In short
A DSO will often pay more than a private buyer, because they are buying a platform rather than a job. But the headline number usually includes an earn-out, an equity rollback, or a multi-year employment commitment, so what you actually receive at closing can be far less than the number in the letter. The decision is about structure and autonomy, not price alone.
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How Sentinel sells a dental practice →The decision in front of you
A typical DSO structure combines cash at closing, rolled equity in the parent group, and an earn-out tied to post-sale production. The rollover can be genuinely valuable if the group grows and sells again, and some owners make more on the second exit than the first. It is also real risk: it is a minority stake in a company you do not control, and it may be illiquid for years. When comparing two offers, compare guaranteed cash at closing first, then value the rest separately.
This is where owners are most often surprised. Ask precisely who sets fee schedules, who chooses labs and materials, who controls hiring, who owns the schedule, and what production expectations apply to you personally. Some DSOs are genuinely hands-off clinically; others standardize aggressively. Neither is wrong, but the difference decides whether your last few working years are comfortable. Ask to speak with a dentist who sold to them two or more years ago, not one who closed last quarter.
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If you want a clean break and no post-sale employment, if your practice depends almost entirely on your personal relationships, or if you would find it difficult to be an employee in a practice you used to own, a private or associate buyer often produces a better life outcome even at a lower price. The best test is simple: imagine the deal has closed and you are working under someone else's protocols. If that thought is intolerable, the number will not fix it.
Often yes on the headline number, because they underwrite a practice as a platform asset rather than as a job. But DSO offers commonly include earn-outs and equity rollover, so the cash you receive at closing can be considerably lower than the stated price. Compare guaranteed cash first, then value the contingent components separately.
Not without competition. An unsolicited approach means someone has identified your practice as valuable, which is useful information. But a buyer negotiating against nobody has no reason to improve price or terms. Owners who run a quiet, competitive process almost always end up with better economics than those negotiating alone against a professional acquirer.
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General information only, researched and drafted with AI assistance — not legal, tax, financial or valuation advice. See our terms.