Ladd Dental Group

 The shift of large Dental Service Organizations (DSOs) toward a De Novo (start-up) growth model —combined with their ongoing financial underperformance —has several important implications for the dental profession, private practice owners, associates, and the broader consolidation landscape. Below is a structured breakdown of what it likely means: 1. Why DSOs Are Moving to De Novo Large DSOs historically grew through practice acquisitions , but that model has become more difficult because: Rising acquisition costs Practice valuations surged from private equity demand. EBITDA multiples expanded significantly (often 8–12x+ for large platforms). Buying growth became expensive and margin-dilutive. Limited supply of quality targets Many top-performing practices have already been acquired. Remaining targets may have weaker payer mix, outdated facilities, or operational inefficiencies. Greater operational control De Novos allow DSOs to: Design offices for e...