TUSK Report: 69% of DSOs Plan More Acquisitions in 2026 Despite Tighter Supply
Sixty-nine percent of DSOs expect to increase their acquisition activity in 2026, but rising competition for a shrinking pool of available practices is forcing organizations to become more selective, according to TUSK Practice Sales’ Q2 2026 Dental Market Report. The data identifies a high-demand, low-supply environment likely to persist through the year, with DSOs placing greater scrutiny on deal financials, clinical continuity, and staffing before closing. Key risk factors prompting deal abandonment include over-reliance on a single producer and insufficient post-close employment commitments — with many DSOs now requiring minimum five-year provider retention terms. Meanwhile, states where more than 40% of active dentists are aged 55 or older represent an emerging seller wave that could shift market dynamics within 24 months, potentially easing supply constraints for buyers who can wait.
For PE-backed DSO operators and deal teams, the TUSK data confirms demand remains strong — but deal quality scrutiny is rising. DSOs that skip rigorous due diligence on staffing and clinical risk are walking into post-acquisition attrition problems that erode EBITDA and complicate future raises.
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