Perspectives

Thoughts for the DSO Industry in 2026 and Beyond

02/27/2026
|
5 min. to read

BY BRIAN COLAO
Director, DSO Industry Group at Dykema

Five Years of Unprecedented Challenges

The last five years have brought unprecedented challenges to the DSO industry including the great lockdown, the great reopening, the great recovery, the great resignation of dental professionals, record levels of inflation and interest rates, and a great uncertainty which continued throughout 2025 and the first part of 2026 as a result of trade wars and continued global unrest. Over the last five years, the dental industry has existed in an unnatural state with almost all expenses including labor, supplies and equipment, and the cost of money going up, while reimbursement rates remained flat or only slightly increased. This has significantly shrunk profit margins, and from 2022 to 2025, caused a number of DSOs to completely restructure their operations to reduce expenses and increase same-store growth by attempting to implement a variety of technology solutions while eliminating or significantly decreasing M&A and de novo activity.

Unfortunately, many innovative samestore growth strategies were hindered by fear and uncertainty, lack of education regarding how to properly use the technology, lack of integration with existing practice management systems (PMSs), lack of a strong plan of implementation, difficulty sorting through the surplus of options, and lack of support from affiliated dentists and staff. Going into 2026, many organizations find themselves in an environment with very little to no M&A and an unclear path to the creation of significant same-store growth through the implementation of innovative technology solutions. But as detailed below, there is reason for optimism as many of these challenges are slowly being solved, and the obstacles blocking the path forward are beginning to slowly clear. These are my thoughts for 2026 and beyond.

Current State of M&A Markets

From June 2022 until the end of 2025, there has been a great M&A drought. Nearly 75 DSO sale processes have been abandoned with only around eight transactions occurring at fairly modest multiples. But going into 2026, interest rates are steadily being lowered. The new federal chairman that will be taking office in 2026 is widely believed to be an aggressive advocate of lowering interest rates. There is a huge amount of money on the sidelines, and almost every organization in the current DSO marketplace is overdue for a recapitalization event, all of which provides the necessary momentum for a gradual market recovery. During the first quarter of 2026, it appears likely that several significant DSO transactions will occur. Other large DSOs are taking steps to position themselves to go public in the future. With respect to smaller transactions: 1) Sellers are beginning to adjust their expectations to more realistic valuations that reflect the 2026 market conditions; 2) Buyers are utilizing more creative acquisition structures that derisk the transactions including earnouts, holdbacks, post-closing purchase price true-ups, and joint ventures. As a result, we are beginning to see a significant uptick in small- to mid-size acquisitions that will likely accelerate even further by the second, third, and fourth quarters of 2026. Therefore, I am cautiously optimistic that the DSO M&A markets will experience a material rebound in 2026, but the volumes will still be much lower than the market highs of 2021. The scope of the rebound will of course depend on how low the interest rates ultimately go, the degree to which sellers adjust their expectations on valuations, and whether or not some of the more global issues such as trade wars and military conflicts subside.

Current State of Innovation and Technology

Most DSOs are well on their way to working through their plans of restructuring and cost and overhead reductions and are now very well poised to implement new innovative technology solutions to improve same-store growth, which means doing more with existing patients, acquiring new patients, and lowering overhead. Over the last two to three years, the DSO industry has learned a lot of valuable lessons from the trial-and-error process with new technology including:

  • There must be standardization of systems across an organization. Attempting to operate with multiple PMSs or multiple technology solutions that serve the same function undermines the efficiency, profitability, and success of the DSO organization.
  • There must be proper education throughout the organization as to how to properly use the technology; otherwise, it likely won’t be used or will be incorrectly used.
  • The technology must integrate with the DSO’s PMS or else it likely won’t be used.
  • There must be a highly organized implementation plan or else the technology will not be consistently adopted.
  • There must be strong collaboration between the technology partner (vendor), DSO leadership, affiliated practice dentists, and affiliated practice staff or else the technology will not reach its maximum value.
  • Not every solution will work for every organization, and time and research must be spent analyzing which solutions will have the greatest ROI for a particular DSO.
  • There is a surplus of solutions in the market, and time and research must be spent determining which solutions are truly a value add and which solutions are “shiny objects” that ultimately do not impact the bottom line in a material way.

My predictions for 2026 are that many organizations will crack the elusive code on properly implementing new technology through education, integration, and collaboration between technology partners, DSO leadership, dentists, and staff. I also predict that we will see a gradual reduction in the number of technology solutions in the market as the weaker, less valueadded solutions are forced to exit the marketplace, and the stronger solutions rightly gain market share.

Final Thoughts

I have been asked many times (after 31 years in the DSO industry) to give my thoughts as to the characteristics of a successful DSO and set forth below are my thoughts for success in 2026. A successful 2026 DSO will do the following:

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The System Is Broken, Not Your Staff

02/27/2026
|
7 min. to read

by Marcus Bertilson
Chief Operations Officer, Weave

A Strategic AI Fix for the Dental Front Office

Dental organizations are not facing a staffing problem—they are facing a systems problem. Rising labor costs, fragmented technology, and escalating patient expectations have pushed the traditional front-office model beyond its limits. The next phase of DSO performance is not defined by hiring more people, but by redesigning how work gets done.

Here, we’ll explore the three reasons why your solution is implementing a modern dental front-office AI platform that helps streamline operations, capture more revenue, and deliver an exceptional patient experience across your DSO enterprise.

01

The High Costs of Static Staffing

According to Dental Protection, nearly two-thirds (63%) of dental professionals report frequent feelings of burnout and exhaustion. If daily administrative tasks stretch your front-office staff to their limits, practices are at increased risk of costly errors, service oversights, and even employee turnover. And what does this mean for peak times and seasons when performance pressures hit overload?

  • Quantifiable Opportunity Loss: Dental practices miss one out of every three calls during business hours, notes an article in Group Dentistry Now, with 65% of those being potential new patients.
  • Loss of Patients to Competitors: When there’s no system to capture missed or after-hours demand, callers may contact competing practices with the capacity to accommodate them.
  • Negative Customer Experience: Consider how patients’ perception of long wait times and distracted in-person service at the front desk may negatively impact their confidence and trust in the practice.

It may appear that adding headcount is the best (or only) answer to ringing phones and lines of patients at the front desk. But take into account the principle of diminishing returns—productivity will yield to inefficiency quickly if existing technology and workflow issues aren’t addressed. Process bottlenecks will continue to slow everybody down and potentially become more pervasive. They’ll also thwart opportunities to attract, serve, and retain patients.

Altogether, a front office that isn’t running optimally can’t be expected to support growth. And adding more people isn’t guaranteed to impact productivity and profitability metrics that matter to scaling DSOs.

The Systems Fix: A comprehensive AI-powered front-office platform will arm your DSO’s practices with 24/7 call and scheduling support functionality that’s inherently scalable—and always there for patients when they need them:

  • AI receptionists capture and qualify patient demand 24/7; convert missed calls into scheduled revenue.
  • AI assistants/co-pilots automatically transcribe voicemails and compose first-draft emails, prioritizing high-importance messages.
  • AI sentiment analysis tools provide real-time insights into patient sentiment and call intent so that when staff take a call, their interaction is targeted, proactive, and genuinely empathetic.

These capabilities help eliminate administrative overhead, enhance the patient journey, and drive revenue. They also directly benefit staff members, who are free to spend more quality time on higher-value patient interactions.

02

Fragmented Technology Impacts Performance

The front-office tech stack in many practices has become a patchwork of individual “point solutions” for marketing, scheduling, insurance verification, and reputation management that rarely communicate with one another. While these tools are intended to help, their disparate systems create data silos and disjointed workflows. Staff pays the price, jumping between multiple applications and manually entering data and reconciling information.

Aside from piling more work onto your staff’s plate, this approach results in operational blind spots and missed revenue opportunities. In this reality, it’s almost impossible to gain a holistic view of the practice’s health or to proactively manage the patient lifecycle. Introducing more people to the situation would only complicate, not streamline, the tangled web of tech.

