Category Archives: Strategies

If you’re a dentist looking to purchase a practice in today’s market, you’ve probably realized something:

It’s not as simple as “find a good practice and buy it.”

The dental economy in 2026 presents a unique mix of:

• Stability

• Opportunity

• And complexity

The fundamentals are still strong—but the way you evaluate a practice needs to evolve.

Because today:

The best opportunities aren’t always the most obvious ones.

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The Old Way of Evaluating a Practice

Historically, many buyers focused on a few core metrics:

• Annual collections

• Patient count

• Location

• Basic overhead

And while those still matter, they no longer tell the full story.

In today’s environment, two practices with similar collections can have:

• Very different profitability

• Very different risk profiles

• Very different growth potential

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What Smart Buyers Are Looking At Now

Let’s break down the key areas that matter most in 2026.

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1. Profitability—Not Just Production

This is the biggest shift.

Buyers today are focused on:

• Net income

• Expense structure

• Margin trends

Why?

Because rising costs and flat reimbursement are putting pressure on profitability  .

A practice that looks strong on paper may:

• Have bloated overhead

• Be inefficiently staffed

• Struggle to maintain margins

Understanding this early is critical.

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2. Staffing Reality

Staffing is no longer a background issue—it’s a central factor.

Buyers need to evaluate:

• Is the practice fully staffed?

• Are key team members likely to stay?

• Is the hygiene department operating at capacity?

Given ongoing hiring challenges, especially for hygienists:

A well-staffed practice has real, tangible value.

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3. Capacity and Opportunity

One of the most overlooked areas is unused potential.

Remember:

• About one-third of dentists report they are not busy enough 

That means many practices have:

• Open chair time

• Underutilized hygiene

• Limited hours

For the right buyer, that’s not a problem—it’s an opportunity.

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4. Insurance Mix and Fee Structure

This is an area that requires careful review.

Buyers should understand:

• PPO vs FFS breakdown

• Reimbursement levels

• Dependence on specific plans

A practice heavily tied to low-reimbursing plans may:

• Limit profitability

• Require strategic changes post-acquisition

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5. Systems and Operations

Not all inefficiencies are obvious—but they matter.

Look for:

• Scheduling gaps

• Poor case acceptance

• Lack of systems or reporting

These are often areas where:

A new owner can create value quickly.

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6. Growth Potential

The best opportunities are often not the “perfect” practices.

They’re the ones where:

• Demand exists but isn’t fully captured

• Capacity can be expanded

• Systems can be improved

This is where buyers can:

• Increase production

• Improve profitability

• Build long-term value

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The Most Important Question to Ask

When evaluating any practice, the key question is:

“Why does this practice perform the way it does?”

Is it:

• Fully optimized?

• Underperforming?

• Constrained by staffing or systems?

Understanding the why behind the numbers is what separates a good decision from a great one.

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Common Mistakes Buyers Are Making

In today’s market, a few patterns are emerging:

• Focusing too heavily on collections

• Underestimating expenses

• Ignoring staffing risk

• Overlooking growth potential

• Assuming current performance is fixed

Avoiding these mistakes can significantly improve your outcome.

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The Opportunity in Today’s Market

Despite the challenges, this is still a very attractive time to buy.

Why?

Because:

• Not all practices are fully optimized

• Many sellers are feeling operational pressure

• Strategic buyers can unlock significant value

In many cases:

The opportunity isn’t in finding the perfect practice—it’s in improving the right one.

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The Bigger Takeaway

Buying a practice today requires a more thoughtful, analytical approach.

But for those who do it well, the rewards are significant.

Because:

The gap between average and high-performing practices is growing—and that creates opportunity.

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Looking Ahead

Next week, we’ll explore one of the biggest factors influencing both value and performance:

  >  How staffing challenges are impacting practice value—and what it means for buyers and sellers.

If you’re considering purchasing a practice and want help evaluating opportunities through this lens, that’s where experienced guidance can make a meaningful difference.

If you’re a practice owner thinking about selling, you’re probably asking some version of this question:

“Is now a good time?”

The answer, as with most things in today’s market, is:

Yes—but with the right expectations.

The dental market in 2026 remains active, with strong buyer demand and continued interest in practice ownership. But at the same time, the factors that drive value—and how buyers evaluate opportunities—have evolved.

Understanding that shift is key to a successful transition.

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The Good News: The Market Is Still Strong

Let’s start with what hasn’t changed.

• Dentistry remains a stable, in-demand profession

• Buyers are still actively looking for opportunities

• Financing is available for qualified candidates

From a high-level perspective:

Well-run practices continue to sell—and sell well.

That’s important.

There’s no indication that the market has weakened in a fundamental way.

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What Has Changed: How Buyers Think

While demand is still strong, buyers today are more analytical than ever.

