U.S. Dental M&A Begins to Rebound as Practice Consolidation Advances

Merger and acquisition activity within the U.S. dental sector showed signs of a rebound during the first half of 2026, driven by ongoing practice consolidation. A recent report from TUSK Practice Sales indicates that at least 175 dental practice locations were acquired by dental support organizations and private equity groups during this period. This trend reflects a broader shift in the industry, which is now estimated to be approximately 35 percent consolidated as valuations and deal structures evolve.

According to a new report from advisory firm TUSK Practice Sales, the first six months of 2026 saw a significant uptick in dental M&A activity, with at least 175 practice locations sold to various buyers. These buyers primarily consist of dental support organizations (DSOs) and private equity groups, though the firm notes that the actual number of transactions is likely higher due to the inherent lag in industry benchmarks. This resurgence comes as the dental industry reaches an estimated consolidation level of 35 percent, a figure TUSK attributes to American Dental Association (ADA) data.

The landscape of dentist affiliation has shifted dramatically over the past decade, with ADA data showing that 16.1 percent of U.S. dentists were affiliated with a DSO by 2024. Furthermore, research published in Health Affairs highlighted that private equity affiliation nearly doubled from 6.6 percent in 2015 to 12.8 percent in 2021. While these metrics measure different aspects of consolidation, they collectively underscore the movement away from independent practice ownership toward larger corporate and institutional structures.

Current practice valuations remain robust, typically ranging from five to more than nine times earnings before interest, taxes, depreciation, and amortization (EBITDA). However, TUSK forecasts a long-term decline in these multiples to between four and six times EBITDA as the industry matures. Despite this projected decrease, deal structures remain favorable for sellers, with DSOs offering between 60 and 85 percent of the total consideration in cash at the time of closing.

Kevin Cumbus, founder and partner at TUSK Practice Sales, suggests that movement among larger dental companies has created a strategic seller’s window for owners of financially healthy practices. Market sentiment remains optimistic for further activity, as more than 78 percent of buyers surveyed by TUSK indicated they expect to complete a recapitalization within the next year. This anticipated financial movement suggests that the momentum established in the first half of 2026 is likely to continue as the market adjusts to new economic realities.