What is the average EBITDA multiple for dental practices?
FOCUS Investment Banking publishes a ladder by adjusted EBITDA with the buyer type named on each rung: under $1M at 5–7×, $1M to $3M at 7–9×, $3M to $5M at 9–11×, and $5M+ at 11×+ in select cases. McLerran & Associates puts platform-grade groups above $5M in adjusted EBITDA at 10x to 12x or more and leaves its lower tiers unnumbered. Neither firm publishes an absolute multiple for orthodontics, oral surgery or pediatric dentistry; McLerran says only that specialty practices run roughly 1 to 3 additional turns of EBITDA above general dentistry at the same size tier. Scale, not clinical quality, is what moves you up the ladder.
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Definition
An EBITDA multiple is the ratio of enterprise value to earnings before interest, taxes, depreciation, and amortization, used to value a dental practice for sale.
The detail
Dental deal pricing comes from the advisory firms that broker the transactions, not from an index, and the two that publish openly do not present it the same way. FOCUS Investment Banking publishes a four-rung ladder by adjusted EBITDA and names the buyer on each rung: under $1M at 5–7× to small DSO tuck-ins or individual buyers, $1M to $3M at 7–9× to regional DSO add-ons, $3M to $5M at 9–11× to emerging platforms, and $5M+ at 11×+ in select cases to platform buyers. FOCUS also cuts the same market by deal type rather than by size, at 9–11× for platform transactions and 5–8× for add-ons, with revenue multiples around 1.0–1.8×. McLerran & Associates lays out four tiers of its own but attaches a figure to only the top one, platform-grade groups above $5M in adjusted EBITDA at 10x to 12x or more, and describes the three tiers below it as lower range, mid-to-upper range and higher range with no numbers on them. On specialties, neither firm publishes an absolute band for orthodontics, oral surgery or pediatric dentistry. McLerran says specialty practices earn a premium over general dentistry at comparable size, and that the premium "often falls in the range of 1 to 3 additional turns of EBITDA." Worked example on the FOCUS ladder: a practice at $800K of adjusted EBITDA sits on the under-$1M rung, so 5–7× puts it at $4.0M to $5.6M. Grow the same practice to $3.5M of adjusted EBITDA and it moves two rungs up to 9–11×, or $31.5M to $38.5M. The gap is scale, not clinical quality, which is why building toward a second and third location is the highest-return exit preparation available to most owners. Move down within your rung for heavy Medicaid concentration, production concentrated in one provider, and a lease with under five years remaining. Buyers scrutinise trailing-twelve-month EBITDA line by line, so the earnings figure you negotiate from matters as much as the multiple. Run your numbers in the dental valuation calculator before you anchor on any offer.
| Segment | Published multiple | Source |
|---|---|---|
| Under $1M adjusted EBITDA (small DSO tuck-ins, individual buyers) | 5–7× | FOCUS Investment Banking (Dec 2025) |
| $1M to $3M adjusted EBITDA (regional DSO add-ons) | 7–9× | FOCUS Investment Banking (Dec 2025) |
| $3M to $5M adjusted EBITDA (emerging platforms) | 9–11× | FOCUS Investment Banking (Dec 2025) |
| $5M+ adjusted EBITDA (platform buyers) | 11×+ (select cases) | FOCUS Investment Banking (Dec 2025) |
| General dentistry / DSO, add-on acquisition | 5–8× | FOCUS Investment Banking (Dec 2025) |
| General dentistry / DSO, platform transaction | 9–11× | FOCUS Investment Banking (Dec 2025) |
| Platform-grade, $5M+ adjusted EBITDA | 10x to 12x+ | McLerran & Associates (Jul 2026) |
| Specialty premium over general dentistry | +1 to +3 turns | McLerran & Associates (Jul 2026) |
No index publishes dental transaction multiples; every row above is one advisory firm's own published figure. FOCUS publishes an EBITDA-size ladder and names the buyer type on each rung. McLerran lays out four tiers of its own but puts a figure on only the top one, describing the three below it as lower range, mid-to-upper range and higher range. The two are not sourced the same way: FOCUS publishes data from the transactions it brokers itself, while McLerran attributes its table to market sources it does not name. Neither publishes an absolute multiple for orthodontics, oral surgery or pediatric dentistry, only the relative specialty premium shown here.
Work out your adjusted EBITDA
The multiples above apply to normalised earnings, not to revenue and not to the profit on your P&L. This calculator works that number out: your compensation added back, the market cost of covering your clinical work taken off, plus add-backs you can evidence. It shows every step and applies no multiple of its own.
Inputs
Your practice
The bottom line your P&L already shows for a full year, after rent, staff, supplies, billing and your own compensation.
Salary, distributions and personal expenses running through the practice. A buyer adds this back, because what you choose to take out is not a cost of running the business.