They’re not just asking:

• “How much does the practice collect?”

They’re asking:

• How profitable is it?

• How efficient is it?

• How sustainable is it?

• Where is the risk?

• Where is the opportunity?

This shift is being driven by the trends we’ve covered over the past several weeks:

• Rising costs

• Flat reimbursement

• Staffing challenges

• Changing patient behavior

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Timing: Should You Sell Now or Wait?

This is one of the most common questions—and one of the hardest to answer generically.

But here’s the key insight:

Waiting doesn’t automatically increase value.

In fact, in some cases:

• Rising costs may reduce profitability over time

• Staffing challenges may become more difficult

• Market conditions may shift in ways that are hard to predict

On the other hand:

• Improving operations

• Stabilizing staffing

• Strengthening systems

can absolutely increase value—regardless of timing.

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Value: What Drives It in Today’s Market

Practice value has always been tied to performance—but today, the definition of performance is broader.

Buyers are focusing on:

1. Profitability

Not just collections, but:

• Net income

• Expense structure

• Margin stability

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2. Staffing Stability

• Is the practice fully staffed?

• Are key team members likely to stay?

• Is the hygiene department functioning at full capacity?

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3. Operational Efficiency

• Scheduling systems

• Case acceptance

• Workflow

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4. Growth Potential

• Is the practice maxed out?

• Or is there room to expand?

Interestingly:

A practice that isn’t fully utilized can still be very attractive—if the opportunity is clear.

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5. Insurance and Patient Mix

• PPO vs FFS

• Fee structures

• Patient demographics

These factors play a larger role than they did in the past.

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Expectations: The Key to a Smooth Transition

One of the biggest challenges in today’s market isn’t finding a buyer—it’s aligning expectations.

Sellers who are best positioned for success tend to:

• Understand how buyers are evaluating practices

• Recognize both strengths and weaknesses in their practice

• Be open to how the story is presented

This doesn’t mean undervaluing your practice.

It means:

Positioning it accurately—and strategically.

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Common Mistakes Sellers Are Making

In this environment, a few patterns are emerging:

• Over-reliance on collections multiples

• Underestimating the impact of expenses

• Ignoring staffing issues until late in the process

• Assuming all buyers will view the practice the same way

Avoiding these pitfalls can make a significant difference in both value and deal structure.

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What You Can Do Now

If you’re considering selling in the next 1–3 years, there are a few things you can do today to improve your position:

• Organize and understand your financials

• Evaluate your expense structure

• Stabilize your team where possible

• Identify areas of growth or opportunity

These steps don’t require a complete overhaul—but they can have a meaningful impact.

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The Bigger Takeaway

The dental market in 2026 is still favorable for sellers.

But success is no longer just about:

Having a good practice

It’s about:

Understanding how that practice is perceived in today’s market—and positioning it accordingly.

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Looking Ahead

Next week, we’ll shift to the other side of the equation:

 >  What buyers should be looking for in today’s market—and how to identify the right opportunity.

If you’re thinking about selling and want to better understand how your practice would be viewed in today’s market, that’s a conversation worth having early.

The more prepared you are, the smoother the process tends to be.

At this point, the trends are clear:

• Costs are rising

• Reimbursement is lagging

• Profitability is under pressure

• Staffing remains a challenge

The question is no longer:

“What’s happening in the dental economy?”

The more important question is:

“What are dentists doing about it?”

And the answer is: a lot.

Across the country, dentists are actively adjusting how they run their practices in response to these pressures—and those decisions are reshaping the market in real time.

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A Shift Toward More Strategic Practice Management

Historically, many practices operated with a relatively simple model:

• Maintain patient flow

• Deliver quality care

• Grow steadily over time

That model still works—but it’s no longer enough on its own.

Today, dentists are becoming more intentional about:

• How they generate revenue

• How they control costs

• How they position their practices for the future

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The Most Notable Strategic Shifts

Let’s take a look at what’s actually happening inside practices.

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1. Re-evaluating Insurance Participation

One of the biggest shifts is how dentists are thinking about insurance.

Many are:

• Dropping out of lower-reimbursing plans

• Becoming more selective about participation

• Exploring alternatives to traditional PPO-heavy models

This is a direct response to:

• Flat fee schedules

• Rising overhead

• Increasing administrative burden

For some practices, this is about protecting margins.

For others, it’s about long-term sustainability.

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2. Investing in Technology and Efficiency

Dentists are also investing in tools and systems that improve efficiency.

Recent data shows that investment in new software has already exceeded initial expectations for 2026  .

These investments are focused on:

• Scheduling optimization

• Patient communication

• Workflow automation

• Financial tracking

The goal:

Do more with the same—or fewer—resources.

