<img height="1" width="1" style="display:none;" alt="" src="https://px.ads.linkedin.com/collect/?pid=938154&amp;fmt=gif">

Chapter 1

Current Trends for Dental Practices

The dental industry is constantly changing with the latest trends in technology and treatments as well as the state of the economy. How your peers are handling current trends can provide great insights into ways you can adjust to the current economic climate.

Here are several trends and considerations for your practice that have emerged in the past few years.


Challenging Labor Market

Most industries are experiencing the challenges of hiring and retaining quality skilled staff, as well as resignations and retirements. This is especially true in the hygiene sector where one-third of hygienists and assistants are expected to retire within five years.

Finding a quality replacement could take more time and cost more money than you may think. An opening in your hygiene schedule equals immediate and future production loss.

To achieve a full staff, a lot of dental practices are hiring less experienced, less trained employees, while at the same time dealing with a higher turnover rate. Review your wages and benefits and compare them to the market to ensure your employees are being compensated fairly.

Download SVA's Dental Industry Salary &  Benefits Survey Executive Summary


Employee Retention

What can you do to retain your valuable staff members? Here are some areas to consider:

Compensation and Benefits

Are your wages competitive? What benefits are you offering? Dental benefits, paid holidays, vacation, and retirement plans are common, so you’re not differentiating yourself from your competition.

Benefits that could make you stand out include health insurance, paid sick time, paid leave, allowance for continuing education and professional development, or production bonuses.


Employees are looking for more flexibility in their schedules to create a better work-life balance.

Opportunities for Growth and Development

Give employees more opportunities to grow and develop in their careers. More responsibilities will help them feel more valued.


Build a company culture that attracts and retains employees. This can lead to employee satisfaction.

Managing and operating your dental practice will become more difficult, more challenging, and more complex as you look at finding unique ways to help keep employees happy in your practice.

Increased Practice Overhead

Over the last few years, there have been several categories of overhead that have increased quite substantially.

Staff Wages and Benefits
In particular, health insurance benefits have increased 15-20%.
Costs for Lab and Dental Supplies
Costs have continued to rise since the beginning of the pandemic.
Higher Interest Rates
Consider retaining cash for necessary dental equipment needs, instead of financing with an increased interest rate.


Some of the old benchmarks you might have used for staff wages/benefits or supplies may no longer be applicable. It is important to adjust your benchmarks because of the ever-changing industry and economic climate.

Increases in Staff Wages

According to a recent survey on the wages of dental staff by years of experience, the average increases seen in practices between 2021 and 2022 are as follows:

  • 0 - 3 Years of Experience = 11.3% Increase
  • 4 - 9 Years of Experience = 8.8% Increase
  • 10 or More Years Experience = 3.5% Increase

The salary information received in the survey is reflective of the need to retain qualified staff by increasing wages. Most dental practices are anticipating increasing staff wages in the range of 1-10%, with the average low increase of 2.46% and the average high increase of 6.29%.

When choosing whether to increase the wages in your practice, ask yourself these questions:

  • What range do you plan to give your employees next year?
  • Will it be a straight percentage across the board?
  • Will it vary based on position?
  • Will it change based on the number of years of experience?

To retain well-trained staff who will provide superior patient care in your practice, ensure they are paid wages that are in line with the market.

Inflation and Interest Rates

A current economic trend that is having a big impact on dental practices is increased inflation. The annual inflation rate in the U.S. was 5.0% for the 12 months ended March 31, 2023.

This is considerably higher than the Federal Reserve target of 2%. As a result, the Fed has taken action to fight it by increasing interest rates.

All of this has a cascading impact on your dental practice.

As interest rates and inflation increase so does overhead costs, mortgage rates, equipment loan rates, rates on lines of credit, and even student loan consolidation rates.

As a result, the way you manage your practice and personal finances needs to change.

SVA Dental Webinar Series: Current Trends for Dental Practices

So What Can a Practice Do to Alleviate the Additional Expense of Increased Overhead Costs?

