🦷 New data shows how your DSO stacks up

August 26, 2025

Good Morning. Researchers at King’s College London say they may have unlocked a way to reverse the erosion of tooth enamel, and the key was on top of our heads this whole time. 

The scientists found that keratin, a protein found in wool and human hair, can be used to form a material that mimics tooth enamel when applied to teeth and are now working on a toothpaste and mouthwash that could be sold commercially.

Inside this issue:
- Why tech upgrades are top of mind for DSO leaders
- How DSOs are coping with staffing chaos

⏰ Your reading time today: 5 mins 42 seconds

👑  And now it’s time to play Word of Mouth, a dental-themed word game inspired by Wordle. Take a coffee break and see if you can top our high score charts.

MARKETS

📈 3D Systems Corp ($DDD) – 2.18 | +0.13 (6.34%)
📉 Align Technology ($ALGN) – 144.96 | -0.20 (0.14%)
📉 Colgate-Palmolive ($CL) – 84.06 | -0.36 (0.43%)
📈 Dentsply Sirona ($XRAY) – 14.40 | +0.43 (3.08%)
📈 Envista Holdings ($NVST) – 21.12 | +0.43 (2.08%)
📈 Henry Schein ($HSIC) – 68.47 | +0.53 (0.78%)
📈 Straumann Holding AG (STMN.SW) – CHF 94.90 | +0.24 (0.25%)
📉 Weave Communications ($WEAV) – 7.62 | -0.35 (4.45%)

Data is provided by Google Finance. Stock data reflects market close at 5:00 p.m. ET, showing changes over the past five days.

THE DRILL DOWN

⚖️ Align Technology sues Angelalign over patents, filing in the U.S., Europe, and China to block what it calls patent infringement by its Chinese rival. The case could reshape global ortho competition if courts bite. Angelalign called the lawsuit “frivolous and without merit.”

🚰 American Fluoridation Society calls out federal health agencies, criticizing what it called “misguided anti-fluoride steps” undertaken by the EPA, HHS, and FDA that could limit public access to fluoride. The fluoride fight is heating up.

✂️ ADA says it will cut $20M from 2025 budget, eliminating several programs and trimming volunteer and trustee expenses to recover from years of deficit spending.

🧪 Oral Genome announced a nationwide partnership with Henry Schein to roll out the company’s saliva testing kits, which it says can provide insights into a patients’ oral health through key biomarkers in 15 minutes, across Henry Schein’s network.

🚀17 DSOs were ranked among the fastest-growing U.S. companies by Inc. Magazine, including Vitana Pediatric and Orthodontic Partners, which took the highest spot at 291.

🏀 Ex-NBA player Sebastian Telfair is seeking a presidential pardon in a dental scam case, which involved defrauding the NBA’s benefits plan with $4M of false dental and medical claims. That’s a lot of crowns.

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TECH TRENDS

Tech upgrades top of mind for DSOs

Planet DDS’s 2025 Mid‑Year Dental Industry Outlook just dropped, and its findings are clear: DSOs that modernize and standardize their tech are pulling ahead. 

What happened: Drawing on data from more than 5,200 practices, the report highlights platform consolidation, AI in clinical and back‑office workflows, intelligent RCM, digital patient experiences, and proactive security as the five technology currents shaping performance in 2025.

That squares with analyst projections showing the cloud-based dental practice management software market size growing by more than 11% per year between 2024 and 2030. 

What they’re saying: Industry leaders underlined the same theme that standardized tech, clean data, and automation shorten diligence, support same‑store growth, and command stronger valuations.

“High levels of standardization and consistency across the platform would be considered best in class,” said Gareth Petsch of pH Partners.

The AI angle: Artificial intelligence and automation is also playing an increasingly important role for DSOs, helping offset labor shortages, reduce admin burdens and improve patient care. 

“AI and automation allow us to do more with less, and to do it better,” said A.J. Peak, founder of Peak Dental Services.

Elsewhere in the healthcare space, leading edge operators say they are already using AI to save thousands of employee hours.

Wondering where you stack up? Check your numbers against some of the key industry benchmarks Planet DDS found:

  • Case acceptance: 56% average across general practices and 70% for orthodontic treatment

  • Case completion: 46% of treatment plans created July through December 2024 completed by June 2025

  • Hygiene reappointment: 65% average reappointment rate

  • Patient flow: 47 new patients per practice per month, including specialty

  • Schedule integrity: 6.2% no‑shows; 14.4% canceled in advance

  • Average daily production by practice: $8,605 per practice

Why it matters: For DSOs, a modern tech stack is quickly becoming a need-to-have that unlocks a number of serious advantages in the marketplace:

  • Stronger cash flow: Intelligent RCM reduces denials, speeds posting, and improves forecasting.

  • Valuation signal: Standardization is being weighed in diligence and can tilt outcomes. Industry reporting and investor commentary confirm buyers want operational consistency, data clarity, and scalable systems, not patchwork tools.

  • Schedule health: Improved no‑show and cancellation rates point to how digital reminders, online scheduling, and two‑way texting can get more patients showing up on schedule.

Bottom line: The mid‑year scoreboard shows meaningful gains for operators that invested in modern systems. The path forward is clear: Simplify the stack, automate the back office, enrich the patient experience, and prove it in the numbers.

BUSINESS BITES

💸 Trust AI raises $6M seed round, the largest ever for a dental tech startup, to scale its AI platform already marketed as “ChatGPT for dentists” to 200,000 U.S. providers. That’s some serious seed cash.

