❓ Frequently Asked Questions

What is DSO Empire Simulator?

It's a free idle (or "clicker") game that pokes fun at the dental industry roll-up world — DSOs, EBITDA multiples, private equity term sheets, and corporate jargon. You start with one operatory, click to see patients, hire staff, and buy Initiatives that keep your revenue growing even while you're not clicking, all the way up to an Exit, a Fundraise, or an IPO.

What is a DSO?

DSO stands for Dental Service Organization — a company that provides the non-clinical, business side of running a dental practice (admin, purchasing, marketing, sometimes ownership of the practice's assets) so dentists can focus on patient care. In real life, DSOs range from a handful of affiliated offices to national platforms backed by private equity. In this game, "DSO Empire Simulator" is a satirical, exaggerated take on that world — it's not real financial or business advice, and it's not affiliated with any actual DSO. If you're researching real DSOs rather than playing a game about them, Dental Strategy Institute covers that territory seriously.

Is it actually free?

Yes. The entire game — every Initiative, every desk card, every Exit — is playable for free, forever, with nothing required to unlock. The one optional purchase is a $1.99 Legendary Card Pack (three real-money-purchased desk cards). It's a small permanent boost for anyone who wants to speed things up, never a requirement to see or finish the game's content.

Do I need to download anything or make an account?

No. It runs entirely in your browser at empire.dentalstrategyinstitute.com — no app store, no install, no email or password. Just open the page and start clicking.

How do I play — what do I do first?

• Click the big button to see patients and earn cash by hand.
• Hire staff (Chair, Associate, Location, and beyond) so revenue keeps coming in even when you stop clicking.
• Buy Initiatives in the Board Room to multiply your output.
• Collect desk cards from random drops — complete a set in The Desk, or trade spares in the Card Exchange, for small permanent bonuses.
• Chase an Exit, a Fund Raise, or an IPO once you're ready to close out a season and start the next one bigger.

Is my progress saved?

Yes, automatically, in your browser's local storage — there's nothing to click to save. Because there's no account, that save only exists on that one browser and device; clearing your browser data, or switching browsers or computers, starts you over. See our Privacy Policy for details.

What are desk cards, The Bench, and the Card Exchange?

Desk cards are collectible items that drop while you play — collect a full set for a permanent bonus on top of what each card gives on its own. The Bench works the same way with staff characters. Short on the specific card you need? The Card Exchange lets you trade spare copies for one you're missing, or combine a pile of lower-rarity spares up into a guaranteed higher-rarity card.

Is this a real DSO, or affiliated with one?

No — it's satire. No real dental practice, DSO, or company is depicted, and nothing in the game is real financial, legal, or business advice. See our Terms of Use for the full disclaimer.

Who made this?

DSO Empire Simulator is made by Dental Strategy Institute. See the Credits page for the full breakdown.