INDUSTRY

Midway through 2026, the M&A thaw in dental is real … for some

Is there a better month than June? The days are long, the weather is gorgeous, we get championship hockey and basketball, the World Cup is on—heck, even the chilly dental dealmaking market looks like it may be starting to thaw.

Driving the news: Despite M&A activity in healthcare services slowing overall, dentistry has actually been a (relatively) hot space, according to recent data from PitchBook. 

• Healthcare services private-equity deal count fell 16% year over year in the first quarter of 2026 and deal value dropped 23.3%, but PitchBook flagged dental among the few subsegments that kept up activity even as the broader market cooled.
  

• Another report published by TUSK Practice Sales also found strength in dental. According to its survey of buyers, 69% of DSOs expect to step up acquisitions this year even as the supply of sellable practices tightens, and 78% anticipate a recapitalization within 12 to 36 months.

Yes, but: The thaw isn't reaching everyone. Two of the country's largest DSOs spent this spring restructuring under their lenders.

• Dental Care Alliance closed a deal earlier this month that cut more than $1.1 billion in funded debt, brought in $95 million of new capital, and pushed maturities to 2031.
  

• Weeks earlier, Blackstone and KKR assumed control of Affordable Care by slashing about 70% of a $1.4 billion private-credit load and wiping out existing equity.

What it means: The cheap-money era that fueled the last boom is over. Buyers are back but far more disciplined—paying multiples that have come back to Earth from pandemic-era highs—while the operators who piled on cheap, floating-rate debt are the ones now getting restructured.

• Dykema's Brian Colao estimates that multiples on larger deals have dropped from the 13–16x of 2021 to roughly 9.5–10.5x today, with solo practices back near 5x after a brief run at 7x.
  

• "[Buyers are] not just going to say, 'Oh, this is a dental deal, let's overpay and throw money at it.' They're being very cautious, very thorough in their diligence—a lot more thorough than they ever were before," said Colao.

What you can do: Focus on the levers you control (and that are valuable for the business anyway), namely same-store growth, higher case acceptance, and leaner operations driven by better technology. 

Bottom line: The thaw is real, but 2026 is sorting DSOs into those positioned to capture some of the dry powder waiting on the sidelines and those scrambling to survive their own balance sheets. The deals under LOI now should start closing in the back half, and a stronger 2027 looks plausible, especially if the macro environment improves and interest rates start easing.