The short answer, and why the headline number misleads
We track 114 disclosed M&A transactions in dental practices and dental groups. Across the 85 of them that reported an EBITDA multiple, the median is 11.0x. That figure gets quoted a lot, and it is the wrong number for most owners. The median deal in that set had an enterprise value of $137.1M, so the all-sizes figure is pulled up by group and platform deals, not a dentist selling a four-operatory practice.
Size is the single biggest thing that changes what a dental business sells for, so the useful question is not “what do dental practices go for” but “what do practices my size go for, and to whom.” The rest of this page answers that.
How buyers measure your earnings
Every serious buyer above the single-dentist level prices off EBITDA. The catch is that your tax return almost never shows the EBITDA a buyer will use, because in most owned practices the owner dentist’s pay is mixed in with profit. The first thing a DSO does is take out everything you pay yourself and put back in what they would have to pay a dentist to do your clinical work. If you take home a lot and produce a lot, that adjustment can move EBITDA more than any other line.
The other adjustments we see argued over most in dental deals:
- Rent to yourself. If you own the building through a separate entity, buyers reset rent to market. Charging yourself below-market rent inflates EBITDA on paper, and buyers will reverse it.
- Family on payroll. A spouse running the front desk at a non-market wage gets normalised either way.
- Personal and one-off costs. Cars, CE travel that was really a vacation, a one-time compressor replacement. These are legitimate add-backs if you can document them. Undocumented ones get rejected.
- Lab and supply costs. Buyers compare these to production. Unusually low lab costs can mean you are referring out complex cases, which caps growth.
For a true single-dentist practice that will sell to another dentist, the business is genuinely owner-operator sized, and the buyer is usually thinking in terms of collections and what is left for them after debt service (SDE). That is a legitimate way to price a small practice. Just know that it is a different conversation from a DSO’s, and the two methods can produce different answers for the same practice. Our SDE vs EBITDA guide explains the difference.
Who buys dental practices, and how they differ
Another dentist. Often an associate or a local dentist adding a second location, usually bank financed. They need the practice to keep producing after you leave and need enough cash flow to cover the loan. They will usually want a clean break with a short transition period from you.
DSOs buying add-ons. Dental service organizations buy individual practices and small groups to fold into their network. Two disclosed 2025 examples: DentalCorp bought a package of 12 practices with combined EBITDA of $0.86M for $6.2M, a 7.2x multiple, and a package of 8 practices with combined EBITDA of $0.47M for $3.0M, a 6.3x multiple. Those are what add-on pricing looks like for small practices in our data.
Platforms and private equity. Once a dental group reaches real scale, the buyer set changes to large DSOs and financial sponsors, and pricing changes with it. In 2025 Heartland Dental acquired Smile Design Dentistry for $165M at 11.0x on $15.0M of EBITDA. GTCR agreed to acquire Dentalcorp, described as the largest Canadian DSO with 575+ practices, at 11.0x. Ontario Teachers’ Pension Plan acquired Donte Group at 12.5x in a $1,166.6M deal. None of those are comps for a single practice, but they are the reason a group with multiple locations and associate doctors gets a different call.
Size thresholds that change pricing
Here is how the median EV/EBITDA moves by enterprise value bracket across our disclosed dental transactions (deal counts are all deals in the bracket; the median is taken over those that reported EBITDA):
- Under $5M EV: 6.6x median (13 deals)
- $5M-$25M EV: 7.1x median (18 deals)
- $25M-$100M EV: 10.4x median (22 deals)
- $100M-$500M EV: 11.8x median (29 deals)
- Over $500M EV: 14.0x median (32 deals)
Two honest caveats. The small-practice brackets are thin: 13 and 18 deals are enough to show a pattern, not to pin your number. And the figure at the top of this page comes from a narrower 2018-2026 cell with fewer deals than this ladder, so it reads a little differently. The pattern is the point: the jump comes between the $5M-$25M bracket and the $25M-$100M bracket, which is roughly where a practice stops being a practice and becomes a group a platform can build on. Full detail is on the dental practice benchmarks page.
How dental deals are usually structured
A sale to another dentist tends to be mostly cash at close, funded by the buyer’s lender, with you staying on for a defined transition so patients meet the new doctor.
DSO deals look different. Expect part of the price to come as rollover equity in the DSO, an employment agreement that keeps you producing for several years, a non-compete around your location, and often an earnout or holdback tied to collections holding up after close. When you compare a DSO offer with a dentist’s offer, compare cash at close and the realistic value of the rest, not the headline. Rollover equity can be worth a great deal or very little depending on the platform and when it next sells. Our guide to selling to a DSO goes through the terms in more detail.
What moves a dental practice’s value up or down
- Who produces the dentistry. If the owner produces nearly all collections, the buyer pool narrows to people willing to bet that patients stay after you leave. Associate-driven production proves the practice transfers, and it is what opens the door to DSO buyers.
- Hygiene. Practices where hygiene is 30% or more of total production get paid more, because that revenue is recurring, high margin and not tied to you.
- The lease. A long lease, ideally 10 or more years remaining, makes it much easier for a buyer to get SBA financing. Under three years left can take SBA-financed buyers out of the running entirely.
- Collections trend. Two or more years of declining collections is a red flag for every buyer type, whatever the reason.
- Payer mix. Fee-for-service and well-negotiated PPO revenue is worth more than heavy Medicaid or deep-discount PPO revenue, because the margin is better and more predictable. Medicaid-heavy practices have their own buyers; see our Medicaid practice guide.
- Capacity and equipment. Unused operatories and modern imaging give a buyer room to grow. An office that needs a full equipment refresh gets that cost taken off the price.
Mistakes we see owners make before selling
The most expensive one is easing off in the last year or two. Owners who cut days and let collections slide often hand away more value than they realise, because buyers price off the most recent twelve months. Close behind it: signing a short lease renewal to keep options open, losing a key associate or hygienist right before going to market, and running heavy personal spending through the practice that then cannot be proved as an add-back. We also see owners talk to one DSO, take the first letter of intent, and only later learn how much of the price was rollover or contingent. And a practice that owns its building should decide early whether the real estate is part of the sale or kept and leased back, because that choice changes both the price and the rent the buyer will underwrite.
What to do 12-24 months before a sale
- Get monthly financials your CPA would stand behind, with production and collections by provider.
- Write down what you pay yourself and why, so the dentist-compensation adjustment is easy to make.
- Extend or renegotiate the lease, and check that it can be assigned to a buyer.
- If you produce almost everything, bring in an associate now and let them build a patient base.
- Fill the hygiene schedule and work down old receivables.
- Stop running personal costs through the practice, or document the ones that stay.
- Get a baseline valuation, then re-run it as the numbers change. Our dental practice valuation tool uses the same disclosed-deal data shown here, and our methodology explains how.