Inside Thirteen Years of the Dykema DSO Conference.

Most moments that change a profession don't announce themselves. There's no headline. No countdown. They usually begin quietly, long before anyone realizes they're making history.

While preparing this week's Foundation Dental Intelligence blog, I found myself chasing what I thought would be a short historical summary of one conference. Instead, it became a much deeper look at one of the institutions that has quietly shaped modern dentistry.

In 2014, an attorney named Brian Colao hosted a single-day meeting in Dallas for a small circle of dental service organization owners and advisors. By his own account, 41 people showed up. There was one speaker. There were no sponsors. Nobody in that room had any reason to think it was the start of anything in particular.

Thirteen years later, that meeting is the Dykema DSO Conference, one of the most influential annual gatherings in organized dentistry, drawing roughly 2,600 attendees to the Gaylord Rockies Resort near Denver this week. And this year carries a second milestone alongside it: 2026 also marks Dykema's 100th anniversary as a law firm, a century of practice now capped by thirteen consecutive years building the conference that's become synonymous with its DSO group.

Official Dykema Conference branding across the firm’s centennial year and the 13th Annual DSO Conference, highlighting a century of legal leadership and the industry’s premier gathering for dental support organizations.

From 41 attendees in 2014 to approximately 2,600 today, the Dykema DSO Conference has grown alongside the evolution of the dental support organization industry.

You don't have to be affiliated with a DSO, or plan to ever be, for this story to matter to you. The forces that fill that room every July, rising DSO affiliation, institutional capital, increasingly sophisticated buyer behavior, shape the competitive environment every independent practice operates inside, whether you're paying attention to it or not.

One of Dykema’s greatest strengths has always been bringing together the people shaping the future of organized dentistry, on stage and off.

A Room That Grew With Its Industry

The conference exists because the DSO industry itself needed a place to work out its fundamentals. Dental service organizations, in some form, trace back to the mid-to-late 1990s, and by the early 2010s the model had gone through a genuinely difficult adolescence. Some early operators ran into serious financial and legal trouble. State dental boards were actively scrutinizing management-service arrangements. There was no shared, credible venue where operators, counsel, and capital could work through the legal and business fundamentals together. Colao built one.

His own path into the DSO world came through a defining early case: representing a group of Texas orthodontists in litigation against practice-management company OrthAlliance, Inc. In Penny v. OrthAlliance, Colao obtained summary judgment in a case of first impression, establishing that certain long-term management arrangements violated state corporate-practice-of-dentistry protections. That case gave him a front-row seat to the industry's difficult early period, and it's exactly the kind of experience that shaped the conference he'd go on to build a decade later, one built specifically to help newer operators avoid the mistakes their predecessors made.

In the years since, Colao has become one of the industry's most recognized figures. He was named to Group Dentistry Now's inaugural 2019 “DSO Influencer's List” as its only attorney honoree, and was named Planet DDS's 2023 Thought Leader of the Year. He's also a founding board member of Women in DSO, the nonprofit dedicated to advancing women leaders across the industry, which held its official launch at his own conference in 2021 before growing into its own independent event.

The growth curve since then is hard to overstate. Attendance climbed from 41 to 75 to the hundreds within the first three years. By 2018 it crossed 500, with NBA legend Bill Walton on stage. By 2019 it hit 800-plus registrants and 68 sponsors, both records at the time, with boxing champion Sugar Ray Leonard as keynote. Then came 2020: the 7th Annual conference, slated for Dallas, was cancelled due to the COVID-19 pandemic, the only interruption in the event's thirteen-year history. It came back in 2021 at the Gaylord Rockies Resort in Colorado, where it's stayed ever since, passing 1,300 attendees with Olympic skier Lindsey Vonn and coach Tom Izzo, and hit a record 1,847 attendees and 152 sponsors at the 10th anniversary event in 2023 with tennis champion Andre Agassi. By 2025, Colao's own figure put attendance at roughly 2,600, a new high-water mark for the event.

Why It's Grown

The conference's rise tracks a genuine structural shift in American dentistry. According to the American Dental Association's Health Policy Institute, the share of U.S. dentists affiliated with a dental service organization has more than doubled over the past decade, from 7.2% in 2015 to 16.1% in 2024. Among dentists within ten years of graduation, that figure climbs to 27%.

