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Scale vs. Independence: Is the Independent Dental Practice a Dying Breed or a Thriving Niche?

By Henry Schein One July 30, 2026 Read time: 5 min

Is the independent dental practice headed for extinction, or are reports of its death greatly exaggerated? That question got a live hearing in pretty much the least neutral room possible: the 2026 Dykema DSO Conference, an event built by and for the industry's biggest consolidators. Dr. Ryan Hungate, Chief Clinical and Strategy Officer at Henry Schein One, hosted the debate on Dinosaurs vs. Disruptors alongside Brian Colao, Director of Dykema's DSO Industry Group and founder of the conference itself. 

Hungate leaned into the irony from the opening minutes. With 2,500 people at the conference whose business is buying, building, or defending consolidated dental platforms, he suggested the room itself might already be the answer to the debate. 
 
The premise of the show is simple. Flip a coin, assign sides, and argue it out. Colao drew the independent practice position. Hungate defended DSO growth and scale. Dr. Greg White, President and CEO of PepperPointe Partnerships and a nearly 30 year practicing orthodontist, joined as judge. 

The case for independent practice

Colao's argument centered on a simple fact: only a licensed dentist can practice dentistry. No technology, AI tool, or practice management platform changes that. He also pointed to shifting generational priorities, arguing that many younger dentists value autonomy and lifestyle over efficiency or maximum profitability. As he put it, "your assumption is faulty that everybody wants to do it the most efficient way and they want to maximize profits." 

The case for DSO growth

Hungate's counterargument focused on what independence often doesn't prepare dentists for: running a business. Between hiring, marketing, insurance claims, and back-office operations, many dentists find themselves managing a company they never trained to run. He argued DSOs increasingly offer relief from that burden, in areas the dental curriculum never covered, freeing dentists to focus on clinical care and the parts of the job they actually went to school for. 

Where the debate actually landed

Dr. Greg White reframed the entire premise. In his view, both sides were describing symptoms of the same root problem: friction. Dentistry, he said, "is the definition of friction," and that complexity, combined with low interest rates and strong margins, is what drew private equity into the DSO model in the first place. 
 
White predicted that in 10 to 15 years, the industry lands roughly a third pure DSO, a third solely independent (often rural or boutique), and a third in a hybrid model, smaller doctor-aligned groups built more like PepperPointe's model than a private-equity backed platform. Colao, arguing his assigned side to the end, predicted a more consolidated future: 75 to 80% DSO, with a "thriving minority" of independents holding on for reasons rooted in autonomy and risk tolerance. 
 
One point all three agreed on: consolidation today is increasingly DSOs acquiring other DSOs, not just independents. And a wider, largely undiscussed opportunity sits outside the DSO versus independent framing entirely: the roughly half of Americans who don't see a dentist at all.

Top takeaways

  • The debate isn't really binary: Even the participants landed on a hybrid future, not a winner take all outcome, closer to "Jurassic Park" than extinction: dinosaurs and disruptors coexisting.
  • Friction, not ideology, is driving consolidation: Administrative burden, insurance complexity, and staffing challenges are pushing dentists toward DSOs more than any belief that bigger is inherently better.
  • Incentive alignment separates thriving DSOs from struggling ones: White pointed to a "feast, famine, and a promise" structure as the reason some DSO models are underperforming, regardless of the overall consolidation trend.
  • The underserved market may matter more than either side of the debate: With roughly 50% of the population not receiving regular dental care, the biggest opportunity in dentistry may lie outside the consolidation conversation altogether.

Worth noting: the live audience vote leaned heavily toward the disruptor side, but even Hungate flagged the obvious catch. A room full of people whose careers depend on consolidation isn't exactly a neutral jury. That's exactly why the online poll, open to the whole industry rather than one conference floor, matters. 
 
Watch the full debate, hear the live audience vote, and see how the online poll results compare in the next episode of Dinosaurs vs. Disruptors. 

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