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Dental Practice Success in Uncertain Times: 3 Lessons from the Great Recession

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In 2008, I had a choice to make about my dental practice organization. The world was melting down, people were just beginning to lose their homes. Banks were beginning the process of foreclosing on thousands of homes in default. People were losing their jobs and our government was scratching its head wondering what to do. I made a decision to do something well outside my comfort zone at the time. That moment seemed to call for caution, preservation, reaction.
Not survive.
Not pause.
Scale.

Dental practice scaling

While most of the market was pulling back, I opened three additional practices and built the foundation of what would become the most profitable phase of my entire career.

This isn’t a story about luck or timing.
It’s about mindset. It’s about systems.
And it’s about making bold moves when others freeze.

If you’re feeling the pressure right now, if inflation, rising costs, or tightening margins are making you question your next move, I want you to know something:

You don’t have to retreat.
You can build in this environment.
You can grow right now.

Here’s how I did it—and how you can too.

Many People React. Entrepreneurs Prepare.

During the Great Recession, I watched good doctors crumble—not because they weren’t skilled or passionate, but because they were reactive. They:

  • Slashed marketing and growth budgets
  • Froze hiring
  • Put expansion plans on indefinite hold
  • Pulled back into survival mode

And I get it. That kind of fear response is human. But it’s not strategic.

I realized early on: if I wanted to build something that could survive any storm, I needed to stop reacting—and start leading. That mindset shift changed everything.

Step 1: I Built Systems That Didn’t Rely on Me

The first thing I did was take a hard look at my operations. The truth?
There were many areas where I was the bottleneck.

Too many decisions ran through me. Too much depended on me showing up and putting out fires. That’s a problem for any dental practice in any season—but in a downturn, it’s a business killer.

So I systemized everything I could:

  • Clinical and operational SOPs
  • Training paths for every team role
  • Metrics that told me whether my systems were working
  • Incentives that built trust, enthusiasm and loyalty

That shift created predictability.
And predictability creates profit.

I also learned some invaluable lessons with each dental practice I opened. I document these lessons in my book, Extraction: The Surprising New Formula to Systemize, Scale and Sell Your Business. It’s got some great exercises, tips, strategies and recommended books for you.

Lesson #1: Don’t be the bottleneck. Scaling or growing your dental practice means your role shifts from strictly practicing dentistry to becoming a leader, investor and CEO of your practice. That means becoming the path to success, not the obstacle in front of it. Learn to extract yourself, little by little, from the day-to-day to focus on the 10,000-foot view so you can lead.

Step 2: I Doubled Down on People

When you’re in a tough economy, it’s tempting to cut your team to save money. But I believe this:

The strength of your practice is a reflection of the strength of your people.

Even in the recession, I prioritized hiring and training A-players. I gave my team a clear vision, I treated them with respect, and I created a culture where everyone knew their role in the mission. Everybody on the right bus and in the right seats.

That kind of leadership doesn’t just retain people—it unlocks their potential.

Lesson #2: Great teams aren’t a luxury in a downturn—they’re your survival strategy. In hard times, cutting your team might save money—but investing in the right people builds a business that can weather anything.
When your team understands the mission, feels trusted, and is trained to lead, not just follow, they become your greatest asset in any economy.

Step 3: I Made Every Decision from Data

If you’re leading a business based on how you feel, you’ll ride the same roller coaster as the economy. But when you use data, you get clarity—and clarity breeds courage.

Before opening a new practice, I made sure:

  • My systems were replicable
  • My overhead was under control
  • My production-per-chair was profitable
  • My KPIs told me it was time to grow

No guesswork. No gambling. Just informed execution.

Lesson #3: Emotions are unpredictable. Data isn’t. In uncertain times, data-driven decisions replace guesswork with growth. When you know your numbers, you lead with confidence—not chaos. Clarity creates courage. KPIs create control. If you can’t measure it, don’t bet your business on it.

Hard Times Are Mirrors—Don’t be Afraid to Look into Them

If you’re anxious about the economy right now, let me tell you: you’re not alone. I’ve coached hundreds of doctors through this exact feeling.

And here’s what I always say:

Hard times are mirrors. They show you exactly what needs to be fixed, rethought, or leveled up.

So instead of asking, “How does my dental practice I survive this?”
Ask constructive questions designed to help you find answers:

  • “Where are my inefficiencies?”
  • “What systems are missing?”
  • “What does my team need from me right now?”
  • “Where can I get better?”

At Optimize Practice Alliance, this is what we do. We help doctors turn their anxiety into strategy.

Because economic downturns aren’t barriers—they’re filters. And those dental entrepreneurs who are prepared will rise.

