DSO Offers: What Dentists Actually Get Paid (2026)
A group buyer pays 5 to 8 times profit for a single-location practice, and 10 to 14 times for a specialty practice. But the headline number is not what reaches your account.
- Only 60% to 80% is cash at closing. The rest is a stake in their company and money that depends on targets.
- They do not use your profit number. They subtract what it costs to pay a dentist to do your chairside work.
- You are agreeing to keep working, usually three to five years, at associate pay.
What They Pay, by Size
The multiple climbs sharply with scale, because a bigger practice depends less on any one dentist.
| Practice | Size | Typical Price | Who Buys |
|---|---|---|---|
| One location, general | Under $1M in profit | 5x to 7x profit | Group buyers, or another dentist |
| Small group | $1M to $3M in profit | 7x to 9x profit | Mid-sized groups, regional chains |
| Big enough to build on | $3M to $5M in profit | 9x to 11x profit | Investor-backed groups |
| Large group | $5M or more in profit | 10x to 12x profit | The largest platforms |
| Specialty, any size | Ortho, oral surgery, endo, perio, pediatric | 10x to 14x profit | Specialty roll-ups |
See what your practice comes to in the dental practice valuation calculator.
Why Three Locations Beat One
Scale is the single biggest lever, and the gap is bigger than most owners expect.
- One location at $400K in profit, priced at 5 to 7 times, is worth $2.0M to $2.8M.
- Three locations at $2.4M in profit, priced at 7 to 9 times, is worth $16.8M to $21.6M.
- The work is the same dentistry. The difference is that one is a job and the other is a business.
They Do Not Use Your Profit Number
This is where most dentists get surprised. A group buyer rebuilds your profit as it would look under their ownership.
- They add back the pay you take above what an associate earns, your personal expenses, and any one-time costs.
- Then they subtract the big one: what it costs to pay a dentist to do the work you personally do, usually 25% to 30% of what you produce.
- They also subtract their own overhead and software costs.
That is how a practice showing $400K to its owner ends up at $200K in the buyer’s model. Both numbers are honest. They measure different things.
The more of the dentistry you personally do, the wider that gap gets. An owner who produces most of the revenue is selling a job.
Dental Practice Valuation Calculator
A $5M offer is not $5M in your account. Here is how it usually breaks up.
- Cash at closing: 60% to 80%. On a $5M deal, $3M to $4M. This is the only guaranteed part.
- A stake in their company: 15% to 40%. You cannot spend it until they sell, typically three to seven years out.
- The rest depends on targets, measured over 12 to 36 months. Two years is most common.
That stake can be worth two or three times what you put in. It can also be worth less, and you rarely control when it pays out.
A generous-looking group offer can net you less than a plain offer from another dentist. See how the held-back money and the stake actually work.
What You Give Up Besides Money
- Three to five years of your time. You stay on as a clinical associate, paid on what you produce rather than what the practice earns.
- Control of everything except clinical care. The law keeps treatment decisions with you. Scheduling, staffing, and targets belong to them.
- A non-compete, typically two to five years within 10 to 25 miles.
- Possibly the stake itself. Leave on bad terms and it can be forfeited. Read that clause carefully.
Who Is Buying, and Why Now
Practice ownership has been falling for two decades. About 73% of dentists own their practice, down from 85% in 2005.
The other side of that is group affiliation. Roughly a quarter of dentists now work with a group, and it is highest among recent graduates.
- The general-practice buyers: Heartland Dental, Aspen Dental, Pacific Dental Services, MB2 Dental, Smile Brands, Mortenson, and Dental Care Alliance.
- The specialty buyers: Smile Doctors, Specialty Dental Brands, USOSM, and Great Expressions.
- Why they are busy: a generation of owners is retiring, and fewer young dentists want to buy a practice outright.
- The associates who do buy usually borrow through the SBA's main loan program, which caps at $5 million.
For the wider picture on how dentists practice now, the ADA's research on dental practice tracks it year by year.
How to Read the Offer You Just Got
Most dentists open the letter and look at the big number. That is the wrong place to start.
- Split it in two. Cash at closing is real. Everything else is a maybe.
- Look hard at the targets. Ask what happens if you miss by 10%, and get the answer in writing.
- Ask about their own exit. Your stake pays out when they sell, so their timeline is now your timeline.
- Work out what you realistically collect, not the best case on the page.
- Get a second offer before you agree to anything, even from a buyer you like less.
The people sending you that letter negotiate practice deals every week. You will do this once. Even the non-binding terms are hard to move once you have nodded at them.
Related Guides
- Selling in New York? A group cannot own the practice there, which changes who signs.
- Dental practice valuation by size, for the underlying math.
- Selling to an associate versus a group, side by side.
- How long a sale takes, and how the held-back money works.
- Selling in Pennsylvania or New Jersey.
- Outside dentistry: what businesses sell for, and how the number is set.
Frequently Asked Questions
Five to 8 times profit for a single location, 8 to 11 times for a multi-location group, and 10 to 14 times for specialty practices. All of it is based on their rebuilt profit figure, not your collections and not what your books show.
Usually 60% to 80% at closing. The remaining 15% to 40% comes back as a stake in their company, plus money tied to targets over the following one to three years. Only the cash at closing is guaranteed.
Because they subtract what it costs to pay a dentist to do your chairside work, usually 25% to 30% of what you produce. They add back your excess pay and personal expenses first, then take that out. A practice paying you $400K can model at $200K.
Three to five years in most group deals, practicing as an associate and paid on what you produce. Selling to another dentist usually means 30 to 120 days instead. That difference matters more than the price for a lot of sellers.
Sometimes. It pays out when they sell, three to seven years later, and it can be worth two or three times what you put in. It can also be worth less, it is not spendable in the meantime, and it can be forfeited if you leave badly.
Yes, 10 to 14 times profit against 5 to 8 for general dentistry. Orthodontics, oral surgery, endodontics, periodontics, and pediatric practices all price higher, because referral-driven work is steadier and the margins are better.
A group pays more on paper but ties you in for years and pays part of it later. An associate pays roughly 70% to 80% of market value, often with you financing part of it, and lets you leave in a few months. Your timeline decides this.