Insights

Empirical research on
dental practice valuation.

Founder-written analysis on the mechanics of valuing a dental practice, the limits of general-purpose AI tools, and the realities of the buy-side. Built on direct data, not speculation.

Two-column comparison of the operational risks a dental practice buyer underwrites: a lease with ten years of runway and an assignment clause, long staff tenure, and documented systems on one side; three years of lease left with no assignment provision, turnover before the sale, and processes living in the owner's head on the other
Karen · Operations & Team
August 6, 2026 · 4 min read

Lease, Location, and a Team That Stays

Before a buyer commits, they underwrite three things that never appear on a P&L: the lease and whether it transfers, the market the practice draws from, and the people who decide whether patients stay through a sale. Each one can be worked in the year or two before a listing.

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Chart of a dental practice valuation range on a $1.2M example practice: the same $392K of adjusted EBITDA is worth $1.76M at 4.5x and $2.16M at 5.5x, roughly $400,000 apart, with payer mix, location, lease security, equipment, and owner-production share deciding where in the range an offer lands
Dave · Valuation Mechanics
August 4, 2026 · 4 min read

The Risk Factors That Move a Buyer’s Offer Within Your Range

A valuation is a range, not a number, and risk decides where in it an offer lands. On the example practice, half a turn of multiple is about $196,000 without a single P&L line changing. Payer mix, location, lease security, equipment, and owner-production share, read the way a buyer reads them.

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Two-column comparison of the hygiene department buyers pay a premium for versus the one that discounts the offer: recare that runs itself, full chairs, and a real perio program on one side; recall postcards and hope, open hours, and a prophy mill on the other
Karen · Operations & Team
July 30, 2026 · 4 min read

The Hygiene Department Buyers Pay a Premium For

A buyer can tell a hygiene engine from a leak in ten minutes with the schedule. Recare that runs itself, chairs that stay full, a real perio program instead of a prophy mill, and the hygienists whose tenure carries patients across a sale.

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Chart of hygiene's contribution on a $1.2M example dental practice: hygiene production of $300K stays with the practice while doctor production leaves with the seller, a healthy department produces about three times its hygienist's wages, and ten empty hours a week is roughly $75,000 a year
Dave · Valuation Mechanics
July 28, 2026 · 4 min read

What Your Hygiene Department Does to EBITDA

Owners read hygiene as a cost. Buyers read it as the most durable earnings in the building, the closest thing dentistry has to recurring revenue. The three-times-wages health check, the $75K capacity leak, and what a systematized hygiene engine does to the price.

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A DSO-readiness checklist: more than one provider or a doctor with a deep hygiene program, adjusted EBITDA scale, recare that runs itself, documented systems, a team that stays, with owner-dependence flagged as the ceiling on buyer interest
Karen · Operations & Team
July 23, 2026 · 4 min read

When Is a Practice “Big Enough” for a DSO?

Group buyers screen for provider count, EBITDA scale, and a recare system that runs itself, then look for the one thing that caps every offer: a practice that only runs with its founder. What DSO interest actually looks for, and what to do if an offer is already on your desk.

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Ranges of dental practice valuation multiples by adjusted EBITDA tier, from roughly 3.5 to 4.5 times for practices under $300K drawing individual buyers, up to 8 times and above for platform-scale practices drawing multiple group bidders
Dave · Valuation Mechanics
July 21, 2026 · 4 min read

Why Two Practices Get Two Very Different Multiples

One practice sells at five times earnings, another at nearly seven, and neither number is wrong. How owner-operator and DSO buyers price differently, the EBITDA tiers where the buyer pool changes, and why one extra turn of the multiple is a full year of earnings at closing.

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Horizontal bars showing common owner perks hidden in dental practice overhead: family on payroll at $28,000, auto at $11,000, CE travel at $8,000, insurance at $6,000, meals at $4,500, and phone at $2,500, totaling about $60,000 a year added back to earnings
Karen · Operations & Team
July 16, 2026 · 4 min read

The Owner Perks Hiding in Your Overhead

The auto lease, the CE trip that was also a vacation, the family member on payroll. The discretionary spending buried in your P&L is not something to hide from a buyer; surfaced honestly and documented, it may be the easiest money in your entire valuation.

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A two-column diligence ledger comparing add-backs that hold up, such as a personal auto lease and CE travel, against add-backs buyers reject, such as recurring one-time repairs and hypothetical savings
Dave · Valuation Mechanics
July 14, 2026 · 4 min read

Add-Backs That Hold Up, and the Ones That Get Laughed Out of Diligence

Every add-back is a claim, and documentation turns it into a deduction. Which adjustments buyers accept with a nod, which ones get rejected in diligence, and why one aggressive add-back can cost you more than the dollars involved.