Quote
Dental organizations don’t have a staffing problem— they have a systems problem.

The Systems Fix: To truly maximize efficiency, practices must move toward a unified technology strategy where systems are deeply integrated rather than just “adjacent.”

When AI has a deep connection to your data, it becomes an intelligent administrative partner enabling you to:

  • Eliminate Administrative Friction: By automating routine tasks like scheduling, follow-ups, and data entry directly within the PMS, AI removes the heavy lifting from your front-office team.
  • Leverage Actionable Patient Data: Connected systems ensure that every piece of patient information is available to power a more responsive patient experience.
  • Maximize Revenue and Conversion: Integrated AI monitors the entire patient journey in real-time, ensuring no opportunity for practice growth falls through the cracks.
  • Streamline Clinical and Business Operations: A unified platform provides a “single source of truth” via dashboards that offer real-time insights into booking rates, handle times, and production trends.

For organizations aiming to optimize ROI, the focus must shift to unified AI platforms. These solutions move beyond simple automations by integrating directly into your tech stack, optimizing every patient interaction and maximizing overall practice efficiency.

03

Patients Expect Speed AND Empathy, Not a Tradeoff

Staff can’t “go it alone” if they want to provide patients with the 24/7 service they expect. Unfortunately, outdated processes and limited access windows create a service gap that makes hightouch, personalized service nearly impossible to scale.

The trick is finding the right balance between tech-driven convenience and human empathy. While AI is engineered for superhuman speed, purely digital interactions can feel cold and transactional, stripping away
the human element that builds clinical trust. This tension prevents many DSOs from fully committing to automation.

The statistics tell a clear story of this conundrum:

  • The Human Preference: An overwhelming 93.4% of consumers still prefer interacting with a person over AI for service needs.
  • Technology As Table Stakes: 79% of patients want the ability to use technology when managing their healthcare experience.
  • Yes, and …: 88.8% of consumers believe companies should always offer the option to speak with a human.

The problem isn’t the technology itself— it’s the lack of a system that knows when to step in and when to step back.

Quote
AI won’t replace empathy, but it can finally make room for it.

The Systems Fix: Rather than forcing a choice between speed and soul, a unified AI platform enables a hybrid service model. Think of it like a self-driving car: The AI handles the simple routing and lane-keeping, but a human driver is always ready to take the wheel during complex, high-speed, or emergency situations.

By strategically aligning tasks based on risk and complexity, DSOs can achieve:

  • Workflow Optimization: By letting AI handle routine, low-risk transactions, you satisfy the demand for speed when patients need it most.
  • Intelligent Handoffs: If a patient expresses frustration or has a complex question, the AI provides a seamless, informed handoff to a staff member who has the full context of the interaction.
  • Elevated Human Role: Your staff can finally focus on the interactions that drive revenue and retention: high-touch patient support, treatment plan presentations, and empathetic engagement.

This hybrid approach ensures that operational savings are never wiped out by patient dissatisfaction. Instead, technology serves as a “force multiplier” for empathy, allowing your team to be more human, more often.

Conclusion: Beyond the Band-Aid— Adopting the Hybrid Model

Leaders must stop applying “Band-Aid” solutions (short-term staff hires) to a systemic technology problem. The future of DSO operational excellence lies in strategically deployed AI. Adopt a hybrid AI model that prioritizes human empathy where it matters most, while leveraging AI’s inherent scalability to achieve the operational consistency and efficiency you need for growth. The true win is improving the system so that your staff can finally deliver the service they want to give. The organizations that lead the next decade of dentistry will build systems that allow their people to do what matters.

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The Muted Recovery

10/22/2025
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7 min. to read

What 2025 Taught DSOs—and the Road to Renewal

By Brian A. Colao
Director, DSO Industry Group at Dykema

The year 2025 will be remembered throughout the DSO industry as The Year of the Muted Recovery. Entering the year, hope was high that the M&A drought and challenging conditions that began in mid-2022 and caused over 50 significant DSO sales processes to be abandoned would finally subside. A succession of interest rate cuts in late 2024, the inauguration of a new presidential administration promising pro-business reforms, and signals of economic stabilization and the promise of an end to a number of global military conflicts gave rise to expectations that the DSO M&A markets would make a robust rebound.

In my previous year-end article, I identified the critical conditions necessary for a true market revival: sustained interest rate reductions, moderation of inflation, resolution of global unrest, and a regulatory environment that fostered business growth. I also projected that DSOs would increasingly focus on technology adoption for same-store growth to drive EBITDA, compensating for muted acquisition activity.

The Reality: A Muted M&A Market

Unfortunately, virtually none of the foundational pillars for recovery materialized. In 2025, interest rates remained stubbornly high; inflation— though improved—never fell below the key 2% threshold; economically crippling tariffs were introduced against most of the developed world and, as of the time of this writing, much uncertainty remains as litigation over the validity of tariffs appears headed to the US Supreme Court for a decision sometime in 2026. Additionally, the military conflicts in Ukraine and the Middle East have not concluded and continue to exert downward pressure on global markets.

The administration, despite its business-friendly posture, has targeted healthcare fraud aggressively, fueling a notable spike in federal enforcement actions and producing further headwinds for DSO deal-making, which is the subject of a separate article contained herein by my partner, Leigha Simonton, former US Attorney for the Northern District of Texas. As a result, M&A volume remained extremely limited, valuations were pressured, and many groups opted to focus inward, delaying growth decisions and focusing on operational efficiency.

Signs of Hope for 2026: The Year of Renewed Opportunity

Despite these frustrations, several positive signals have emerged, setting the stage for potential improvement in 2026—The Year of Renewed Opportunity:

  • The Federal Reserve at its Sept. 16 meeting, finally, in a highly anticipated move, reduced interest rates by a quarter point. As of the time of this article, there is optimism that there will be additional rate cuts in 2025 and into 2026 because it will take several more rate cuts to create truly favorable economic conditions for the M&A markets.
  • Preliminary peace talks in Ukraine and calls for resolution in the Middle East offer guarded optimism regarding global stability.
  • Legal challenges to tariffs may result in their invalidation, potentially easing supply costs and reducing inflation.
  • Sellers are increasingly adopting pragmatic valuation standards, acknowledging the need to turn investments amid evolving market conditions.
  • There have been at least two significant transactions that have closed and several potential transactions that, as of the time of this article, are under Letter of Intent (LOI) and there is cautious optimism that several closings will be announced before year-end, which represents at least a muted recovery with the chance for a fullblown recovery in 2026.

Given these developments, I anticipate an uptick in M&A activity beginning in the second half of 2026, with the potential for momentum to accelerate should economic circumstances and policy frameworks finally align.

A New Era of Healthcare Enforcement

By Leigha Simonton, Former High-Level DOJ Official and Leader of Government Investigation and Defense Practice for Dykema’s DSO Industry Group

This year has ushered in a markedly elevated threat landscape for health care businesses. The US Department of Justice (DOJ) has prioritized healthcare fraud enforcement at an unprecedented level, shifting its approach from isolated financial disputes to aggressive criminal prosecution in cases that, in prior years, might have remained civil contract matters.

This effort accelerated following the DOJ’s May announcement identifying healthcare fraud as a top priority. New initiatives include financial incentives for whistleblowers to report offenses spanning federal benefit programs, private insurer schemes, and a broader array of conduct now categorized as “fraud,” including actions impacting patients, investors, or other nongovernmental entities. The DOJ reinforced its commitment with new dedicated teams, collaborative working groups with HHS, and the launch of the Health Care Fraud Data Fusion Center—a sophisticated operation leveraging advanced analytics and AI to identify emerging fraud schemes.

“The risks of proceeding without expert guidance have never been greater.”

June 2025 saw the largest healthcare fraud takedown in American history, with criminal charges brought against 324 defendants—including nearly 100 licensed medical professionals—for allegedly orchestrating $14.6 billion in fraudulent activity. Notably, this crackdown involved coordination with 12 State Attorneys General’s Offices and extended beyond federal payer fraud to include wire and mail fraud charges associated with private payers, demonstrating a wide net of enforcement.

