By Wesley W. Lyon II, CPA, CFP

My company has seen more change in the business side of dentistry over the last decade than we saw in the previous few decades combined. Most of this change is centered around private equity entering the marketplace, looking to acquire practices. Equity firms’ strategy revolves around creating economies of scale and receiving higher multiples on much larger businesses — versus lower valuations of single dental practices. While I am not for or against private equity in dentistry, I am very much for transparency. The cold reality is that many private practices have sold to private equity firms based on misleading information. This results in an influx of associates willing to work for private equity dental practices that might not offer them the possibility of ownership. This means that big money is being funneled into messaging that may not be in the best interest of dentists. In this quarter’s column, I will try to debunk some of the biggest myths around practice ownership.

Myth 1: Young Dentists Are Not Buying Practices

I recently spoke to a dentist here in Charlotte, North Carolina, who was considering selling to private equity based on the notion that young dentists aren’t purchasing practices. She was shocked when I told her that I could have the practice sold within five minutes, even more so when she realized I was serious. Here in Charlotte, five minutes might have been an overestimate of the time required to sell a practice at 100% of revenue. The truth is, there are more private buyers in Charlotte than there are sellers — it’s not even close. My company estimates there are at least 15 buyers in Charlotte for every practice for sale.

Diving a bit deeper into our internal data nationally, we found that practices took, on average, 305 days to sell privately in 2023. In 2024, that number decreased to only 177 days. Through September 2025, practices on average took only 162 days to sell. What is driving this trend? The answer is simple: Inquiries from buyers on good practices are up, indicating more buyers in the marketplace.

According to the American Dental Association’s Health Policy Institute, practice ownership has been delayed, not reduced, with over 80% of dentists owning practices 15–19 years after graduation.(1) The bottom line is that young dentists are buying practices, but the definition of “young” has changed. A 28-year-old is unlikely to be in the marketplace, but a 35-year-old is.

Myth 2: Young Dentists Cannot Afford to Buy Practices

According to the American Dental Education Association, the average student loan debt for the dental Class of 2024 was $312,700.(2) Most dentists assume that this means they cannot afford more debt. This couldn’t be further from the truth; the fastest way to get out of student loan debt is to increase your income by purchasing a practice. Over the last few years, one of the most sought-after presentations I have given is “Why You Can’t Afford to Not Buy a Practice.”

Unfortunately, for the last seven to 10 years, young dentists have heard they can’t afford to buy practices, often lured by large signing bonuses and salary expectations from corporate groups that may not always come to fruition. While the increased student loan debt and corporate offers have certainly had an impact on young dentists, have they really stopped buying practices?

Why Are Dentists Delaying?

My next point is pure speculation. A 28-year-old dentist making $200,000 per year is not going to feel squeezed until they start a family. With Americans today in general waiting longer to have children than previous generations, additional responsibility may not be top of mind. For those readers with children, we all know how quickly your income can disappear with a mortgage, car payment, daycare, etc. Eventually, reality strikes, and increased income becomes a priority. I have also heard from many young dentists who started to work for corporate dental offices that they have become increasingly unhappy. Common complaints include excessive workloads, lack of independence regarding decision-making, lackluster staff and lack of income.

In good news, the tides seem to be shifting. In my experience over the last decade, my speaking engagements had been largely eliminated from dental schools in favor of donors that have a different message. Over the past two years, however, I have been invited back by part-time faculty senior dentists looking to get the message of ownership instilled in the younger generation. The younger generation also seems to be learning from the experiences of their slightly older peers. I recently spoke to a group of young dentists and full-heartedly believed I’d hear them say that corporate dentistry was their only option. To my surprise, most of them had stories to tell about friends regretting not purchasing a practice earlier.

Myth 3: Banks Will Not Lend to Young Dentists Due to Student Loans

This couldn’t be further from the truth. I recently had a conversation with Kameron Barton, Bank of America regional business development officer, and he explained that student loan balances of $500,000 or less will not usually impact approval, and balances of more than $500,000 do not mean rejection, but rather require additional analysis to ensure cash flow supports the deal. Instead, young dentists need to focus on what does matter to the banks — having 7%–10% of purchase price in liquidity (in a checking or taxable brokerage account) and a production history showing 80% of the selling dentist’s work.

Not only can young dentists be approved for loans, but rates these days are less than mortgage rates, with recent deals being approved at 5.25% or less. The best part for young dentists — even after accounting for the loan payments and taxes — is that take-home pay is higher as an owner than it is as an associate (assuming a properly valued practice and similar production numbers).

Final Thoughts

Young dentists are buying practices, although not as quickly as previous generations. High-income practices in desirable areas are becoming increasingly easy to sell, with sales prices increasing due to demand. Practices in more rural areas still take longer to sell, but they are selling privately. To all young dentists: Practices in more rural areas have less insurance, less competition and higher profits and sell for less money. With less demand than in major urban areas, the smart thing to do is seek out practices in small towns with high profits.

I recently had a young dentist approach me after my “Why You Can’t Afford to Not Buy a Practice” presentation to explain he took good advice from an older dentist and purchased a practice two hours outside of Charlotte. The results were astounding. At 34 years old, he only had $62,000 of debt to his name, including student loans, a home mortgage, an office building loan and a practice acquisition loan. When he wants a weekend away with his wife, he simply brings in a nanny or grandparents and heads to the Charlotte airport with his wife, staying at nice hotels and living worry free.

For young dentists: Start your journey to ownership sooner rather than later. You won’t regret it. To the senior dentists: Corporate is an option, but by no means is it your only option. Young dentists are buying practices, and demand has been substantially increasing over the last few years.

Wesley W. Lyon II, CPA, CFP, is president and CEO of McGill and Lyon Dental Advisors. For more information on his firm’s comprehensive tax and business planning services for dentists and specialists, contact Danielle Fitzgerald at 877.306.9780, or email consulting@mcgillhillgroup.com. To comment on this article, email impact@agd.org.

References

1. “The U.S. Dentist Workforce.” American Dental Association Health Policy Institute, 2025, ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/us_dentist_workforce_2025.pdf. Accessed 1 Oct. 2025.

2. American Dental Education Association. “Educational Debt.” ADEA GoDental, adea.org/godental/Apply/financing-dental-education/educational-debt. Accessed 11 Sept. 2025.