Here’s What I Recommend Right Now

If you’re running a dental business in 2025 and feeling uncertain, you’re not alone. But don’t let that stop you from moving forward with your plan or dream. These are the same steps we guide our Optimize clients through—and they’re the same principles I used in 2008.

1. Audit Your Systems

What are you still doing manually that could be automated or delegated? Do you have SOPs that a new team member could follow without confusion?

2. Know Your KPIs Cold

To truly lead your dental practice through uncertainty, you need to know your numbers. Revenue per provider tells you how productive your team is. Overhead ratio shows how lean or bloated your expenses are. Patient retention reveals the strength of your relationships and systems. And case acceptance shows how well patients understand and commit to care. These aren’t just numbers—they’re signals. When you track the right ones, you lead with clarity, not guesswork.

3. Overcommunicate With Your Team

Fear thrives in silence. Let your team know the plan. Share the wins. Share the challenges. Build trust and they’ll follow you anywhere.

4. Invest in What Moves the Needle

Now is the time to double down on what works—whether that’s leadership training, marketing that actually brings in patients, or improving your patient education process.

5. Protect Your Mindset at All Costs

You can’t lead in fear. You can only lead in focus. I built my growth mindset during the worst of the economy—and it’s the one thing that’s never failed me.

If You Want Help, That’s What We’re Here For

I built Optimize Practice Alliance so other doctors wouldn’t have to figure this out the hard way like I did.

We help dental entrepreneurs:

  • Cut out inefficiencies
  • Build strong, self-led teams
  • Systemize their operations
  • Develop real growth plans
  • And eventually exit at top value

We’ve walked this road—and we walk it every day with clients across the country.

If you’re ready to build a recession-resistant practice that runs with confidence, not chaos, let’s talk.

Final Thought

When the economy gets shaky, your business doesn’t have to.
You can grow now.
You can lead now.
You can build your most profitable phase right now.

I did it in 2008.
And I promise you—you can do it now.

Let’s get to work.

Schedule a Consulting Call

PRESS RELEASE: Henry Schein One Unveils The Catalyst Index, a Look into Dentistry’s Top 10%

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AMERICAN FORK, Utah–(BUSINESS WIRE)–Henry Schein One today announced the launch of The 2025 Catalyst Index, its exclusive report offering dental practices an unparalleled view into the strategies transforming performance across the industry. Built on years of trusted benchmarking and informed by Henry Schein One’s most connected platform, the fourth annual report, The Catalyst Index, raises the bar by revealing the specific actions that distinguish the top 10% of DSOs and private practices.

“We’re at a turning point in dentistry,” said Dr. Ryan Hungate, Chief Clinical and Strategy Officer, Henry Schein One. “Practices can no longer afford to operate without clear insight into what separates top performers. The Catalyst Index gives them that competitive edge. It’s like peeking behind the curtain at how the best practices operate.”

Transforming Care Through Insights

According to the report, top-performing practices significantly outpace their peers in both patient growth and revenue, even while seeing fewer patients than the previous year.

Top performers are focused on simplifying the full patient experience, including faster appointment access, streamlined forms, improved billing clarity, and flexible scheduling. This contributed to stronger patient retention, better reviews, and greater acceptance of care plans. The most profitable practices are also operating more efficiently as a team.

The takeaway is clear: there’s a huge opportunity here. Here are just a few of the insights uncovered in the full report:

  • Nearly 60% of patients decline care due to ineffective education, lack of pricing clarity, and a frustrating overall experience.
  • Month-long appointment lead times are common among average practices, while top performers prioritize access for new and emergency patients.
  • Patient experience directly impacts performance. Practices that offer online forms, transparent billing, and flexible scheduling see stronger retention and treatment acceptance.
  • Chairside revenue potential remains underutilized. On average, daily gross production is nearly four times lower than that of the top 10%.

“If you’re average, get mad and fix it. The amount of production being left on the table is mind-boggling,” said Joshua Gwinn, CEO, Optimize Practice Alliance. “The top 10 percent are absolutely crushing it, and it’s not a secret why. They follow a process, build the team, execute, hold people accountable, and analyze their data. If you don’t do that, you’ll stay average or below.”

Driven by Data, Designed for Care

Henry Schein One’s annual benchmarking reports continue to empower thousands of dental practices to measure their performance, identify opportunities, and chart paths for growth. The Catalyst Index expands on previous reports by not only benchmarking results but also highlighting the concrete strategies that drive success.

With its deep commitment to creating the most connected platform in dentistry, Henry Schein One continues to help practices automate and simplify workflows, secure patient data, and drive profitability, delivering technology that allows clinicians to refocus on what matters most: patient care.

