In this episode of the Dental Boardroom Podcast, host Wes Read, CPA and financial advisor at Practice CFO, and Dr. Howard Farran, Founder of Dentaltown, delve into the evolving landscape of dental ownership from the rise of private equity in dentistry to the challenges and opportunities facing today’s practitioners.

They explore how cheap financing and investor enthusiasm fueled massive consolidation in the dental space over the past decade, and why the focus is now shifting from quantity to quality. As interest rates rise and capital tightens, DSOs and private equity groups are becoming more selective, prioritizing well-run, profitable practices over sheer scale.

The discussion also contrasts private equity-led DSOs with those founded and guided by dentists, examining how leadership, culture, and long-term vision shape patient outcomes and professional integrity.

Dr. Farran passionately defends the importance of dentist-led organizations, transparency, and long-term patient relationships, emphasizing that dentistry is a “sacred profession,” not just a business. Wes complements this view with a grounded financial perspective, offering practical advice for dentists who aspire to grow sustainably, without losing their clinical focus or personal balance.

Key Takeaways

• The PE Boom and Shift: Low interest rates and abundant capital fueled a buying frenzy in dental practices, but the landscape is changing with higher borrowing costs.
• From Volume to Value: DSOs are now focused on high-quality operations and sustainable cash flow rather than mass acquisitions.
• Dentist-Led vs. Investor-Led DSOs: Dr. Farran stresses that DSOs led by clinicians, not “suits,” create better care models and stronger trust with patients.
• Operational Mastery First: Before expanding, dentists should perfect one successful “prototype” practice much like McDonald’s perfected its first store before scaling.
• Liquidity and Transparency Matter: Private equity’s lack of transparency and illiquidity pose risks; publicly traded or dentist-owned models offer more accountability.
• AI and Dentistry: Both see promise and potential pitfalls as AI expands into diagnostics and insurance, cautioning that technology can empower or restrict clinicians depending on who controls it.