their regional gaps. They are no longer chasing every good practice. They are pursuing the best strategic fits.

This means fewer automatic bidding wars. Multiples are stabilizing. Buyers are becoming more selective. They want operational excellence, clean financials, scalable systems, and cultural fit. Practices that check those boxes still command strong valuations. Those that don’t are starting to see weaker offers or longer deal cycles.

The financial environment is changing too.

Capital markets have tightened, interest rates remain elevated, and private equity investors are more focused on disciplined returns. DSOs are feeling that pressure. They are refining their checklists, scrutinizing the quality of earnings, and prioritizing practices that deliver predictable results with minimal risk.

The “easy money” deals of 2021–2023, where practices received premium offers without serious positioning work, are fading. In their place are sophisticated, data-driven buyers who expect sellers to meet a higher standard.

If your practice is strong but unprepared, you may still receive offers, but they will be lower and more structured. If your practice is strong and strategically positioned, you’ll still see competition and premium multiples. The difference is preparation.

Strategists treat the sale of their practice like a business deal.

They start preparing months, sometimes years, in advance. They clean up their financials, tighten operations, stabilize their teams, and document their systems. They understand what DSOs value and position accordingly. When they go to market, they look like the exact type of practice buyers want.

Sellers, on the other hand, call a broker, get a quick valuation, and toss their practice on the market.

They hope the offers will come. They assume their collections and reputation will speak for themselves. In 2026, that assumption will cost them.

I’ve watched two nearly identical practices take these different approaches. One spent nine months preparing strategically. They received multiple offers, created competitive tension, and ultimately sold at a premium multiple. The other relied on a quick broker valuation and went straight to market. They received a single lukewarm offer and ended up accepting far less than they could have achieved.

The difference wasn’t the practice. It was the strategy.

The playbook for 2026 is clear.

DSOs are using sophisticated checklists to decide where to invest their capital. If you want to stand out, your practice needs to meet that standard before you go to market.

That means strong hygiene programs that drive recurring revenue. Clean, organized financial reporting. Documented systems that make your practice transferable. A stable, loyal team that signals operational continuity. Growth capacity that gives buyers upside potential.

Strategists look at their practice through the eyes of a buyer and make targeted improvements before ever engaging the market. They don’t wait for offers to appear. They engineer them.

Selling a practice in this new environment isn’t just about knowing your numbers.

It’s about understanding the buyer’s playbook and positioning your practice to win. That’s where experience and foresight matter.

For years, I’ve worked with high-performing doctors who wanted more than a quick sale. They wanted a strategic exit that rewarded their years of work and set them up for their next chapter. My role has always been to bring clarity to a complex process, identify hidden value, and structure deals that align with their goals.

As the market tightens, having that kind of guidance isn’t optional. It’s the edge that ensures your practice stands out when buyers become selective.

The next twelve months will define the next decade of value for many practice owners. Those who prepare strategically now will be in control. Those who wait will find themselves reacting to a buyer’s agenda instead of leading their own.

If your practice is generating more than one million dollars in revenue, now is the time to assess where you stand. My team and I offer a comprehensive appraisal and positioning analysis, valued at $2,743, at no cost to qualified practice owners. It’s the smartest first step you can take to ensure you’re playing on the strategist’s side of the line in 2026.

The market is shifting. The rules are changing. Next year will reward those who prepare now. Which side will you be on?

To your unstoppable success,
Your Team at Everything DSO