“Being recognized as part of the top 10% is a reflection of the steps we’ve taken to simplify and strengthen how we run our organization,” said Evelyn Lahiji, COO, Children’s Dental Fun Zone. “Centralized billing and AI-supported diagnostics have made a big difference for our team and our patients. The Catalyst Index does a great job of showing what’s possible, and I think it will give other practices a practical way to evaluate what’s working and where they can improve.”

The Catalyst Index is Now Available

Click here to explore the full Catalyst Index and find out where your practice stands.

About Henry Schein One

Henry Schein One, a leader in dental software, empowers dentists to focus on patient care, ensuring practice success.

With its simple and integrated software, practices are finally more seamless, more efficient, and more profitable—meaning patients and practitioners are happier. With comprehensive solutions: demand generation, patient experience, practice management, revenue management, dental analytics, and clinical workflow, dental practices will be running smoother than ever before.

Henry Schein One, LLC, is a joint venture between Henry Schein, Inc. (Nasdaq: HSIC) and Internet Brands. The company’s portfolio of leading brands includes Dentrix®, Dentrix Ascend®, Jarvis Analytics™, TechCentral™, Lighthouse360+, and DentalPlans.com®, along with solutions offered through international companies, including Dentally and Software of Excellence, among others. For a full list of our brands, please visit our website or connect with us on LinkedIn.

Contacts

Claire Barbier, Communications Manager, Henry Schein One, Claire.barbier@henryscheinone.com, (631) 559-2942

For Dental Entrepreneurs, A Wake-up Call from The Top 10%: Stop Being Average 

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Attention: Dental Entrepreneurs: “If you’re average, get mad and fix it.” 

That’s a line in the recent Business Wire article that I stand by 100%.  

I said that in response to the newly released Catalyst Index by Henry Schein One—a data-backed breakdown of what separates the top 10% of dental entrepreneurs from everyone else. Spoiler alert: the gap is massive. And it’s not about talent—it’s about intentional action. 

The numbers are clear, and they should light a fire under all dental entrepreneurs who want to grow, scale, and eventually sell their practice for what it’s really worth. 

Let’s break down a few of the standout findings—and what they mean for you.

Catalyst Index 2025 for Dental entrepreneurs

1. 60% of Patients Decline Care Due to Ineffective Education 

That’s not a patient problem. That’s a communication problem. Patients don’t say “no” to treatment—they say “no” to things they don’t understand or see value in. 

The best way to fix this is with patient education strategies that connect, convert, and build trust at every single touchpoint in your patient experience, starting with your marketing. If you’re not actively educating your patients in a way they get, you’re leaving money on the table—period. 

Most treatment plans don’t fail because patients can’t afford them. They fail because patients don’t understand them. According to the Catalyst Index, nearly 6 out of 10 patients walk away from care—not because they don’t want it, but because no one translated the value of the treatment in a way that clicked. This is one of the most common—and most costly—gaps we see in average practices. 

The top 10% of practices and dental entrepreneurs are winning because they’ve built systems and scripts that explain care in terms patients can emotionally and logically buy into. They leverage visual aids, digital presentations, clear language, and consistent messaging across every touchpoint—from the first call to the final follow-up. 

When you educate with empathy, clarity, and structure, your case acceptance doesn’t just increase—it skyrockets. 

2. Top Performers Prioritize Access. Average Practices Have Waitlists. 

If your patients have to wait a month to get in, they’ll find someone else—or just forget about treatment altogether. Meanwhile, the top 10% of dental entrepreneurs are designing access around convenience, not tradition. 

They’re proactive. Nimble. Smart about systems. This is exactly the kind of operational agility we coach with in our Practice Optimization Process tm when we work with our consulting clients. Working with Wincrest Orthodontics in Plano, TX, we focused on their patient experience.  By transforming a few key areas in the patient journey, they were able to gain a 7x increase in starts over 2024.

Read the Case Study.

What’s the use of an amazing treatment plan if the patient can’t get on your calendar until next month? Access is everything. According to the Catalyst Index, long lead times are killing momentum for average practices. When patients are ready to say yes, any delay becomes friction—and friction kills conversion. 

In contrast, top 10% of dental entrepreneurs are engineering access into their daily operations. They use advanced scheduling systems, reserve time blocks for high-priority patients, and design their workflows to accommodate same-week (and sometimes same-day) appointments. 

This isn’t about working longer hours. It’s about structuring your schedule so it serves both your production goals and your patients’ timelines. It is absolutely possible to rework your scheduling models to maximize availability without burning out your team.  

3. Patient Experience Drives Revenue 

Your patients aren’t just judging your clinical work—they’re judging your front desk, your follow-ups, your technology, your vibe. The best-performing practices in the country are obsessed with experience, and the numbers back that up.  

