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How to Build a Dental Practice Startup

I hate to break it to the “experts” out there who offer their “humble but helpful” advice to all the curious but unknowing associate dentists, but opening a dental practice is not that difficult.

Consider the simple 2 Steps to Start a Dental Practice:

Step 1: Get a building.

Step 2: Install dental chairs.

BAM! You’ve got yourself a dental practice.

But here’s the question: if it were really that easy, why do so many startup doctors struggle?

If you’re researching how to start a dental practice, this question makes perfect sense.

My name is Jayme Amos, CEO of Ideal Practices. My team of consultants and I have guided hundreds of associate dentists to open successful dental startups in almost every state in the country. Hundreds.

And we are the experts with the REAL answers.

Sure, any dentist can put some dental chairs in a building and hang an “Open” sign. But do you want to open a dental office, or do you want to have a successful practice that opens for you?

In this article, you will learn about 6 topics to help you avoid the typical dental startup struggles so you can own a successful practice.

  1. The Problem with Dental Startups
  2. The #1 Reason Startups Struggle
  3. 9 Questions to Plan Your New Dental Practice
  4. Costs for Average Startups
  5. What to Expect After Opening Your Dental Office
  6. The Course for Associate Dentists

Let’s begin…


The Startup Denstist

The Problem with Dental Startups

Every year, my consulting team helps associate dentists with no business experience open startups that go from zero to a million dollars in production—many in their first year.

The results literally change the lives of associate dentists all over the country.  You should see how proud they are on opening day!

BETTER YET—you should experience the excitement for yourself at the grand opening of YOUR dental practice! And imagine this: Not only is it opening day, but you already have over 100 new patients. Talk about success from the start!

But too many associate dentists open new dental offices and struggle for years to get profitable. Some never even grow their practice to become full-time, having to continue their associateship several days a week while wasting their life savings in the process. Others have gone bankrupt.

It doesn’t have to be that way. I assure you.

When you follow the proven process, I can show you how to have a successful practice that you’re proud to own, even on opening day.

Though it’s not a guarantee, it takes away the confusion and the risk when you have a predictable process working for you.

Which brings us to the real question…

What is the #1 Reason Startups Struggle?

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If you’re an associate dentist and you’re researching how to start a dental practice, I want you to know the #1 reason most dental startups struggle.

It’s not demographics. It’s not marketing. It’s not real estate, hiring, finances, or even clinical skills. I can confidently tell you it’s none of those things.

The #1 reason startups struggle is because their focus is on “getting open.”

Be careful—you might think this sounds simple.

But when you understand this concept, you will avoid the risks and mistakes that hurt colleagues with dental practice startups.

This is why I’m sharing the 5 checklists and resources in this article. I can only personally help a handful of doctors each year, but I want to see every dentist with a desire to own a dental office succeed.

*HINT* You may want to bookmark this page.  There is so much helpful information and real, proven advice packed into it—you will likely want to revisit this page multiple times.

First: The goal is never to “open” a practice.

In fact, dentists email me every month asking for help and describing their struggles with their dental offices.


Doctors who focus on “getting open” experience these things:

  • They earn lower profits
  • Their growth is slow
  • Expensive mistakes are made before opening day
  • Steps are taken in the wrong order
  • They sacrifice long-term planning
  • Decisions feel rushed and pressured
  • Choices become defensive and reactive

Can you imagine how these create problems with a new practice?

Sadly, those doctors try so hard. They accidentally increase risk and, in many cases, make irreversible bad choices in the process.

Many of your colleagues end up on this path. They spend months—even years—trying to learn how to “open.”

But they get it wrong. There’s a huge difference between “getting open” and having a SUCCESSFUL dental practice open for you.


Getting “open” requires some knowledge of the following:

  • Banking negotiations
  • Construction management
  • Real estate
  • Demographics
  • Equipment negotiations


Compare that list to what comes with a successful startup:

  • 100+ new patients within the first week
  • Profits in the first weeks
  • Lower risk
  • Marketing that works
  • Hiring the right team members the first time
  • Philanthropy that matters on day one
  • Media relationships
  • A reputation that you are proud of
  • Business systems and training (like the Startup MBA)

If you want to learn how to open a dental startup, you could try to “Dr. Google” your way to opening your dental office…but be careful. While Google can “answer” all your questions, you can’t learn everything there.

