Starting a Dental Practice vs Buying an Existing Practice

starting a dental practice vs buying an existing practice

By: Bruce Bryen

Considering starting a dental practice vs buying an existing practice?

Whoever said that it was going to be easy had no idea what had to be done to start up a dental practice from the ground up.

This is in comparison to acquiring an existing dental practice through a dental practice broker or through marketing approaches to the purchase of the practice.

The upside to a dental practice startup and the problems and comparisons with the existing practice that is on the market for transition is something that the buying dentist must analyze carefully.

The acquiring dentist should also have his team of advisors available for this analysis. These professionals should all have experience with the financial side of dental practices.

The startup can be financed through legitimate conventional banking contacts just as the acquisition of an existing dental practice would be.

The following will be a comparison for understanding the pitfalls of each approach and the advantages of each for the dentist who is intent of having his or her own dental practice. 

Starting a Dental Practice

For the startup, the dentist first should retain a dental CPA and then an attorney who has some knowledge of dental practices and what they must do to prosper financially and grow in value.

There are dental CPAs who are available to assist and who have experience in the dental field. It is important that the CPA is a dental CPA and not one who has expertise in general business dealings.

The dental profession is different from most businesses especially when valuing goodwill. Many businesses with an inventory do not have the goodwill value of a dentist or dental practice.

As an example, a dentist and his or her dental practice may have goodwill that represents 75% or more of the value of the dental practice.

For a general business with inventory, the goodwill may represent 10% to 15% of the value of that business since the inventory is the highly valued item in it and many times there is no value for goodwill.

Finding an attorney with experience in the dental world is rare. The dental CPA is the one who usually can refer the attorney to the dental client. When the dentist goes to get financing for the startup, his or her professional dental CPA should come along to present the financial projections, floor plans for the office layout, and a potential opening date for the office.

This is what the startup has along with the dentist’s reputation, credit score, and relationship within the community.

The banker will have questions, which is why it is a good idea to have the dental CPA at the meeting so that answers can be given to the lender right away and there does not have to be waiting time wasted trying to contact the dental CPA. 

Buying an Existing Dental Practice

Buying an existing dental practice with tax returns, financial statements, and projections on the future based on proven historical facts.

Since an existing dental practice has the necessary financial statements and tax returns from its past, the preparation of financial projections is easier to prepare as they are based on historical records.

Compared to the startup dental practice, the projections are based on the dental CPA’s ideas and knowledge from other start-ups that he or she may have been involved with during his or her career.

They are based on the dental CPA’s understanding of the geographic area in which the dentist will be opening his or her office, reviewing his or her other dental clients for their beginning years of operating, and with input from the dentist.

The input from the dentist should be tempered for the optimism or “puffing,” of the concepts that the dentist gives to the dental CPA.

Realistic forecasts are what will be the difference between hope and despair and the dental CPA will certainly not prepare something for the lender that is out of the reach of the ability for achievement by the dentist.

This is where the dental CPA really earns his or her fees because compared to a general business CPA, there can be no comparison to the difference in knowledge about dental practices that each of them has.

The knowledge will be transformed into projections for the start-up and for the acquisition of an existing dental practice. Going to the bank is helpful since each banker may have similar but not identical questions about what is being presented. A lender with experience in advancing funds to dental practices understands as does the dental CPA what reasonable percentages are of dental supplies to gross revenue as an example.

The history of the dental practice being acquired should reflect those percentages as well as the percentages of marketing to gross revenue, professional fees to gross revenue, and other items of expense to gross revenue as well.  

Starting a Dental Practice vs Buying an Existing Practice: Which is Best for You?

Which is best for those dentists who want to own their dental practice and not work for someone else as an associate?

The choice is certainly a difficult question for a dentist. The most important thing in choosing is to have the correct type of dental practice advisor who can assist in the choice.

As an example, a dental practice advisor such as a dental CPA compared to a CPA with expertise in general business advice means so much and will help the dentist make his or her choice.

An attorney with some dental practice experience is better than an attorney with no dental practice experience.

Also, having a financial planner who gets along with the other dental practice advisors is a must. The choice of the type of practice whether startup or the purchase of an existing practice will fall upon the shoulders of the dentist.

The advice to make the right choice is something that will cause the dentist’s life to be affected by that choice.

Having the best advisors who understand what dentistry is about will have a great bearing on the choice and will assist in making the right choice.  

Photo by Mikhail Nilov

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Testimonials

Dr. Justin Elikofer

Dr. Justin Elikofer

Our story with IgniteDDS began almost five years ago when my wife and I purchased an established fee-for-service practice. At...