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Two bars comparing an owner's annual production of $600,000 against the roughly $180,000 cost to replace it with an associate paid about 30 percent of production
Karen · Operations & Team
July 9, 2026 · 4 min read

What a Replacement Dentist Really Costs

When you sell, someone still has to do the dentistry you do today, and that person gets paid at market rate. How associate compensation actually works, how procedure mix changes the math, and why this number may also be your own future paycheck.

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Two bars comparing owner pay of $250,000 on the books against a $180,000 market rate to replace the owner's dentistry, with the $70,000 difference added back to earnings
Dave · Valuation Mechanics
July 7, 2026 · 4 min read

The Single Biggest Number in Your Valuation: Owner Compensation

One adjustment moves a valuation more than any other, and it is the one DIY tools most reliably get wrong. The two-step normalization of owner pay, why paying yourself below market can lower your value, and what happens with multiple providers.

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Dental practice overhead categories — team wages, supplies and lab, facility, and administrative — shown against typical healthy ranges as a share of collections
Karen · Operations & Team
July 2, 2026 · 4 min read

Reading Your P&L the Way a Buyer Does

Your profit-and-loss statement is a story about how your practice runs, and a buyer reads it that way. A chairside tour of the overhead categories, the staff-cost ratio buyers watch first, and why clean books translate into a higher, more defensible number.

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An EBITDA waterfall for a single-doctor dental practice: net income near $289,000 rises to about $343,000 of EBITDA, then to roughly $392,000 of adjusted EBITDA after owner-compensation normalization and add-backs
Dave · Valuation Mechanics
June 30, 2026 · 5 min read

EBITDA for Dentists: How a Buyer Rebuilds Your Profit

Every serious buyer prices off adjusted EBITDA, and most owners have never had it explained plainly. The rebuild from reported net income to adjusted EBITDA, one line at a time, and why that number — not net income — is what an offer is built on.

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From Roll-Ups to Real Value: Dr. David Eslinger on the Healthcare Intelligence Podcast, on how AI is changing the future of dental DSOs
Dave · Podcast
June 25, 2026 · Podcast · Watch

From Roll-Ups to Real Value: AI and the Future of Dental DSOs

Dave joins Ember AI’s Healthcare Intelligence Podcast to talk about where dental consolidation is headed, what separates real value from the hype, and how AI is reshaping the way practices are valued and bought.

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Two practices with equal collections, expenses shown as a share of collections: one with disciplined overhead keeps more profit, the other carries heavier staff and facility costs and keeps less
Karen · Operations & Team
June 25, 2026 · 4 min read

Same Collections, a Very Different Practice

Two practices can collect the same and be worth very different amounts. The operational reasons why: overhead discipline, a hygiene department that carries its weight, a team that stays, and what a buyer notices walking in the door.

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Two dental practices with identical $1.2M collections end at very different values, one near $1.96M and the other near $1.3M, because their underlying profit differs
Dave · Valuation Mechanics
June 23, 2026 · 5 min read

Your Practice Isn’t Worth a Percentage of Your Collections

The 70-to-80-percent-of-collections rule is wrong often enough to cost owners real money. Collections tell you how much came through the door, not how much stayed. What a buyer actually prices off, and why it can swing a value by six figures.

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Beyond the earnings, what a buyer pays a premium for: hygiene program, a team that stays, transferable patient goodwill, and a practice that runs without the owner
Karen · Operations & Team
June 18, 2026 · 5 min read

The Most Valuable Part of Your Practice May Be the Part Your P&L Never Shows

Beyond the earnings, a buyer pays a premium for your hygiene program, a team that stays, patients who belong to the practice, and an office that runs without you. After two decades chairside, a hygienist and co-founder on the value most calculators can’t see.

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From tax-return profit to normalized earnings: $300,000 grows to $445,000 after owner-compensation normalization and legitimate add-backs
Dave · Valuation Mechanics
June 16, 2026 · 5 min read

The Number on Your Tax Return Isn’t What Your Practice Is Worth

The honest number rarely matches the one on your tax return, and the gap is usually six figures. Where it hides: normalizing owner compensation and the legitimate add-backs a free calculator never sees.

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$2.4 million of errors from ChatGPT across two dental practice valuation tests
Dave · Empirical Research
May 26, 2026 · 6 min read

What Happened When We Asked ChatGPT to Value Two Dental Practices

We ran two realistic dental practice P&Ls through ChatGPT and Practice Worth side by side. The errors added up to $2.4 million across two test cases, in opposite directions. A founder’s account of where general-purpose AI falls short on dental valuation, and what it means for any practice owner planning a sale.

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In the news: Practice Worth Launches Dental Practice Valuation Platform · June 9, 2026.