  • Put a staff member in charge of ordering supplies with a budget
  • Provide an incentive bonus to staff members who maintain supplies within the industry average
  • Negotiate a discount for early payments with vendors
  • Utilize CEREC to reduce lab fees
  • Renegotiate and/or extend your current lease at a favorable rate
  • Consider a 3D printer to produce orthodontic aligners at lower costs and to increase treatment efficiencies
  • Reduce credit card processing fees through Best Card to cut processing costs by taking advantage of the ADA member benefit
  • Have an outside consultant review your insurance (CDT) coding to ensure your billing for all procedures performed is accurate

Decreased Collection Percentage

More and more dental practices are experiencing a decrease in their collection percentage. Even practices that have been historically stable in their collection percentage are seeing some decreases because of the impact of insurance companies not increasing their reimbursements.

As practices experience higher overhead costs and they increase their fees, reimbursement stays the same and collection decreases.

According to a recent survey, 87.5% of practices have increased their patient fees this year, with the average increase at 4.5%. Most implemented one fee increase, with some doing two, to try and keep up with the increases in input costs.

Some ways to combat this decrease in collection percentage include:

  • Increase fees annually to cover inflation pressures and increased expenses
  • Structure bonus plans and compensation formulas on net collections, not on gross production
  • Offer a dental membership plan

Practice Appointment Schedule

The trend of lower than typical appointment scheduling can be attributed to three issues:

  1. Trouble filling vacant staff positions
  2. Not enough patient visits
  3. Patient no-shows or cancellations

If your practice is experiencing no-shows or cancellations, implement a fee if they don’t cancel within 48 hours. This policy will give you the chance to fill that appointment.


Teledentistry has been around for a number of years, but the pandemic has put this practice into the spotlight.

The more patients and providers learned about how teledentistry works, the more they realized its potential as a long-term complement to traditional dental care.

The benefits of using teledentistry in your practice include:

  • Conduct pre-appointment consultations
  • Improve referral experience
  • Boost productivity and efficiency
  • Expand patient reach in outlying areas
  • Triage cases to determine immediacy of appointment needed

Other Trends

Additional trends that are impacting dental practices in positive and negative ways include:

  • Investments in 3D Printing
  • Consolidation of Practices into Larger Groups
  • Digital Marketing
  • Improvement of Customer Experience
  • Automation of Insurance Paperwork/Verification
  • More Convenient Payment Options
  • Laser Technology
  • Natural "Green" Dental Products



Chapter 2

Dental Profitability Tips

Running a dental practice can be both challenging and rewarding. While the primary focus of any dental practice is to provide high-quality dental care, it is essential to also consider the business aspects of the practice.

One of the most important aspects of running a successful dental practice is ensuring that the practice is generating enough revenue and profitability to sustain itself in the long run.

Let’s explore various strategies you can implement to increase revenue and profitability in your practice.

Improve Patient Experience

The first step in increasing revenue and profitability in a dental practice is to ensure that patients have a positive experience.

This can be achieved by providing exceptional customer service, creating a welcoming atmosphere in the practice, and investing in modern equipment and technology.

Patients are more likely to return to a dental practice where they feel comfortable, respected, and valued.

Offer Expanded Services

Another way to increase revenue and profitability in a dental practice is to offer expanded services.

This can include cosmetic dentistry, orthodontics, and periodontics. By offering these services, you can attract new patients and increase revenue from existing patients.

Also consider offering flexible payment plans and financing options to make these services more accessible to patients.

Optimize Scheduling and Appointment Management

One of the biggest challenges in a dental practice is scheduling and managing appointments.

By optimizing scheduling and appointment management, you can ensure that your time and resources are utilized efficiently.

This can be achieved by implementing an online booking system, setting realistic appointment times, and utilizing reminder systems to reduce no-shows.

Implement Effective Marketing Strategies

Marketing is essential to attracting new patients and promoting the services of a dental practice.

Implement effective marketing strategies by using social media platforms, creating informative and engaging content, and partnering with local businesses and organizations to reach a wider audience.

Also consider investing in paid advertising such as Google Ads and Facebook Ads to increase visibility and attract new patients.

