An Open Letter · Industry · 2026

This is the right time
to do the work.

Higher rates. Reduced M&A. Staffing pressure. The rise of AI. The question is no longer which tool to buy — it is whether your organization can absorb it, operationalize it, and measure whether it is actually improving the business.

Jill Nesbitt
Jill Nesbitt
Founder, Optimize Dental Consulting · 12 min read
Abstract flowing design
Part I · The Market Shift

To my colleagues across dentistry — we are entering a more demanding phase of business maturity. One where technology decisions have to translate into operating results.

For years, the market rewarded growth, acquisition, and speed. Many groups expanded quickly across different practice management systems, different workflows, and different management styles. That made sense in the “buy and aggregate” environment dentistry was operating in.

But the environment has changed.

Higher interest rates, reduced M&A, staffing pressure, more experienced investors, and the rise of AI are changing what leadership teams need from technology. The question is no longer simply, “Which tool should we buy?” The more important question is, “Can our organization absorb this technology, operationalize it, and measure whether it is actually improving the business?”

That is the work I care about. And it is the work Optimize Dental Consulting was built to do.

My father built something remarkable in a small town in Ohio. Eight doctors. Eighteen treatment rooms. An ambulatory health center under one roof — decades before anyone called it a DSO. I grew up inside that practice. I watched him treat patients by name, develop his team's skills, and make decisions that put people ahead of margin.

Dentistry was not a sector to him. It was a calling.

That is the lens I have carried through 25 years inside dental organizations — as an operator, a leader, a technical guide, and eventually in a strategic guidance role at Henry Schein One, where I had a front-row seat to the cloud transition that reshaped this industry.

The Thesis
The next stage of value creation in dentistry will require more than buying new AI tools. It will require building the operating discipline to make technology work.
The Market · By the Numbers

Dental M&A volume has fallen 30% from its 2022 peak.

U.S. Dental M&A · Deals per Year
0
2019
0
2022
Peak
0
2023
0
2024
The “buy and aggregate” era is giving way to operating discipline. Capital is no longer free, and consolidation alone is no longer the strategy.
Source: Levin Associates / LevinPro HC Dental Deal Tracker
Part II · Where Value Happens

The technology is powerful.
The workflow is where the value happens.

I believe technology can make a meaningful difference in dentistry. I have seen it happen.

I have seen the right system, configured well, reduce manual work and give teams time back. I have seen better workflows improve collections, scheduling, reporting, and patient communication. I have seen leaders gain visibility they did not have before. I have seen teams move from fighting the system to trusting it.

But the value does not come from the software by itself. It comes from the workflow.

If you want to impact the practice, you have to impact the workflow. And in modern dentistry, workflow is often shaped by the technology the team uses every day — the practice management system, the patient communication platform, the imaging tools, the insurance verification process, the claims workflow, the scheduling rules, the reporting logic, the automations, and the AI tools starting to appear in more and more parts of the business.

All of these tools can help. But only when they are connected to the way the organization actually operates. That is why technology strategy has to start with business strategy.

What are you trying to improve? What needs to be standardized? Where does local flexibility still matter? What workflows are creating drag?The questions that matter now
Interlude · AI Raises the Stakes

AI did not create the gap.
It exposed it.

AI is getting most of the attention right now, and for good reason. It is moving quickly across imaging, phones, scheduling, eligibility, claims, clinical documentation, analytics, patient communication, and revenue cycle workflows. That is exciting.

But AI also makes something very clear: technology is no longer just a software decision. It is an operating model decision.

AI · Awareness vs. Adoption

Most dental practices are thinking about AI. Far fewer have actually absorbed it.

