The Real Cost to Acquire a Dental Practice

cost to buying a dental practice

By: Bruce Bryen

The dental school graduate is ready to acquire a dental practice and wants to understand how much it really costs:

You have been a dental school graduate for the last five years and have been working as an associate in someone’s dental practice. The clinical skills you have learned have gotten you to the point where you are ready to acquire a small dental practice of your own. You have also mastered a lot of non-clinical administrative skills so that you are sure you are ready to buy a practice

You are also at a point where you want to hire a dental CPA to assist you in this endeavor since you know that he or she is the right person to help with understanding the profit potential of the practice you seek to purchase. You think you found the right office so the dental CPA begins his or her work to advise you on what price to offer for the practice.  You are advised not to worry about the listing price of the practice because the dental CPA will prepare an evaluation of the practice to give you a “true,” value, and the price he or she will advise you of the offer to purchase that you should present. 

Is the dental CPA at the top of his or her game or do you need a credentialed CVA to make sure that you have gotten the real price of the acquisition?

What does the real price mean if the buyer and seller have agreed upon the transition price being $500,000?  The listed price of the practice may have been $550,000. Aren’t you as the buyer paying $500,000 and the seller accepting $500,000? This is where the CPA/CVA earns money.  Many tax considerations affect what the price really is.  Do you get to write off part of or most of the purchase price on your tax return?  Does the seller report a capital gain and pay the least amount of tax possible?  Does he or she report some or a lot of ordinary income and pay a higher tax?  Your CPA/CVA will or should tell you that the more the seller reports as capital gains, the more you will pay in tax. 

As an opposite approach, the more the seller reports as ordinary income, the more he or she pays in tax and the less you pay. This tax is part of the additional cost to acquire a practice that is above the $500,000 transition price.  As a buyer, you have to understand this concept because the additional “price,” in tax dollars is a real price and should be added to the cost of the practice for your understanding. The explanation is also providing the proper amount of financing to acquire the practice and to have the needed working capital. This is so the practice can afford to wait as the insurance collections arrive or the regular accounts receivable is collected.

An explanation of the way the taxes appear for the buyer and the seller:

Many think that the taxes to be paid come from the seller only because he or she is the one who is receiving the money for the transition so he or she must be the one who is paying the tax.  That is not true.  An outline of the buyer and his or her tax will be explained in this paragraph.  The best example may be to use a person’s home mortgage as a guide to understanding the tax implications of the buyer.  In a typical transition, the buyer makes an application to a lender to borrow the $500,000 needed for the acquisition.  There should be a working capital component that the borrower needs that is also borrowed from the lender so that there is enough cash in the account to pay all the bills while waiting for collections to be provided.  If you think about making a mortgage payment, the interest is deductible for the most part on your tax return but the principal payment is not.  Because on a long-term mortgage almost all of the payment goes to interest for quite a few years, most people don’t pay attention to the small part of the payment that amortizes the loan. 

There are only two ways that the principal can be paid. One way is by refinancing the loan and paying down the balance with a new loan.  This is not taxable. The other way is to report enough income to pay down the balance.  Since income must be reported to get the funds to pay the balance, there is a tax on that amount.  So in essence, the loan is being paid and then the funds to pay the loan which come from income are taxed. This means that the money used to pay the loan is subject to a tax. The tax is based on the taxpayer’s individual rate.

Let’s be specific:

Since you can’t get a long-term loan for the acquisition of a dental practice like for example, a twenty-five-year mortgage loan for a house, you will feel the sting of the principal payment immediately.  Using the $500,000 transition price as the loan amount, which is a normal approach, and receiving a seven to ten-year loan from the bank for the purchase of the practice, you would be paying $50,000 per year in principle, based on a level ten-year amortization. Where does that $50,000 come from to make the loan payment?  If it comes from earning $50,000, you then are subject to tax on that amount. 

Remember that with a mortgage payment on a house, you will probably be paying approximately $100 give or take, in principal payments per month.  On the $50,000 payment, with federal, state, and double social security taxes since you are the owner, your tax rate will be about 50% so to pay $50,000 against a loan balance, you will need another $50,000 to pay the tax on $50,000 loan payment. The dental CPA may save you some money but you can’t escape the large tax on the principal payments that will have come from your income.

Photo by Karolina Grabowska

Up Next: How Dental Students Can Save for Their Own Practice

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Testimonials

Rosie, RDH

Rosie, RDH

I had the pleasure of working with Candy as a dental hygiene consultant over the course of several months, and her...
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Rosie, RDH

I had the pleasure of working with Candy as a dental hygiene consultant over the course of several months, and her impact on both our hygiene department and overall practice was exceptional. Candy is highly knowledgeable, approachable, and genuinely invested in the success of the team. She is an excellent listener who takes the time to understand challenges and provide practical, effective solutions. One of the qualities I appreciated most was her accessibility, she was always available to answer questions, offer guidance, or return a call when needed. Her hands-on approach and commitment to helping our team succeed were evident in every interaction. Candy’s focus extends beyond productivity and practice growth; she truly cares about the people within the practice and works to create a supportive, collaborative environment. As a fellow dental hygienist, it was especially refreshing to work alongside someone who shares a similar philosophy and approach to patient care, team development, and practice success. We view many aspects of dentistry and hygiene through the same lens, which made collaboration seamless and productive. Having the opportunity to work with another hygienist who understands the challenges, opportunities, and importance of our role was invaluable. The hygiene modules she developed were incredibly valuable. They were well organized, easy to follow, and provided clear, actionable guidance. The accompanying handouts and resources gave our team the tools and confidence needed to implement new concepts successfully. Her training materials were practical, relevant, and tailored to the real-world needs of a busy dental practice. Candy’s expertise and dedication to excellence have made a lasting impact on our team. I would highly recommend her to any dental practice looking to strengthen its hygiene department, improve systems, and support the growth and success of its team. She is a true asset to any practice fortunate enough to work with her.
Rosie, RDH
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

Bruce Bryen

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

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