Given this aggressive climate, industry participants must maintain rigorous compliance and seek experienced counsel with deep knowledge of the DSO industry, government agency processes, and the structuring of advertising, marketing, business development, patient incentive, and compliance programs—and certainly at the earliest indication of possible scrutiny or an internal concern. The government’s sophisticated investigative approach means that even seemingly minor abnormalities can escalate quickly, and the risks of proceeding without expert guidance have never been greater.

Technology: The Imperative of Innovation

Just as predicted, technology adoption for same-store growth has become essential. DSOs nationwide have piloted—and increasingly implemented—innovations in diagnostic AI, cloud-based practice management, automated RCM tools, patient finance solutions, and specialty integration platforms. While adoption has advanced more slowly than hoped—primarily due to challenges in education, training, integration, and implementation—it is steady and inexorable.

Rising costs for labor, supplies, and equipment, combined with stagnant reimbursement rates, have made technology the only viable solution for sustaining margins and driving growth.

A Bright Spot: The 2025 Dykema Definitive Conference for DSOs
Amid an otherwise stagnant year, the Dykema Definitive Conference for DSOs emerged as the industry’s true highlight and north star. With attendance surpassing 2,500 and experiences selling out within just hours, the event reaffirmed the strength and future promise of the DSO community. Breakouts and workshops quickly reached standing-room only, underscoring the appetite for practical insights and forward looking strategies. The conference also shined a spotlight on industry leadership: Bob Fontana (The Aspen Group) and Stan Bergman (Henry Schein) received the Lifetime Achievement Award, while respected voices like Dr. Sulman Ahmed (DECA Dental) and Steve Bilt (Smile Brands) reinforced their commitment to advancing the profession.

Just as significant, vendors and sponsors showcased innovations that will help power a new era of growth—advancements that align directly with the industry’s need to innovate, refine operations, and prepare for the rebound ahead. The conference made clear that while recovery may take longer than hoped, the foundation of innovation, leadership, and community is firmly in place to carry the industry forward.

Strategic Outlook: Thriving in Uncertainty

As The Year of the Muted Recovery draws to a close, DSOs must remain strategic and resilient. The best-run organizations will not simply survive the volatility; they will use this period to innovate, refine internal operations, and position themselves to lead as the market rebounds.

My prediction: 2026 will begin with the same cautious progress but, as the year unfolds, will reward those organizations who are prepared—operationally flexible and technologically advanced—when true recovery gains traction. With strategic adaptation and forwardthinking investment, DSOs will be well-positioned to lead dentistry’s next era of growth.

 

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Aligning Data, Advancing Oral Health

10/22/2025
|
7 min. to read

Wardah Inam walked into a dental office for treatment and left with more questions than answers. A new plan conflicted with what she had previously been told, insurance coverage was a mystery, and no one could explain the discrepancies.

For most patients, this confusion is just part of the system—but for Inam, who has a Ph.D. from MIT, it sparked a bigger question: why was dental diagnosis so hard to understand?

“I asked for my X-rays, then left the office. That’s when I started learning dental basics myself, reading books and papers to understand how dental diagnosis works,” Inam says. “I shared my data with multiple dentists, and they gave me different recommendations as well.”

Even with identical data, dentists offered conflicting recommendations. Inam plunged into dental research, consulted multiple providers, and observed dentists in action. Dentistry wasn’t failing from lack of skill— it was failing from a lack of tools assisting dentists.

Bridging the Divide

Inam founded Overjet with a powerful goal: to make dentistry more quantitative and get every stakeholder on the same page to deliver the best care.

“With my background in AI and technology, I realized this was a place where I could make a meaningful impact,” she says.

By analyzing dental images and patient data, the platform ensures that diagnoses and treatment plans are consistent, transparent, and aligned with best practices.

“Overjet is on a mission to improve patient care, create exceptional experiences, and optimize outcomes. To achieve this, we need technology that considers the patient experience end-to-end, while also supporting the multiple stakeholders who deliver and pay for care and ensure the system works effectively across the ecosystem,” Inam explains. “Technology can serve as a facilitation layer, enabling providers and payers to share information more seamlessly. This leads to faster, more accurate decisions and, ultimately, better care for patients.”

From the patient’s perspective, the dental journey—from diagnosis to treatment, claim submission, and payment—can feel complicated and opaque. Instead, Inam argues the journey should be more collaborative at every step. “Our AI-native imaging software helps providers communicate more effectively, so patients truly understand their oral health and the treatments they need,” Inam says.

“AI is a tool,” Inam says. “Our goal is to ensure that patients feel understood, providers feel confident, and payers can make faster and accurate decisions. When all three sides trust the system, everything improves—outcomes, costs, and patient experience.”

Measuring What Matters
One of the ways Overjet builds this trust and collaboration is through the introduction of the Oral Health Score: a measurable, objective metric that connects patients, providers, and payers.

“It shows where they are today, what treatments are needed, and how those treatments will improve their health. It also helps providers and payers work from the same objective data,” Inam notes.

By creating measurable, objective metrics, Overjet reduces friction and aligns all stakeholders, fostering transparency. “If you can measure it, you can improve it,” she emphasizes.

The Oral Health Score isn’t just internal innovation—it has a scientific foundation. “We’ve used data from more than 340,000 patients across all 50 states,” Inam says. “That scientific foundation is what excites us most— bringing measurable, data-driven improvements to oral health.”

Tackling the Taboo: Working with Payers

While internal metrics like the Oral Health Score bring much-needed clarity, one of the biggest barriers to progress in dentistry is the payerprovider relationship. For decades, it has been defined by mistrust.

Collaboration between providers and payers is rarely simple, but it is absolutely essential. Overjet streamlines this process by helping providers verify insurance in seconds, a task that traditionally takes hours, through aggregated eligibility and benefits data combined with direct payer connections. Its evidence-based AI annotations also empower providers to submit stronger claims, resulting in faster payouts. Overjet’s ReviewPass further accelerates the process by enabling instant payer approvals and skipping manual insurance reviews. In addition, Overjet has introduced credentialing automation software used by both providers and payers to deliver instant, automated credentialing and remove unnecessary administrative friction.

“Providers and payers don’t need to love each other, but they do need to figure out how to work together more effectively to better serve patients,” she notes.

The message to providers is clear: avoiding payers is no longer a strategy. The leaders who embrace collaboration will not only reduce friction—they will gain a competitive edge in dentistry.

Empowering DSOs to Take Bold Action
Overjet is a lever for leadership courage and collaboration, enabling an endto- end, streamlined experience from diagnosis to claim submission.

Standardizing and scaling tools supports both DSOs and solo practices. Patients benefit from more clarity and fairness in treatment, which leads to better outcomes. Providers make more accurate and faster claim decisions with less admin burden.

Payers reduce costs by cutting down administrative overhead.

“The power of AI is not just operational efficiency,” Inam says. “It’s about giving DSO leaders the confidence to grow fast while providing the best care to their patients.”

Overjet allows DSO leaders to step into a new type of leadership—one that prioritizes collaboration, clarity, and courageous decision-making.

Thought leader Kerry Straine, CEO at Straine Dental Management, is confident about the opportunities ahead, “Patient care is at the heart of everything we do. Our goal is to help our partners elevate the patient experience through AI-powered tools. With Overjet, we’re unlocking new levels of precision, efficiency, and performance that will redefine what’s possible in dentistry.”

That same clarity and collaboration extend beyond patient care— transforming transparency into a powerful driver of trust, growth, and competitive advantage.

Turning Transparency into Market Power
Trust cannot be spun, it must be earned through transparency, data, and the courage to confront hard truths directly. When done right, it doesn’t just improve patient care, it drives measurable business results:

  • Patient retention: Clear communication and reliable care build loyalty.
  • Operational efficiency: Consistent treatment planning reduces errors, unnecessary procedures, and administrative burden.
  • Strategic growth: Easier payer collaborations and smoother integration across locations.

