How Dentists Should Prepare for 2026: Get Your Internal House in Order Before the Market Shifts
- Spiro Leunes
- Dec 9, 2025
- 3 min read
The dental profession is accelerating toward another major consolidation cycle, and far more dentists are selling to private equity–backed DSOs than forming their own organizations.
But before any dentist considers selling, scaling, or staying independent, there is one universal truth for 2026:
The dental profession is accelerating toward another major consolidation cycle, and far more dentists are selling to private equity–backed DSOs than forming their own organizations.
But before any dentist considers selling, scaling, or staying independent, there is one universal truth for 2026:You must get your internal house in order.
Practices that demonstrate operational discipline, profitability, and modern systems will command higher valuations, greater negotiating power, and stronger long-term stability.
Here’s what every dentist must do going into 2026.
1. Evaluate Every PPO Plan — Unprofitable Plans Must Go
PPO reimbursement pressures are crushing margins.
2026 will reward practices that:
Identify loss-making or low-margin PPOs
Renegotiate or drop plans that do not cover overhead
Strengthen out-of-network communication strategies
Improve collections and reduce write-offs
Your payer mix will be one of the most heavily scrutinized components of your practice’s valuation.
2. Fill the Hygiene Schedules — This Is Your Production Engine
Hygiene is the backbone of every healthy practice, yet most offices run with 20–35% hygiene holes.
In 2026 you must:
Increase reappointment rates
Reduce no-shows through automation
Implement consistent perio protocols
Use hygienists to support diagnostic quality and treatment acceptance
A consistently full hygiene department increases revenue, stabilizes EBITDA, and raises your valuation multiple.
3. Raise Fees Strategically and Annually
Inflation, staffing, and supply costs are rising faster than dental fees.
To stay competitive in 2026:
Benchmark your fees at least annually
Adjust based on regional market data
Implement uniform fee schedules across providers
Monitor fee acceptance rates
Failing to raise fees is one of the biggest profit leaks in dentistry.
4. Expand Your Clinical Offering — More Procedures, More Value
General dentists who perform more procedures in-house consistently outperform their peers.
2026 priorities:
Add clear aligners
Add implants or guided implant workflows
Add molar endo if clinically appropriate
Adopt digital dentistry and same-day services
A broader clinical mix increases collections, enhances EBITDA, and makes your practice more attractive to buyers.
5. Leverage AI for Better Diagnoses, Efficiency, and Outcomes
AI in dentistry is no longer optional.
PE buyers and advanced DSOs have already adopted it.
In 2026, dentists should use AI tools for:
Radiographic detection
Caries and perio diagnostics
Treatment planning
Clinical consistency and documentation
Predictive scheduling and production analysis
AI improves accuracy, increases case acceptance, and creates data-driven transparency — a major valuation enhancer.
6. Adopt Modern Technology or Fall Behind
A modern practice infrastructure is essential for scalability and saleability.
2026 must-haves include:
Digital workflows (scanners, sensors, CAD/CAM)
Cloud-based practice management software
Automated patient communication systems
Online scheduling
Revenue cycle automation
Analytics dashboards for KPIs
Practices that remain “analog” will see lower margins and lower valuations.
7. Understand SDE vs. EBITDA — Your Numbers Define Your Future
SDE
(Seller Discretionary Earnings)
Used for single-owner practices to measure total economic benefit to the owner.
EBITDA
The valuation metric used by private equity and DSOs, reflecting the performance of the business independent of the dentist.
If a sale is on the horizon in 2026 or 2027, EBITDA — not SDE — is what buyers will focus on.
2026 Will Be a Separation Year
Dentists who:
Analyze PPO profitability
Fill hygiene chairs
Raise fees
Increase clinical offerings
Adopt AI
Modernize technology
Produce clean financials
Build predictable systems
…will maximize practice value and stay competitive in a transforming industry.
Those who ignore these steps will fall behind — in profitability, scalability, and valuation.
From your New Jersey Dental CPAs, New York Dental CPAs.
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