In this first blog post from our "What We Learned" series where the Ntiva team shares takeaways from the events we attend, we cover our lessons learned from the 2026 Dykema DSO Conference.
The 13th Annual Dykema DSO Conference ran July 15–17 at the Gaylord Rockies Resort in Denver. More than 2,000 people attended: DSO executives, dentists, private equity investors, and vendors. Many in the industry, including our team, refer to it as “the Super Bowl of Dentistry.” It's the largest DSO gathering in the country with a room full of leaders: CEOs, CFOs, CIOs, and clinical directors who show up to compare notes on where the industry is going.
We spent three days in sessions, at our booth, and in hallway conversations. Here's what stuck with us.
The biggest change from last year was the number of AI vendors on the floor. There were far more than in 2025. There were AI companies with tools handling patient engagement, online booking, phone systems, imaging, revenue cycle management, and numerous other use cases.
Many of them do something useful. Dentistry has been slower than the rest of healthcare to adopt technology, so there's plenty left to fix, and these companies are trying to fix it. The problem is volume. With this many options, it's hard to tell what's good, what will connect to the systems you already run, and what will just become one more tool that doesn't talk to the others.
For years, software was built to help staff work faster with features focused on reminders, marketing, and dashboards. Now vendors are asking a different question: what work can we take off the practice's plate entirely, so teams need fewer people on admin and can spend more time with patients?
The talk around mergers and acquisitions was calmer this year. Money is tighter and debt is expensive. The current debt on many DSOs' books is negatively impacting what those businesses are worth. The buy-everything phase has slowed.
Deals are still happening, but they’re happening a little more carefully, with more attention to whether a business is actually good rather than simply big. A lot of groups have turned inward and are working on running what they already own more efficiently.
Our partners at Planet DDS made the same point with data. CRO Mike Huffaker took the main stage to present the 2026 Mid-Year Dental Industry Outlook. His argument: growth now comes from focus and connected systems, not from scale alone. That aligned with what we heard all week.
For many DSOs, growth tends to stall at a specific size. Margins are thinner across the board, and a lot of DSOs hit a wall anywhere from 15-25 locations.
The main reason for this came up repeatedly. Groups buy practice after practice but never standardize the technology supporting them. That often means they use different practice management software, different imaging, and different workflows at every office. Each new location adds complexity.
Some leaders found that a number of the practices they'd acquired were underperforming. Right now, the appetite is for fixing what you own before buying more.
Cybersecurity always comes up at Dykema. This year more leaders admitted they were less secure than they'd assumed. That’s a real concern for groups handling patient data across dozens of locations.
From an IT support standpoint, the conversations that stuck with us most came from specialty groups, especially surgical practices. Their complaint was that their IT providers don't understand how urgent a dental environment is.
When a system goes down mid-procedure, a generic IT company might treat the outage like any other ticket. But if there's a patient under anesthesia, a slow response isn't really an option. That can put patients at risk. More than one group told us their IT team just didn't get it, and their patients felt it. That's the difference between a provider that happens to serve dental offices and one that understands their unique experience and needs.
Overall, it was a wonderful week. We learned a lot and had an enlightening time meeting so many fresh faces and making more connections. A few key threads tied the week together:
DSO leaders are less interested in acquiring more practices and more focused on running the ones they already own well, using standardized systems and security that protects their data to enable success.
A major desire for many DSOs is to leverage IT support that understands a treatment room and not just a ticket queue. Responsiveness is also a critical component of what DSOs are looking for from their IT teams. What resonated with the leaders was the idea of being able to reach a real person on the phone almost immediately, connecting with a team that knows what's at stake when something breaks mid-procedure.
And as groups keep trying to grow and their internal IT teams get stretched thin, support that scales with them and standardizes their technology along the way is exactly what several told us they're missing.
Curious how Ntiva supports dental practices and DSOs? Explore our dental IT services.