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Blog By:
Nick Fotache
Nick Fotache

Should you buy a dental practice or start one from scratch?

7/30/2026 2:38:00 AM   |   Comments: 0   |   Views: 44
This is the first question most dentists face when they're ready to own a practice. Ask the ones who've already been through it, and you'll get two very different answers: half will tell you buying an existing practice was one of the best decisions they ever made. The other half swear by starting from scratch because it worked for them.

The thing is that both options can be viable for specific situations, and choosing the right one for you depends on several factors such as budget, timing, and location. It’s important to keep in mind that what worked for someone else might not work for your specific situation.

According to Bill Henderson and Jennifer Blair, both paths can be successful or complete failures. In the following paragraphs, they will share with what differentiates the ones that worked from the ones that didn’t. The takeaway is clear: 

"The number one success factor in every dental practice in the country is patients. You've got to either have patients or be able to attract them in large numbers. And the defining issue in the industry is there are too many dentists and not enough patients to go around." Bill Henderson

And this is not just one person’s opinion. The Globe and Mail reported that for years, the number of dentists has grown faster than the population, leaving practices in major cities fighting hard for patients.

The number of dentists who spend months deciding the layout of their waiting room, the right aesthetic for their office, and the best brand of equipment would surprise you. And what’s even more fascinating is that these dentists never even stop to ask a simple question: “How will I get patients?”

The most modern appliances or a marble countertop will not fill your chairs. At the end of the day, it won’t matter if you have a TVs in your waiting room if no patients are sitting there to watch it.


Here's what Jennifer and Bill told us about bringing in more patients, and how the choice between a new or existing practice can make that easier or harder.

Jennifer Blair explains why buying an existing practice can offer a head start:

"You're buying into a dental practice that already has an existing patient base, staff that are trained and know how to do their jobs, the location is set up, everything's already built out, but most importantly you've got ongoing cash flow. Theoretically, you've got a practice that's already making good money after paying all the expenses." Jennifer Blair


Starting a new practice doesn’t offer any of these advantages, and the timeline to get to that point is usually longer than most dentists initially plan for.


"It might be two years before you start to break even or make a little bit of a profit. It might be three years before it really starts to do well. So if your horizon is five to ten years, a startup might be a great idea. But if you're thinking I'm going to start it up, you know, sprinkle a little bit of local SEO and some Facebook advertising and within six months I'll be doing great — you're setting yourself up for a big headache." Jennifer Blair


Bill Henderson explains how the referral numbers add up:

"The number one source of new patients for most practices is referrals from satisfied existing patients. That's also the lowest cost new patient. If you're going to get referrals from five percent of your patient base and you're starting with two thousand patients, that's a hundred new patients a year right out of the gate. If you're starting with zero patients, that's zero referrals right out of the gate.” Bill Henderson

According to Bill, starting a practice from scratch isn't the impossible mission a lot of dentists assume it is, and plenty of people have pulled it off. But it does call for a specific skill set and a clear sense of the timeline, particularly how long it takes before the business actually starts making money.

He adds that the majority of dentists don’t plan for this scenario. They think that they will get results in a few months, but the truth is that a new dental practice usually takes around two or three years before the numbers start to look good.

"If you can build a practice from scratch and rapidly fill it with patients economically, you're better off than buying a practice from me. But it's a unique skill set, and you need to have a really good business plan, a great location, and you need the backing of somebody who knows how to market to attract new patients in big numbers. Because otherwise you're just going to be sitting there with empty chairs.” Bill Henderson



Due Diligence Checklist

We talked to dentists who've been on both sides of buying a dental practice. One thing that came up a lot: the practices that looked great on paper but turned into disasters almost always had the same 2-3 warning signs, and the buyer either missed them or talked themselves out of caring about them.

We broke everything down along with a due diligence checklist dentists can use before signing: check it out here.
Category: Marketing, Practice Management, HR and Accounting, Practice Transitions
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