What Dental Leaders Are Prioritizing in 2026

Recent ADA/HPI data indicates that, despite ongoing economic pressure, many owner dentists expect to add staff, make major equipment purchases, and invest in software in the year ahead.¹ This signals not a pullback, but a more selective approach to where and how capital is deployed. 

At scale, selectivity matters. For DSOs and multi-location groups, the timing of equipment rollouts, vendor coordination, and installation requirements can create operational ripple effects across multiple sites. The organizations navigating this effectively are focusing less on spending less—and more on sequencing investments thoughtfully and aligning them with operational realities.

With increasing costs cited as a top-three challenge by more than 4 in 10 dental leaders heading into 2026, practices are placing greater emphasis on how capital decisions affect cash flow, operational capacity, and implementation complexity.¹ The focus is not only on what to purchase, but on how to move forward efficiently in a constrained environment.  

That shift has practical implications for how DSOs evaluate financing. Total cost of ownership, payment structure, and timeline flexibility are increasingly part of the conversation alongside the equipment itself. A purchase that looks sound on paper can create friction if financing terms, vendor timelines, and implementation requirements aren't aligned from the start.

Structural trends across the industry continue to add complexity. ADA/HPI reports ongoing growth in DSO affiliation among younger dentists, alongside a long-term decline in traditional practice ownership.² Over time, this points to larger, more operationally complex organizations. 

As scale increases, so do the demands on capital planning. A single-location practice may absorb delays or adjust informally. A DSO managing equipment lifecycles across dozens—or hundreds—of locations operates in a fundamentally different environment, where standardization, vendor relationships, and financing infrastructure must keep pace with growth.

As the second half of 2026 unfolds, dental leaders are sharpening their focus from planning to execution.

• Which locations are due for equipment replacement this year?
• Are expansion- or acquisition-related equipment needs still unresolved? 
• Are installation timing, vendor requirements, and budget expectations aligned? 
• Are critical initiatives being delayed due to process complexity?

1. American Dental Association Health Policy Institute, Economic Outlook and Emerging Issues in Dentistry: 4th Quarter 2025 (2025)
2. American Dental Association Health Policy Institute, Practice Ownership Trends in Dentistry: A New Look at Old Data (2025)