Archived newsletter • October 2026 • Issue II
The Private Practice Path
A Dental Strategic newsletter for students and early-career dentists.
Issue II • October 2026
Buy a practice or start from scratch?
Two ownership paths. Different risks, timelines and opportunities. Here is how to start evaluating them before you are ready to sign anything.
Information now. Options later.
Practical guidance to help you understand your options and prepare for the business side of dentistry.
Take the quick poll
If ownership is in your future, which path feels most like you right now? Select one answer below.
| Buy an Existing Practice | Start from Scratch |
| Associate-to-Owner | Still Figuring It Out |
Your response helps shape future issues. Find poll results and other resources in the Student Hub.
Did you know?A Nashville dentist helped invent cotton candy. Dentist William J. Morrison and confectioner John C. Wharton co-developed the machine that spun sugar into “fairy floss,” then sold more than 65,000 boxes at the 1904 World’s Fair. The irony writes itself. Brush twice a day. Historical note: Smithsonian Magazine / History. |
Tip from older you“Don't listen to the naysayers. Dentistry is a great profession! Find a good mentor and be your own boss.” — Dr. Kelli Fischer, 1989 UK College of Dentistry |
Acquisition vs. startup: what really changes?
Buying an existing practice can provide an established patient base, a team, systems and historical collections from day one. But you inherit the reality behind those numbers: overhead, lease terms, staffing, equipment needs and patient retention risk.
Starting from scratch gives you more control over location, design, systems and culture. The tradeoff is a slower revenue ramp, startup costs and the need for sufficient working capital while patients and collections grow.
| Question | Buy an existing practice | Start from scratch |
|---|---|---|
| Revenue | Historical production and collections to review | Must be built over time |
| Patients | Existing relationships; retention matters | Must attract and retain new patients |
| Cash needs | Down payment, transition and operating cushion | Buildout, equipment, launch and operating cushion |
| Key diligence | Quality of earnings, staff, lease, clinical mix | Site demand, demographics, buildout and ramp |
Neither path is automatically better. The right decision depends on the economics, your clinical capacity, your household finances and your preferred community.
Cash needed before the practice supports you
For a purchase, budget closing cash and a transition reserve. For a startup, budget cash needed to open and fund the patient ramp. For each path, calculate the monthly shortfall until collections cover practice expenses, loan payments and your household needs; that shortfall determines the additional cash required.
Ownership tools in the Student Hub | Student Hub |
Check your personal financesUpdate assets, debt payments and readily accessible cash; target 3–6 months of personal expenses as a planning reserve, in addition to transaction-specific needs. |
Track your production | Already practicingIf you are already practicing, log clinical days, doctor production, collections and procedure mix. This record helps you evaluate compensation and prepare for lender review. |
Review the readiness guideUse the five-part check: credit, financial snapshot, liquidity, clinical production and ownership path. |
Review your non-compete | Already practicingIf you are already practicing under an employment agreement, record any restricted area, duration and start trigger. Have a dental attorney review the terms before choosing a practice location. |
Build your advisory team before you need it
A dental-focused CPA helps evaluate earnings and taxes; an attorney reviews the transaction, employment terms and restrictive covenants; a lender tests borrowing capacity; and a Buyer Advocate represents your interests in finding, evaluating and negotiating an opportunity. Build trust with each advisor before you are under a deadline.
Three questions worth asking
- What does realistic owner cash flow look like after debt service and a fair amount of clinical work?
- What cash must remain available for my household and for the practice after closing or opening?
- Where do I want to practice—and how do family, spouse/partner career needs and community ties affect that decision?
Your Student Hub
Find the tools above, previous issues, poll results and dental student-loan repayment resources in the Student Hub. You can also ask a confidential question, request the Readiness Tool, share your preferred practice location, and sign up for SMS or email updates there.
| Visit the Student Hub |
SMS sign-up is optional, and you may opt out at any time.
Current opportunities
Purchase: #1514 East Tennessee | #1512 Greater Decatur, AL | #1507 Greater Nashville | #1501 Northwest Tennessee. Associate: Franklin | Knoxville | Jackson | Florence, KY | additional specialty opportunities.
| Purchase opportunities | Associate opportunities |
Have a business-of-dentistry question? Submit it through the Student Hub for this issue’s monthly drawing and possible inclusion in a future issue. Let us know if you prefer to remain anonymous.
Coming next month: Know your numbers before you own
Issue III will break down production, collections, compensation and practice cash flow, continue the Buy vs. Start-Up roadmap, and add a young dentist viewpoint.
Educational information only; not legal, tax or lending advice. Opportunity availability may change.