Salary, benefits and payroll tax for an associate who would carry your caseload. Use a figure from your own market: what you last paid an associate, or what a recruiter quoted you. There is deliberately no default here, because provider pay varies too much by specialty and region for a guess to help you.
Costs that will not repeat under a new owner, and only the ones you can evidence line by line. If you cannot produce the invoice, leave it out. A buyer will.
Adjusted EBITDA
Enter your profit and what you paid yourself. Nothing is calculated from figures you have not entered, so this panel stays empty until then.
Every figure on this panel is arithmetic on the numbers you typed in. Nothing is asserted about the market, nothing is stored, and nothing is sent anywhere. It is a normalisation for planning, not a valuation opinion, and no transaction should be priced from it.
FOCUS publishes multiples by adjusted EBITDA with a buyer type on each rung: under $1M at 5–7× (small DSO tuck-ins or individual buyers), $1–3M at 7–9× (regional DSO add-ons), $3–5M at 9–11× (emerging platforms), and $5M+ at 11×+ in select cases (platform buyers).
Source: FOCUS Investment Banking — Dental Practice EBITDA (Dec 2025)
General Dentistry / DSO: 9–11× EBITDA for platform transactions, 5–8× for add-ons, with typical revenue multiples of ~1.0–1.8×.
Source: FOCUS Investment Banking — Dental Practice EBITDA (Dec 2025)
Platform-grade groups above $5M in adjusted EBITDA price at 10x to 12x or more. McLerran leaves its three lower tiers unnumbered, and says specialty practices earn a premium over general dentistry that "often falls in the range of 1 to 3 additional turns of EBITDA."
Source: McLerran & Associates — DSO Dental Practice Multiples 2026
In 2022, 13% of U.S. dentists were affiliated with a DSO, up from 10.4% in 2019 and 8.8% in 2017 — and 27% of dentists who graduated five or fewer years ago.
Source: ADA Health Policy Institute — Practice Modality by the Numbers
What this means for clinic owners
From Sorso
The single biggest driver of your dental practice multiple is scale. FOCUS roughly doubles the multiple between the bottom rung of its ladder and the top, and applies that higher multiple to a much larger earnings base, which is why building toward a second and third location is the fastest route to a materially different exit. What no source quantifies is how quickly a given practice climbs, so treat the ladder as direction, not a timetable.
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What does a medical practice valuation cost?
A formal medical practice valuation costs $5,000 to $25,000 depending on practice size, purpose (sale, divorce, partner buy-in, estate), and whether you need a calculation engagement (lower cost, narrower scope) or a full opinion of value (higher cost, defensible in court).
How do PE firms value medical practices?
Private equity firms value medical practices primarily on a multiple of trailing twelve-month adjusted EBITDA, typically 5x to 12x, with the multiple driven by scale, growth, payer mix, and provider retention.
What is the difference between platform and add-on multiples?
Platform acquisitions trade at 8x to 14x EBITDA — the buyer pays for scale, infrastructure, and management. Add-on acquisitions trade at 4x to 7x EBITDA because they bolt onto an existing platform. The same practice can be worth 2× more depending on which the buyer needs.
How much will a DSO pay for my dental practice?
DSOs typically pay 5x to 8x EBITDA for single-location dental practices, and 8x to 11x for multi-location platforms with $1M+ EBITDA. Consideration is split: 60–75% cash at close, 15–30% rollover equity, the rest in earnouts tied to retained EBITDA over 12–36 months.
What is a good profit margin for a dental practice?
A healthy general dental practice runs 35 to 45 percent owner profit margin (pre-tax, including owner comp). Normalized EBITDA margin runs 18 to 28 percent after market-rate clinical and management compensation. Below 30 percent owner margin signals a problem worth investigating.
How long does it take to sell a medical practice?
Selling a medical practice to a PE buyer typically takes 6 to 12 months from engagement to close, with 2 to 3 months of prep, 1 to 2 months of marketing, 2 to 3 months of diligence and negotiation, and 1 to 2 months for definitive documents and closing.
How do medical and dental practice partnership buy-ins typically work?
A practice partnership buy-in is the structured purchase of an equity stake by an associate from existing owners, typically priced as a pro-rata share of fair market value (tangible assets plus goodwill) and financed over 3 to 7 years through a combination of cash, seller note, and reduced compensation. The mechanics vary widely by specialty but the underwriting questions are the same: what is the practice worth, what are you buying, and how does the cash flow service the debt.
Founder of Sorso and a CFA charterholder. Before Sorso, Stan spent 19 years in corporate finance at institutions including UniCredit and Société Générale — managing a $450M loan portfolio and making senior partner at a major mezzanine lender by 29 — then built a fractional CFO firm exclusively for outpatient healthcare clinics.
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