Improve Treatment Planning and Case Presentation

Treatment planning and case presentation are critical components of any dental practice. Take the time to thoroughly explain treatment options and costs to patients and present a clear and comprehensive treatment plan.

This can help patients make informed decisions about their dental care and increase case acceptance rates, resulting in increased revenue and profitability for the practice.

Increase Patient Retention

Patient retention is essential to the long-term success of a dental practice. By providing exceptional customer service, maintaining open communication with patients, and offering incentives for referrals and loyalty, you can increase patient retention rates.

This can result in a steady stream of revenue and increased profitability over time.

Implement Cost-Cutting Strategies

Reducing costs is another way to increase profitability in a dental practice. Implement cost-cutting strategies by negotiating with suppliers, reducing overhead expenses, and outsourcing certain tasks such as billing and coding.

Also consider investing in energy-efficient equipment and technology to reduce utility costs.

Focus on Continuing Education and Professional Development

Continuing education and professional development are essential for dentists to stay up to date with the latest techniques, technologies, and trends in the industry.

By investing in professional development, you can provide better care to your patients, increase your knowledge and skills, and attract new patients who are looking for the latest and most advanced dental services.

Increasing revenue and profitability in a dental practice requires a combination of strategies and a commitment to providing exceptional patient care. By implementing these strategies, you can attract new patients, retain existing patients, and increase revenue and profitability over time.

It is essential to regularly assess your practice’s financial performance and make adjustments as needed to ensure long-term success.


Chapter 3

Understanding Dental Practice Financial Statements

A dental practice is a business, and like any business, it requires financial management to be successful. Financial statements (such as balance sheets and income statements) can provide valuable information about a dental practice’s financial health.

Let’s discuss what financial statements are, what they include, and how to use them to make informed business decisions.

What are Financial Statements?

Financial statements are reports that provide information about a company’s financial performance and financial position. The two primary financial statements used by businesses are the balance sheet and the income statement.

The Balance Sheet

The balance sheet provides a snapshot of a company’s financial position at a specific point in time. It lists the company’s assets, liabilities, and equity.

  • Assets are items that a company owns such as property, equipment, and cash
  • Liabilities are things that a company owes such as loans and accounts payable
  • Equity represents the value of the company that is owned by its shareholders

When reviewing a dental practice’s balance sheet, there are several key things to look for:

Total Assets
The total value of everything the practice owns including equipment, property, and cash
The amount the practice owes to creditors and other third parties. It includes things like loans and accounts payable


Current Assets
Assets that can be easily converted to cash within one year such as accounts receivable and inventory
The value of the practice that is owned by shareholders

The Income Statement

The income statement provides information about a company’s financial performance over a specific period of time, typically one year. It shows how much revenue the company generated and the expenses it incurred during that time.

When reviewing a dental practice’s income statement, there are several key things to look for:

The total amount of money the practice earned from patients and insurance companies
The total amount of money the practice spent on items such as salaries, rent, supplies, and equipment
Net Income
The profit or loss the practice made during the period covered by the income statement

What to Look for in Financial Statements

When reviewing a dental practice’s financial statements, there are several things to review:

Revenue Trends
Is the practice's revenue increasing or decreasing over time? Are there any seasonal trends that should be taken into account?
Expense Trends
Are the practice's expenses increasing or decreasing over time? Are there any areas where expenses are particularly high, and if so, why?
Is the practice profitable? If not, why not, and what can be done to improve profitability?


Does the practice have any outstanding debt? If so, what is the interest rate and repayment schedule?
Cash Flow
Is the practice generating positive cash flow, or is it struggling to make ends meet? If cash flow is a problem, what steps can be taken to improve it?

How to Use Financial Statements

Financial statements can be used to make informed business decisions. For example:

Use financial statements to create a budget for the practice, which can help to ensure that expenses are kept under control and that revenue goals are met
Investment Decisions
Evaluate investment opportunities, such as purchasing new equipment or expanding the practice, by reviewing your practice's financial statements


Strategic Planning
Financial statements can be used to identify areas of the practice that are particularly profitable or unprofitable and to develop strategies to address those areas
Performance Measurement
Financial statements can be used to track your practice's performance over time and compare it to industry benchmarks




Chapter 4

What Ratios Should You Use to Benchmark Your Practice?