Key market indicators help explain why the Dykema DSO Conference has expanded so dramatically over the past decade, reflecting the rapid evolution of the dental support organization landscape.

Deal activity has followed the same trajectory. Industry trackers recorded 161 dental-care private equity transactions in 2024 alone, the highest of any healthcare category tracked that year. As that capital moved into dentistry, the conference Colao built to explain the model to a skeptical industry became the place where that capital, those operators, and their advisors now convene every summer. The agenda itself has moved in lockstep, from early sessions on legal structure and compliance, through the acquisition-driven growth years, into today's focus on operational discipline, technology, and sustainable growth.

Relationships are built between sessions as often as they’re built on stage. Over the years, Dykema has become one of dentistry’s most important places to exchange ideas, strengthen partnerships, and reconnect with colleagues from across the industry.

Where the Market Actually Stands

Colao remains one of the industry's most direct and closely followed voices on where the DSO market sits today. In a recent appearance on Dental City's Beyond the Operatory program, he described the period following 2022's interest-rate shock as a “great M&A drought,” and offered a Costco analogy that's circulated widely since: dentistry, like Costco, is learning the discipline of maximizing profitability at existing locations before opening the next one.

DSO valuation multiples have normalized from the extraordinary highs of 2021, reflecting a more disciplined, sustainable market rather than a weakening one.

Large-DSO platform multiples that reached 13 to 16 times EBITDA at their 2021 peak have settled closer to 9 to 10 times. Smaller-practice multiples that briefly touched 7 times during the peak years have returned to a more traditional 5 to 6 times range. Colao frames that recalibration not as a setback, but as a return to a more sustainable foundation for the industry's next phase.

Where It Sits in the Landscape

The Dykema DSO Conference isn't the only major gathering serving organized dentistry, but it occupies a distinct position among the events built around the business side of the profession. The ADSO Summit, hosted by the Association of Dental Support Organizations, centers on advocacy, policy, and association leadership for the DSO trade group's membership. SmileCon, the American Dental Association's flagship meeting, serves the broader dental profession with clinical education and exhibitor access. The Chicago Midwinter Meeting remains one of dentistry's largest clinical and commercial conventions, built around continuing education and product discovery rather than business strategy.

Women in DSO's own “Empower & Grow” event held its official launch at the Dykema conference back in 2021 before growing into its own independent, standalone gathering serving women leaders across the industry, with Colao continuing as a founding board member. Where the Dykema conference distinguishes itself among all of these is in the density and specificity of who's actually in the room: DSO founders and executives, private equity investors, lenders, and the attorneys and advisors who structure the deals between them, all gathered specifically around the business of building and scaling dental organizations.

The 2026 Program

This year's conference carries forward the same range of programming that's defined the event for over a decade, alongside a retrospective lens fitting for a 13th anniversary that lands the same year as Dykema's centennial. “Reflections on DSO History”, moderated by Colao himself with fellow Dykema DSO Industry Group attorneys Zach Hoard, Eric White, Craig Woods, and Virgil Ochoa, opens the retrospective, backed by a commissioned short film tracing the industry's roughly 30-year arc.

Fred Lowery, Henry Schein's new CEO following Stanley Bergman's more than 35 years in the role, headlines a session on the company's next era. Larry Benz, the new CEO of Dental Care Alliance, shares what he learned in his first year leading the organization. A dedicated Women in DSO panel, moderated by founding board member Dr. Aman Kaur alongside panelists Pat Bauer, Bob Fontana, DeAnn McClain, and Lori D'Anna, runs alongside workshops on AI adoption and a full-day pre-conference session from TUSK Practice Sales on market disruption and economic uncertainty. Rick Pitino headlines Thursday's mainstage, and Nick Saban headlines Friday's, a fitting pairing of leadership and resilience for a conference built on exactly those qualities.

The conference has always been about more than the sessions. The relationships built between them are part of what has kept people coming back year after year.

What Independent Owners Can Take From This

The event also offers a useful lesson in how sophisticated buyers actually evaluate a dental practice, and it differs meaningfully from how many owners think about their own businesses. Owners tend to focus on gross production, collections, loyal patients, and years in business. Buyers focus on EBITDA, provider concentration, payer mix, transferability, team stability, and growth potential.