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Dr. Justin Elikofer

Our story with IgniteDDS began almost five years ago when my wife and I purchased an established fee-for-service practice. At the time, we promised the team that everything would stay the same. The practice was thriving, and from the outside it seemed clear they had found a successful recipe for success. Our goal wasn't to change it—we simply didn't want to mess it up.

What we discovered was that while everyone wanted the outcome of success, there wasn't alignment around how we achieved it or measured it. Success in room 1 wasn't the same as Room 2. It took us nearly four years to fully understand that because we were doing well. During that time, we also realized we weren't leading as effectively as we could have been. We weren't communicating a clear vision, establishing consistent standards, or implementing clear protocols. Instead, we allowed people to continue doing things their own way. Some team members appreciated that freedom, while others felt frustrated by the lack of consistency and direction.

After four years, we found ourselves at a crossroads. We felt stuck. Morale was low and we weren't sure we could get the practice where we wanted it to go on our own.

As owners who value relationships as much as results, David immediately stood out to us. His personality was authentic, approachable, and trustworthy. He was someone we could see ourselves learning from and building a genuine relationship with. Being local was a bonus, but what really resonated with us was that his vision for practice growth, demonstrated through his own private practice, closely mirrored our own. He had already built the type of practice we wanted to create.

This stood in contrast to many other consultants we spoke with, whose focus seemed to be on PPO models and increasing volume. David's experience aligned with the type of practice we wanted to build: a high-touch, high-end patient experience centered on quality rather than quantity.

The IgniteDDS team—David, Dawn, and Candy—started by helping us understand where we truly stood. Through discovery, data gathering, and DISC assessments, they helped us identify opportunities for improvement and build a foundation for long-term growth. Rather than jumping straight to solutions, they gave us clarity.

Candy's coaching was instrumental in aligning our hygiene department and our office as a whole with the hygiene department. With her help, we were able to improve the patient experience and new patient process.

We also tackled practical issues that had become major challenges, including an accounts receivable system that was largely out of control. IgniteDDS didn't just point out problems—they provided systems and processes to solve them.

One of the most valuable aspects of the relationship was having experienced coaches to help us navigate team conflict and leadership challenges. As practice owners, those situations can feel isolating. Having a trusted team to walk through difficult conversations and decisions was invaluable.

Another large impact came through our office managers' work with Dawn. Rather than relying on the doctors to drive every initiative, IgniteDDS empowered our office managers to take ownership of the process and lead from within the organization. They embraced that responsibility wholeheartedly. No challenge was too large or too small. Dawn consistently met them where they were and helped them develop the confidence and skills to lead. The answer was rarely, if ever, "no." Instead, it was, "Let's figure out how."

Today, our practice is more aligned, more accountable, and better equipped to deliver the experience we've always envisioned. We have clearly defined protocols, team agreements, and expectations that simply didn't exist before. Our collections have improved significantly, particularly through implementing systems that helped us address and recover outstanding balances.

If we could offer one piece of advice to another practice owner considering IgniteDDS, it would be to identify the team members who are willing to take ownership and invest in their growth. Share your vision with the IgniteDDS team, trust the process, and allow them to help shape your team into the organization you want to become.

Working with IgniteDDS has been one of the most impactful investments we've made in our practice, our team, and our own growth as leaders. Are things perfect? No. Are we closer? Absolutely, yes!

Dr. Justin Elikofer
Dr. Sanjie Jackson

Dr. Sanjie Jackson

I was running on empty, and honestly, everyday I thinking of my exit strategy when I met Dr David Rice. ...
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Dr. Sanjie Jackson

I was running on empty, and honestly, everyday I thinking of my exit strategy when I met Dr David Rice. As the sole owner of two dental practices, I knew I couldn't continue trying to do everything on my own. Not if I wanted to grow and lead at a higher level. Partnering with IgniteDDS has been, hands down, one of the best investments I've made for both my practices and my team. Just halfway through my first year with IgniteDDS, the impact has already been remarkable. The knowledge, systems, accountability, and leadership development they have provided have transformed the way we operate. Not only have I gained valuable tools and insights as an owner, but my entire team is getting empowered with skills and confidence that are helping us elevate every aspect of our patient experience and practice performance. What sets IgniteDDS apart is the genuine commitment they have to their clients' success. Their guidance is practical, actionable, and tailored to the everyday realities of me running two dental practices. I am incredibly grateful for Dr. David Rice, Dawn, Candy, and the entire IgniteDDS team. Their expertise, continuous encouragement, and unwavering support have made me feel like I am not alone on this journey. If you're a practice owner looking to strengthen your leadership, improve your systems, and create sustainable growth, I cannot recommend IgniteDDS highly enough. The value they provide is truly exceptional, and I am excited to see what the rest of this journey brings.
Dr. Sanjie Jackson
Alyse Berta

Alyse Berta

Dawn, thank you for the great advice and guidance you’ve shared as we work on improving our practice's efficiency. I...
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Alyse Berta

Dawn, thank you for the great advice and guidance you’ve shared as we work on improving our practice's efficiency. I truly appreciate your support and the time you’ve taken to help us move forward in a more streamlined and effective way. Your insight has been incredibly valuable and is helping us make meaningful progress.
Alyse Berta
Dani S.

