Six DSO Leaders on De Novos vs. Acquisitions: Expect a Selective Shift, Not a Reversal
Six dental leaders told Becker’s Dental Review that DSOs are likely to build more new locations over the next two years, but selectively rather than as a replacement for acquisitions. Viviscus Dental Partners’ CEO expects AI-enabled operating models to change build-versus-buy economics, while the leaders at Altius Dental and EPIC4 Specialty Partners stress discipline, market fit and capital access. Providence Dental Partners’ CEO cites interest rates, construction costs, student debt and labor rates as headwinds. One executive noted that only about 50% of people use dental services in a given year, framing de novos as a way to reach untapped patients. Responses were lightly edited and reflect individual opinion, not survey data.
Build-versus-buy is a core capital allocation decision for DSO and multi-site operators. This panel shows how peers are weighing de novo ramp-up risk against acquired patient bases.
Use it for: Framing a board or investment-committee discussion on whether the next five to ten sites should be acquired or built from scratch.
Watch out for: This is a six-person opinion panel, mostly DSO executives with a stake in their own models, and it offers almost no hard ramp-up or return data. Treat it as a list of decision criteria, not a benchmark.
Try this: For each target market, compare the acquisition price per patient against the build cost plus months to break-even for a new site, then test both cases in the valuation calculator before committing capital.
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