Episode: What Is My Practice Worth When Selling To An OSO Or DSO In 2026? Show: GrowOrtho Podcast, Host: Luke Infinger, CEO and co-founder, HIP Creative Guest: Brian Christensen, CFA, Chief Development Officer, 7 Pillars Published: Summary: Selling an orthodontic or dental practice to a DSO or OSO usually takes about six months from signing with an M&A advisor to closing, according to Brian Christensen, CFA, Chief Development Officer at 7 Pillars, and 60 to 90 days of that is due diligence after the letter of intent. Buyers price the practice on adjusted EBITDA, which is revenue minus true go-forward operating expenses minus market-rate doctor pay, and multiples start to climb at roughly $1 million of EBITDA. Christensen estimates a one-doctor practice with $2 million of EBITDA an hour outside Atlanta would trade at about 7.5x to 8.5x, while very high EBITDA concentrated in one provider creates key-person risk that lowers the multiple. Earnouts only count if the targets are achievable, and buyers weigh the last three to six months of performance heavily. In 2026 the DSO market is shifting toward large groups buying smaller groups, sponsor-led platform mergers, and IPOs as alternatives to the traditional private equity recapitalization. Topics covered: practice sale timeline, M&A advisor engagement letters and success fees, adjusted EBITDA and add-backs, buyer selection and letters of intent, due diligence, exit multiples, earnouts, key-person risk, DSO consolidation, private equity recapitalizations, dental IPOs, the orthodontic M&A market. Key entities: 7 Pillars, Brian Christensen, Brett Pierce, Christy Ratcliff, Luke Infinger, HIP Creative, GrowOrtho Podcast, US Oral Surgery Management (USOSM), MB2 Dental, Heartland Dental, Foundation Dental Partners, Smile Doctors, myOrthos, Paradigm Oral Health, BlackRock Long Term Private Capital, Warburg Pincus, Thurston Group, SGA Dental Partners, Gen4 Dental Partners, Modis Dental Partners, Tyree & D’Angelo Partners, Park Dental Partners, Blackstone, KKR, Invisalign. About The Author Luke Infinger CEO and co-founder, HIP Creative | Host, GrowOrtho Podcast Luke Infinger leads HIP Creative, a growth partner for orthodontic, dental, oral surgery, and multi-specialty practices, and hosts the GrowOrtho Podcast, where he interviews the advisors, operators, and doctors behind growing orthodontic practices. Profile: [AUTHOR PROFILE URL] Featured Expert Brian Christensen, CFA Chief Development Officer, 7 Pillars Brian Christensen oversees client development at 7 Pillars, an M&A advisory firm that represents healthcare business owners. He previously worked in M&A at US Oral Surgery Management and as Vice President of Business Development at BOND Orthodontic Partners, and he holds an MBA from Southern Methodist University. Profile: https://www.7pillarsadvisory.com/our-practice/meet-our-doctors/brian-christensen/ Selling to a DSO or OSO takes about six months once the process starts, according to Brian Christensen, CFA, Chief Development Officer at 7 Pillars, and many practice owners start the conversation later than they should. Christensen has worked both sides of these deals. He did M&A for US Oral Surgery Management, helped a West Coast orthodontic support organization grow from 3 locations to 50 in about two years, and now represents sellers at 7 Pillars, a healthcare M&A advisory firm that completes 20 to 25 DSO and private equity transactions a year. In this GrowOrtho Podcast episode, Luke Infinger, CEO and co-founder of HIP Creative, asks Christensen to walk through a sale from the first signature to closing. They cover how buyers calculate adjusted EBITDA, which add-backs raise it, what multiples a single-doctor practice can expect, why an earnout can make an $8 million offer look like $10 million, and how the DSO market is moving toward platform mergers and public offerings. Christensen’s main advice for sellers is to know your numbers the way a buyer will calculate them, and to keep growing after you sign with an advisor, because the last three to six months of performance can move your multiple. Key Takeaways A practice sale run by 7 Pillars typically takes about six months from engagement to closing, with 60 to 90 days of due diligence after the letter of intent; the fastest deal Christensen cited closed in five and a half months.Adjusted EBITDA for a practice sale equals revenue, minus true go-forward operating expenses after personal and one-time add-backs, minus market-rate doctor compensation, which most groups set as a percentage of collections.Christensen said EBITDA multiples start to rise at about $1 million of EBITDA, and he estimated a one-doctor practice with $2 million of EBITDA an hour outside Atlanta would trade at roughly 7.5x to 8.5x.Very high EBITDA produced by a single doctor creates key-person risk, and 7 Pillars has advised owners in that position to add an associate or partner because the higher multiple can outweigh the lower ...
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