Notice how each one of the above skills can be a career’s worth of information.

This is your “aha” moment: With a startup, you get just one chance to get it right. When you do, you can enjoy decades of practice ownership that is created with your standards from the beginning.

Next, we will cover the Top 9 Planning Questions:

  1. The Problem with Dental Startups
  2. The #1 Reason Startups Struggle
  3. 9 Questions to Plan Your New Dental Practice
  4. Costs for Average Startups
  5. What to Expect After Opening Your Dental Office
  6. The Course for Associate Dentists

9 Questions to Begin Your Dental Startup

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If you want to follow the proven process, start with planning a customized vision.

Did you get that? CUSTOMIZED.

Here at Ideal Practices, we have created and implemented HUNDREDS of customized plans that have led to highly successful practices.

One of the most important things you can do is ignore the cookie-cutter approaches and social media forums.

By planning your vision properly, you focus on the real goals. You go beyond “getting open.”


9 Questions for Startup Vision Planning:

  1. What customized dental practice model is right for you?
  2. Who is your Ideal Patient?
  3. How quickly do you want to grow?
  4. What is your definition of a successful practice?
  5. How soon do you want to be full-time?
  6. What is your goal for the first year?
  7. Where do you want the practice to be in five years?
  8. What reputation in your community will you pre-plan?
  9. Which proven model will you follow to cut out risk?

Imagine how much clarity you will have when you have answers to these questions. With these answers, a customized business plan can be created for you.

The team of consultants at Ideal Practices will help you answer these questions and customize a plan that matches your vision. Then, our team builds the entire strategy for your customized dental practice model through REVERSE-ENGINEERING.

This is how we help new practices open predictably, anywhere in the country. This is how we make the dreams of dental office ownership come true while remaining true to the vision of each doctor we work with.

Unfortunately, most associate dentists focus on the wrong pieces. They get stuck on “getting open” and miss the important stuff.

Beyond “Getting Open” in a Dental Startup

When I stepped off the stage at a large dental conference last year, a young dentist ran up to me. We’ll call him Dr. Xavier. Seeing the stress on his face, it was completely obvious that Dr. Xavier was anxious about something.

Dr. Xavier shared his story, saying he was desperate for advice. I listened closely as he described risking everything to open the doors of his practice.

Now nearing his first anniversary, he was barely scraping in $20,000 per month. With production levels that low, he couldn’t keep up with his many bills. Xavier was sinking further and further into debt.

I predict he was two wrong moves away from losing everything he had sacrificed so much to build.

Dr. Xavier’s story is like so many heartbreaking stories I hear from dentists.

He was failing.

What did Dr. Xavier do wrong?

He worked hard. He researched for hours. He joined Facebook groups. He looked at piles of demographics data. He spoke with colleagues. He received batches of random opinions.

He had done everything he could—on his own with the limited knowledge he had about a startup practice.

His Biggest Mistake? He acted like a WebMD patient

You’ve seen that patient, right?

WebMD Patients spend hours researching, trying to diagnose themselves. They think they can put together a treatment plan on their own with nothing more than “helpful” advice.

They ask their friends for opinions. They read WebMD and search on Google. They poll Facebook friends and put out “in search of” posts.

Let me ask you: When your patients bring that kind of research information to you as their dentist, is ANY of it helpful?

Why would the opinions of their neighbors, friends, family members, and online strangers matter for the customized needs of that patient?

Even with all the research, the WebMD patient will only bring unnecessary questions and unhelpful advice because no one giving answers examined him. Most didn’t even go to dental school.

Doctor Xavier was accidentally acting like the WebMD Patient.

He was attempting this on his own. And failing as a result.

As I listened to his story, I pinpointed several areas where this brilliant doctor had blundered, despite his best intentions.

But his absolute worst mistake was focusing his efforts on getting his doors “open” while believing everything else would just fall into place.

The Planning Stage for New Dental Offices

Your startup will match your planning stage. This can be good or bad, depending on how effectively your planning strategies are.

Some colleagues are just plain lucky, to whom success seems to happen without lifting a finger. But, for the vast majority of us, success doesn’t just happen. For people like us, we plan it. Create it. Build it.

Then, after hundreds of attempts, results finally become more predictable.

It’s like that for dental startups.

And this is where doctor Xavier had failed—he hoped his first time would be plain lucky.