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3. Adjusting Staffing Models

Given ongoing staffing challenges, many practices are:

• Rethinking team structure

• Cross-training staff

• Being more selective in hiring

Some are also:

• Reducing reliance on certain roles

• Adjusting hours or services based on available staff

Rather than forcing growth, they are aligning operations with what is sustainable.

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4. Focusing on Higher-Value Procedures

Another key shift is a greater emphasis on:

• Comprehensive treatment

• Higher-value services

• Case acceptance strategies

This is a response to the reality that:

Increasing volume alone may not improve profitability.

Instead, practices are looking to:

• Increase production per patient

• Improve treatment planning

• Enhance patient education

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5. Adding (or Planning to Add) Staff—Carefully

Interestingly, despite staffing challenges, many dentists are still planning to:

• Add staff

• Expand capacity

But they’re doing so more cautiously.

This reflects a balancing act between:

• Growth ambitions

• Hiring realities

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What This Means for the Market

These strategic shifts are having a direct impact on both buyers and sellers.

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For Sellers: Your Strategy Is Part of Your Value

Buyers are no longer just evaluating:

• What your practice has done

They’re evaluating:

• How your practice is positioned

A seller who can demonstrate:

• Thoughtful decision-making

• Adaptation to current trends

• A clear operational strategy

will stand out in today’s market.

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For Buyers: Opportunity Lies in Execution

For buyers, these shifts highlight an important truth:

Two practices with similar numbers can have very different futures.

A practice that has:

• Not adapted

• Not optimized systems

• Not addressed inefficiencies

may represent a significant opportunity.

At the same time, a well-run practice may offer:

• Stability

• Predictability

• Lower risk

Understanding the difference is critical.

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The Bigger Insight

We’re entering a period where:

Dentistry is becoming more of a business—and less of a passive profession.

Success is increasingly tied to:

• Decision-making

• Strategy

• Operational execution

Not just clinical skill or patient demand.

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Looking Ahead

Next week, we shift the focus directly to sellers:

  > What this market means for dentists thinking about selling—and how to approach timing, value, and expectations.

If you’re considering a transition—or evaluating a potential purchase—understanding how these strategic shifts impact your specific situation is key.

That’s where thoughtful guidance can make a meaningful difference.

One of the most common things we hear from dentists today is:

“We’re busy—but it doesn’t feel like it used to.”

That statement captures one of the most important shifts happening in dentistry right now.

Because in 2026, being busy no longer guarantees strong profitability.

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The Old Model: Busy = Profitable

Historically, the formula was straightforward:

• More patients → more production

• More production → higher income

As long as a practice was busy and well-run, profitability tended to follow.

But that model is changing.

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What’s Different Today

Across the country, many practices are experiencing a new reality:

• Schedules are full (or close to it)

• Demand still exists

• But margins are tighter than expected

So what’s driving the disconnect?

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The Three Forces Pressuring Profitability

This shift is largely the result of three overlapping trends we’ve been discussing throughout this series.

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1. Rising Costs Are Eating Into Margins

Practice expenses continue to increase across the board:

• Supplies and materials

• Equipment and technology

• Staffing and wages

Even modest increases in these areas compound over time.

And importantly:

These costs are largely outside the dentist’s control.

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2. Reimbursement Isn’t Keeping Up

At the same time, revenue per procedure is not increasing at the same pace.

• Insurance fee schedules remain relatively flat

• Increases are limited and inconsistent

• Administrative friction adds hidden costs

The result is a growing gap between:

• What it costs to deliver care

• What the practice is paid for that care 

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3. Patient Behavior Is Shifting

Even when patients are coming in, they may:

• Delay larger cases

• Decline elective treatment

• Focus on immediate needs

This leads to:

• Smaller case sizes

• Lower production per visit

• More effort required to generate the same revenue

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Why “Busy” Can Be Misleading

A full schedule doesn’t always mean:

• High-value procedures

• Efficient production

• Strong profitability

In fact, some practices are:

• Working harder

• Seeing more patients

• Generating similar (or only slightly higher) revenue

but experiencing:

Lower net income at the end of the day.

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What This Means for Sellers

If you’re considering selling, this is one of the most important shifts to understand.

Buyers today are focused on:

• Net income and cash flow

• Expense structure

• Sustainability of earnings

Not just:

• Collections

• Production

• Patient count

A practice that is busy but inefficient may still sell—but:

• The valuation may reflect those inefficiencies

• Buyers will factor in the cost to improve performance

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What This Means for Buyers

For buyers, this creates both risk and opportunity.

The risk:

• Overestimating profitability based on collections

• Underestimating expenses

• Assuming current performance is sustainable

The opportunity:

• Identifying inefficiencies

• Improving systems and workflows

• Increasing profitability without necessarily increasing volume

In many cases:

The fastest way to grow income isn’t more patients—it’s better operations.