As a dental practice owner, it is important to understand the financial health of your business. One way to do this is by using financial ratios, which are calculated by taking one financial metric and dividing it by another.

10 Financial Ratios to Measure Your Dental Practice



How to Analyze

Gross Profit Margin
Indicates how much profit a dental practice is making after accounting for the cost of goods sold.
(Revenue - Cost of Goods Sold) / Revenue
A higher gross profit margin indicates a more profitable practice
Net Profit Margin
Measures how much profit a dental practice is making after accounting for all expenses, including overhead.
Net Profit / Revenue
A higher net profit margin indicates a more profitable practice
Debt-to-Equity Ratio
Shows how much debt a dental practice has relative to its equity.
Total Liabilities / Total Equity
A lower debt-to-equity ratio indicates a less risky practice
Current Ratio
Measures a dental practice's ability to pay its short-term debts.
Current Assets / Current Liabilities
A higher current ratio indicates a more financially stable practice
Accounts Receivable Turnover Ratio
Measures how quickly a dental practice is collecting payments from patients.
Revenue / Average Accounts Receivable
A higher accounts receivable turnover ratio indicates a more efficient practice
Days Sales Outstanding (DSO)
Reveals how long it takes for a dental practice to collect payments from patients.
(Accounts Receivable / Revenue) x Number of Days
A lower DSO indicates a more efficient practice
Return on Investment (ROI)
Indicates how much profit a dental practice is generating relative to its investments.
Net Profit / Total Assets
A higher ROI indicates a more successful practice
Return on Equity (ROE)
Measures how much profit a dental practice is generating relative to its equity.
Net Profit / Total Equity
A higher ROE indicates a more successful practice
Expense Ratio
Indicates the percentage of revenue that is spent on overhead expenses.
Overhead Expenses / Revenue
A lower expense ratio indicates a more efficient practice
Production-to-Collections Ratio
Measures the percentage of production that is actually collected.
Collections / Production
A higher production-to-collections ratio indicates a more efficient practice


By understanding and using financial ratios, dental practice owners can better assess their practice’s financial health, identify areas for improvement, and make informed business decisions.

However, it’s important to keep in mind that financial ratios should not be used in isolation but in conjunction with other financial metrics and considerations.



Chapter 5

Implementing and Monitoring Dental Membership Plans

Dental membership plans provide an alternative to dental insurance and address the primary barrier to increasing new patient flow and practice growth.

Practices that offer these plans generate predictable recurring revenue, reduce dependence on insurance companies, and increase practice value. Offering a plan is a win-win for both your practice as well as your patients.

SVA Dental Webinar Series: Implementing and Monitoring Dental Membership Plans

Dental Membership Plan Overview

A dental membership plan is a type of dental insurance alternative that allows patients to receive affordable dental care without the restrictions and limitations commonly associated with traditional insurance plans.

There are several attributes of a dental membership plan:

Practice Specific

A dental membership plan is a benefit specific only to the practice that is offering it.

If you’re a practice that has multiple locations, one dental membership plan can cover all your offices. Unlike insurance, it is not portable.

Set Fee Per Member

Typically, there is a set fee charged per member, either on an annual basis or a monthly basis.

This fee covers all preventative wellness services such as dental exams, cleanings, and x-rays.

Patient Discounts

Anything not covered by the set membership fee can be offered to the patient with a discount.

Examples of discounts include restorative or cosmetic work, as well as discounts on family plans.

Reasons to Offer a Dental Membership Plan

No Excuses

A dental membership plan removes the barrier to receiving treatment in your office. Typically, the number one reason patients don’t see their dentist is not having dental insurance.

Although it’s not insurance, a dental membership plan is a way to give patients something that feels like an insurance plan and take away that excuse for not seeking treatment.


Once someone enrolls in your dental membership plan, they have a strong tie to your office. Because they have paid for services in advance, they will remain loyal to your practice.