They create a culture patients want to return to and refer their friends to. That’s not fluff. That’s scalable brand equity. Here’s a truth most dentists don’t want to hear: your clinical skills matter—but your experience as dental entrepreneurs matters more. 

The Catalyst Index found that the best-performing practices treat patients like VIPs from the moment they call to the moment they leave. 

Think about it—patients don’t just evaluate your dentistry. They’re judging your customer service, your follow-up, your payment options, your digital forms, your team’s attitude, your office design, and even your Spotify playlist. 

The top 10% of dental entrepreneurs are dialing in every detail to create an experience that builds loyalty and referrals. They know that patients won’t remember the exact margins on a crown—but they will remember how your team made them feel. 

Learning to build experience-first cultures that translate into retention, reviews, and revenue is essential in a successful dental business. It’s what keeps your patients coming back, your teams happy and your practice scalable and profitable.  

4. Chairside Revenue Is Being Ignored 

The Catalyst Index found a fourfold difference in average daily gross revenue between average dentists and the top 10%. Four times more—same number of hours in the day. 

Why? Because the top 10% of dental entrepreneurs know how to maximize every chair, every hour, every treatment opportunity. No guessing, no coasting. 

This isn’t about working harder—it’s about working smarter with systems that support production without burnout. 

The most shocking Catalyst Index stat? Top 10% of dentists are making almost 4x more in average daily production than their peers. Same chair. Same number of hours. Radically different outcomes. 

So what gives? 

Top performers don’t just hope for revenue—they engineer it. They know how to spot production opportunities in hygiene. They cross-train their team to recognize when a patient needs same-day treatment. Furthermore, they optimize chair flow, tighten turnover times, and use data to set production targets that actually mean something. 

On the flip side, average dental entrepreneurs are bleeding money because their chairs aren’t working at full potential. Too many holes in the schedule. Too few upgrades. Too much “I’ll just wait” from patients. 

At Optimize, use a tool called the Practice Optimization Process tm. It helps you map your chairside revenue potential and install systems that ensure you’re not just busy—you’re productive. 

The truth is, being average in today’s market isn’t safe. It’s a slow bleed. And it’s avoidable.  

If your practice isn’t growing the way you want, you’re not broken—but your systems probably are. At Optimize Practice Alliance, we work with dental entrepreneurs every day to fix what’s not working and install what is—so you can grow with confidence. 

The Bottom Line: It’s Time to Decide—Are You Average, or Are You Ready to Lead? 

The Catalyst Index didn’t just shine a light on what the best dental entrepreneurs are doing—it held up a mirror to the rest of the industry. And what it revealed is hard to ignore: 

Too many practices are operating far below their potential. 
Too many teams are frustrated but don’t know what to fix. 
Too many owners are working harder than ever—and still falling short. 

But here’s the truth: it doesn’t have to be this way. 

At Optimize Practice Alliance, we don’t believe in generic coaching or cookie-cutter solutions. We believe in partnering with bold, committed dental leaders who are ready to take ownership of their growth and play in the top 10%. 

If your gut tells you your practice could be doing better—you’re right. And if you’re mad about being average? Good. That’s your fire. 

Now let’s turn that fire into a plan. 

Ready to Stop Leaving Money on the Table? 

Book a free 30-minute strategy call with our team. We’ll give you a custom action plan, specific to your practice, with real strategies you can use right away. No fluff. No pressure. Just the clarity you’ve been missing. 

Stop being average—Let’s fix it. Together.  

BOOK YOUR CALL

Supercharge your Dental Practice Exit: Don’t Ignore the 4 Pillars of a Strong Exit Strategy

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As a dental entrepreneur, I know firsthand the years of dedication, long hours, and relentless passion that go into building a successful dental practice. But here’s the thing: while running the day-to-day operations is important, what’s equally crucial is planning for the day you’ll eventually step away from the business. You may not be thinking about retirement just yet, but having an exit strategy in place is key to preserving the legacy you’ve built, maximizing the value of your dental practice, and ensuring your financial future is secure. 

Exit your Dental Practice Successfully

By 2012, I had built my organization from 1 to 8 practices across 2 states. I was traveling between dental practices, overseeing a complex and wide-ranging organization and leadership team and quite frankly, I was burnt out, stressed out and looking for a way out. That is not the place of strength to be negotiating or navigating an exit from at all.  

I needed to take a step back, listen to myself and reassess my roles and my life. So, I did just that. I began to think seriously about exiting my organization, as hard as that was for me to imagine at the time. I regrouped, and after several months of consideration and feedback from others, I made the decision to exit.  

But that was only the beginning of another process, exiting. Exiting is a process and like most everything else I did as a dental entrepreneur, I learned how to do the process correctly through trial and error and going through my own journey with it. Let’s look at the steps you need to take for a healthy, successful and profitable exit from your dental practice.  

