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 10–12× 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.
Thinking about selling in the next one to three years?
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 10–12× 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×; one of its tables widens the platform band to 9–12×. 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. McLerran lists what moves a practice down within its rung: Medicaid or HMO concentration above 40% of collections, which it says can take 0.5x to 1.0x off the multiple, production concentrated in one doctor, and a lease with fewer than five years remaining. Buyers scrutinize 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 (Apr 2026) |
| $1M to $3M adjusted EBITDA (regional DSO add-ons) | 7–9× | FOCUS Investment Banking (Apr 2026) |
| $3M to $5M adjusted EBITDA (emerging platforms) | 9–11× | FOCUS Investment Banking (Apr 2026) |
| $5M+ adjusted EBITDA (platform buyers) | 10–12× (select cases) | FOCUS Investment Banking (Apr 2026) |
| General dentistry / DSO, add-on acquisition | 5–8× | FOCUS Investment Banking (Apr 2026) |
| General dentistry / DSO, platform transaction | 9–11× (9–12× in one FOCUS table) | FOCUS Investment Banking (Apr 2026) |
| 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 sourced differently: FOCUS says its tables draw on the reports it cites (TUSK Practice Sales, VMG Health and others) and its own knowledge, while McLerran attributes its table to 2026 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 EBITDA size 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 10–12× in select cases (platform buyers).
Source: FOCUS Investment Banking: Dental Practice EBITDA Multiples 2026 (Apr 2026)
FOCUS prices general dentistry and DSO deals at 9–11× EBITDA for platform investments and 5–8× for add-ons, with typical revenue multiples of about 1.0–1.8×; its benchmark table widens the platform band to 9–12×.
Source: FOCUS Investment Banking: Dental Practice EBITDA Multiples 2026 (Apr 2026)
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. The add-backs and the normalized EBITDA are the part you control, and a dental practice CFO builds that file over the year before you talk to a buyer; the dental practice valuation calculator shows what each add-back is worth at your rung of the ladder.
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What does a medical practice valuation cost?
A formal medical practice valuation costs from about $2,500 to $50,000 or more, depending mainly on the type of engagement and what the valuation is for. Peak Business Valuation puts a typical medical practice valuation at around $2,500 to $8,000 or more, while Nouvelle Analytics, a valuation firm, quotes $4,000 to about $10,000 for a calculation engagement and $8,000 (summary report) to $50,000+ (detailed report) for a full valuation engagement.
How do PE firms value medical practices?
Private equity firms value a medical practice as a multiple of its trailing-twelve-month adjusted EBITDA, and the multiple rises with scale. Published ladders run from 2.5–4x for a single owner-operated physical therapy clinic (Breakwater M&A) to 10x–20x for large primary care platforms (Scope Research), and payer mix, growth and owner dependence move a practice within its band.
What is the difference between platform and add-on multiples?
Platform acquisitions trade at higher EBITDA multiples than add-ons because the buyer is paying for scale, management and a base to acquire from, while an add-on brings its earnings into a platform that already has those things. In dental, FOCUS Investment Banking puts platform investments at 9–11× EBITDA and add-on acquisitions at 5–8×.
How much will a DSO pay for my dental practice?
DSOs typically pay 5x to 8x EBITDA for an add-on practice of one to three locations and 9x to 11x for a platform-size group, according to FOCUS Investment Banking; Jaffe Law, a dental M&A law firm, puts typical DSO offers for individual practices lower, at 3x to 5x EBITDA or 80% to 100%+ of collections. Only 60% to 80% of the price usually arrives as cash at closing, per Jaffe Law; the rest is rolled equity and an earnout, which Jaffe puts at 20% to 40% and 10% to 30% of the price. Those are separate ranges, so a deal that uses both sits in the lower half of each.
What is a good profit margin for a dental practice?
A healthy general dental practice keeps 35 to 45 percent of collections for the owner (pre-tax profit plus owner pay). That is a Sorso estimate: it is what remains after the 55 to 65 percent overhead range ZenOne cites from Overjet's 2025 data, and Overjet's national median overhead of about 62 percent leaves about 38 percent. Pay the owner a market salary for the dentistry and the normalized EBITDA margin is lower, and it rises with practice size.
How long does it take to sell a medical practice?
Selling a medical practice to a PE buyer usually takes about six to nine months from hiring an advisor to closing. FOCUS Investment Banking says its healthcare sell-side process typically takes 6 months, and broker Raincatcher puts a clinic or small-group sale at six to nine months: preparation and valuation in months one to two, marketing and offers in months two to five, and diligence, licensing and closing in months five to nine.
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 several 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.
How much does a dental practice owner make?
A general dentist who owns a practice earned $228,980 on average in 2025 and $199,140 at the median, according to the ADA Health Policy Institute's Survey of Dental Practice. Specialist owners averaged $372,460 (median $259,550). Employed general dentists averaged $164,510, so on these figures owning a practice added about $64,000 a year on average and about $34,000 at the median.
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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