Offering a plan is a great way to lock patients into your practice, at least for the year of that dental membership plan.

Easy Access

Dental membership plans are easy for patients to enroll in as there’s no preapproval process, there’s not a big insurance application, and they can’t only get it through their employer like health insurance.

Patients can easily complete the quick signup, pay the fee, and be covered under your dental membership plan.

Patient Power

Unlike the typical doctor/patient paradigm, the responsibility shifts in the relationship between a practice and its patients. It empowers patients to take more of a proactive approach to their dental health.

Because the patient has already paid for cleanings and other follow-up appointments, the pressure is on them to make sure they’re scheduling and attending those appointments.


Typically, patients with dental insurance come with a fee schedule and payment plan set by the insurance company. As costs continue to rise, insurance companies can maintain their profits by not increasing reimbursement rates.

With a dental membership plan, the practice sets the price and their fee schedule, thus the practice controls the revenue stream.

New Patients

Dental membership plans are another marketing tool practices can utilize to attract new patients.

The plan helps build a secure future for your practice and attracts more fee-for-service patients.

Acceptance Rates

Dental membership plans help to increase acceptance rates on additional work (i.e., restorative and cosmetic procedures) due in large part to the discount the plan offers its members.

Patients are also motivated to schedule their hygiene appointments since they’ve already paid for them.

Benefits to Patients

Dental membership plans are becoming increasingly popular due to their many benefits to patients. Here are just a few:

Typically, a dental membership plan is very affordable for patients. At the high end, many plans are no more than $500 - $600.
Plus, the patient knows exactly what they are paying for upfront so it’s easy to fit it into their budget.
Budget Friendly
Depending on how the plan is designed, payments can be spread out over the full year.
Make it even more budget-friendly for your patients by breaking up the payment into four quarterly payments or a monthly payment to make it more affordable and cost competitive.
Unlike most traditional dental insurance plans that are sometimes difficult for the patient to understand, the dental membership plan is very clear about what the patient is paying, what they’re receiving for that payment, what services will be covered, and what discount they will receive on everything else.
All the confusion about deductibles, co-pays, out-of-pocket maximums, and annual and lifetime caps are eliminated.


Target Patients

As dental care costs continue to rise and patients experience limited access to insurance, a dental membership plan can provide a convenient solution.

By targeting patients who will benefit most from the membership, you can increase your patient base and build long-term relationships.

No Dental Insurance Through Employer

If you have patients who don’t have dental insurance through their employer, a dental membership plan can be a great offering.

If someone doesn’t have dental insurance, they might be hesitant to seek treatment. Having the dental membership plan takes away that fear and uncertainty of how to pay for their dental appointments.


There are patients who have had a lifetime of dental insurance coverage. Then upon retirement, they feel they don’t have a safety net without that dental insurance.

The dental membership plan can be a way to bridge that gap for patients, especially if they find dental insurance in the private market to be too expensive or too confusing.

Dental Insurance Too Costly

Someone might have access to a dental insurance plan but it might be too costly or the benefits don’t justify the expense. The dental membership plan can bridge that gap as well.

Have Dental Insurance Your Practice Doesn't Accept

If you have patients that have access to dental insurance but it’s a plan you don’t accept, the dental membership plan can be a way to give them a benefit in your practice without being out of your network.

Benefits to Practices

More and more practices are offering dental membership plans as a means of providing affordable and comprehensive dental care to patients.

Membership plans can help build a loyal patient base, increase revenue, and streamline administrative tasks, making it a win-win situation for all parties.

Marketing Tool

A dental membership plan can be an effective marketing tool for practices looking to attract and retain patients. Offering a plan can also differentiate you from your competitors, as it shows a commitment to patient care and affordability.

Additionally, membership plans can increase patient commitment and referrals, as patients are more likely to stay with a practice that offers them value and convenience.

Consistent Income and Cash Flow

Whether your dental membership plan is set to process patient payments on an annual, quarterly, or monthly basis, the plan will generate consistent and regular income for your practice.

40% of uninsured patients visit the dentist only once per year whereas plan members visit twice as often, leading to 50% more revenue per patient.

