Scaling a dental service organization (DSO) today isn’t just about adding more locations or acquiring more practices. It’s about building a modern, resilient organization that can adapt to changing patient expectations, rising operational complexity, and rapid technological advancement. From navigating AI integration to rethinking patient acquisition strategies and revenue management, DSOs must evolve thoughtfully to scale successfully.
Based on my experience collaborating with dental leaders over the years, I’ve found four practices essential for growth-minded DSOs looking to scale without losing efficiency or patient focus.
Stop letting legacy systems hold you back: Prioritize interoperability and flexibility
Eric Giesecke.
Let’s be blunt: Dental software is broken. The legacy systems many DSOs still rely on were built for a slower, simpler era -- before multilocation growth, cloud computing, or rising patient expectations.
Today, these outdated systems don’t just underperform but actively block progress. They create data silos, slow down decision-making, and limit a DSO’s ability to adapt and scale. And in an industry where flexibility is everything, that’s a serious liability.
The solution? Cloud-based platforms with open APIs that support true interoperability. These systems empower DSOs to connect imaging, analytics, AI diagnostics, patient communication tools, and more, building a tech stack that fits their unique needs and grows alongside them.
The future belongs to modular systems that enable choice, not those that lock DSOs into rigid, one-size-fits-all platforms. If your systems can’t talk to each other, your teams can’t move fast. If your software can’t flex, neither can your business.
Investing in interoperability isn’t just about smoother workflows. It’s also about removing the roadblocks to growth. This is how DSOs can truly future-proof their operations, stay nimble in a changing market, and focus on what matters: delivering exceptional patient care.
Choose AI solutions that solve real problems
AI has become a buzzword in the dental industry, but not all AI is created equal. Too often, DSOs adopt solutions labeled as “AI powered” without a clear understanding of what value they actually deliver or whether they meaningfully address their operational needs.
When evaluating AI tools, DSOs should ask three questions:
- Does this technology automate a real bottleneck in our workflow?
- Can it enhance clinical accuracy or improve case acceptance rates?
- Will it integrate easily with our existing systems?
A thoughtful approach to AI means prioritizing tools that contribute to tangible outcomes like reducing appointment no-shows, assisting with diagnostic accuracy, or improving insurance verification and claims processing. For example, predictive analytics tools can identify patterns in patient behavior, allowing teams to proactively reduce cancellations or optimize schedules. And AI-powered x-ray analysis can support providers in delivering consistent, evidence-based care.
Scaling successfully requires discernment. Don’t chase hype, chase impact. The best AI tools are the ones that quietly make your team faster, smarter, and more patient-focused.
Plug the patient acquisition leak: Track referrals and own the experience
With an average case acceptance rate of just 57% and 15.5% of patients canceling appointments in advance, DSOs are losing nearly half their potential revenue before treatment even begins. For DSOs trying to grow, this isn’t just a missed opportunity but a costly operational failure.
Improving patient acquisition starts with visibility. Are you tracking where new patients are coming from? Are you measuring conversion rates from referral to appointment booked? Without clear data, marketing efforts and referral networks can’t be optimized.
But visibility alone isn’t enough. DSOs must also improve the ease and appeal of the patient experience. That means offering user-friendly digital tools like online scheduling, automated reminders, and transparent treatment plans, and meeting patients where they are with omnichannel communication. Convenience is the new currency of patient loyalty.
If referrals are leaking out of your funnel, it’s time to rethink your intake process and reframe your tech stack. The groups that succeed in scaling are those that control the full patient journey, from first contact to post-treatment follow-up.
Treat RCM as a growth strategy, not just a back-office function
Revenue cycle management (RCM) has traditionally lived behind the scenes, but in a scaling DSO, it must take center stage. Inconsistent workflows, manual processes, and siloed data across locations can delay payments and drag down profitability.
Optimizing RCM means automating what can be automated, such as insurance eligibility checks, clean claims submission, payment posting while also centralizing oversight. Modern APIs and integrated tools now make it possible to track real-time cash flow, flag outstanding claims, and even predict payment delays before they happen.
For DSOs, RCM is no longer just a finance issue; it’s a scalability issue. By reducing administrative friction and speeding up reimbursements, strong RCM practices fuel expansion, enable reinvestment, and create the financial runway needed for growth. DSOs that embrace RCM as a strategic lever rather than a reactive function are better positioned to scale sustainably.
Flexibility is the foundation of scale
At its core, scaling a DSO requires more than growth, it requires adaptability. Whether you're implementing new technologies, expanding into new markets, or acquiring new practices, flexibility in systems, processes, and mindset is critical. One-size-fits-all solutions won’t work in a landscape this dynamic. Instead, think modular. Think customizable. Build your infrastructure so it can change as quickly as the industry does.
By investing in AI with discernment, creating a patient acquisition system that works end-to-end, and elevating RCM to a growth driver, DSOs can position themselves for expansion and excellence. The future of dentistry belongs to those ready to lead it.
Eric Giesecke is the CEO of Planet DDS. Prior to joining the company, he co-founded District Line Partners, a private investment fund. Giesecke has a Master of Business Administration from Harvard Business School and a Bachelor of Science in mechanical engineering from the University of Virginia.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