An exit strategy isn’t just about the moment you sell your practice. It’s about crafting a roadmap that ensures a smooth transition—one that protects everything you’ve worked so hard for. And the extraction process that I’ve written in regard to scaling applies to selling and exiting as well. First, let’s look at why you need to plan well in advance for your exit. 

The Advantages of a Solid Exit Strategy 

  • Maximizing Your Dental Practice’s Value 

If you’re going to sell your practice, you want to get the best possible value, right? A well-thought-out exit strategy allows you to identify areas where your dental practice can improve—whether it’s streamlining operations, boosting patient satisfaction, or enhancing your marketing efforts. These are all factors that can significantly increase the attractiveness of your practice to potential buyers. I have an interesting story about my marketing program at my exit. In the last two years, I did not have a marketing program. I had shut down all marketing because we had too many patients. My teams could not handle the patient retention we were seeing so I stopped spending money on marketing completely.  

Before that, I was spending about $100,000 a month to get us where we were. And as PE and other entities came in to review our financials they got spooked because we didn’t have any marketing. I said to them, look at our patient retention, look at our daily schedules and then tell me where we’re going to put the patients that come in from implementing a new marketing program. They didn’t have an answer for me. Our financials were strong and solid. Extracting my marketing program increased our valuation. And these outside entities started to realize and understand the value I had created with these decisions.

  • Financial Security for Life After Dentistry 

Selling your dental practice is a major financial event. It’s not just about getting a lump sum; it’s about ensuring that the sale aligns with your retirement plans or other financial goals. A strategic exit plan helps you map out how the proceeds from the sale will fit into your overall financial future, giving you peace of mind as you look forward to the next chapter of your life. This applies to not just selling your practice outright, but also to joining a DPO or DSO.  

  • A Seamless Transition 

Dentistry is all about relationships—those bonds you’ve formed with patients over years of care and trust. A well-constructed exit strategy ensures that these relationships, along with the reputation you’ve built, are preserved. It helps facilitate a smooth handover to the new owner, ensuring continuity in patient care and trust. You want to ensure that the hands you turn your patients over to are hands you trust too.  

  • Preserving Your Legacy and Brand 

Your practice isn’t just a business; it’s a reflection of your personal brand, values, and hard work. Having a thoughtful exit plan can make sure that the standards and reputation you’ve built continue to thrive long after you step away. 

The Necessities of an Exit Strategy – Your Foundation  

Now, let’s look at the foundational aspects of a strong exit strategy. These are areas you will need to spend time on, but I also recommend hiring professionals to execute these aspects of the business successfully.  

  • Understanding Your Dental Practice’s True Value 

First things first: you need to know what your dental practice is worth. This involves a thorough assessment, including your financial records, patient base, market reputation, and even intangible assets like goodwill. Understanding the true value of your practice will give you a strong starting point when negotiating a sale. One of the ways you can get started is by understanding and determining your organization’s EBITDA. My partner and the CEO of Optimize, Josh Gwinn, has written a great post on understanding this metric and how to get there.  

  • Legal and Financial Preparedness 

Ensuring your legal and financial documents are in order is critical. This means up-to-date financial statements, clear legal agreements, and full compliance with any industry regulations. It’s not the most exciting part of the process, but it’s essential to avoid any surprises down the road. 

  • Succession Planning 

Whether you’re passing the dental practice to a family member, selling to a partner, or bringing in a completely new owner, you need a succession plan. Identifying and preparing a suitable successor ensures that the practice continues to run smoothly once you’re no longer in charge. And ideally, this starts at least a couple years before your actual exit to prepare everyone involved in the process and set your expectations for your legacy.  

  • Understanding Tax Implications 

Taxes are unavoidable, and selling a practice comes with its own set of tax challenges. Consulting with a financial advisor or accountant early on can help you understand the tax implications of the sale and minimize your liabilities. 

Strategies for Effective Exit Planning 

I took 2 years to prepare my organization for my exit. And my organization looked vastly different after those two years than it did when I started. For one, I sold 3 of my practices and scaled down from 8 to 5. I needed to make that change for my sanity, but I also did it because it made the process of consolidation easier, and more attractive to buyers. I was able to increase my valuation by taking the steps to scale down and consolidate.  

The other thing I did was, I made my leadership team fully autonomous. They knew exactly what to do and how to do it, without me. I made myself essentially obsolete, another attractive feature to buyers and a much-needed mental relief for me. But those two actions took time, strategy and fore thought to execute. Nothing was left to chance in my preparation for what was to come next. So, here are some strategies for effective planning.  

