How Do Dental Service Organizations (DSOs) Function?

DSOs provide non-clinical support to dental practices, handling billing, marketing, human resources, and supply chain management.

These organizations recruit staff, manage payroll, and run targeted marketing campaigns to help practices remain competitive.

DSOs have grown quickly because many dentists—especially newcomers—value streamlined management. Stepping away from business administration and achieving a better work-life balance appeals to those who just want to focus on practicing dentistry.

By covering operational costs and marketing, dental service organizations lower financial barriers and support new offices and practices in underserved regions. Dentists experience less stress, better patient focus, and an easier path toward professional development.

What Are the Functions of Dental Service Organizations (DSOs)?

Understanding the specific functions of DSOs allows you to understand how they can help your dental practice be more successful. Below, we explore the key areas where DSOs make a significant impact.

Business Management and Administrative Support

Dental service organizations lighten the load of non-clinical tasks by handling billing, insurance reimbursement, and human resources, including dental staffing.

They handle front desk management and use centralized systems to make scheduling smoother for both staff and patients, which improves the practice's operations. DSOs also guide the launch and management of new or existing practices.

Marketing and Patient Acquisition

DSOs use strategic online marketing to drive patient acquisition and retention.

For example, they use SEO to help practices rank higher in search results, social media outreach to engage patients, and review management to build trust. This digital-first mindset helps affiliated practices maintain steady growth in patient volume.

Supply Chain and Procurement

DSOs offer advantages in purchasing dental supplies and equipment. Their buying power often secures better pricing and ensures materials are readily available. For busy dentists, uninterrupted access to supplies means smoother operations and consistent, high-quality patient care.

Technology and Software Integration

Technology is another area where DSOs shine. They introduce practice management software, electronic health records, scheduling tools, and billing systems that streamline daily routines. These updates help teams work effectively and make decisions based on real-time data. DSOs also provide continuing education and mentorship programs so dental professionals can stay current with the latest treatment options and meet changing patient expectations.

Types of Dental Service Organizations

Exploring the various types of DSOs can help you identify which model aligns best with your practice style and career aspirations.

Equity-Based Dental Service Organizations

Equity-based DSOs let dentists become part-owners by trading assets for equity shares. Benefits include:

• Financial Growth: Dentists share in equity that can appreciate over time as the DSO grows.

• Operational Support: Day-to-day management and administrative duties are handled by a dedicated team.

The downside? Less control, because private equity investors often have the final say on major decisions.

Affiliation-Based Dental Service Organizations

Affiliation-based DSOs offer partnership options without requiring dentists to give up full control. You can keep running your practice while offloading nonclinical tasks like marketing and HR. This approach is often a comfortable middle ground for those hesitant to commit to a fully integrated DSO framework. It also offers financial security, which has become especially important through recent economic shifts.

Franchise Model Dental Service Organizations

Franchise model DSOs let dentists operate under a recognized brand while following standardized procedures. This allows professionals to benefit from name recognition and proven systems:

• Brand Support: A known brand can increase patient volume from day one.

• Standard Operating Procedures: Less guesswork compared to launching a private practice.

However, franchise agreements may limit customization and restrict how you shape your practice's identity. Dentists should carefully balance brand requirements with personal preferences.

Read more: What are the differences between DSOs and DPOs?

Advantages of Partnering with Dental Service Organizations

Joining a DSO brings a host of benefits that can take your professional career to new heights. Here are some key advantages to consider.

• By taking over tasks like billing, HR, and compliance, DSOs let dentists focus on clinical work. This approach helps raise the standard of care. For example, during the COVID-19 pandemic, many DSOs handled extra safety protocols.

• DSOs bring financial backing, which can mean dependable payroll, stronger marketing initiatives, and better rates on supplies through group purchasing. Practices often redirect these savings toward modern equipment or technology.

• Many DSOs run in-house training and development programs. From seminars on the latest procedural updates to one-on-one mentorship, it's easier to stay current in a rapidly evolving field.

• Handing off administrative duties to a DSO often leads to clearer schedules and reduced stress. Dentists can focus on their patients during work hours and enjoy more personal time afterward. This setup helps prevent burnout.

Challenges of Joining a Dental Service Organization (and How to Overcome Them)

While DSOs offer many benefits, the transition can pose challenges. Being aware of these potential hurdles can help you navigate them.

• Loss of autonomy: Some dentists fear losing decision-making power when they go into corporate dentistry. To navigate this, maintain open dialogue with DSO management. Negotiate terms that allow you a voice in daily operations or committees. Evaluating the DSO's culture and goals early on can help ensure your clinical approach remains valued.

• Financial commitments: DSOs may offset the upfront costs of starting a private practice, but their contracts often include production quotas and non-compete clauses. Carefully review any agreement or employment contract, especially the details about bonuses, salary structure, and penalties for leaving.

• Standardization of care: DSOs typically look for consistency across locations, which can mean strict protocols on treatments or materials. Dentists should ask detailed questions about how much flexibility they'll have in patient care. Some DSOs encourage a personalized touch, while others enforce uniform methods.

Examples of Dental Service Organizations

Looking at real-world examples can provide valuable insight into how DSOs function. Here are some prominent organizations in the industry.

Heartland Dental

Founded in 1997 by Dr. Rick Workman, Heartland Dental has grown to support over 2,800 dentists across more than 1,700 dental offices in 38 states. The organization offers comprehensive non-clinical services, including administrative support, marketing, and continuing education, enabling affiliated dentists to concentrate on clinical excellence. Heartland Dental emphasizes a doctor-led culture, providing resources and support to help dentists achieve both professional and personal growth.

Aspen Dental

Aspen Dental Management, Inc. (ADMI) supports a network of over 720 independently owned and operated dental practices across 38 states. ADMI provides a range of non-clinical services such as scheduling, billing, and marketing, allowing dentists to focus on patient care. Aspen Dental practices are known for offering extended hours and a wide range of dental services, including general dentistry, dentures, and cosmetic procedures.

Pacific Dental Services (PDS)

Established in 1994, Pacific Dental Services supports over 700 dental practices across 20 states. PDS pioneered the Private Practice+ model, providing business support services while allowing dentists to maintain clinical autonomy. The organization integrates advanced technology, such as digital X-rays and electronic health records. PDS is committed to ongoing growth, with plans to add approximately 80 new supported offices annually.

Smile Brands

Smile Brands encompasses a network of over 600 affiliated dental offices across the US. The organization offers comprehensive business support services, including human resources, marketing, and finance, enabling dentists to prioritize patient care. Smile Brands is recognized for its positive workplace culture and commitment to providing "Smiles for Everyone," engaging in various charitable initiatives to extend dental care to underserved communities.

How to Make an Informed Decision

Assess a DSO’s structure and policies thoroughly before signing on. Clarify everything from patient scheduling protocols to the metrics they'll use to gauge growth, such as appointment counts or utilization rates. It's equally smart to investigate how team hiring works—who does it, how much say you'd have, and what training staff members receive. Get a clear picture of your clinical responsibilities and how far your decision-making authority will stretch.

Compensation matters as well. Some DSOs offer revenue sharing or bonuses, others a set salary, and some propose equity options. Make sure you understand joining bonuses, retirement plans, and any potential education reimbursements.

The right DSO can give you the support you need to focus on patient care—but that support depends on a skilled, reliable team. A strong hygiene department keeps your schedule running smoothly and helps maintain high-quality patient experiences. Teero connects DSOs with top-tier dental hygienists, making it easier for dentists to work alongside well-trained professionals who fit their practice needs. Find out how Teero helps DSOs build better dental teams.