AI Was Everywhere at DSO Tech Summit, But Discipline Was the Real Takeaway

Two days in Nashville, one ballroom, and a room full of the people who actually run DSOs: CIOs, IT directors, operations leaders and executives from groups of every size.

AI was also the undercurrent at DSO Tech Summit 2026, it showed up on almost every slide.

But the conversations that stuck weren't about what AI can do, they were about what DSOs should actually do next, in a market that isn't giving anyone much room for error.

Here's what we heard:

The market isn't stalled, but it isn't forgiving

Brian A Colao, who leads Dykema's DSO Industry Group and is one of the most prominent voices in the DSO space, opened day two with "The New DSO Growth Equation: What Leaders Can Control in an Uncertain Market." The premise was simple. Labor costs, the cost of capital, reimbursement pressure, M&A conditions and the pace of technology change are all outside a DSO's control. How an organization responds is not.

Colao has described the last stretch as a "great M&A drought," and his mid-year read on 2026 is that the industry "isn't stalled. It's restructuring for what comes next." He's also written that much of the market is overdue for a recapitalization, which raises the stakes on how groups perform in the meantime.

One slide put it in terms anyone could follow. Colao compared the DSO market to the English Premier League and the leagues below it, where teams are promoted or relegated based on how they perform. Most groups sit somewhere in the middle of the table. But a meaningful minority are near the bottom: selling off locations, closing offices, or exiting altogether.

The message for everyone else is that growth has to come from inside the business. A slide titled "2026 DSO Mission Statement" made the point directly, calling for "leveraging technology and business innovations to streamline operations" in order to drive same-store growth and build enterprise value in a selective, competitive M&A market.

The stack doesn't need more tools. It needs better decisions.

If one theme ran through the day-two panels, it was restraint. "When Everything Competes at Once: How Leaders Prioritize Growth, Technology, and Operations," moderated by Dr. Aman Kaur of Women in DSO, and "Before It Enters the Stack: How Leaders Decide What Deserves a Place," with Dr. Robin Reich, Emma Cifuentes and Kevin Calk, came at the same problem from different directions.

Every new platform promises efficiency, growth or a better patient experience. Adding one is easy. Deciding what earns a place, what creates complexity, and what to say no to is the hard part.

Later sessions picked up where that left off. "The New Reality of Technology Adoption" with Cary Mayo and Joel Olivio, "What Survives at Scale" with Robert Boone and Cassie Tallon, and David Kochman's "The Speed of Innovation vs. The Reality of Scaling" all pointed at the gap between buying a tool and getting real users to adopt it across dozens of locations.

That lines up with something Colao has predicted: the number of technology vendors in dental will shrink as weaker solutions exit and stronger ones gain share. Based on the agenda, DSO leaders are already planning for it.

AI is getting practical

AI was on most of the agenda, but the framing has shifted. The session titles told the story: "The Boring Side of AI that Actually Pays" with Rami Rustom, "Building an AI-Powered Front Door You Can Actually Trust" with David Bryant, and "The Art of Choosing AI" with Adam Willson. The question is no longer whether to use AI. It's where it delivers a real return, and where it adds risk or work.

VoiceStack's Krishnan R V took that question to the front desk with "The Call Was Answered. Was the Problem Solved?" His point was that answering a call is not the same as resolving it. An AI that picks up every call but leaves the front desk with a pile of follow-up tasks hasn't automated much.

He put the realistic share of calls AI can handle start to finish at about 30 to 40 percent. The rest need a person, and those are often the calls that matter most, like a patient in pain or a cancellation worth saving. The approach he described: automate the routine, assist with the complex, and keep people on the conversations that need them.

Visibility is still a gap

A few sessions focused on what leaders can actually see. Jake Larsen's "Beyond the Dashboard: What a More Complete DSO Data Strategy Looks Like" and Scott Cote's "Do You Actually Own Your Data?" both pushed past reporting for its own sake.

Most DSOs have dashboards. Fewer have a clear, consistent view of what's happening across every location, or confidence that the data underneath is theirs to use. That gap matters more when growth has to come from existing offices. You can't improve what you can't see, and you can't standardize performance across 40 locations when every office is measured differently.

The growth is already coming in the door

Put the sessions together and a clear picture emerges. Deals are slower and capital is more expensive. The groups that climb the table over the next few years will be the ones that get more out of what they already own: stronger same-store growth, better EBITDA and more efficient operations.

One of the most overlooked places to find that growth is demand DSOs are already generating. Groups spend real money on marketing, referrals and recall to get the phone to ring. But a lot of that demand leaks out before it becomes a booked appointment.

Calls go unanswered when front desks are stretched. Follow-ups slip. Call handling varies from office to office. And leadership often can't see answer rates, or how many calls actually turn into appointments, by location.

None of that requires a new location or an acquisition to fix. It's demand that's already there, waiting to be converted.

At VoiceStack, the phone is where we spend our time, because it's where a lot of that demand is won or lost. If your team is looking at how patient calls are handled across your offices, we'd be glad to compare notes.