  • Start Early 

If you take nothing else away from this post, remember this: start planning early. Ideally, you should begin exit planning years before you intend to step away. This gives you time to implement the necessary changes to enhance your dental practice’s value and ensures a smoother transition when the time comes. 

  • Build a Strong Management Team 

A reliable, competent management team adds enormous value to your practice. It not only reassures potential buyers but also makes the transition process easier when you do step back. Empowering your team to handle the day-to-day independently is a huge plus. 

  • Enhance Your Marketability 

Take the time to invest in modern equipment, upgrade your office environment, and embrace technology. Having a strong digital presence, solid reviews, and an updated office can make your practice far more appealing to prospective buyers.  

  • Explore Different Exit Options 

You’ve got options when it comes to how you exit. You could sell to a partner, merge with another practice, or bring in a new owner entirely. You may also opt to sell to a PE, join a DSO or a DPO. Each option has its pros and cons, so it’s important to weigh them based on your personal and financial goals. 

  • Engage Professional Advisors 

Don’t go through this process alone. Surround yourself with a team of experts—financial planners, accountants, lawyers, and brokers. They can guide you through the legal, financial, and market complexities that come with selling a dental practice, ensuring you get the best outcome. 

Build an Environment of Negotiating Strength 

Exit planning isn’t something you leave until the last minute. It requires foresight, strategic thinking, and a commitment to preserving the legacy you’ve worked so hard to build. The earlier you start, the better prepared you’ll be to maximize your practice’s value, ensure a smooth transition, and achieve your financial goals. Whether you’re aiming to retire, reduce your role, or pursue new ventures, a solid exit strategy is your foundation for future success.

When I exited my own practice for an 8-figure valuation, it was the result of careful planning and knowing my numbers inside and out. One of the most effective ways to strengthen your negotiating position is to track and understand your key performance indicators (KPIs). When you have a clear grasp of your financials and operational metrics, you can demonstrate the true value of your practice to any potential buyer.

That’s why we created the OPA KPI Tracker—a free, easy-to-use tool designed specifically for dental entrepreneurs. With the KPI Tracker, you’ll monitor the metrics that matter most for scaling, growing, and ultimately exiting your practice on your own terms.

Ready to lay the groundwork for a successful exit?
Download our free OPA KPI Tracker now and start building a practice—and a future—that’s ready for any opportunity.

Download Your KPI Tracker

Understanding EBITDA: 3 Key Dental Practice Metrics for Measuring Success

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The dental practice industry is rapidly moving toward massive consolidation. Most dental practices operate at 50% of their potential with slim profit margins, typically 15-25%. The root cause of these outcomes is a lack of entrepreneurial focus and understanding of how to operate a business.  

We at Optimize see an urgent problem in this, which is, dentists need to learn quickly how to fulfill their potential, increase profit and build a sustainable exit strategy to protect their assets and retirement prospects. The hard part is…How? How do you increase your potential, while increasing revenue, while building a sustainable exit strategy? That’s a lot.

Think Like an Entrepreneur 

There are many ways to increase revenue, you can scale your business model and open a second or third location; plan and execute an expansion of your practice in another way, like adding an associate or hygienist; or you can implement and aggressive marketing strategy. There are a few effective ways to expand efficiency, fulfill your potential and increase your profit and revenue. And some of these will create a successful exit ramp when you’re ready.  

Measure Twice, Cut Once 

And in dentistry, you need to be measuring, like, all the time. But there is one key metric to look at, gauge and increase as you look to grow, build and exit. It’s called EBITDA.  

This is the one essential financial metric for evaluating the performance of your practice and figuring out what you’re fiscally prepared to take on. EBITDA is a magical formula that allows you to measure the actual and fiscal success of your business. So, what is it?  

What is EBITDA? 

EBITDA stands for Earnings Before Interest, Taxes, Depreciation, and Amortization. It is a financial metric used to measure a company’s operating performance by excluding certain expenses that can vary widely between different businesses. EBITDA provides a clearer picture of a company’s core profitability and operating efficiency. 

dental entrepreneur

Why is EBITDA Important for your Dental Practice? 

In the context of dental practices, EBITDA offers valuable insights into the business’ financial health and performance. And if you’re interested in fulfilling the potential of your practice, which leads to an increase in profitability which leads to an increase of protecting your most valuable asset on your way to retirement, then it’s EBITDA that will allow you to see the big financial picture and track the value of that asset.

