The process behind Sage Dental's 'opportunistic' acquisition strategy

There are a multitude of factors that go into a DSO's decision to add a new practice, whether it be an existing practice acquisition or the opening of a new de novo location.

Boca Raton, Fla.-based Sage Dental is one of the larger players in the DSO space, supporting more than 125 practices — and looking to reach 150 by the end of the year.

Sage Dental Chief Development Officer Jim Mizouni recently connected with Becker's to discuss the DSO's plans for the rest of 2024 and upcoming dental industry trends.

Editor's note: Responses were lightly edited for clarity and length.

Question: What goals does Sage Dental have for the second half of 2024?

Jim Mizouni: Sage’s growth plan operates on a 50% acquisition and 50% de novo-based model, placing us in a unique category, especially in relation to other branded DSOs. On the acquisition side, we remain opportunistic, recognizing that it's challenging to forecast where and when acquisition opportunities will arise. We maintain high standards for the quality and size of sites, making us selective in our acquisitions. Despite these challenges, we are confident in our current pace, aiming to add new locations through a combination of acquisitions and de novo developments. As of now, we have 126 locations and project that we’ll reach around 140 to 150 by the end of the year. Once we achieve this, we will reassess and refine our plans for 2025.

Q: What are some trends you are following in the dental/DSO industries going forward?

JM: One significant trend is the availability of practices becoming available that opened during the COVID period but struggled to grow successfully. These practices are a significant opportunity, but our aim here is to be selective in pursuing them, particularly those in prime locations where operational challenges have hindered their growth.

We’ve also observed a slight effect of over-saturation in highly competitive markets. Recruitment remains intensely competitive, with more entities looking to expand into attractive markets than there are available doctors, hygienists, dental assistants and specialists. To succeed, it's crucial to become the employer of choice, attracting and retaining top clinical talent. 

We anticipate some competitive consolidation, with disciplined DSOs like Sage potentially gaining market share by acquiring practices from struggling competitors. Additionally, technology is a critical dynamic for future positioning. We are investing in AI technologies and testing 3D printing to facilitate services that enhance patient care, such as same-day crowns, and to positively impact lab costs and structures.

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