But this is where the team at Ideal Practices can help you succeed with a proven planning process.

My team of consultants and I have helped hundreds of doctors—most with zero business experience—create successful private practice dental startups.

I want to show you the world of difference that working with professionals can make when it comes to building a successful practice.

Check out Dr. Nadya’s story. 

You will see—in her words—how she says, “I am a much happier dentist now.”


Through our process, she found a sense of pride and fulfillment—and has a highly profitable practice too.

The Cost of Starting a New Dental Practice

Next, we will cover the costs for average startups:

  1. The Problem with Dental Startups
  2. The #1 Reason Startups Struggle
  3. 9 Questions to Plan Your New Dental Practice
  4. Costs for Average Startups
  5. What to Expect After Opening Your Dental Office
  6. The Course for Associate Dentists

Now that you understand the difference between opening a dental office and creating a successful startup, let’s look at the average financial costs.


What Will a dental practice startup cost?

This is one of the top questions that dentists from all across America ask me.


There are 8 primary factors that affect the costs of a dental startup:

  1. What is your market’s price of commercial real estate?
  2. The square footage of the office you want to start with
  3. The cost of construction in your market
  4. Your choice of construction finishes (think: marble vs. plastic)
  5. Size of the practice build-out for future growth
  6. Your high-tech capital equipment budget
  7. How much you can negotiate in lease from your landlord
  8. Marketing, hiring, and systems budget


Average Costs:

With the 8 factors above, the nationwide average cost of a dental practice startup can approach $500,000.

The most important topic related to the cost of a dental startup is designing a budget with proper funding for your customized plan.

With a budget, you will be able to enjoy having balanced spending categories. This gives you the freedom to invest the right amount into your dental practice model.


How to Lower the Costs for Your New Dental Practice

Dr. Bryan saved over $500,000 in just two stages.

First, he wanted to open his dream practice but was worried he would have budget problems in the size of the facility. During his Vision Stage, we explored a potential space of 5,000 square feet.

That would be a huge dental office! We were able to show him a modified plan that gave him just as many operatories for half the cost, in the same building.

This saved him $200,000 on Real Estate through negotiating the size and scope of the footprint on his portion of the building.

Next, we reached the equipment stage of his dental practice and negotiated another $300,000 off the price of his equipment.

This totaled over $500,000 in savings from just two stages!

You can watch Dr. Bryan’s entire story in the Startup Practice Documentary here:

What About Extreme Cost Savings?

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If you need extreme cost-reductions, here are 4 cheap and easy methods to cut costs with your dental startup:

  1. You can lower costs by 50 percent if you build a smaller practice. Half the practice, half the costs, right? But will that get you the practice you have been dreaming of owning?
  2. Spend even less money if you choose a remote, rural area where real estate is dirt cheap. But do you really want to operate in that area?
  3. Get an economic grant by opening in an economically depressed area where businesses are leaving town. In many shrinking towns, grants may be offered to attract new businesses—this generates new tax revenue for them.
  4. Cut your construction and labor costs by 50 percent of the national average when you open in an area with a low-income workforce (lowering the cost of construction wages).

But are those the things you want for your dental office?

There is no right or wrong answer, but your choices for cost-cutting will have long term effects on the future of the practice.

For example, if you have the world’s smallest dental office…in the most rural area… with the cheapest building in town…and invest in just one chair while cutting your marketing budget…

…you WILL spend less…

But your dental practice may not even cover the costs of your student loan payments, let alone provide for your family.

Spending less is never inherently better.  Often, spending less simply prevents practice growth.


Instead, focus on proper funding

Our consulting team guides startups to plan for the right costs and fund the right plan. Then the practice can grow based on your standards, creating a dental office that matches the reputation you want in the community.

 What About Lower “Risks”?

Unfortunately, some people will say you can lower your risks by spending less and cutting costs. Not true. Colleagues who have never opened more than one dental office give this advice.

Startups with the lowest risk have proper funding. Not “less” spending.  The best dental startups have a balance based on a proven process.

Less is not better.

Make your top priority to open your practice with a proven plan and a budget based on hundreds of successful startups across the country.

Some “experts” will suggest you open your dental practice startup with a partner. They believe this will cut your costs and risks in half.


Read about the real risks of partnership and learn that what you are really cutting in half is your profits.


When are Costs Higher for Dental Startups?

