The business of dentistry is changing fast. For decades, American dentists worked as solo practitioners, juggling patient care, payroll, marketing, staffing, insurance administration, and equipment maintenance. Today, an increasing number of dentists are choosing to partner with Dental Support Organizations (DSOs), companies that oversee the administrative side of dental practices. By managing human resources, billing, compliance, and supply chains, these partnerships allow clinicians to focus solely on what they do best: delivering quality patient care. In an era when operating costs are rising and workforce pressures persist across healthcare, this shift from solo entrepreneurship to organizational support is reshaping how dental care is delivered throughout the US.
Few people have seen that transition from as many angles as Dave Gaspar, CEO of Smile Partners USA. Dave leads a network of more than 130 affiliated practices across seven states. His responsibilities span growth strategy, operations, technology, workforce development, acquisitions, and partner relationships. Yet as dentistry becomes more complex, his focus remains remarkably consistent. Whether evaluating a new acquisition, implementing technology, or expanding into a new market, the question is often the same: how can the organization remove barriers that prevent clinicians from delivering care and patients from receiving it?
“Working on the operations side gave me a clear understanding of the challenges practices face every day and the need to reduce friction in delivering quality care. You see it through insurance verification and coverage issues, staffing challenges, patient experience, patient education, and helping clinicians develop the skills to practice the dentistry they want. Those friction points show up every day, and the better you address them, the better the experience becomes for patients, clinicians, and teams.”
An operator’s path
A career in healthcare wasn’t part of Dave’s original plan. He graduated with a communications degree and pictured himself behind a microphone. “My goal and dream was to be a sports play-by-play broadcaster.”
Instead, his early career took a different route. He worked in radio and business roles before an opportunity in veterinary medicine introduced him to the healthcare sector for the first time. There, he realized he enjoyed helping clinicians succeed. “When I got into healthcare and started seeing some of the challenges beyond clinical care, I realized this was exactly where I wanted to be. I get to work with smart, talented, caring people, and I get to do what I love, which is communicate, lead and mentor.” Dentistry followed naturally, and that move revealed a challenge that would define much of his career.
Dentists spend years training for clinical care, yet most find themselves running a business from day one – all of it far beyond the work they trained for. “Dental school doesn’t really prepare dentists to run a business. Most dentists, honestly, don’t go through business, communication, or leadership courses. They focus on the clinical side, which makes sense, because that’s important. But when they graduate, they have to become leaders.”
What started as an interest in operations became a philosophy about leadership. Working alongside clinicians showed Dave that leadership begins with understanding each person’s ambition, not forcing everyone onto the same path. “Working with doctors who wanted to learn different things and pursue different paths in their careers has really shaped who I am as a leader. It taught me to be open and growth-minded, to focus on opportunities, and to think about how we support clinicians so they can deliver quality care, practice the type of dentistry they want to practice, and provide the experience they want for their patients.” That lesson remains central to how Smile Partners USA develops clinicians, supports partners, and grows.
Growth with purpose
Smile Partners USA has expanded through acquisitions across Michigan, Illinois, Alabama, Georgia, Colorado, Ohio, and Massachusetts. More recently, the company added de novo practices to complement that strategy, giving it another way to enter markets and create opportunities for clinicians seeking partnership roles.
Growing through acquisitions is one thing. Preserving support and culture is another. “Discipline is a word you’ll hear consistently throughout everything I say.”
People often measure growth by numbers, but Dave uses a different lens. “As critical as the success of a practice is, there must be alignment on the mission, vision, and values. If there’s alignment but it’s not a successful practice, we have to be thoughtful. If it’s a successful practice but there isn’t alignment, we have to be thoughtful. We spend a lot of time with prospective partners before entering a partnership to make sure we have that alignment, because that’s such a critical part of our success.”
Smile Partners USA plans to double in size by 2030, but Dave’s operations background keeps him focused on a familiar risk. “I’ve worked in businesses where growth outpaced support. The desire to expand comes so fast, the support team can’t catch up.” That’s why Smile Partners USA invests in infrastructure before growth demands it.
One of the company’s biggest projects brings multiple practice management systems onto one platform. The goal goes beyond just technology. “Getting everyone onto a single platform means we’re speaking the same language and working from the same data. We’re looking at the same schedules, clinical records, revenue cycle, and patient information. That single source of truth gives us the ability to keep improving our processes and standardizing the things that help us scale and support practices more effectively.”
That single platform sets the stage for automation and AI across the business. But the success of this transformation depends just as much on people as on systems. “Change is hard. Changing a practice management system is tough. We’ve chosen to invest a lot of time, money, and energy so we can support teams through that transition. We’ll spend what’s needed to help them because we believe that ultimately reduces friction and helps transformation happen faster.”
The partnership principle
Partnerships are core to how the company operates. “The word partnership is really critical to us.” Smile Partners USA provides support across revenue cycle management and procurement, as well as technology, finance, human resources, and facilities. Yet the organization believes clinical autonomy must remain with clinicians.
The conversations that shape partner relationships shape careers within the business. As expectations at work keep evolving, Dave believes companies should spend less time guessing what people want and more time asking them. On scheduling, he says, “Over time, people want different hours, days, or have different motivations and interests. Assuming I know or the organization knows what somebody wants is a mistake. You must take time to understand what they want and what motivates them, then decide if you can make that happen.”
Listening has become a business discipline rather than a management exercise. “There are so many pathways within the industry, particularly within DSOs, that allow people to grow, learn, and build long careers. If we take the time to understand where people want to go and what they want to achieve, we can create opportunities that support that journey.”
Every conversation about growth, talent, or operations is grounded in the belief that dentistry can change someone’s life. For Dave, dentistry is about making a difference. “I tell my team, we’re in a spot where we get to make the world better every single day. We literally get to change the world. That’s something I think about every morning when I get up. I’m so blessed to be in this position. There’s going to be someone today in our organization whose life will change because of what we do.” That sense of responsibility goes far beyond the practice walls. “Giving back to communities is core to who we are.”
As Smile Partners USA expands through acquisitions, de novo practices, technology investments, and new market entry, Dave sees a common thread running through each challenge. Whether the issue is workforce development, systems integration, patient access, or insurance administration, the objective remains consistent: “It would be reducing the friction patients and dental offices face in using dental coverage. If I could solve that, it would make the entire process so much easier.” It’s the same question that’s guided every acquisition, every new market, every partnership since he started.