 

Fred Ward, CEO of Marquee Dental Partners, has seen the impact up close: “The best dental offices I’ve ever been associated with were the offices who focused on the patient. I’m excited about what AI can bring—real-time data, real-time recommendations—all the things that enhance a doctor’s opportunities are right in front of them. They can spend their time with the patient doing the treatment right now.”

That, Inam emphasizes, is the real mission: “We’re not just building better AI. We’re building a system where data drives decisions. That shift is the most powerful driver of better care, lower costs, and stronger leadership.”

The Shift: From Blame to Collaboration

Looking forward, Inam envisions a healthcare ecosystem where patients, providers, and payers interact seamlessly, supported by technology that is transparent, reliable, and evidence-based. Overjet is leading this charge in dentistry, creating a model that could expand across broader healthcare.

“Imagine a frictionless dental experience for every patient,” Inam says. “Providers should be empowered to make confident decisions, and payers should feel secure in coverage. When you align all three, you unlock a system that’s smarter, faster, and more humane.”

For DSOs, embracing this model is an invitation to rethink legacy processes, adopt innovative tools, and place trust at the center of leadership.

“This isn’t about asking ‘who wins?’ It’s about asking, ‘How do we all win?’ By shifting from blame to collaboration, we can inspire a new generation of dental professionals and DSO leaders to embrace data-driven care,” Inam says.

Her confusing dental visit years ago pushed Inam to act, and that courage created a platform reshaping an entire industry. The choice now lies with every DSO leader and decisionmaker: remain stuck in uncertainty, or build a future defined by clarity, collaboration, and bold action.

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Broken Smile to Industry Breakthrough

10/22/2025
|
12 min. to read

My cousins and I tumbled, laughing, into the car. I climbed into the middle front seat with no seatbelt.

The last thing I remember was my face smashing into the dashboard. Broken nose, jaw, teeth, maxilla.

It was the most devastating moment of my life.

The road to revolutionizing oral care didn’t start in a lab, it started with a broken smile.

Beyond Aesthetics

The culture I grew up in was traditional Georgian, very rooted in family values. Getting married young was expected. People would formally ask for your hand in marriage. Beauty was everything—how you looked often mattered more than anything else. But I was different. I had a mind I wanted to use, dreams I wanted to pursue. My father knew that. Nevertheless, at 13, I was being prepped for introductions and weddings.

My parents, new immigrants, didn’t know the best doctors or have access to top care so we went to the local clinics. I went through years of dental work with implants, root canals, veneers, and braces. I hated looking in the mirror. I felt insecure and carried this invisible pain.

But one day, the orthodontist said something I never forgot. He said, “Don’t worry, great things will come from you. You’ll change people’s lives.” 

He gave me hope. He made me stop focusing on what I looked like and start thinking about what I could do. That one moment changed everything. I cared about making a difference. And from then on, my life took a different path.

No Complaints, No Excuses, Just Work

In addition to the complete change in my life’s trajectory, my parents’ compassion, respect, and tenacity influenced my decision to become a doctor.

My father drove a taxi for 14 years, an old yellow Checker. Eventually, he built his own company, bought medallions, and ran a fleet of cabs. He’d be up at 3 a.m., fixing cars when they broke down. There was no complaining, just work, determination, and problem-solving. He did whatever had to be done and so did my mom. It’s almost like you forget the past, you forget the future, and you just keep doing the next step. That’s the resilience that I’ve learned.

My mother had followed the customary Georgian path of getting married young—in fact, she left school one semester shy of becoming a physician to marry my father.

She sacrificed so much of herself. She was brilliant. She’d help me with chemistry and organic chemistry. It pained me as a girl to watch her life revolve around domestic duties when I knew she was meant for so much more. I chose a different path. 

Trading Prestige for Purpose

I started dental school at the University of Pennsylvania. After a residency at New York Presbyterian, I spent two years practicing cosmetic dentistry on Fifth Avenue in New York City. While doing that, I was offered a teaching position at NYU in their Advanced Aesthetic Dentistry program, which I held for two years. But eventually, I returned to Penn for orthodontic school.

I graduated at the top of my class and practiced orthodontics in NYC for 10 years. That time was incredible. I met amazing patients, colleagues, and mentors. But over time, I knew I wanted to go beyond the practice and build something that would impact lives on a larger scale.

Quote
“I wasn’t chasing approval, I was chasing impact.”

Emergency Calls Spark Innovation

Throughout my career as an orthodontist, I always took the emergency calls. My husband, also an orthodontist, and my father-in-law would hand them to me because I had the patience to walk my patients through what to do. Over the years, I felt the pain and frustration on the other end of those calls: parents trying to help their kids with swollen gums, broken appliances, sleepless nights. I kept thinking there had to be a better way. They shouldn’t have to resort to toenail clippers or pliers to make urgent fixes. Kids shouldn’t have to suffer through school or another night in pain.

I carried that frustration with me for years. Then COVID hit. Suddenly, families from all over were showing up at our home because they had nowhere else to turn. We saw so many people, each with urgent problems. That was the breaking point.

One night, I was in the basement, my husband next to me, the kids playing nearby. I began sketching ideas and drawing designs for what became Tweakz®. I couldn’t stop. My husband was chiming in: “Add a diamond file. A diamond tip.” I kept going, researching clinical trials, studying what worked and what didn’t.

It felt like solving a giant puzzle, and I thought, “I can do this.”

Within weeks, I created 18 products, organized into three collections: Oral Relief, Microbiome, and Aesthetic.

30 Patents and Zero Tolerance for Band-Aid Fixes

At the core of it all was the same why: the voices on the other end of those calls, the desperate parent, the crying child, the family in chaos. As orthodontists, we hand out goody bags filled with toothbrushes and floss that patients just throw away—because when they’re in pain, they’re not thinking about brushing or flossing.

The real question is: How do we get them out of pain so they can achieve proper oral health? When you solve the actual problem, everything else falls into place. If you don’t, you’re just putting a band-aid on it. 

I wanted to solve the problem and that led me to create a portfolio of sciencedriven, research-backed products designed to help patients when they’re at their most vulnerable.

I returned to Penn to deepen my research in preventive medicine, focusing on oral wellness, the oral microbiome, and new delivery systems. I now have about 30 patents pending.

Toenail Clippers Don’t Belong in Orthodontics

People are still using toenail clippers to fix broken wires. It’s awful, and dangerous. Pieces can fly off, lodge into the buccal mucosa or esophagus. It’s a huge liability for the doctor, but no one talks about it. And when people speak up, there’s pushback: “Oh, it’s fine, just come in, miss work, miss school, don’t sleep for two nights while a wire digs into your cheek, causing inflammation, bacteria buildup, plaque, and demineralizations.” All of it is preventable.

That’s why Tweakz for Braces was the first product. It includes a flush distal end cutter that safely trims wires without leaving sharp edges or loose pieces, unlike old nail clippers. The dislodged bracket remover clears broken brackets, while the rubber band applicator makes changing elastics easy. The diamond dental file smooths rough spots on brackets, hooks, and bands.

The Tweakz for Aligners kit offers an elastics applicator, an aligner remover that removes the most retentive of aligners with ease, and the diamond dental file.

 

Clinician First, Businesswoman by Fire

Starting the business came with a kind of fearless ignorance. I didn’t know what I didn’t know, and in a way, that protected me. I simply focused on the next step: Ask questions, find answers, and keep moving. The stress didn’t hit until my expectations collided with the real mechanics of business— timelines, margins, negotiations. I didn’t yet understand how deals were made or what tradeoffs were required to keep things moving.

The hardest part wasn’t the work itself; it was staying grounded in a world where I no longer felt like the expert. In medicine and oral health, I was confident. In business, I was uncomfortable. Constantly. But instead of pulling back, I focused on what I knew: how to help people, how to remove pain, and how to prevent suffering. My fascination with removing discomfort from someone’s life is what still drives me today.

There were plenty of times I was told “no.” 

But I learned something important: 

When you hear “no,” you’re probably just talking to the wrong person.

So I kept going.

Because I wasn’t chasing approval, I was chasing impact.

