Selling a Dental Practice: Associate vs. DSO (2026)
Sell to another dentist and you get 60% to 80% of a year’s collections, mostly in cash, and you are out in a few months. Sell to a group and the number is bigger but you stay for years.
- An associate buys your chair. Simple deal, fast exit, and the practice stays roughly as you built it.
- A group buys a business. Higher headline, three to five years of your time, and part of the money arrives later.
- How much dentistry you personally do often decides which one is even available to you.
Selling to Another Dentist
This is the traditional path: your associate buys you out, or an outside dentist does. They borrow, or you carry part of the price yourself.
- The price: 60% to 80% of a year’s collections, which is what dental advisers see on bank-financed deals and below what a group would pay for a practice that qualifies.
- The money: usually a bank loan through the SBA’s main program for most of it, or you finance it over five to ten years.
- The certainty: far more of it is guaranteed. Nothing sits in someone else’s company waiting for their exit.
What You Gain
- A simpler deal, with fewer conditions and less paperwork.
- A faster close, often 60 to 120 days.
- A real exit. Thirty to 90 days of handover, not three to five years of employment.
- Your team and your way of practicing, largely intact.
What You Give Up
- A lower headline number than a group would offer, if your practice is one they want.
- Certainty about the financing. The deal depends on your buyer qualifying for the loan.
- Some risk if you carry the note, because you only get paid if the practice keeps performing.
- Time spent finding the right person, which is getting harder.
Selling to a Group
Here you sell to an organization rather than a person. They take over everything that is not clinical, and you keep treating patients.
- The price: 5 to 8 times profit for one location, 8 to 11 for a group, and 10 to 14 for specialty practices.
- The structure: 60% to 80% cash at closing, 15% to 40% as a stake in their company, and the rest tied to targets.
- Your pay changes. You go from taking the profit to earning 25% to 30% of what you personally produce.
What You Gain
- A bigger headline number, if your practice is the kind they compete for.
- Someone else doing the admin: hiring, billing, marketing, buying, compliance.
- A possible second payday when they sell to the next investor.
- Clinical work without the management, which suits some owners well.
What You Give Up
- Certainty. Only the cash at closing is guaranteed. The rest depends on targets and on their next sale.
- Three to five years, and longer in some specialties.
- Your income shape. Associate pay is a real cut for most owners.
- Control of everything except treatment, and sometimes the culture along with it.
Side by Side
| What to Compare | Another Dentist | A Group |
|---|---|---|
| What they pay | 60% to 80% of collections | 5x to 12x profit |
| What they measure | Everything the practice pays you | Profit after replacing you clinically |
| Cash at closing | 80% to 100% | 60% to 80% |
| Money that waits | Little, unless you finance it | 15% to 40% as a stake, plus targets |
| How long you stay | 30 to 120 days | 3 to 5 years, longer in specialty |
| Who runs it | They do, their way | Their systems, your clinical calls |
| A second payday | No | Possibly, when they sell |
The Comparison Most Dentists Get Wrong
On a practice collecting $1.5M, the gap between the two headline numbers can pass $500,000. That gap is misleading.
The group’s number includes money that depends on targets and a stake you cannot spend. The associate’s number is mostly cash in hand.
- Compare what you expect to collect, not the biggest number on either page.
- Six times from a group, with money held back, can leave you worse off than a clean sale to a dentist.
- Most dentists never run the associate numbers before signing with a group. That is the mistake.
Which One Fits You
Sell to Another Dentist If
- You are a year or two from retiring and want to be finished.
- Your practice clears under $1M in profit, which is below what groups pay up for.
- You want the money certain rather than large.
- You care what happens to your team after you go.
- You already have an associate capable of buying it.
Sell to a Group If
- You clear $1M or more in profit, with other dentists producing and a couple of thousand active patients.
- You are willing to practice as an associate for three to five more years.
- You want a shot at a second payday when they sell.
- Retirement is five or more years out.
- You would happily hand off the admin tomorrow.
Your Production Decides More Than You Think
One number quietly determines which path is open to you: how much of the dentistry you do yourself.
At 90% of production, groups either cut 10% to 20% off or walk away. They cannot buy a practice that leaves with you.
That same practice can be an excellent sale to another dentist, because they are buying your chair on purpose.
- It works the other way too. A practice with real associate depth is what groups pay up for, and it may be underpriced in an associate sale.
- Fewer young dentists are buying practices. Ownership has fallen to about 73% from 85% in 2005, which thins your associate buyer pool.
- And more are joining groups instead. About a quarter of dentists now work with one, per the ADA’s practice research.
- The full set of options, grouped by who ends up owning it.
Related Guides
- In New York the associate clears a rule no group does. See selling a dental practice in New York.
- What group buyers actually pay, and how the held-back money works.
- Valuation by practice size, and how long a sale takes.
- Selling in Pennsylvania or New Jersey.
- Whichever buyer you pick, the sale structure decides your tax bill.
Frequently Asked Questions
On paper, usually. But 20% to 40% of a group’s offer is tied to targets, or locked into a stake in their company. An associate’s offer is mostly cash. Once you weigh what you actually expect to collect, the gap narrows and can flip.
A group typically wants three to five years, and longer in some specialties. Selling to another dentist means 30 to 120 days of handover and then you are done. For a lot of sellers that difference matters more than the price.
Selling to another dentist, by a wide margin. Fewer conditions, a close in 60 to 120 days, and straightforward financing. A group deal brings employment terms, target provisions, a stake agreement, and a non-compete.
One clearing $1M or more in profit, with other dentists producing and a couple of thousand active patients. Below that, especially if you do most of the dentistry, another dentist is usually the better and more realistic buyer.
Yes, more than anything else. If you produce 90% of the work, groups will cut 10% to 20% or pass entirely. That practice often sells well to another dentist, who is buying your chair deliberately rather than working around it.
Often some of it. Most associate deals use a bank loan for the bulk of the price, with you carrying the rest over five to ten years. That gives you steady income, and it means you only get paid if the practice keeps performing.
Strip both down to what you expect to actually receive. Discount the group’s target-based money by how likely you are to hit it, and treat the stake as uncertain. Then set that against the associate’s mostly guaranteed cash.