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The Bigger Insight

This is the key takeaway:

Productivity and profitability are no longer the same thing.

And in today’s market:

• Efficiency matters more

• Cost control matters more

• Strategic decision-making matters more

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Where This Is Heading

As these trends continue, we’re likely to see:

• Greater separation between high-performing and average practices

• Increased focus on business fundamentals

• More sophisticated buyers entering the market

This is part of a broader shift toward dentistry being viewed not just as a profession—but as a business that must be actively managed.

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Looking Ahead

Next week, we’ll look at how dentists are already responding to these pressures:

  >  What strategic changes dentists are making in 2026—and what it means for the future of the market.

If you’re evaluating your own practice—or considering a purchase—understanding the difference between being busy and being profitable is critical.

That’s where a deeper level of analysis makes all the difference.

If there’s one topic that consistently comes up in conversations with dentists today, it’s this:

“Insurance just isn’t what it used to be.”

That sentiment isn’t anecdotal—it’s backed by data.

While practice costs continue to rise, insurance reimbursement has not kept pace, creating increasing pressure on dental practices  .

And that pressure is doing more than just affecting margins.

It’s reshaping how practices operate, how they are valued, and how transactions are structured.

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The Core Problem: A Growing Gap

At a high level, the issue is simple:

• The cost of delivering care is increasing

• The amount paid for that care—especially through insurance—is not

Over time, this creates a widening gap between:

• What it costs to run a practice

• What the practice earns per procedure

That gap is one of the main drivers behind the “fiscal squeeze” we discussed last week.

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Why This Is Becoming a Bigger Issue

This dynamic isn’t new—but it’s becoming more pronounced.

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1. Fee Schedules Are Largely Static

Many insurance fee schedules:

• Have seen minimal increases over time

• Do not adjust meaningfully for inflation

• Vary widely between carriers

As a result:

The same procedure often generates less real income today than it did years ago.

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2. Administrative Burden Is Increasing

It’s not just about reimbursement levels.

Practices are also dealing with:

• Pre-authorizations

• Claim denials and resubmissions

• Longer payment cycles

These factors increase the cost of collecting revenue, not just delivering care.

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3. Patient Sensitivity to Cost Is Rising

Patients are becoming more aware of:

• Out-of-pocket expenses

• Coverage limitations

• Alternative treatment options

This can lead to:

• Lower case acceptance

• More treatment deferrals

• Pressure on treatment planning

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How Dentists Are Responding

Dentists are not standing still—they’re adapting.

Recent trends show that many are:

• Dropping out of certain insurance networks

• Becoming more selective with participation

• Focusing on higher-value procedures and services 

Others are:

• Investing in patient experience

• Enhancing marketing to attract better-fit patients

• Reevaluating fee structures

In short:

Practices are becoming more strategic about how they generate revenue.

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How This Is Changing the Market

These shifts are having a direct impact on practice transitions.

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1. Insurance Mix Matters More Than Ever

Buyers are taking a closer look at:

• PPO vs FFS composition

• Concentration within specific plans

• Fee schedule structures

A practice heavily dependent on low-reimbursing plans may face:

• Increased scrutiny

• Adjusted valuation expectations

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2. Profitability Is Driving Value

Historically, collections were a primary benchmark.

Today:

Profitability and sustainability carry more weight.

Two practices with identical collections can have very different values depending on:

• Insurance participation

• Fee structures

• Cost control

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3. Strategic Positioning Is Critical

Practices that have:

• Thoughtfully managed their insurance relationships

• Built a strong patient base

• Maintained pricing discipline

are often better positioned in today’s market.

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What This Means for Sellers

If you’re considering selling, your insurance profile is part of your story.

Buyers will want to understand:

• Which plans you participate in

• How those plans impact revenue

• Whether there is flexibility to make changes

This doesn’t mean you need to overhaul your model before selling—but it does mean:

You should be prepared to explain it clearly.

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What This Means for Buyers

For buyers, this is one of the most important areas to evaluate.

A practice’s insurance mix can:

• Limit profitability

• Create opportunity for improvement

• Affect long-term sustainability

In some cases, a practice with a challenging insurance mix may still be a great opportunity—if:

• There is a clear path to optimization

• The patient base supports adjustments

• The buyer is comfortable making strategic changes

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The Bigger Insight

Insurance isn’t just a billing mechanism—it’s a strategic lever.

And in today’s market:

How a practice engages with insurance can be just as important as how many patients it sees.

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Looking Ahead

Next week, we’ll build on this and explore a question many dentists are starting to ask:

   > Are practices becoming less profitable—even when they’re busy?

If you’re evaluating a practice—or thinking about positioning your own for sale—understanding the role of insurance in your financial model is critical.

That’s an area where thoughtful analysis can make a significant difference.