Your startup may have higher costs if:

  • you plan to have a large dental office
  • you want a stronger marketing budget for faster growth
  • Your plan includes high-end technology, like CBCT or CAD/CAM
  • you choose to open on the beach in California, where real estate prices are very high

Have we helped new practices succeed, even in situations like those? Yes, in each of those examples.

The solution for higher-cost startups is proper planning and properly funding, following a proven process, customized for your dental practice model.

How to Finance a Dental Practice

Before you can finance a practice, you will need to be able to prove to a bank that you are creditworthy and capable of building a successful dental practice.

Often, banks will ask you for dozens of documents. But to begin, you should be prepared with at least the following:

  1. Production reports from your current associateship
  2. Proof of at least one full year of clinical experience
  3. Licensure in that state

However, every bank has different criteria. What one bank requires may not be needed for another. 

Additionally, what a bank considers successful will vary based on that bank and its underwriting department.

Some banks may need to see your plan to break even within a year, while others may just need to know you can make your payments on time each month.

Our recommendation is to build your entire business plan before talking with banks.

For our high-level consulting clients, we customize your business plan by REVERSE-ENGINEERING your vision. We then use what we call the “silver platter strategy” to prepare you and find the right banks based on their lending criteria. We then present you on a “silver platter” and get the banks hungry to work with you. This puts you in a powerful negotiating position.



Do Banks Require Business Plans?

Some banks will tell you a business plan is needed. Others may say it is not necessary. 

But for a first-time practice owner, this is irrelevant. A business plan is more than a document with graphs and text used to get your loan.

Even though a bank may not require you to have a business plan, you should have one for the business health and success planning of your dental practice.

This would be like an MD telling a patient they don’t need to brush their teeth to get their blood pressure prescription refill. While it might be true, the recommendation is irrelevant.

It’s like that for business plans and startups. Those with customized dental startup business plans have a process, a plan, and a direction for the comprehensive health of the dental office. It’s not just about the loan.

Clients of Ideal Practices have a full business plan created for them during the Vision Stage of their startup. We work with you to build this plan, and it becomes a defining piece of your budgeting and planning during our proven 13-Stage Process, which takes you from business idea to 100 patients on opening day in a year.

What to Expect After Opening Your Practice

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Next, we will cover what to expect after opening:

  1. The Problem with Dental Startups
  2. The #1 Reason Startups Struggle
  3. 9 Questions to Plan Your New Dental Practice
  4. Costs for Average Startups
  5. What to Expect After Opening your Dental Office
  6. The Course for Associate Dentists

Do you believe there is such a thing as good stress? When you finally get to that finish line, good stress is what will await you.

Owning your dental office is a much bigger responsibility than being an associate. As an associate, you clocked in, served your patients, went home, and someone else worried about all the numbers.

Now, the numbers game will be yours to play. You will need to ensure:

  • Your new patient growth is on track each month (like David who reached 1000 patients in his first 12 months)
  • Your team is hired well and lead well (like Alexis designed for her practice)
  • Your budget and business plan are followed (like Gerry did)
  • Your marketing strategy is bringing in good ROI (like Lauren with 209 patients in the first 4 days)
  • You pay yourself for all your hard work! (like Danny who had a million-dollar practice in his first year)

This means that you may spend some time balancing books and doing payroll in the beginning. You can hire-out these services later on, but it’s a good idea to get a feel for them at the start.

Don’t worry, here at Ideal Practices, we will teach you all you need to know and work side-by-side with you through our Startup MBA program.

Despite the added responsibilities you take on, you will also enjoy a sense of pride and fulfillment when you control the way the dental practice is created.


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The Startup Course for Associate Dentists

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Want to learn the entire step-by-step process in a course taught by the best experts in the country?

Apply today to attend our next two-day Startup Blueprint Course.

We’re so confident this course will provide you with high-quality resources to build your best possible dental startup, we back it by our 150 percent money-back guarantee.

What are you waiting for? Check out our next available event dates to learn how to start a dental practice THE RIGHT WAY.

If you want to get started right away so you can get your dental practice open, apply now to see if you qualify. We only take on a handful of clients each year so we can remain 100 percent available and responsive. Will you be our next client?

The above link begins with case studies of Drs. David, Alexis, Gerry, Lauren, and Danny. Watch their videos and see their excitement and pride. 

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