Good morning. Analysis of a molar with a jade inlay discovered at an ancient Mayan archaeological site suggests that the civilization had sophisticated dental practices and used drilling tools to perform operations to relieve pain caused by cavities. 

That’s interesting to be sure, but we’d like to hear more about the operational side of ancient Mayan dentistry—what sort of RCM processes did they use? What was their treatment acceptance rate like? Hopefully someday we’ll have answers.

Inside this issue:

- DSOs are scooping up smaller DSOs
- Can DSOs help fix burnout?

⏰ Your reading time today: 5 minutes 49 seconds

🏆 Enjoy your coffee break with Word of Mouth, a dental-themed word game inspired by Wordle.

MARKETS

📉 3D Systems ($DDD) – 2.83 | -0.23 (7.52%)
📈 Align Technology ($ALGN) – 188.39 | +10.59 (5.96%)
📈 Colgate-Palmolive ($CL) – 93.39 | +1.59 (1.73%)
📈 Dentsply Sirona ($XRAY) – 12.32 | +1.32 (12.00%)
📈 Envista Holdings ($NVST) – 27.51 | +0.57 (2.12%)
📈 Henry Schein ($HSIC) – 86.62 | +2.57 (3.06%)
📈 Park Dental Partners ($PARK) – 20.80 | +1.32 (6.78%)
📈 Straumann Holding ($STMN) – CHF 108.35 | +0.65 (0.60%)
📈 Weave Communications ($WEAV) – 6.70 | +0.59 (9.66%)

Stock data reflects market close as of the last day of trading, showing changes over the past five trading days.

THE DRILL DOWN

🔐 Russian-linked ransomware gang Qilin claims to have breached 1-800-Dentist, threatening to leak health data tied to millions of patients and more than 5,000 dental practices unless the company pays an undisclosed ransom—1-800-Dentist has not confirmed the hack. 1-800 needs to call 911.

📉 Dentist net income has fallen nearly $60,000 since 2010 in inflation-adjusted terms, dropping from $274,198 to $215,320 by 2025, as practice expenses continue to outpace reimbursements according to new ADA data. Income eroding faster than enamel.

🦷 ADA throws its support behind the Primary Care Team Education Centers Act, calling the bill, which would expand training opportunities for healthcare workers, pivotal for directing dental professionals to underserved regions.

🏆 Magdent, the maker of a device that helps bone heal faster around dental implants, took home top honors at Dentalcorp's inaugural Demo Day, winning a US$150,000 SAFE investment and a potential pilot across Dentalcorp's 600+ practice network.

👁️Wyssta Services, which operates an online portal for some Delta Dental plan members, settles class-action privacy lawsuit for $12.7 million, resolving allegations it used tracking cookies and pixels without users' knowledge or consent on its member portal. Those are some expensive cookies.

🛑 Colorado Dental Board adopts new regulations on DSOs, prohibiting them from owning a dental practice’s equipment, holding the lease of dental practices, and influencing clinical decisions, among other regulations.

🪥 Rhode Island expands who can reimburse public health dental hygienists, passing legislation to allow hygienists working in public health settings to be paid by private insurers—not just Medicaid and state programs.

INDUSTRY

DSOs are buying DSOs

When the supply of solo practices to buy dries up, what's a DSO in growth mode to do? Opening de novos is one option, but some buyers are finding that scooping up smaller groups is an appealing alternative.

Driving the news: Deals where one dental group absorbs another are stacking up.

• In a widely shared LinkedIn post, Dental365's Joshua Gish called his company a "consolidator of consolidators," saying it has absorbed four or five smaller groups of six to ten offices each across New Jersey, Massachusetts, Pennsylvania, and Ohio.
  

• Heartland Dental bought Smile Design Dentistry last year, a roughly 60-office Florida group, in a deal reportedly priced at a low double-digit EBITDA multiple.
  

• Earlier this month, Thurston Group folded three of its platforms—SGA, Gen4, and Modis—into one organization under the SGA Dental Partners banner, a network of more than 250 locations and over 500 dentists across 26 states.

Zoom out: This isn't a run of one-offs. LevinPro has logged 110 dental transactions so far in 2026, and industry observers note a growing split between DSOs that expand by opening de novos and those that grow by acquiring smaller groups.

Why it's happening: Attractive solo practices are getting scarce and expensive, while smaller DSOs that never hit maturity—some carrying debt troubles—are starting to hit the market. Restructurings and shelved sale processes are leaving a growing pool of stranded and orphaned groups hunting for, in Gish's words, "a stronger home."

• Buying a group also comes with other benefits, like instant density in a regional market and, often, redundant overhead you can trim by folding its back office into shared services.

Yes, but: Buying existing groups isn't all sunshine and rainbows. There are real challenges to buying DSOs that, for one reason or another, never lived up to their owners' ambitions.

• That can mean half-built integrations, antiquated systems, and broken revenue cycles—all the usual problems of DSOs that aren't firing on all cylinders.
  

• Culture clash, low morale, and staff turnover are common too, and industry experts flag them among the top reasons DSO deals underperform.