Using or actively considering AI· U.S. dental professionals
0%
Plan AI & cloud upgrades· but face implementation delays
0%
Have actually integrated AI into their workflow
0%
0pts
The Gap
66 points separate the practices thinking about AI from those who have actually absorbed it into their workflow. The gap is operating-model readiness — not curiosity.
Sources: The Dental Guide U.S. AI Adoption Survey 2025 · Clerri Dental Tech Adoption Report 2024–25

Boards and management teams are being asked to understand how technology affects strategy, risk, workforce planning, patient experience, reporting, accountability, and financial performance. In dental, that is especially complicated because many groups are operating inside years of accumulated technology — multiple PMSs, different workflows, inconsistent data structures, and tech stacks that grew location by location through acquisition.

AI rewards organizations with consistent workflows, clean data, clear standards, and strong adoption. But those conditions do not appear automatically. They are built through practical decisions about the PMS, the workflow, the roles, the training, the reporting, and the way technology is actually used at the practice level.

AI did not create that need. Cloud software exposed it. Multi-location growth exposed it. Revenue cycle breakdowns exposed it. AI simply raises the stakes.

Part III · The Missing Discipline

The missing discipline is technology enablement.

At Optimize, this is the work. Technology enablement is the work of helping dental groups choose the right technology based on their model, design the workflows around it, validate the model, roll it out across locations, drive adoption of the most valuable features, and measure whether it is actually improving the business.

That work starts before a contract is signed.

The Optimize Method

Five stages, end to end. One measure of success: outcomes that show up in the business.

Step 01Software Selection

The right system has to fit the business.

The right system has to fit the business model, the specialty mix, the leadership structure, and the operational goals of the group. Before a contract is signed, we evaluate fit — not features.

Part IV · In Practice

This work is practical.
And it is measurable.

One of the reasons I care so much about this work is that it reveals what is really happening inside the business. In recent client projects, implementing new software did more than move the organization to a new system. It brought deeper operational issues into focus — from revenue cycle accountability to reporting accuracy and leadership visibility.

01Revenue Cycle Discovery

The work revealed that a daily RCM process was focused on closing claims rather than collecting money — creating reporting issues that impacted doctor compensation and led to provider escalation. Once the COO and CFO could see the issue clearly, they had the information they needed to address the workflow, accountability, and leadership structure behind it.

02Reporting Clarity

The work allowed the organization to accurately represent net production for the first time — eliminating 28 waterfall reports the CFO had been using to estimate performance, and giving the CEO the visibility needed to confidently acquire and improve underperforming offices.

These discoveries can be uncomfortable at first, because they make long-standing operational gaps visible. But that visibility is exactly what gives leaders the ability to fix the right problem.

And that is where technology can become a real lever for the business. Not because the software magically fixes the problem — but because the right implementation process brings the workflow, the data, the accountability, and the operating model into focus.

Part V · The Path Forward

Our loyalty is to the outcome.

Optimize helps dental groups turn technology decisions into operational results. We are vendor-agnostic. We do not push preferred products.

That means we are not here to refer you to the newest shiny AI tool. We are here to help leaders choose what fits, implement it well, and make sure the work translates into better workflows, better visibility, better adoption, and measurable business results.

Did the workflow improve? Can the team use the system consistently? Can leadership trust the data? Are the most valuable features being adopted? Is the organization stronger because of the technology decision?What we measure

I am optimistic about where dental technology is going. It is easy to feel overwhelmed by the number of tools, vendors, integrations, dashboards, automations, and AI promises entering the market. But underneath all of that noise, there is a real opportunity.

Dental groups can build stronger operating models. They can create cleaner workflows. They can reduce unnecessary manual work. They can improve revenue cycle performance. They can make reporting more trustworthy. They can support teams more consistently. They can give doctors and operators better systems to work within.

And yes, they can use AI and automation in ways that genuinely improve the business.

But the groups that create the most value over the next five years will not simply be the ones that buy the “best” technology. They will be the ones that build the operating discipline to make technology work.

That is the work ahead. And I believe it is worth doing well.
With respect and optimism for what we are building together,
Jill Nesbitt
Founder, Optimize Dental Consulting
GPS for Dental Technology
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