I’m building the dental practice that runs itself.
What does that mean? A variety of things. For now, I’ll focus on what it means to my client: the DSO, a company that manages multiple dental practices.
The main concept of a DSO is this: the gains from bringing multiple locations under one management umbrella must exceed the losses.
This is always the tradeoff. The goal is to cut administrative costs while avoiding excess management fees.
What we’ve seen in the last 20 years is that the management costs are outpacing the gains in administrative efficiency.
So when I say I'm building the dental practice that runs itself, I'm building a practice for DSOs to sidestep this tradeoff. When the dental practice runs itself, management no longer needs a large team to fight fires. They need a small team to drive growth.
The DSO of the past centralized administrative work and paid the management price. The DSO of the future will automate the administrative work and cut down the management fee.
The Decentralized DSO
In theory, this sounds great. But what does this look like in practice?
The easiest way to explain it is through the term The Decentralized DSO.
In the past, DSOs were about centralization. To bring down administrative costs, workflows were systemized and brought to HQ. If the DSO let each practice run their own playbook, administrative fees would stay constant and management fees would go up. The only way overhead could decrease was via centralization.
As of February, this is no longer the case. The DSO of the future does not need to centralize to cut administrative costs. DSOs can allow each practice to run their own playbook because the playbook is automation.
What changed in February?
In February, “AI Agents” increased their context window (the amount of information they can act on at once) and increased their agency (the amount of action they can take to achieve the goal set by the human).
This marked a critical juncture in the tech world and will mark a critical juncture in dentistry. Before February, tech workers were generally skeptical of work done by agents. After February, the same workers trusted agents to handle most things for them.
The rest of the world hasn’t caught up. And this is not their fault. The state of the art models were built by and designed for the tech worker. And even amongst this group, futuristic agents like OpenClaw and Hermes struggle to find adoption and value.
All of this is to say: the DSO model that existed before February 2026 is not the DSO model that will win after February 2026.
Good news, operators know this. You can’t scroll on LinkedIn or Twitter without seeing someone proclaim AI is reinventing their business. However, be skeptical of this. Most tech workers at AI companies can’t even figure out how to use AI to increase their productivity outside of code. Operating a dental company is an entirely different beast.
DSOs are entrenched in how things have been done for the last 30 years. It will take a herculean effort to shift from that path.
The promise is that AI will replace jobs and make life easy. I am sorry to tell you this is not the case. AI will make your job more difficult. Just with all innovation, you are now capable of doing more with less. Your job is to figure out how.
To me, the how in dentistry is The Decentralized DSO. It is the task given to the DSO operators of the future. Figure out how to manage more practices with less overhead. AI makes this possible. But it’s gonna be a damn fight to get there.
The Technology Required
In my mind, there are three underlying issues that must be solved for The Decentralized DSO to work. When the three issues are solved, the dental practice can run itself.
- A+ Dentist
- Kill RCM
- Accounting on autopilot
A+ Dentist
I start with the one I as a tech person can do almost nothing about: finding a great dentist. For a location to run itself, you must have an A+ dentist. Everything else can be perfect but if the person primed to take charge of the practice and provide quality care isn’t bought in, all else fails.
Pragmatic ways to find an A+ Dentist:
- pay them what they are worth
- give them equity upside
- remove all administrative work from their plate
This is the same strategy the tech world has ran for the last 30 years to find quality engineers.
Kill RCM
RCM is the most overloaded term in the dental vocab. For that reason, RCM is the root of all evil.
Insurance collections, patient collections, scheduling, insurance verification, patient refunds, denial follow up, payment posting.
Almost all administrative time is spent figuring these things out. Current tech companies sell solutions to help automate RCM. That is the wrong approach. With RCM, there will always be fires.
The only option is to kill RCM. Rev Cycle Management should not be a thing. You should be paid immediately, correctly, and without gripe. When that is solved, practices can run themselves.
Accounting on autopilot
If you have an A+ Dentist and have successfully killed RCM, one dragon remains: accounting.
How much money should you spend? How much money have you spent? Where is the money going?
These are generally the questions accounting tries to answer. Currently, you need people to figure this out. But if there’s one thing AI is quite good at it is classifying items and analyzing a ton of numbers at once.
The practice that runs itself will know how much to spend on each expense and allocate resources accordingly. This is why I originally built Denta.
The Future
Unfortunately, even with all the cool technology out there, the practice that runs itself does not yet exist, meaning the Decentralized DSO does not yet exist.
Luckily, when solved, the whole industry wins.
DSOs increase their margins and give dentists more autonomy
Dentists make more money and have more time to spend with patients
Patients receive better care
The last one drives the rest of the growth. Everything else is a means to support this. Our industry is in service of the patient. The value the patient assigns to our services sets the market cap for the industry as a whole.
When practices run themselves, the patients receive better care, and there is more for everyone.
I founded Denta to tackle this goal. However, I am not able to do it alone. That’s why I’m hiring the most talented AI engineers and partnering with the best DSO operators. Engineers to build the tools and operators to implement those tools at scale.
Everything else is noise. Everything else does not serve the patient. Everything else does not increase the strength of our industry.
If you are in position to help build the DSO of the future, please reach out: jack@trydenta.com