There were moments of real doubt, days when I questioned everything and nights when I leaned hard on even the smallest wins to keep going. But those glimmers of clarity and hope kept me moving forward. I’ve never looked back. The vision I hold now is bigger, clearer, and more powerful than ever, and it’s rooted in helping others feel empowered too.

Being an orthodontist always felt natural to me, but becoming an entrepreneur felt like learning a whole new language. Every day is unpredictable. But little by little, the products have started to speak for themselves. That’s been my greatest challenge, bridging the gap between my skill set as a clinician and the skill set you need as an entrepreneur. It’s so important to me that someone opens that package with a smile, knowing this product is going to help them.

90% of Emergencies Solved Before They Start

Beyond improving patient care, these products protect the bottom line by preventing emergencies that can cost orthodontists up to $300 at each emergency visit. Ninety-nine percent of bracket emergencies are due to broken brackets or sharp distal ends. For aligners, 92% involve rough edges or trays that are challenging to remove.

Those unexpected visits, usually right after school, at the busiest time of day, can throw an entire office into chaos, from sterilizing tools and turning over chairs to derailing the schedule. 

OrthoNu® products help protect profits by solving 90% of emergencies right at home. The Tweakz tool cuts and holds the wire safely, so patients don’t have to rush in. The Oral Relief collection includes Mouth-aid™ to soothe sores, Comfort Tape™ to help with sensitivity, Chillin’ Strips™ to soothe wounds, and the OrthoChewz™ to ease dry mouth and oral fixation. Today, Tweakz is used in 500+ practices and shipped to 5,000+ patients nationwide, in addition to over 8,000 Oral Relief collections. We’re just getting started.

For big practices and DSOs, these tools don’t just save time, they save thousands of dollars. And they open up new revenue streams by offering parents a kit they want to buy. It’s a win-win-win: Practices save money, create new revenue, and less-stressful experiences for patients.

Precision Tools for the Pain No One Plans For

While I originally created these products for orthodontic patients, the oral relief kits are just as effective for anyone recovering from all dental procedures. Whether it’s after a scaling, root canal, crown, periodontal surgery, or multiple extractions, patients never had anything meaningful to take home to ease pain and discomfort. Now they do. Smart strip technology allows the product to stay in place for hours, deliver active ingredients, and support real healing.

Our current Chillin’ Strip molds anywhere in the mouth and stays in place. The more saliva you have, the better it adheres, the opposite of wax. Soon we’ll have strips that last 8, 24, even 72 hours. That means safer wounds, fewer infections, and better outcomes for surgeries, extractions, biopsies, and even for cancer or radiation patients dealing with oral sores.

In the end, it was never just about orthodontics, it was about listening to the pain, the panic, and the unmet needs on the other end of those calls. I realized those moments weren’t interruptions. They were insights.

They pushed me to ask myself: Am I truly solving the problem, or just applying another short-term fix? That question became my compass. I stopped accepting temporary fixes and started building solutions that treat the root causes—solutions that bring real relief, restore confidence, and shift the standard of care.

Because in a field built on precision, we can no longer afford to think small. Our patients deserve more.

I created OrthoNu to solve the problems I lived. First as a teenager in pain with nowhere to turn, then as a doctor who kept running into the same missing pieces in care. Too many gaps. Too little access. Not enough empathy. 

If you believe care can be better, make it better. Because when your mission is rooted in truth, and your drive is unstoppable, you don’t wait for permission—you lead.

The Next Frontier in Diagnostics

The future of healthcare lies in smart strip technology—advancements that extend beyond conventional treatments to support early detection, prevention, and accessible care on a global scale.

Over the next 18 to 24 months, OrthoNu will release a series of innovations—each one grounded in science, built with precision, and driven by one goal: to empower patients and providers.

From targeted pain relief to early disease detection, our IP-protected smart oral strips are changing what’s possible in oral health—making care more effective, more accessible, and more human.

But this isn’t just about product launches or patents.

It’s about leading with purpose.

Often, these lesions are nearly invisible—a faint white line, like lichen planus—that even dentists might miss. Patients are being diagnosed years too late, and doctors face lawsuits because these signs go undetected.

I’m excited about what the products could do for underserved populations. We could triage patients early, in a way that’s affordable and accessible worldwide. We could catch diseases early. Consider a seven-year-old boy who has no idea he has cancer in his mouth. Without this technology, it might not be found until it becomes a much bigger problem years later. The dream is to save lives through early detection.

This vision pushes oral care far beyond the dental chair—toward a future defined by value-based care, personalized wellness, and minimally invasive diagnostics.

The goal is to empower clinicians to be the frontline heroes for their patients. By creating data collection tools for every patient, we can track changes in their oral health over time and catch problems before they escalate.

This technology could revolutionize disease prevention. Think about populations with limited access to healthcare—being able to give them oral smart technology that detects early signs of oral disease, diabetes, heart disease, or cancer. It’s an affordable, accessible way to triage health worldwide.

Because when you build from a place of compassion, you don’t stop after one success. You keep going—because you have to. And when innovation starts from the heart, it becomes unstoppable.

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Perspectives

Waterlines as a Leadership KPI

10/22/2025
|
8 min. to read

Many dental offices manage waterlines blindfolded: dump in treatment products, test sporadically, and hope for compliance. But waterline safety isn’t just a clinical detail—it’s a litmus test for leadership. Reliable waterline testing reveals more than bacteria counts; it exposes the strength of a practice’s discipline, accountability, and patient-first values. In an era where a single outbreak can shatter brand equity, erode investor confidence, and damage leadership credibility, treating waterline testing as a core key performance indicator (KPI) separates the organizations that scramble from those that lead.

Some argue the cost of compliance outweighs the risk of penalties. But that perspective collapses when you factor in the true cost of reputational damage and litigation. In 2016, one pediatric dental group learned this the hard way after an outbreak linked to contaminated waterlines resulted in 71 confirmed infections, 49 probable cases, and more than 200 lawsuits— an incident estimated to cost tens of millions.

But it doesn’t have to be this way.

There are large DSOs hitting waterline compliance rates well above 95%. That’s not luck. It’s the result of empirically driven, well-built water management protocols that allow waterline testing to shift from a reactive headache to a strategic KPI. High pass rates aren’t just about ticking regulatory boxes; they offer a window into the health of the entire operation.

When DSOs start proactively treating waterline testing as a KPI, they unlock powerful insights into their training effectiveness, operational discipline, and compliance culture at a team and organizational level.

Treatment Isn’t Enough— Test or Risk It

While roughly 75% of offices actively treat their waterlines, fewer than 25% test them. That’s a dangerous disconnect. Regulations require meeting a 500 CFU/mL bacterial threshold. Treatment alone isn’t a guarantee; without testing, there’s no way to confirm the treatment worked. 

“Laws and regulations are created because the mass population is not following best practices and guidelines. Those who understand testing is doing the right thing for the patients are the early adopters, starting processes long before they are forced,” Kendra Flowers, a clinical operations/ compliance leader, says.

Quote
“Waterline safety isn’t a checkbox —
it’s a competitive advantage.”

Many waterline test failures come down to simple, preventable oversight, like forgetting to add a treatment tablet or neglecting in-line filters on ultrasonic scalers. These small gaps often fly under the radar until a failed test forces attention.

Water quality KPIs should be treated like spore testing: nonnegotiable and high stakes. “Unsafe water has deadly consequences,” Flowers says.

The key? Integrate waterline data into dashboards, reviews, and incentive programs. What gets measured—and rewarded—gets done.

Training That Shows Up in Every Test Result

Waterline test results don’t just measure bacteria—they measure training. When pass rates are consistently high across locations, it’s a strong signal that teams are intentionally following protocols.

According to Flowers, high failure rates are common during the initial implementation of a dental waterline protocol. The failure rates reflect the lack of standardized processes, such as:

  • Heavily occluded lines requiring replacement
  • Elevated bacterial levels from municipal sources
  • Staff unfamiliar with proper procedures

 

Over time, as the protocol becomes embedded in daily operations, staff gain greater awareness, adopt best practices to prevent failures, and consistently follow maintenance routines.

