Hi there,

I want to talk about something a lot of people in this sector are dancing around.

The DSO gold rush is over. Not slowing down. Over.

I say this as a Chartered Accountant who has advised hundreds of dental practices over 25 years, and as someone who actually owns dental practices alongside my wife, Dr Smita Mehra. I know how this game is played.

How did we get here?

Back in 2020, the Bank of England slashed its base rate to 0.1%, the lowest in the Bank's 300-year history. Private equity could borrow for next to nothing and went on a shopping spree. The plan was simple, buy a well-run practice, bolt it onto a platform, sell the whole thing to a bigger fund at a higher multiple.

Financial engineering, dressed up as a dental revolution.

The model rested on two things- cheap money and a bigger buyer waiting in the wings. Both have now gone.

America is your crystal ball

The US has the most mature DSO market in the world, and what happens there tends to wash up on UK shores two or three years later.

Here is what is happening there right now. Heartland, Aspen and Smile Brands, the biggest names in American dentistry, now carry sub-investment-grade credit ratings. Over a two-year stretch, more than 40 DSOs were put up for sale. Fewer than 10 actually sold. In early 2026, lenders to Dental Care Alliance moved to take control of the business entirely. Dentists who took shares instead of cash found their paper was worth roughly what it was printed on.

Europe ran this experiment first

Spain, France and Germany ran the same playbook years before the UK did.

Spain's largest dental chains collapsed one after another. An estimated 400,000 patients were left with unfinished treatment, many still repaying loans for work that was never done. In France, a chain called Dentexia was liquidated in 2016, leaving around 2,300 patients in pain and out of pocket. A class action was filed in 2025. A decade on, it still is not resolved. In Germany, the health minister branded private equity buyers "locust investors" and tried to legislate them out of dentistry entirely.

And the UK?

Our own cautionary tale is hiding in plain sight. mydentist has been passed around like a parcel: Merrill Lynch, then Carlyle in a heavily leveraged 2011 deal, then Palamon, then sold again to Bridgepoint in 2025. Hundreds of practices were quietly sold or closed along the way. Bupa went further and announced it would close, sell or merge 85 practices in 2023, affecting around 1,200 jobs. When one of the best-capitalised operators in the country starts handing contracts back to the NHS, that is not a growth story.

The only question worth asking

When a private equity buyer makes you an offer, ask yourself: what do they know that I do not?

They buy practices for a living. They have run the numbers on your business more thoroughly than you ever have. They are offering you a price because they believe your practice is worth more in their hands than what they are paying. The gap between what they pay and what they believe it is worth is your money.

If you are done and ready for your life back, take the cheque. No shame in that at all.

But if you are selling because you think you have run out of road, while a stranger with a spreadsheet has concluded there is plenty of road left, the rational move is not to sell. It is to do exactly what they were planning to do.

Bet on yourself.

Read the full article here: Why the DSO Party Is Over in the UK and Europe

As always, if you want to talk through what this means for your practice, my team is here.

Speak soon,

Arun