“Dentists need to learn quickly how to fulfill their potential, increase profit and build a sustainable exit strategy to protect their assets.“

~ Josh Gwinn, CEO, Optimize Practice Alliance

Three Invaluable Tools in One 

EBITDA does three things – 

  • Focuses on Core Operations: By excluding non-operating expenses such as interest, taxes, depreciation, and amortization, EBITDA focuses solely on the core operations of the dental practice. This allows practitioners to assess how well the business is performing in terms of generating revenue from patient care. 
  • Facilitates Comparisons: EBITDA provides a standardized measure that allows dental practices to compare their performance with industry peers or benchmark against historical data. This comparative analysis can help identify areas of strength and areas needing improvement. 
  • Simplifies Financial Analysis: Calculating EBITDA simplifies financial analysis by removing the impact of non-operating factors that can distort profitability metrics. It provides a clearer picture of the underlying profitability of your dental practice, making it easier for practitioners to make informed decisions. 

How to Calculate EBITDA for Your Dental Practice 

Calculating EBITDA for your dental practice involves several steps –

  • Start with Net Income: Begin by determining your practice’s net income, which is the total revenue minus all operating expenses, including salaries, supplies, rent, utilities, and other overhead costs. 
  • Add Back Depreciation and Amortization: Next, add back depreciation and amortization expenses to the net income. These are non-cash expenses that represent the gradual reduction in value of assets over time. 
  • Add Back Interest and Taxes: EBITDA excludes interest and taxes, so you’ll need to add them back to the net income. Interest expenses represent the cost of borrowing, while taxes are statutory payments to the government. 
  • Adjust for Non-Recurring Expenses: Finally, adjust for any one-time or non-recurring expenses that are not reflective of the normal operating performance of the practice. 

Once you’ve completed these steps, you’ll arrive at your practice’s EBITDA figure, which can be used to assess its financial performance. 

Use EBITDA to Measure your Success 

Now that you understand how to calculate EBITDA for your dental practice, let’s look at tactics for how you can use this metric to measure success – 

  • Monitor Trends Over Time: Track your practice’s EBITDA over different time periods to identify trends and patterns. A consistent increase in EBITDA indicates improving profitability and operational efficiency. 
  • Set Performance Goals: Use EBITDA as a benchmark to set performance goals for your practice. Establish targets for EBITDA growth and strive to achieve them through strategic initiatives and operational improvements. 
  • Identify Areas for Improvement: Analyze your practice’s EBITDA to identify areas where costs can be reduced, or revenue can be increased. This may involve optimizing staffing levels, improving billing and collection processes, or expanding service offerings. 
  • Inform Strategic Decision-Making: EBITDA provides valuable insights that can inform strategic decision-making for your dental practice. Whether it’s expanding into new markets, investing in technology, or negotiating favorable terms with suppliers, EBITDA can guide you in making informed choices that drive long-term success. 

EBITDA is a valuable metric for measuring the success of your dental practice or organization. By focusing on core operating performance and excluding non-operating factors, EBITDA provides a clearer picture of profitability and operational efficiency. By calculating and monitoring EBITDA, dental practitioners can make informed decisions to drive growth, optimize performance, and ensure the long-term success of their practices. 

One Tool – Three Powerful Uses

This is one powerful way you can focus on the three areas: low potential, slim profit margins and little to no exit strategy. But by using this one metric effectively, you are switching your mindset from dentist to dental entrepreneur. You are getting out of the dentist’s chair and taking a 10,000-foot view of your practice or organization.  

And it’s imperative you take this step, for yourself, for your family, for your team and for your legacy. My business partner, Dr. Jack Bayramyan, and I believe the future of dentistry belongs with dentists. Using EBITDA is one way to keep that future safe.  

One More Tool to Measure Growth in your Dental Practice

Understanding and tracking your practice’s financial metrics, like EBITDA, is essential for sustainable growth. But making real progress means consistently measuring what matters most, so you can spot trends, identify opportunities, and make confident, data-driven decisions.

That’s why we created our KPI Tracker. This free, easy-to-use tool helps dental entrepreneurs like you monitor the key performance indicators that drive profitability, efficiency, and long-term value. With the OPA KPI Tracker, you’ll have a clear picture of your numbers, empowering you to make smarter choices as you grow your business.

Ready to move beyond guesswork and take control of your practice’s success?

Download Your KPI Tracker

Leverage a Successful Exit in your Dental Practice: The #1 Tool for Scaling and Exiting

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This month we’ve taken a deep dive into scaling your dental practice and doing it successfully. Scaling any business is time-consuming and work intensive. You need the right teams, tools and resources to scale effectively. And there is one tool that stands out among all the others. But this tool is versatile. There are a couple vital ways to use it, so let’s get into it.

In the dynamic landscape of dental practice management, finding effective metrics to guide growth is crucial. One such metric that has gained prominence is EBITDA, or Earnings Before Interest, Taxes, Depreciation, and Amortization. This is also a tool used by PE, banks, and other investing institutions when they are interested in buying a dental practice or organization. So, why not learn how to use this tool to your advantage, even and especially when devising your exit strategy. In this post, we’ll explore how leveraging EBITDA can be a strategic move to scale and even selling your dental practice. 

