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#Dental Ma
25 articles
What Comes Off Your Number: The 14 Ways a Buyer Reprices a Dental Practice's EBITDA
In a dental practice sale, the add-backs list runs in reverse. The 14 adjustments a buyer's diligence team makes to EBITDA, grouped by what each comes off: the price, the terms, or the cash at close, with what each one costs at 7x.
Private Equity Isn't Wrecking Dentistry. It's Pricing It.
Is private equity wrecking dentistry? No. It is pricing it, with an instrument that cannot see where a dental practice's value lives. A former DSO operator on what the machine measures, what it misses, and what owners should actually be angry about.
Between the LOI and the Wire: What Dentists Who Sold to a DSO Said Surprised Them
I asked dentists who sold to a DSO one question: what surprised you between the LOI and closing? Twenty-one answered. They sort into three shapes, and nobody answered the part that mattered most.
The SBA Just Made Phantom EBITDA a Loan Condition
From October 1, a $3 million practice purchase financed through an SBA 7(a) loan needs an independent Quality of Earnings the seller can't supply. Here is what it will find, and what it won't.
The Three Faces of Phantom EBITDA
Phantom EBITDA has three faces: accounting, operational, clinical. Each is found by a different reader on the buyer's side and prices differently. One $10M practice, all three.
The Graded Exam: Why Your Earnout Is Scored by the Person Who Owes the Money
An earnout is 10-30% of a dental practice sale, paid only if targets are hit — targets the buyer models, under operations the buyer controls, measured on the buyer's books. The mechanics, the tax trap, and the five clauses that un-tilt the table.
The Legislative Squeeze and the Pricing of Risk: Why CT HB 5127 Matters to Your M&A Exit
Connecticut HB 5127 bans healthcare providers from promoting medical credit cards like CareCredit starting January 1, 2027. Why the law is a template, how buyers will price financing-dependent case acceptance, and the defense.
The Paper Millionaire: What Your Rollover Equity Is Actually Worth
Rollover equity is 20-40% of a dental practice sale taken as stock in the buyer's platform. The buyer audits you for 90 days; most sellers audit the buyer over a dinner. The five-question diligence every seller owes their second bite.
The CPA Trap: Why Financial Historians Cannot Fight Data Wars
Your CPA is a trusted advisor and a skilled financial historian — and structurally unequipped to defend a practice sale. Why QoE teams bypass the General Ledger, attack the Clinical Ledger, and what a seller's defense actually requires.
The Handshake Valuation: Why Selling to Your Associate Is the Most Mispriced Deal in Dentistry
Selling a dental practice to an associate skips the auction — and usually the forensics. How internal transitions get priced by relationship, why the seller becomes the bank, and what a defensible internal deal requires.
The Net Number: Why Your Multiple Isn't the Money You Keep
Two dentists sell for the same $5M headline, but one keeps $700K more. How deal structure — asset vs. stock sale, purchase-price allocation, and entity type — decides your after-tax dental practice sale proceeds.
The Wrong Board: Why Dentists Optimize a Game They Never Chose to Play
Most dentists inherit their practice model — insurance contracts, real estate, associate hires — and optimize a game they never chose. Why that path builds a high-paying job, not the business an institutional buyer pays a real multiple for.
The Broker's Prospectus: A Marketing Brochure, Not a Forensic Baseline
A broker's prospectus is a marketing brochure, not due diligence. Why buying a dental practice on reported collections and a few KPIs is a faith-based multiple — and what a forensic clinical baseline reveals that the prospectus hides.
The Boutique Fallacy: Why Size Sets Your Dental Practice Value
Two dental practices, same profit, can sell millions apart. Why size — not margin — decides whether you get an SDE multiple or an institutional DSO/EBITDA exit.
The Consultant's Mirage: Why Standard Advice Fails a Dental QoE Audit
The standard dental consultant advice — boost production, cut overhead — is exactly what gets your EBITDA slaughtered in a buyer's Quality of Earnings audit.
Personal Goodwill: Why a Dental Buyer Can Withhold Your Cash
Goodwill is 75% to 85% of a dental practice's price, and buyers only pay full for goodwill that transfers. How personal goodwill and a 5% to 25% key-person discount cost you at close.
Operational Due Diligence for Dental Practices: Know Your Baseline Before You Buy or Sell
The broker, lender, and CPA all give sound advice — but none establishes your operational baseline. Why buyers and sellers need forensic operational due diligence before they act.
Dental Practice Broker: The Incentive Problem Nobody Explains
You almost certainly need a dental practice broker. But a 6% to 12% success fee pays for the buyer, not the audit: defending your number through diligence was never their job. Here is the gap and what it costs.
What Is My Dental Practice Worth? Why the Answer Depends Entirely on Who's Buying
The value of your dental practice depends entirely on who is buying. Here is how individual buyers and institutional buyers calculate it — and why those are two different numbers.
Dental Practice Exit Strategy: The 5-Year Forensic Blueprint for an Institutionally Auditable Sale
A year-by-year dental practice exit strategy for building a practice that institutional buyers pay premium multiples for — the forensic blueprint starting 5 years before you sell.
The $250,000 Audit: How Retroactive Payer Downgrades Destroy Enterprise Value
A $25,000 insurance chargeback becomes a $250,000 enterprise value reduction at a 10x multiple. Here's how retroactive payer audits and QoE extrapolation compound to destroy dental practice valuations.
Legal For A Price: How Algorithmic Denials Are Stealing Your Clinical Autonomy
Insurance carriers are deploying AI-driven denial algorithms that override clinical judgment at scale. A 90% overturn rate on appeal proves the denials are engineered for deterrence — but only 1% are ever contested.
The KPIs That Kill Your Multiple: Which Dental Practice Metrics Institutional Buyers Actually Score
Not all dental KPIs matter at exit. Here are the metrics PE-backed buyers weight most, the thresholds that move multiples, and the vanity metrics they ignore entirely.
The Other Side of the Door: What You Are Actually Trading When You Sell Your Practice
A 45-year practice owner sold into a DSO and was forced out during COVID by someone 75 miles away. The number was right. The trade was not what he expected.
Governance Debt: The Compounding Liability Silently Eroding Your Practice's Enterprise Value
Governance debt — compliance gaps, undocumented SOPs, key-person risk — compounds silently and surfaces during due diligence. Here's how to quantify and eliminate it before a buyer's algorithm does.