Dani S.

IGNITEDDS has made a real difference in our practice and in my role as office manager. The support I’ve received has...
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Dani S.

IGNITEDDS has made a real difference in our practice and in my role as office manager. The support I’ve received has helped me grow with more confidence and clarity, and our systems and leadership have improved because of it. Dawn has been an incredible support to me personally, always present, approachable, and truly invested in our success. I never feel alone when challenges come up, and that level of guidance and encouragement has been invaluable. IGNITEDDS doesn’t just support practices; they support the people behind them.
Dani S.
Eva B.

Eva B.

Working with IGNITEDDS Coaching has been such a great experience! Having David as a dentist makes a huge difference. He truly...
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Eva B.

Working with IGNITEDDS Coaching has been such a great experience! Having David as a dentist makes a huge difference. He truly understands the day-to-day challenges we face in practice. His insight makes their guidance practical, relevant, and easy to implement. Working alongside Dawn has been such a gift! She’s always available to answer questions, talk through ideas, and help us find the right solutions. Her advice is thoughtful, effective, and supportive. It hasn’t just helped me, it’s positively impacted our entire team and elevated our patient experience. I’m incredibly grateful to partner with Ignite as we continue to grow, strengthen our team, and serve our patients at a higher level.
Eva B.
Kylinn Tucker, RDH

Kylinn Tucker, RDH

I had an amazing experience with the IGNITEDDS Coaching program. Especially since I am a new hygienist, everything...
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Kylinn Tucker, RDH

I had an amazing experience with the IGNITEDDS Coaching program. Especially since I am a new hygienist, everything you guys shared was so helpful. It’s evident that you guys prioritize each individual team member of a dental office and do everything you can to make the environment and schedule run as smoothly and efficiently as possible. I learned so much about treatment planning, Dentrix, scheduling, teamwork, and overall ways to continue improving as a new grad. I wish every dental office had the opportunity to complete this program.
Kylinn Tucker, RDH
Dr Ben Truong

Dr. Ben Truong

It was great working with a team to help bring out the best in each of us. Our team is ...
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Dr. Ben Truong

It was great working with a team to help bring out the best in each of us. Our team is small, but we work closely together to provide a great patient experience, while having fun at work as well! Your team was able to help us learn to work together, with each person having a vital role in providing care to the patient! Helping us all become streamlined and on the same page will help us become an even more successful practice!
Dr Ben Truong
Dr. Ronnetta Sartor

Dr. Ronnetta Sartor

The 90-Day Jump Start has been transformative for our office. Dawn and Dr. Rice guided us through implementing essential systems ...
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Dr. Ronnetta Sartor

The 90-Day Jump Start has been transformative for our office. Dawn and Dr. Rice guided us through implementing essential systems and processes, from new patient calls to treatment planning and case acceptance. Their focus on patient care and team accountability has helped us create better structure, improve work/life balance, and stay aligned with our goals. In a short time, our practice has grown tremendously.
Dr. Ronnetta Sartor
Dr. Chandler Oldenburg

Dr. Chandler Oldenburg

IGNITEDDS has been truly transformative for our practice. Within just a few months, our accounts receivable collections increased by $30K, ...
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Dr. Chandler Oldenburg

IGNITEDDS has been truly transformative for our practice. Within just a few months, our accounts receivable collections increased by $30K, and our operations became far more streamlined. Their clear procedures and policies gave our team structure and confidence, while their step-by-step ownership guidance addressed our specific challenges. Thanks to David and Dawn, we feel more organized, empowered, and aligned than ever before. I highly recommend IGNITEDDS to any practice ready to grow and strengthen its foundation.
Dr. Chandler Oldenburg
Dr. Layla Lohmann

Dr. Layla Lohmann

Working with Dr. David Rice through IGNITEDDS was a game-changer for our Doctor Development Program. We have a solid foundation ...
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Dr. Layla Lohmann

Working with Dr. David Rice through IGNITEDDS was a game-changer for our Doctor Development Program. We have a solid foundation with our business content and organizational support, but Dr. Rice brought in the critical pieces that truly completed the puzzle. His seamless integration of dental expertise, vendor relationships, and mentorship made an undeniable impact.
Dr. Layla Lohmann

Bruce Bryen

Bruce Bryen, CPA/CVA Dental Practice Valuation Analyst, Baratz & Associates, PA

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