Insurance mergers always precede reimbursement reductions (2-5% in year 2-3). Practices with concentrated insurance revenue lose the most.

CBCT and intraoral scanner prices have collapsed 40-70% in five years as market saturation hit. Your resale assumption is wildly optimistic.

DSOs are failing to replicate Amazon's scale strategy because dentistry has no network effects, pricing power, or logistics leverage. The math breaks.

Heartland Dental's $4.2B portfolio is restructuring after PE realized DSO consolidation math doesn't work. Expect more dominos to fall.

PE DSO deals dropped 37% in 2024, but consolidation is shifting, not stopping. Independent practices face lower valuations and longer integration timelines. Know your options.

New dental grads owe $270K-300K in student loans. DSOs offer signing bonuses + debt assistance ($30-50K value). Independent practices offering no debt help can't compete for top talent.

Infection Control: New OSHA Guidance Raises Compliance Costs OSHA updated infection control mandates in June 2025. New standards for sterilization validation, water quality testing, and sharps handling. Implementation deadline: January 2026. Your sterilization logs need to match new protocols. Water testing moves from quarterly to monthly. Sharps containers now require

The implant market is growing 6-8% annually, but 5 companies control 88% of market share. Consolidation means pricing power for manufacturers and margin pressure for practices.