Patient Loyalty

When a patient signs up for a dental membership plan, the relationship between the practice and the patient strengthens.

Members are more likely to schedule preventive care since they have already paid for it, and they are more likely to accept treatment plans because of the discount they receive.


Steps to Get Started

1. Design

Determine the pricing to set for your dental membership plan. What is the fee? How frequently will payment be required (i.e., annually, quarterly, monthly)?

Typically, plans range from approximately $250 to $450, depending on the services that are included.

Keep in mind that it will vary based on geographic location so it’s important to know what’s going on in your marketplace and price your plans accordingly to remain competitive.

Another consideration is the discount you are willing to provide on the additional services for your patients. You might also consider offering a discount depending on how the patient is paying (i.e., cash vs. credit card vs. CareCredit).

Finally, what services are covered by the annual fee? What services include a discount and what services, if any, are not covered at all? These factors all go into the design of your dental membership plan.

2. Education

It’s important to educate your patients about your dental membership plan – in your office as well as on your website. Consider a special marketing push to spread the word.

Make sure your hygienists and front desk staff understand the plan and its benefit to current and new patients, as well as to the practice.

3. Marketing

Promote your dental membership plan:

  • on your website
  • through marketing materials in your lobby and at your front desk
  • perhaps a one-page handout that covers key components of the plan to hand out and use as a guide for having discussions with your patients

Consider launching a marketing campaign to the surrounding areas around your office. This might be the push someone needs to help them make the decision to change dental providers.

4. How to Price

There are a number of different factors to consider as you look at how to price your dental membership plan.

The most important step is to determine the discount you want to offer within the plan. Typically, the average discount is between 10 and 15 percent. Compare this discount to your insurance contracts, your average patient base, and the discount most average patients are receiving.

Generally, the fee for the dental membership plan is the covered services multiplied by the plan’s discount rate.

Consider a one-time initial enrollment fee to cover additional administrative costs for establishing the dental membership plan, or to cover a comprehensive exam if it’s a new patient to your practice.

Determine the services that will be included in the standard fee of the plan. Know your patients and offer the types of treatments and benefits they will want in your plan.

It’s also imperative to look at how your plan compares to your competitors. Don’t price yourself too high or too low in relation to the market rate.

5. Special Considerations

Do Not Combine with CareCredit

If patients want to be in the dental membership plan, they can enroll and pay with cash, credit card, or check.

If they need to use CareCredit, that should be outside of the plan and they don’t get the general plan discount. Patients must choose one or the other, not both.

Payment Timing

Think about the timing of the payments in your dental membership plan. Should payments be annually, quarterly, or monthly?

Balance how much more administrative time it will necessitate if you’re billing more frequently with the benefit of receiving regular and consistent cash flow.

Tracking System

Create a tracking system to administer the plan and document those patients enrolled, who’s eligible for discounts, when their membership period ends, and how to renew their membership.

Automatic Re-Enrollment

Structure your dental membership plan to automatically renew patients when their term is up. This will keep them committed to your practice year after year.


Consider how you want to handle the administration of your dental membership plan. Do you want to take care of it in-house by your office staff, or do you want to contract with a third party?


Monitoring the Dental Membership Plan

Not only are the steps in implementing your dental membership plan important, but it is also critical to monitor your plan along the way.

Leverage Existing Dental Software

Set up your dental membership plan as an insurance in your dental software. This will allow you to run reports for plan patients.

You could consider contracting a third-party administrator, but the fees can be as high as $40 a year per member. Unless enrollment is high or your staff is already at capacity, use your existing staff where possible.

Be Proactive About Renewals

Communicate with enrolled patients 60 days in advance of their membership expiration date giving them direction to renew.

Track Production and Realization

Run reports for your dental membership plans and include the fee to join as this fee covers the procedures provided.

Dental membership plan payments should compare well to other practices overall and should be better than most insurance payments in realization. If not, does the pricing of the plan need to be reevaluated?

The Most Important Step

A dental membership plan is an effective incentive to bring in new patients who want affordable care and do not have insurance available to offset the cost.

