69% of DSOs Plan More Acquisitions in 2026, TUSK Reports
Sixty-nine percent of DSOs expect their private equity sponsors to push for moderate-to-high increases in acquisition activity in 2026, according to TUSK Practice Sales’ Q2 2026 Dental Market Report — but a high-demand, low-supply market could constrain those plans. TUSK expects the supply crunch to persist for roughly nine months, making DSOs more selective and more rigorous on financials and clinical continuity. Seventy-eight percent of DSOs anticipate recapitalizations within 12–36 months, and private placement memorandum exit counts rose 57.1% last year, redeploying liquidity into new deals. With more than 40% of dentists aged 55+ in several states, a large seller pool may soon shift leverage back toward buyers.
For DSO operators and sponsors, 2026 is a seller’s market that rewards discipline: deeper diligence, wide valuation variance across buyers, and minimum five-year provider retention terms to close. The aging dentist population signals where the next supply wave — and renewed buyer leverage — will come from.
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How many DSOs plan to increase acquisitions in 2026?
Sixty-nine percent of surveyed DSOs said their private equity sponsors expect a moderate or high increase in acquisition activity in 2026. However, a high-demand, low-supply environment that TUSK expects to last about nine months may limit how many deals actually close.
Why are DSO practice valuations becoming less predictable?
TUSK reported a wider variation in dental practice valuations during the first two quarters of 2026, with multiple DSOs assigning different values to the same practice. The supply shortage is pushing buyers to scrutinize financials, operations, and performance projections more closely before closing.
What is driving the future supply of dental practices for sale?
Several states now have more than 40% of active dentists aged 55 and older — one of the largest potential seller pools in dental M&A history. As these dentists begin to exit, the market could shift to favor DSO buyers, while AI-enabled de novo offices offer an alternative to acquisitions.