📈 USOSM expands into Nebraska with four new practice partnerships, bringing its network to more than 265 surgeon partners across 31 states. Welcome to the Cornhusker State!

💵 Great Hill Partners acquires majority stake in Blue Cloud Pediatric Surgery Centers, the nation’s largest pediatric dental ASC platform, buying from TPG’s The Rise Fund to fuel further expansion.

🤝 Imagen Dental Partners expands into Kentucky, marking the dental partnership organization’s expansion into its 17th state. 

👑 Bob Fontana named 2025 Dental Titan at the Dykema DSO Conference, honoring The Aspen Group’s CEO for leadership in building one of the largest dental and health services platforms in the U.S. Well-deserved kudos. 

💼 Sonrava Health appoints new CFO, announcing Judd Tirnauer (most recently the CFO for California Pizza Kitchen) will serve as the company’s new executive vice president and CFO.

LAST ISSUE’S POLL RESULTS

STAFFING STRATEGIES

How DSOs are finding and keeping staff in a challenging hiring market

Ask any DSO operator what is slowing growth this year: staffing. Among dentists who tried to hire in the last quarter, three in four said recruiting hygienists was very or extremely challenging, and nearly as many said the same about assistants. The bottleneck is real, and it shows up on tomorrow’s schedule.

What’s happening: The hiring market for clinic staff remains tight. In Q2 2025, 37.1% of dentists recruited hygienists and 39.7% recruited assistants. Of those recruiting, 74.1% reported hygienist hiring as very or extremely challenging, and about 71% said the same for assistants. 

Most owners also reported staff wages edging up, with many expecting another 1 to 5% rise over the next six months. According to the Bureau of Labor Statistics (BLS), employment of dental hygienists is expected to grow by 9% by 2033, “much faster” than the average occupation.

How the industry is responding: Some DSOs are investing to create supply. Heartland Dental and Concorde Career Colleges are opening a co‑branded campus in Fort Myers in fall 2025, designed to train up to 120 hygienists and 72 assistants annually using Concorde’s curriculum, with Heartland funding construction and equipment. Heartland also runs a ten‑week dental assisting course to move candidates into chairs faster.

The industry is also embracing more temporary staffing. ADA Member Advantage endorsed onDiem in June for compliant, on‑demand staffing. Some companies, like Kwikly, Cloud Dentistry and GoTu, also offer marketplaces for DSOs to access a large, verified talent pool.

Yes, but: There are tailwinds forming in the labor market. First‑year enrollment in dental hygiene programs rose nearly 20% from 2020 to 2024, suggesting more graduates ahead. BLS data also confirmed where wages have landed: Median pay in May 2024 was $94,260 for hygienists and $47,300 for assistants.

Why It Matters: Staffing is now a strategic lever and a potential edge DSOs can earn in the market, not just a back‑office function. Given that, some practical moves for smart DSOs to consider include:

  • Stand up or co‑brand training in your hotspots. Heartland’s Fort Myers model shows how to anchor a market with a steady flow of graduates. If bricks and mortar are out of scope, consider digital options or partnering with local colleges for “externships.”

  • Build an internal float pool for hygiene. Post dedicated “float hygienist” roles across a region, with premium pay and mileage, to cover vacations and vacancies without collapsing the schedule. Aspen Dental’s postings illustrate the approach.

  • Blend temp coverage the right way. See temps as an opportunity for recruitment and operate accordingly. Track conversion from temp to permanent as a KPI. Use compatible HR platforms to reduce misclassification risk and administrative lift.

  • Create visible ladders. Fund expanded-scope training for assistants and structured continuing education (CE) for hygienists.

  • Comp with intent. Benchmarks have shifted. Validate that your hygiene and assisting pay bands reflect today’s medians, then pair dollars with four‑day weeks, team bonuses, and schedule control.

Bottom line: The staffing crunch is easing in slow motion, not disappearing. Treat talent as a supply chain: Invest upstream, maintain flexible capacity, and lock in retention with growth, flexibility, and fair pay. Operators who master “build, borrow, keep” will protect same‑store growth now and be first to capture demand as new grads hit the market over the next 12 to 24 months.

🗳️ The Check-up:

⬆ VOTE: Have you found it challenging to hire and retain full-time staff in the past year?

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CLINICAL NOTES

🥗 A six‑week pilot of 120 women showed probiotics may help treat periodontitis, with patients who received conventional therapy plus probiotics and a personalized diet seeing better outcomes than patients who received conventional treatment alone.

🧲 Magnetically guided nanobots could be used to relieve dental hypersensitivity, according to an experiment from the Indian Institute of Science. Researchers used the tech to penetrate deep into dentinal tubules of ex vivo teeth and form durable plugs that relieved hypersensitivity. That’s an attractive idea. 

🧘 Mindfulness improved pressure pain thresholds in a randomized eight-week trial of 84 women with chronic painful temporomandibular disorders, as well as reducing tender points, stress, and catastrophizing versus the no‑treatment control group.

🦷 Arginine dentifrices reduced dental caries in children as much as, or more than, a sodium fluoride dentifrice in a new study of 6,000 children aged 10 to 14, with subjects assigned an 8.0% arginine-containing dentifrice seeing results similar to those using a sodium fluoride dentifrice.

FUN AND GAMES

BEYOND THE CUSP