A membership plan gives people a reason to say yes to dental care from your practice. Patients face slightly less out of pocket and the office increases new patients, patient retention case acceptance, and profitability.

As you’re thinking about whether to implement a dental membership plan in your practice, you should first and foremost consult with a professional.

SVA has in-depth knowledge of the dental industry that comes with years of experience working with dental practices. We can assist you with all aspects of a dental membership plan such as:

  • helping determine pricing
  • knowing what services to offer
  • assisting with the design
  • creating the reporting required to help you monitor and track your membership plan.

Chapter 6

Get Ready for a Buy, Sell, or Owner Transition Scenario


A transition in a dental practice requires a lot of planning. Whether you are buying a new practice, selling an existing practice, or transitioning owners in or out of the practice, you need to plan ahead to achieve the best results.

Some Questions to Get Started

When preparing for a practice transition, ask yourself…


Pick a tentative date of when you plan to buy or sell your practice, so you always have that goal in mind.


Determine what you are buying or selling. Is it just the practice? Is it a portion of the practice? Is real estate involved?


Will you sell to a known associate in your practice, or will they come from a different practice? Or are you looking at a corporate buyer or a private equity firm?

How Much?

Is the practice worth the sales price it’s listed at?

What Are You Buying and Selling?

Very simply, when you buy or sell a practice, it’s more desirable to structure it as an asset transaction. If you’re buying the assets, you’re starting your own entity and moving forward.

What happened in the past stays in the past. In contrast, with a stock sale, you’re also buying any liabilities and inheriting anything that may have happened in the past.

There are two categories of assets in a dental practice:

Tangible Assets

These are assets you can touch, feel, and see (i.e., hard assets). Examples include:

  • Accounts Receivable
  • Inventory/Supplies
  • Equipment
  • Leasehold Improvements
  • Real Estate

Intangible Assets

This is everything else in the practice. Examples include:

  • Goodwill
  • Covenant Not to Compete
  • Trade Name
  • Right to Earn Income Off of a Block of Patients in the Future

Typically, goodwill is a range between 100% to 150% of one year’s net income before dentist compensation.

There are various factors that might impact the price you negotiate when you go to buy/sell your practice. These include:

  • Physical location of the practice
  • Favorable long-term lease and/or option to buy real estate
  • Physical condition of equipment and facility
  • Current expense structure
  • Doctor production and hygiene production ratios
  • Current fee schedule
  • Can the buyer perform all services currently provided, or more?

(Download Video Transcript)

Common Payment Terms

Once the sales price is negotiated and both parties agree to the transaction, how will the money change hands? Typically, there’s a portion paid in cash at close and there’s a portion that’s deferred over time.

Here are some examples:

  • Cash at closing for tangible assets
  • Accounts receivable can either be cash at closing or paid over the first 12 months as collected
  • Seller financing allows the seller to defer some of their gain into future years
  • Land contract if you’re selling the building
  • Goodwill is dependent on the financing source:
    • If you’re letting an associate buy in, it might be structured as a deferred compensation arrangement.
    • If you’re selling to a corporate or private equity buyer, there may be a portion of the valuation and the sale that will be deferred as equity in the new corporation.



Chapter 7

Is It Time to Bring on an Associate?

The most frequent question asked by a seasoned dentist is..."Should I have an associate?"

The answer to this question is complicated. To truly come to the right answer, the first thing to do is step back and determine what you want to accomplish.

  • What is the main driver behind wanting to add an associate?
  • Do you want to reduce your hours?
  • Are you looking for an exit strategy?
  • Do you have a patient base that's growing and you need help managing the workload?

There are numerous factors to consider when deciding on whether to add an associate. Revenue-based factors include:

Growth of Practice

Mature practices with an annual revenue of approximately $1 million require 15 to 20 new patients a month just to maintain themselves.

Moving from 1 to 2 Dentists

Production needs to consistently be more than $90,000 a month with 40 to 50 new patients per month.

If you can answer yes to both of these factors, your practice is growing at a pace in which you could use help from an associate dentist.