“Protocol makes or breaks waterline safety. We’ve tested hundreds of thousands of samples, and the truth is simple. Every product can work, and every product can fail if protocols slip. With the right training and site-specific procedures, the majority of failures never have to happen,” says Brianna Niederschulte, President of Agenics Labs.

In short, high scores are proof that the training stuck. Use top-performing offices as a blueprint and treat low pass rates as flashing signs for retraining or standard operating procedure (SOP) overhauls.

Onboarding Passes the Ultimate Test

Waterline test results also serve as a real-time gauge of new hire readiness. When DSOs walk every new hire through SOPs in detail from day one, they sharpen accountability and drive better results. If waterline scores dip after onboarding, it’s time to tighten the process—and make sure new hires aren’t just trained but battle-ready. 

To assist in new hire readiness and better results, Agenics Labs provides customized onboarding and training for DSOs, including developing and maintaining SOPs.

“Not only does this allow us to provide DSOs with solutions we know will work, but it also means we can work right alongside their practices, helping staff adhere to the group’s established procedures,” says Niederschulte. 

Celebrate Your Champions

When offices proactively test and maintain waterlines without reminders, it reveals a culture of discipline and pride in clinical excellence.

“I like to identify champions in all areas of focus or initiatives I oversee,” Flowers explains. “Showcasing the team’s best practices, whether through a company newsletter, peer training for new offices, or coaching support for underperforming teams, not only drives broader adoption of effective strategies but also fosters the development of future leaders within the organization.”

Average DSOs comply because they have to, while great DSOs embed infection control into their operations because giving their patients the greatest care possible is their standard. Recognize and reward the teams that use best practices. Then, use their success to inspire others and embed a culture where accountability isn’t just expected. It’s celebrated.

A Hidden Indicator of Employee Burnout

If well-trained teams are still failing waterline tests, it’s often a red flag for deeper operational issues like understaffing, burnout, or lack of support. This reflects breakdowns in communication, resources, or trust between staff and leadership. 

“Most issues turn out to be workflow inefficiencies requiring coaching or protocol tweaks. But when real resource gaps arise, it’s critical to escalate and engage leadership to find solutions,” Flowers emphasizes.

Use low pass rates as a trigger to reassess staffing, redistribute duties, and provide targeted support before small cracks become big problems.

Compliance as a Strategy, Not a Scramble

By adopting the most rigorous, yet reasonable, waterline testing protocols across all states, organizations can create a consistent standard of care and sustainable compliance culture. 

“This approach not only mitigates risk but also positions the organization ahead of regulatory changes, ensuring readiness and reinforcing our commitment to patient safety and compliance,” Flowers says. 

But protocols alone don’t cut it.

“For any system to succeed, it must be fully integrated into daily workflows, routinely measured, and supported by clear accountability,” Flowers adds.

That’s where deeper, more informative testing can make the difference. Equipping teams with the knowledge to understand what their results mean allows them to take ownership of the process.

“Our mail-in tests include additional water quality metrics that not only help us understand why a sample may have failed but also empower dental team members to identify their own protocol gaps. We are the only lab in the industry to include these extended metrics in every mail-in test, demonstrating our commitment to being comprehensive—one of our core values,” Niederschulte says.

Without this level of integration and insight, compliance becomes a scramble, not a strategy. The best DSOs embed waterline management into the daily routine, track it relentlessly, and use detailed data to prevent failures before they happen. 

Quote
“Embedding waterline results into dashboards, onboarding, and incentives creates a system-wide feedback loop that builds trust with patients, investors, and regulators.”

Benchmarking That Drives Results

Waterline compliance data isn’t just numbers. It’s a spotlight on which offices are excelling and which need help. By centralizing test results, DSOs can benchmark performance (and check compliance culture) across locations, identify top performers, and replicate their success.

“In addition to our online reporting hub, we curate customized reporting for DSOs, allowing them to view their test data in a variety of ways that can be leveraged for insights into their different locations and collective performance as an organization,” Niederschulte says.

The best teams pass on the first try, no hand-holding required. Their secret? Simple, consistent habits like daily maintenance logs, visual checklists, and operatory signage.

When shared through coaching, newsletters, or onboarding, these practices fuel a culture of compliance and improvement. This isn’t just about tracking—it’s about setting the pace.

Lead the Charge or Get Left Behind

When waterline safety becomes a core KPI, DSOs don’t just check boxes. They drive real, measurable excellence.

“Two factors consistently drive reliable waterline outcomes: first, standardized protocols tailored to the organization and second, ensuring teams understand the why behind waterline management through meaningful education. When both are in place, we routinely see offices jump from the industry average of around 70% pass rates to exceeding 95%,” Niederschulte explains.

Waterline safety isn’t a checkbox—it’s a competitive advantage. For DSOs, every test is more than a compliance measure; it’s proof of operational discipline, staff readiness, and patient-centric leadership.

The groups that test, not just treat, demonstrate to patients, regulators, and investors that they put safety and accountability first. Those are the DSOs that will earn trust, scale with confidence, and lead the industry forward. The challenge is simple: Use waterline testing as your gauge. It won’t just tell you if your water is safe—it will tell you if your organization is built to win.

Sources:

Ross, Erin. “Infection Outbreak Shines Light on Water Risks at Dentists Offices.” NPR, Average Top-Performing DSOs September 30, 2016.

 

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Perspectives

A New Path to Ownership

10/22/2025
|
4 min. to read

BY MARKO VUJICIC AND RACHEL MORRISSEY

For most of dentistry’s history in the U.S., being a practice owner was an essential part of being a dentist. The traditional career path was clear: graduate, associate with an established practice for a few years, and then buy in or build a practice of your own. Practice ownership was the marker of success and stability. Most dentists still follow this path. But for younger dentists, the timing of when they get into practice ownership has shifted.

For decades, the American Dental Association has surveyed the U.S. dentist workforce to collect information about their occupation (including ownership status) and basic demographic information. We use the term “practice ownership” here to include dentists who fully own their own practice as well as those who are partners or shareholders in other practice types, such as group practices and dental support organizations (DSOs).

To get a better understanding of how practice ownership has played out for dentists generationally, we looked at survey data from over 55,0000 unique dentists who graduated from dental school between 1991 to 2020 and reported ownership status at least once in their career. To track practice ownership over the career span, we grouped dentists into six graduation cohorts, starting with the classes of 1991-1995 and ending with the classes of 2016-2020. We then looked at practice ownership rates at different career stages for each of these cohorts.

Dentists who graduated from dental school in the early 1990s through the early 2010s show strikingly similar patterns in practice ownership. For these cohorts, ownership was achieved relatively quickly. By the time they had completed their first decade in the workforce, more than three out of five dentists who graduated in the early 1990s through 2010 were practice owners. Although dentists who graduated before 2006 were more likely to be owners at the very early career stage, by the 15 to 19 years of experience stage these differences narrow. The practice ownership rate was 89% for the 1991-1995 cohort compared to 81% for the 2006-2010 cohort.

By contrast, dentists graduating in 2011 or later are following a very different career trajectory than their predecessors. While 63% of dentists from the 2006-2010 graduating classes were owners five to nine years out of dental school, only 33% of the 2011-2015 graduating classes were owners at the same career stage. Thus, there is a significant decline in practice ownership rates in the early career stage for newer graduates. However, as these newer graduates move into the next career phase, their practice ownership rates catch up to their predecessors.

Quote
There is a significant decline in practice ownership rates in the early career stage for newer graduates.

Gender adds yet another layer to the story. Across all graduation cohorts, and all career stages, men are more likely than women to own a practice. The gender gap is largest in the early career stage, and then gradually diminishes toward the later career stages. For the newest cohorts of dental school graduates, the rate of ownership for men was 30% compared to 14% for women early in their careers. One thing to note is that while the levels differ, the shapes of the trend lines across the career span are similar for both genders. Practice ownership generally rises over time but starts at a much lower level for more recent graduates.

