For decades, dentist-owners followed a familiar path: build a practice over 30 years, find a young associate, sell the practice for what the bank would lend (or self-finance), and retire with a sizable check. Even then, it was a challenging exit strategy—today, it’s nearly impossible.

Those clinging to this outdated playbook have learned the hard way that it no longer works. Many who have successfully exited their practice have settled for far less than expected—or even needed—to retire comfortably. A survey by the American Dental Association found that 96% of dentists weren’t financially prepared to retire at 65, with 72% relying on their practice sale for financial security.

At the same time, corporate dental groups and DSOs (Dental Service Organizations) are rapidly acquiring practices nationwide. While selling to a DSO might seem like an easy exit—cash in hand and keys handed over—it comes at a cost. Dentists give up control and often receive only a fraction of their practice’s true value.

Even more concerning? Many DSOs are no longer interested in solo practices. The profit margins and team skill sets often don’t justify the investment. Today, private equity-backed acquisitions typically focus on small group practices (6 to 10 offices) selling to mid-market DSOs (50 to 150 offices).

And even when dentist-owners attract a buyer, they discover the hidden costs of selling are too high—eroding their financial security and dismantling the culture they spent years building.

A New Era of Transition Strategies

The good news? New transition strategies are emerging that give dentist-owners more options. These strategies allow them to exit profitably, build long-term value, and influence their practice’s future.

Hybrid ownership models are gaining traction, allowing owners to bring in younger talent while retaining control. This approach lets dentists protect their legacy, maintain financial security, mentor the next generation, and shape the practice’s future—without walking away overnight.

Valuation: Beyond the Multiples

In the past, practice valuation was based on a percentage of annual collections. Banks were happy to loan buyers the asking price based on little more than a dental degree and a license. That’s no longer the case.

Today’s buyers care about more than collections. They evaluate a practice’s true financial health using EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization).

EBITDA provides a clearer snapshot of profitability, long-term viability, and growth potential. Buyers prioritize practices with room to grow—whether by expanding the physical space, adding locations, or incorporating innovative services that meet evolving patient demands.

Any dentist considering a sale should understand their EBITDA and how their decisions impact it. Today, practice valuations are based on an EBITDA multiple, meaning higher-value practices command higher multiples, regardless of last year’s collections.

The Evolving Definition of “Exit”

Another major shift? When and how dentists exit their practices.

Instead of waiting until retirement to sell and walk away, more dentist-owners are choosing phased transitions—staying involved in mentorship, consulting, or part-time roles.

This model benefits everyone:

✔ Buyers gain from the seller’s experience and relationships with staff and patients.
✔ Sellers ensure their practice continues to thrive.
✔ Both parties achieve financial stability with a smoother transition.

This isn’t just about “exiting”—it’s about shaping the future of the practice while maintaining financial security and professional identity.