On the flip side, if growth is not moving at that rate and you add an associate, the owner’s profits will decline because of the additional costs of the associate and the inability to meet the new break-even point.

If you’re not experiencing exceptional growth, one solution is to consider hiring a part-time associate. Oftentimes with good planning and a good strategy, an associate who starts part time can transition to full time seamlessly.

SVA Dental Webinar Series: Dental Staffing Stats, Trends, and Tips

Associate Employment Options

Now that you have the associate in mind, what employment option will you offer?


A W-2 employee will have set hours and they can help grow your practice without any long-term commitments. However, the downsides of hiring a full-time employee are the additional costs and risks.

In addition to the base salary, the costs include payroll taxes, health insurance, potential retirement plan, extra benefits, etc.

By hiring an employee, the practice also takes on additional risk by assuming the liability for the worker’s performance.

Independent Contractor

This employment option is rare in the dental industry. The downsides are increased liability for on-the-job injuries, less control over workers, and temporary staff.

Buy-In/Out Partner/Owner

This is where an associate is interested in coming on board with the intent of buying into your practice. In this situation, an employment transition agreement will be drafted and signed that details the timeframe and terms of the transition.

This option is ideal if you’re looking to hire someone with the intent of selling your practice to that individual.

Which option is right for you? It depends on your goals, the specifics of your situation, and the facts and circumstances.

One size does not fit all, so it’s important to evaluate what makes sense for you.


If I Hire an Associate as an Employee, What Comes Next?

  • Base salary, dependent on experience
  • Bonus potential
  • Employee benefits
  • Allowances for continuing education, dues, and other professional expenses
  • Additional overhead expenses paid by the practice (i.e., lab, supplies, hygienist, assistant, malpractice, etc.)

Everything Can Be Negotiated and Should Be Included in a Contract

Consider your production allocation and how it affects bonus potential. How will you allocate production for exams, hygiene, and x-rays for the associate’s bonuses?

Finally, look at compensation trends to ensure you are offering a competitive benefits package as compared to your marketplace.

If the Associate Were to Transition or Come in as an Owner, Some Considerations Include:


How will they be paid? How are you paid? They might expect to be paid on a similar structure.

Base Salary

Share of Practice Profits

How will you split the profits of the practice? Typically, it’s a formula to allocate practice profits between owners.

In the past, you’re used to getting 100% of the profits in your practice.

When an associate comes on board, you now have a minimum requirement to break even on the cost to have that associate, otherwise some of the profits will need to be pulled away from you to cover the associate’s costs.

It’s crucial to know the break-even point so you can make sure you’re covering the cost of the associate.

Protect Your Practice

Work with your attorney to draft a contract to clearly outline all employment terms (including renewal), conditions, and compensation in writing before the associate starts working. Then detail reasonable notification terms (standard is 60 to 90 days) to ensure that if the associate decides to leave, you are prepared.

Make sure you also have a termination clause that protects both you and your practice. Have a covenant not to compete as well as a non-solicitation of staff, patients, and confidential information. The last thing you want is to see your associate walk out the door and take your patients and staff with them.

Chapter 8

How SVA Can Help

Fact-Based Decisions Maximize Practice Profitability


Our professionals have in-depth knowledge of the dental industry that only comes with years of experience working with practices like yours.


We can help with every life stage of your practice – from start-up, through the growth phase, and eventually when you transition out of the practice.

Contact SVA


Madison, WI
1221 John Q Hammons Dr, Suite 100
Madison, WI 53717
(608) 831-8181

Milwaukee, WI
18650 W. Corporate Drive, Suite 200
Brookfield, WI 53045
(262) 641-6888

Colorado Springs, CO
1880 Office Club Pointe, Suite 128
Colorado Springs, CO 80920
(719) 413-5551

SVA BBB Business Review Man Standing


(888) 574-4782

Are you in the know on the latest business trends, tips, strategies, and tax implications? SVA’s Biz Tips are quick reads on timely information sent to you as soon as they are published.

Connect With Us

Copyright © 2024 SVA Certified Public Accountants | Privacy Policy | Cookie Policy | CCPA