Why is practice ownership in the early career stage dropping for younger dentists? While there is no definitive research, we think several forces are at play. Educational debt might steer new dentists away from pursuing practice ownership right out of the gate. Some younger dentists may value flexibility or reduced administrative burden and may not see ownership as immediately appealing or conducive to work-life balance. The changing demographics of the dental workforce, where now the majority of dental school graduates are women, is another factor at play.

Quote
While men and women follow similar paths, women start at a far steeper climb toward ownership.

While some version of practice ownership still seems to be the end point for most dentists, it is clearly no longer the quick step it was a generation ago. We also caution that for the newest cohort of dental school graduates we have only limited data—for the first 10 years of their career. There is clearly something quite different about this cohort, and it remains to be seen if their “catch up” rate is indeed as quick as the cohort before. We will update the data as they become available. Stay tuned.

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Markets & Enterprise

AI At Scale

10/22/2025
|
4 min. to read

How Dentistry Is Leading the Enterprise Revolution

AI in healthcare often lives in theory. In dentistry, it’s already in daily practice. More than 50,000 providers and eight of the top ten largest DSOs in North America use VideaAI by VideaHealth, shifting the conversation from potential to performance. Heartland Dental, for example, adopted the platform across 1,500 supported locations in just 10 weeks, proving that AI can scale seamlessly across enterprise operations, deliver consistent clinical support, and strengthen patient trust. For DSO leaders, dentistry shows what it looks like when AI becomes standard care rather than a pilot program.

Heartland Dental: Enterprise Proof in Action

Heartland Dental, the largest DSO in the U.S., became the proving ground for AI at scale. Within weeks, the platform was not only rolled out but also embraced. With adoption across nearly every supported practice, VideaAI quickly became part of the clinical workflow rather than an added step.

Dr. Seth Gibree, Senior Director of Clinical AI and Innovation, underscores the impact, “When integrated with clinician expertise, AI diagnostics provide valuable assistance, helping dentists detect issues earlier and enabling less invasive care that enhances patients’ well-being and promotes overall long-term health.”

For multi-site leaders, Heartland’s experience signals something bigger: AI is not a side tool—it’s an operational backbone that scales without compromise.

  • Scale That Moves Markets: VideaAI powers more than 50,000 providers and eight of the top ten largest DSOs in North America, proving that AI can operate at full enterprise scale, embedded into every workflow.
  • Rapid Adoption: Heartland achieved 95%+ user adoption in just 10 weeks, showing that clinicians adopt and trust AI when it delivers real value.
  • Results You Can Measure: Improved treatment acceptance, stronger patient trust, fewer missed diagnoses, and reduced administrative burden demonstrate measurable impact.

These enterprise wins aren’t just numbers; they play out at the chairside every day. Dr. Tim Quirt, SVP of Clinical Operations, explains, “Our supported clinicians use VideaAI every day to detect details even the most observant human could miss, while retaining complete control of treatment planning.”

Operational Impact That Scales

The benefits of AI extend far beyond individual patient encounters. Nearly 60% of patients say they feel more confident in their dentist when AI tools are used. These measurable outcomes translate into fewer missed diagnoses, better clinical results, and reduced costs associated with delayed or complex treatments.

AI also tackles the persistent staffing crunch. In early 2024, nearly 40% of private dental practices were actively recruiting assistants, with most describing the process as augment human capacity, democratize data, and reduce clinician burnout.

By 2027, Gartner projects that AI will cut clinical documentation time in half, amplifying efficiency without proportional increases in staffing. For dental organizations, this goes beyond a point solution and marks a full-scale operational shift that delivers measurable results across the enterprise.

Policy and Payment Momentum

Dentistry’s AI adoption also reflects a larger policy trend: incentivizing prevention. Regulators and payers are encouraging early detection to reduce downstream costs, and dental practices with AI-driven diagnostics are well positioned under these value-based care models. Dentistry is also emerging as a test case for AI transparency and accountability, helping set standards for how patients experience AI across healthcare. For example, insurers are beginning to reimburse claims supported by AI findings, while professional associations are piloting guidelines that ensure patients understand when AI is used in their care.

Quote
AI has moved from pilot programs to a standard for care.
–  Florian Hillen

What to Look for in a Dental AI Platform

As practices explore AI solutions, it’s clear that not all platforms are created equal. The most effective tools are FDA-cleared, clinically validated, and built to meet the highest standards of compliance and data privacy. They are seamlessly integrated into existing workflows and designed with patient trust in mind. They provide intuitive visuals for communication, robust reporting at every level, and proven scalability across enterprise DSOs.

Choosing the right partner means selecting a solution that elevates both clinical precision and the patient experience, without introducing new barriers.

Dentistry: A Blueprint for Healthcare AI

The story of dental AI isn’t just about better X-rays—it’s about building trust, supporting clinicians, and making preventive care the norm. Dentistry is already doing what the rest of healthcare is still debating: proving AI works at enterprise scale.

If AI can transform one of the most anxiety-filled visits in healthcare into a moment of clarity and confidence, it’s not hard to imagine how this model could reshape medicine more broadly. The dental chair may well be where healthcare AI proves its true value.

Sources:
The 2025 State of America’s Oral Health and Wellness Report. Delta Dental.

State of the U.S. Healthcare Workforce 2024. Bureau of Health Workforce.

Predicts 2024: Healthcare Delivery, AI’s Proving Grounds. Gartner.

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Leadership

Sisters Defying Dental Norms

10/22/2025
|
9 min. to read

From a pediatric clinic to a global healthcare brand, Haley and Goly Abivardi are rewriting the rules of dentistry with drill-free innovation.

 

They were never destined for the ordinary.

Swiss dentists and sisters Haley and Goly Abivardi have spent their careers asking why dentistry should look and feel the same as it did a generation ago. The answer? It shouldn’t. From running a pediatric clinic in rural Switzerland to pioneering Europe’s first fear-free DSO, their path has always led toward a bigger idea: that oral health is inseparable from overall health, and that care should be non-invasive, patient-friendly, and accessible.

Today, through their company vVARDIS and its breakthrough treatment CurodontTM, the Abivardis are pushing dentistry into a future of non-invasive care, inspired by nature. Stylish, uncompromising, and deeply human, their story blends science with innovation, patient compassion with commercial success. What they are building isn’t just a company—it’s a movement.

The Abivardis’ story is proof that big visions can upend old systems. Case in point: Their non-invasive early caries treatment was being used by two DSOs serving 250 offices, but 18 months later, it had reached 13% of U.S. dental offices—a rapid leap in influence and impact.

CurodontTM, vVARDIS’ proprietary, biomimetic solution, treats early-stage caries through hydroxyapatite generation, offering the opportunity to preserve the natural tooth structure without the need for drilling, injections, or artificial filling materials.

The Abivardi sisters fuse cutting-edge science with a deeply human mission: to improve oral health for better overall health—and make it available to everyone.

In this Q&A, they open up about their journey, the lessons that shaped them, and why they believe dentistry is on the verge of a revolution.

Origins & Influences

What sparked your journey into dentistry, and how did your early influences shape your vision?

Dr. Haley: Powerful role models deeply influenced our upbringing. Our mother, an entrepreneur, showed us the possibility of balancing a career with being a dedicated mother. What we hold most dear about her is her commitment to making a positive impact on people’s lives and her determination to pursue one’s goals.

Dr. Goly: Absolutely. She instilled in us the belief that the most beautiful achievement is bringing happiness to others. On the other hand, our father, a natural scientist, was a pioneer in sustainability, having written his thesis on the subject 60 years ago. He taught us the invaluable lesson Mother Nature always knows best.

How did your journey in dentistry begin, and what inspired your first steps?

Dr. Haley: After studying medicine and dentistry as DMDs, knowing how important oral health is, we wanted to treat children to make an impact on their overall health.

Dr. Goly: Having the same mission, we decided to work together as sisters and to run a public pediatric dental office in the rural areas of Switzerland, linked to elementary schools with the focus on prevention and early intervention. As healthcare professionals and mothers, it was heartbreaking to witness our patients suffering and to observe the impact of poor oral health on their physical and psychological well-being, mainly due to a lack of knowledge, awareness, or often anxiety associated with dental visits.