Why it matters: Still, group acquisition is becoming a real lever for scale—and one well suited to a market where good small deals are scarce. But it raises the stakes on integration, putting a premium on operators with a proven ability to absorb what they buy.

Bottom line: Earlier cycles rewarded whoever bought fastest. This one will reward whoever absorbs and integrates best—and in 2026, the best deals may go to the larger groups with the proven ability to do exactly that, scooping up the groups that couldn't quite achieve lift-off.

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BUSINESS BITES

👔 Notable leadership changes: 42 North Dental makes Tracy Ziskovsky its CMO, the Association for Dental Safety names Andrea Haymore as its executive director, and Steven Hall becomes CEO of My Community Dental Centers.

📈 Deals and de novos: Aspen Dental opens a new location in Alabama and North Pittsburgh Oral Surgery opens a fifth location in Pittsburgh.

🤝 GoTu and Henry Schein form strategic staffing partnership, integrating GoTu's dental talent marketplace into Henry Schein Dental Recruitment Services for access to hygienists, assistants, and associate dentists for both temporary and permanent placements.

CAREERS

Can DSOs help solve clinician burnout?

You've upgraded equipment, tightened schedules, and centralized billing, but if your best clinicians are running on fumes and sprucing up their CV, you’ve got a major problem on your hands.

Catch up: It’s no secret that dentistry can take a toll on clinicians’ mental health. One peer-reviewed analysis put clinical burnout among dentists at roughly 13%, with about a quarter showing high emotional exhaustion.

• The problem seems to be getting worse. The ADA found anxiety diagnoses among dentists more than tripled between 2003 and 2021, to 16%, with 13% of dentists reporting depression. Another ADA survey from last year found the youngest dentists struggling most.

Why it matters: Burnout is a morale problem, but it also shows up in the numbers. In one study, higher distress scores among dentists tracked with more reported clinical errors and a higher intent to leave.  

• Losing clinicians to turnover hurts the bottom line, too. Research from DANB and the DALE Foundation found that a single dental-assistant vacancy can put roughly $110,000 of annual revenue at risk for an average practice, and that losing one midyear pushes about a quarter of practices to reschedule patients—a 6% hit to daily revenue. 

The good news: DSOs are well positioned to attack some of the biggest burnout drivers in dentistry through technology and centralized systems that take billing, staffing, and compliance off of clinicians’ shoulders. Those are all pain points that modern tech platforms can help solve.

• For example, a 2025 study of 263 physicians in a broader healthcare setting saw burnout fall from 51.9% to 38.8% after just 30 days on an ambient AI scribe. Eligibility checks, claims scrubbing, and automated RCM can all ease the administrative burden further. 

Yes, but: The same model can manufacture a different stressor driven by production targets built on private-equity return expectations, loss of autonomy, and rigid scheduling—all factors also linked to burnout.

• This may be one of the reasons why the ADA Health Policy Institute found new dentists in affiliated practices are about six times more likely to plan to leave than those in unaffiliated ones (48% versus 8%), often citing insufficient autonomy and influence over business decisions.

What you can do: If you’re making clinician mental health a priority, you can stand up dedicated programs (Heartland, for example, has created a dedicated Director of Wellness role), but the larger impact may come from operational decisions, like:

• Reducing admin burden with technology. Offloading paperwork and manual administrative tasks is a win that should bear fruit for your bottom line as well. Modern dental tech platforms can relieve your staff of many of these unloved jobs.
  

• Pressure-testing your production math. Understand that ramping up targets beyond what is sustainable may be a way of funding this quarter’s growth with next year’s turnover.
  

• Protecting clinical autonomy. Loss of control is a leading driver of burnout, so give clinicians a real voice in protocols, materials, and scheduling.
  

• Measuring mental health like you measure other key metrics. Adopt a validated tool—the Well-Being Index is free to ADA members—and track scores by location and manager, not just enterprise-wide.

Bottom line: Dentistry's mental-health problem is older than any DSO, but DSOs are now big enough to do something about it that no solo practice can. Operators who take clinician well-being seriously will build a hiring edge that goes beyond just competing on compensation.

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CLINICAL NOTES

🥗 Poor diet may raise oral cavity cancer risk in women, even without tobacco or alcohol use, according to the largest prospective cohort study of its kind, which found the risk increase was actually higher among women who reported little or no drinking or smoking, with no parallel effect seen in men. What you eat may matter more than what you avoid.

🦷 New research challenges the assumption that cracked teeth inevitably require extraction, with findings showing favorable outcomes for many treated cracked teeth and reinforcing that preservation should be explored before pulling the tooth.

🍲 A fasting-mimicking diet may help reduce inflammation in gum disease patients, with researchers at King's College London exploring the approach as a complement to professional cleaning and oral hygiene support. 

BEYOND THE CUSP

• Swiss researchers built a prototype of a tiny robot to prepare teeth for crowns.
  

• Scientists in Brazil have developed a gel made from jackfruit and pomegranate that shows promise in fighting periodontal disease.
  

• How dentists and doctors uncovered the cause of a mysterious, electric pain in a woman’s tooth. (The New York Times, paywalled)
  

• Watch: Ergonomics expert explains how to sleep on a plane.
  

• How to stay hydrated in a heatwave.