She says they put metrics in place to focus on DSOs, days payables, inventories.

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DSOs perform the business requirements of a dental practice, leaving dentists free to perform dentistry.

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Using economies of scale and leveraging business efficiencies, DSOs overcome constraints on traditional dentistry.

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Today there are more than 3, 500 DSOs in operation, according to the Dental Group Practice Association.

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After DSOs appeared in the mid-1990s, Medicaid population children seeing a dentist doubled from 20% to 40%.

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In 2011, DSOs performed 10.15 procedures per patient, DSO Kool Smiles (which Laffer openly noted funded the study but had no input) performed 8.24 and non-DSO dentists performed 12.39.

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Starting in the late 1990s, dentists began banding together under DSOs, taking advantage of economies of scale in order to cut overhead costs and provide quality service at much lower prices.

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