Understanding EBITDA and How To Use it for your Dental Practice 

EBITDA is a financial indicator that provides a snapshot of a company’s operational performance by excluding certain non-operating expenses. It essentially measures a company’s ability to generate operating income before considering the impact of financing and accounting decisions. Investors use this tool so they can have a clear picture of your short-term operational efficiency, in short, a dental practice’s profitability.

EBITDA essentially isolates earnings in your dental practice to gauge the value and feasibility of your practice as it stands separate from external financial factors.  

  • Earnings: The total revenue (all the money earned from your dental services) minus the cost of services sold (the money spent to offer those services). Also known as net income. 
  • Interest: The cost of debt financing (like loans or credit). 
  • Taxes: The amounts paid to the government can vary and thus are excluded. 
  • Depreciation: The decrease in value of tangible assets (like operatory tools and equipment, office equipment, etc.) over time. 
  • Amortization: Similar to depreciation, but for intangible assets (investor arrangements, real estate, dental offices, etc). 

Why EBITDA Matters for Scaling your Dental Practice 

1. Operational Efficiency:

EBITDA focuses solely on the core operations of your dental practice, making it an effective tool to assess operational efficiency. By identifying areas where costs can be optimized, dental practice entrepreneurs can streamline their operations for better scalability. This is also an incredibly valuable tool for dental practice exit strategies. Having a clear picture of your operational efficiency can put you in a strong negotiating position while giving you better tools for exit strategy planning.

2. Comparative Analysis:

EBITDA allows for easy comparison between organizations in the same industry. This can be invaluable for benchmarking your dental practice against your competitors, identifying areas for improvement, and implementing best practices to foster growth as well as exit strategy analysis.

3. Investor Appeal:

Investors often look at EBITDA as a key metric when evaluating an organization’s financial health. A strong EBITDA margin can make your dental practice more attractive to potential investors, facilitating funding opportunities for expansion and exit. You’re in a much stronger negotiating position when you see what they see and work on increasing your profitability.

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How Dental Practices Can Increase Their EBITDA and Why You Should Care

Steps to Utilize EBITDA for Scaling your Dental Practice 

1. Detailed Financial Analysis of your Practice:

Conduct a thorough analysis of your dental practice’s financial statements to calculate EBITDA. Understand the components and identify any extraordinary items that might distort the true operational performance of your practice. This step cannot be overlooked. In order to get from point A to point B, you’ve got to design a roadmap with the correct data and information.

2. Identify Cost Optimization Opportunities:

Utilize EBITDA as a tool to pinpoint areas where costs can be optimized without compromising operational efficiency. This may involve renegotiating contracts with your vendors, streamlining processes, or investing in upgraded technology for your operatories for greater efficiency. Whether you’re scaling or planning to exit, optimizing your operations will have strong long-term benefits.

3. Strategic Decision-Making:

Armed with a clear understanding of your dental practice’s EBITDA, make strategic decisions aligned with your growth objectives based on your Strategic Plan. This might involve where you choose to open your next location, expanding services perhaps into cosmetic or surgical dentistry, investing in affiliates and partners to increase value, or building your strategic plan for exiting your dental practice organization.

4. Communicate Effectively:

When communicating with stakeholders, including team members, investors, and partners, use EBITDA as a transparent metric to showcase your practice’s financial performance. This fosters trust and confidence in your growth strategy and strategic planning.  

One More Tool for Investing in your Dental Practice  

Leveraging EBITDA can be a game-changer for dental practices aiming to scale or exit successfully. By focusing on operational efficiency, comparative analysis, and strategic decision-making, a dental entrepreneur can use EBITDA as a compass to navigate the path to sustainable growth or a profitable exit.

And don’t overlook mindset. The mindset of a dental entrepreneur cannot be underestimated. You are the driving force behind your vision, mission, and strategic plan. Your passion and clarity are what inspire your team, your vendors, and your partners, they need to trust not just where your practice is headed, but that you have a plan to get there.

If you’re ready to put your vision into action and keep your finger on the pulse of your practice’s value and growth, the next step is simple: track your key performance indicators.
That’s why we created the OPA KPI Tracker, a free, easy-to-use tool designed for dental entrepreneurs. With it, you’ll gain clear insights into the metrics that matter most for scaling, boosting EBITDA, and preparing for a successful exit… whenever that day comes.

Ready to turn clarity into momentum?
Download your free OPA KPI Tracker now and start making every decision data-driven, from growth to exit and every step in between.

The future of dentistry belongs with dentists.

DOWNLOAD YOUR KPI TRACKER

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