Most of the patients missed their appointments or came too late. Those early experiences inspired us to seek positive patient experiences and to elevate patient care, specifically to ease the anxiety associated with delaying dental visits. Ultimately, this led us to develop a new concept of a fear-free dental clinic, and that is how we opened our first clinic.

At that time, we were young—driven by vision yet facing the challenge of having no patients in a city with the highest number of dentists in the world, and only modest savings to rely on. Despite initial skepticism, our clinic proved remarkably successful, capturing 14% of the market within three years.

Encouraged by our success, we expanded by opening new clinics in Switzerland and Europe, founding the first Swiss DSO, the first European fear-free DSO, and expanding the brand worldwide.

How did you transform the traditional dental clinic into a fear-free, patient-first experience?

Dr. Goly: We founded our DSO over 20 years ago with an entirely new approach. This innovative concept combined state-of-the-art technologies and techniques with an unprecedented level of comfort and well-being for patients. For the first time, all specialists could be found under one roof with extended opening hours, until 9 p.m., seven days a week, with a walk-in concept.

We created a unique experience, maintaining consistent identity and design across all clinics. We even had our own music and fragrance. Unlike traditional clinics, we reimagined the entire patient experience, putting the emphasis on overall health and wellness and delivering a spa-like atmosphere, as opposed to one of a dental room.

The Breakthrough

Why has Curodont taken off so quickly—and what makes it a win for dentists and patients alike?

Dr. Haley: Because it is a win-win for everyone. For clinicians there is finally a drill-free solution for early-stage carious lesions and you can treat them in as little as three minutes during the same appointment. Patients are motivated to return because the treatment is completely drill-free. When the dentist performs a recall after six months, any new lesions can again be treated without drilling. This not only encourages repeat visits but also helps dentists save valuable chair time for more complex procedures.

When did you realize Curodont could upend traditional dentistry and why was it a game-changer?

Dr. Goly: We founded vVARDIS around four years ago, but the groundwork for our vision started almost two decades back with the pediatric dental clinic. Those experiences deeply influenced us. That is why our vision has consistently revolved around practicing minimally invasive, early intervention care rather than relying on reparative dentistry.

In addition to our clinics, we led our own dental hygienist school, complete with a research center, facilitating various clinical studies. It was during this time, over 10 years ago, that we came across groundbreaking technology offering a non-invasive treatment for early decay, without the need for a needle or a drill.

For decades, we’d been scouting for a solution and finally one day, we found it! The proprietary formulation disperses throughout the depth of the lesion and treats the early-stage caries by restoring the lost or damaged hydroxyapatite crystals with minerals from saliva.

As daughters of a natural scientist, we were fascinated by this innovation. Despite years of trying everything possible to improve our patients’ oral health, we felt that something was still missing.

Tooth decay remains the number one disease in the world. Despite significant improvements in oral health and dietary habits over the past 50+ years, around 95% of the global population is still affected. More common than heart disease, diabetes, or even cancer, tooth decay impacts millions—especially vulnerable populations. Until now, there has been no satisfactory solution for treating the early stages of the disease.

Dr. Haley: We see early-stage lesions in nearly 80% of our patients, but most leave the office untreated, with dentists putting a “watch” on it without having a suitable solution available. However, patients may not return for a follow-up appointment, which exposes them to the risk of cavity progression and potential severe secondary diseases.

Dr. Goly: Motivated by the aspiration to make this groundbreaking innovation accessible to everyone, we decided to sell our dental clinics and reinvest everything into the creation of vVARDIS.

How is vVARDIS pushing the boundaries of dentistry—and inspiring change beyond the dental chair?

Dr. Haley: Now that Curodont is available in over 13% of U.S. dental offices, an increasing number of dental professionals—or “Curodontists”—are embracing our treatment and giving patients access to this revolutionary solution with fast adoption rates. It demonstrates the demand dental professionals have for a solution capable of treating tooth decay at an early stage.

Dr. Goly: We are thrilled to witness a ground-breaking transformation in dentistry similar to the advancements that medicine embraced years ago toward non-invasive, early intervention approaches. In the same way, Curodont is helping to elevate the standard of care for the early treatment of tooth decay.

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CAVITIES ARE THE WORLD’S NUMBER ONE DISEASE—AFFECTING 95% OF PEOPLE.

Sisterhood & Vision

How do sisters turn shared vision into a powerhouse partnership and make it last 25 years?

Dr. Haley: People often ask us why and how it’s been possible. We challenge each other, yes—but our shared mission of improving lives through better oral health keeps us aligned.

Dr. Goly: We have such a strong bond that we’ve cultivated over the years. This deep connection has enabled us to discover the most effective ways to complement each other. 

When did you see that dentistry can transform not just health—but someone’s entire future?

Dr. Haley: Looking back, we see countless experiences that shaped us into who we are today, but the most impactful experience was when we decided to give back to our community and provide free dental treatment to the homeless in our clinics. After restoring their smiles with implants and crowns, many patients regained employment and reestablished connections with their loved ones. This was the exact moment where we saw the impact a healthy smile can have on others.

Dr. Goly: This was a very moving experience and reinforced our belief in the idea that proper dental care can change lives. We learned that if everyone has access to dental care, not only will their mental and physical health benefit, but their overall quality of life will as well.

What advice would you give to anyone chasing a bold vision, even when the path feels impossible?

Dr. Haley: The same advice that we received from our parents that helped us become who we are today: “If you have a vision, go for it. ‘It doesn’t work’ doesn’t exist.”

For Haley and Goly, vVARDIS is more than just a company—it embodies a mission to make non-invasive dentistry and early caries treatment accessible to all, creating a meaningful impact on people’s lives, especially underserved communities.

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IF YOU HAVE A VISION, GO FOR IT. ‘IT DOESN’T WORK’ DOESN’T EXIST.
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Women in DSO®

Canadian Expansion

10/22/2025
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3 min. to read

With women now representing more than 50% of Canada’s recent dental graduates, the expansion of Women in DSO® into Canada couldn’t have come at a better time. At the forefront of this movement are Education Committee Co-Chairs Joseé Desjardins and Sanaz Nestorov, who are championing the next generation of women leaders through dynamic programming— including the launch of Canadian Exchange Circle panels.

Desjardins reflects, “Within a year, we were diving into webinars with people we didn’t really know. I’ve done this kind of thing before with boards of trade or think tanks, but this felt different—it was more natural. I was outside my comfort zone, but I was loving it.”

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It’s not just professional— it’s personal. It’s powerful.”

Nestorov shares that the impact has gone far beyond professional development. “I echo everything Joseé said. From an educational perspective, this experience has been intangible—but incredibly powerful. One of the biggest takeaways for me has been seeing how women can truly help each other stand taller.”

That peer-to-peer learning and support is central to the mission.

“Being exposed to a diverse group of women has been incredibly valuable,” says Desjardins. “The conversations are richer, more open. There’s a strong spirit of women lifting one another, especially in a space designed for vulnerability and growth.”

In May 2025, Women in DSO hosted its first-ever DSO Summit in Canada, a milestone event that brought together professionals from across the country.

“There were people from large, competing DSOs who didn’t even realize they needed to learn from one another—until they were in the same room,” Nestorov recalls. “We’re creating space for meaningful engagement and building an ecosystem of mentorship that the corporate dental space in Canada has been missing.”

Now Women in DSO is coming back to Toronto on May 5th and 6th, conveniently preceding the ODA’s Annual Spring Meeting.  Over 15 DSOs are expected to be represented with over 250 attendees.  Don’t miss this upcoming event.  For more details, visit Canada DSO Summit.

The expansion of Women in DSO into Canada is more than a geographic move—it’s a strategic investment in the future of the industry, one powerful woman at a time.

 

Joseé Desjardins
Joseé Desjardins is the Vice President of Business Development and Marketing at iFinance Canada, leading business development efforts focused on sustainable growth, innovation, and partnership.
Sanaz Nestorov
Sanaz Nestorov served as the National Account Manager, Enterprise DSO at Align Technology, leveraging extensive expertise to drive growth and innovation.

 

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