That buyer lens is worth understanding even if you never plan to sell. It's a discipline for building a stronger, more resilient practice regardless of the outcome you're aiming for, and it's one of the clearest reasons a room built for DSO executives still has something to teach a fee-for-service owner who has no interest in joining one.

One of the greatest mistakes I see dentists make is assuming industry trends only matter if they plan to participate in them. That's never been true. Whether you eventually join a DSO, compete against one, sell to one, or simply practice beside one, understanding the forces shaping the profession isn't optional. It's part of being a better owner.

A Note From Denver

This will be my fifth consecutive year attending the Dykema DSO Conference, and it's one of the industry events I look forward to most each year. I've attended more than a dozen industry events already this year, and very few create the same concentration of relationships and perspective that Dykema does. Operators, investors, attorneys, lenders, and technology leaders are all in one place, and that kind of access is hard to find anywhere else in the profession.

The conference can feel overwhelming simply because there are more people worth talking to than there are hours in the schedule. Over the years, I've responded by hosting smaller gatherings for the people I'm closest to. Two years ago, after the formal events wrapped for the evening, roughly eighty-five people gathered in my suite to talk about business and where dentistry was headed. Moments like that are a large part of what makes Dykema different. The conference creates business opportunities, but it also creates real relationships, and some of the most useful conversations happen in a hallway or over dinner rather than during a panel.

I returned from Santorini, Greece, a few hours before writing this, where I'd spent a week planning our October 2026 Luxury Dental Retreat. With less than twenty-four hours at home, I'll be flying to Denver to attend for the fifth year in a row.

Why It Matters

What Colao built in that Dallas meeting room in 2014 has become something rare in any industry: a gathering that grew alongside its field rather than apart from it, earning its size one year at a time rather than through scale alone. That the 2026 program turns deliberately backward, with two dedicated panels on the industry's history, is itself telling. Many of today's DSO operators have only five to ten years of experience in the space and never lived through the industry's earlier cycles firsthand.

A conference built to give an emerging industry its first shared professional language has, thirteen years later, taken on the job of making sure that industry doesn't forget where it came from. History almost never announces itself. It simply asks who was paying attention.

After thirteen years, Dykema has become more than a conference. It’s one of the places where the future of organized dentistry is discussed, debated, and shaped.

Extractable Takeaways

• The Dykema DSO Conference grew from 41 attendees in 2014 to roughly 2,600 in 2025, a nearly sixtyfold increase across thirteen years.
• 2026 marks both the conference's 13th year and Dykema's 100th anniversary as a firm.
• DSO affiliation among U.S. dentists more than doubled between 2015 and 2024, from 7.2% to 16.1%.
• Large-DSO valuation multiples have fallen from a 2021 peak of 13 to 16 times EBITDA to 9 to 10 times today.
• Understanding how buyers evaluate a practice is valuable even for owners who never plan to sell.

Frequently Asked Questions

What is the Dykema DSO Conference?

It's an annual business conference, formally the Definitive Conference for Dental Service Organizations, hosted by law firm Dykema's DSO Industry Group. It's built around the legal, financial, and operational side of dental consolidation, not clinical education.

Do I need to be part of a DSO to benefit from understanding this event?

No. The forces driving DSO growth, capital, buyer behavior, and consolidation, shape competitive conditions for every dental practice, independent or affiliated.

Who founded the conference?

Brian Colao, Director of Dykema's DSO Industry Group, hosted the first gathering in Dallas in 2014.

What's changed in DSO valuations since 2021?

Large-DSO platform multiples have fallen from a 2021 peak of roughly 13 to 16 times EBITDA to about 9 to 10 times today, reflecting higher interest rates and a more disciplined capital environment.

ABOUT THE AUTHOR

Dr. Jim Arnold, DDS is the Founder and CEO of Foundation Dental Alliance, a leadership and practice development organization serving independent dental practice owners. With more than 25 years in dentistry, multiple successful practices, 31% EBITDA achievement, and involvement in more than 60 dental practice transitions, Dr. Arnold writes and speaks on leadership architecture, practice systems, enterprise value, and the future of independent dentistry. He is the host of the Foundation Dental Podcast and the founder of the Foundation Dental Mastermind and Luxury Dental Retreats.

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