The Pros and Cons of Starting a Dental Practice from Scratch vs. Buying an Existing One

Launching your own dental practice is more than a career move—it’s a defining moment in your professional journey. One of the biggest choices you'll face is whether to build a practice from the ground up or invest in an existing one. While the idea of creating something entirely your own may sound exciting, it also comes with significant challenges.

On the other hand, buying a dental practice can fast-track your path to ownership with less risk and quicker profitability. Whether you're a recent graduate ready to take the leap or an experienced associate weighing your next step, understanding the strengths and drawbacks of each route is essential to making a confident, future-focused decision.

Top 5 Key Considerations To Make An Informed Decision

If you’re ready to become a dental practice owner, your first major decision is whether to start from scratch or buy an existing dental practice. Each path has unique advantages and challenges. What’s most important is aligning your choice with your goals, financial readiness, risk tolerance, and professional vision.

Let’s break down the most critical factors that should guide your decision:

1. Timeline to Profitability

Starting a practice from the ground up requires time to build patient flow, credibility, and revenue. On average, scratch-start dental offices take 12–24 months to reach breakeven. Buying an existing practice, on the other hand, provides you with immediate income from an active patient base, making it easier to cover operating costs and loan repayments from day one.

2. Access to Financing

Lenders often view a dental practice to buy as less risky than a startup because it comes with predictable revenue. Established practices have financial records, allowing banks to assess historical performance. Startups typically require a more detailed business plan and may receive less favorable loan terms unless you have significant assets or cosigners.

3. Operational Infrastructure

An existing practice already has working systems—billing software, staff routines, insurance processes, and vendor relationships—which saves time and stress. Starting from scratch requires you to build everything from zero, including staff recruitment, technology setup, and legal compliance.

4. Cost of Entry

Startups can cost just as much—or more—than acquisitions. When you add up build-out expenses, permits, marketing, and dental equipment for sale, a new office can exceed $500,000 before you even open the doors. Buying an existing practice may offer better value, especially when you consider the goodwill and existing revenue.

5. Risk vs. Control

If you want full control and creative freedom, a scratch start offers a clean slate. However, with it comes higher risk and delayed returns. Buying a practice means inheriting someone else's systems, but it typically provides a faster, safer return on investment.

Ultimately, the best decision depends on your professional goals, financial comfort zone, and readiness to manage either a new build or an inherited operation. Both options require careful planning, but many dentists find that buying gives them a head start toward long-term success.

Why Buying a Dental Practice Often Wins: A Closer Look at the Pros and Cons

When it comes to setting up a successful dental career, both routes come with trade-offs. But buying an existing practice often proves to be the more strategic move, especially from an investment and operational perspective.

The Pros of Buying a Dental Practice

1. Immediate Patient Flow and Revenue

Buying a practice means you acquire an existing patient base, often numbering in the thousands. This gives you a jumpstart—patients are already accustomed to visiting that location and relying on its services.

A 2023 ADA study found that the average gross billings for a general dental practice owner were over $218,710 annually, with many established practices hitting this benchmark or higher. Starting from scratch often requires years to reach the same level of income.

2. Established Systems and Team

Existing dental practices come with staff, systems, workflows, and processes in place. From billing systems to insurance credentialing, a turnkey environment can reduce the stress and steep learning curve of launching a new clinic.

3. Predictable Cash Flow and Financing Benefits

Banks are typically more comfortable financing a Dental Practice to buy rather than a startup. The reason? Proven cash flow. When a practice already demonstrates profitability, lenders view it as a lower risk investment, giving you access to better interest rates and terms.

4. Location, Location, Location

Established practices are often situated in proven, high-traffic areas with good visibility. Securing medical commercial real estate in a desirable location can be challenging and expensive if you’re starting from scratch.

5. Lower Marketing and Branding Costs

With brand awareness and a known local presence already built, your need for initial marketing is reduced. You’re not introducing a new business to the community—you’re continuing one that already has trust and reputation.

The Cons of Buying a Dental Practice

While buying offers many advantages, there are considerations to keep in mind:

1. Inherited Reputation

If the previous dentist had poor relationships or questionable treatment standards, it may take time and effort to rebrand and rebuild trust.

2. Possible Equipment Obsolescence

While you inherit a functioning practice, some dental equipment for sale might be outdated or incompatible with modern technology. This could require capital investment post-purchase.

3. Staff Resistance to Change

Existing teams may be resistant to your new management style or policies. While many transitions go smoothly, it’s important to lead with transparency and respect.

The Reality of Starting a Practice from Scratch

Though it sounds appealing to create your dream office from the ground up, the startup route isn’t for everyone.

The Pros of Starting from Scratch

1. Full Control

From the name of the practice to the layout of the operatories, starting from scratch offers complete freedom. You get to implement your own systems, culture, and brand from day one.

2. Modern Technology

You can invest in new medical equipment for sale suited to your style of dentistry without having to work around outdated systems or hardware.

3. Custom Patient Demographics

By choosing your location and services carefully, you can shape your patient base and niche offerings from the start.

The Cons of Starting a Dental Practice

1. Slow Ramp-Up

It can take 12 to 24 months before a scratch practice reaches financial stability. Meanwhile, you’re paying rent, staff, marketing, and loan payments—with limited revenue coming in.

2. Hefty Upfront Costs

Startup dental practices typically require $350,000–$550,000 in financing. This includes leasehold improvements, equipment purchases, working capital, and marketing spend.

3. Higher Risk

Without historical revenue to show lenders, obtaining practice financing may come with stricter terms or personal guarantees. Also, startup failure rates are higher than those of acquired practices.

Buying Offers a Head Start, Stability, and Smart ROI

While the freedom of building from scratch is appealing, the financial and operational benefits of buying often outweigh the creative flexibility. For most dentists, acquiring an existing practice offers a faster route to profitability, fewer startup headaches, and a built-in patient base that delivers immediate revenue.

If you're weighing both options, take time to evaluate your personal goals, risk tolerance, and financial standing. But know this: when you find the right listing, buying can be one of the smartest investments you make in your dental career.

Looking for the perfect opportunity to buy?

The PracticeFinder App is your all-in-one solution for finding the right Dental Practice for sale or Private practice for sale near you. With verified listings, direct broker access, and real-time alerts, it’s the easiest way to buy with confidence.

Download the PracticeFinder App today and explore dental practices near you ready for acquisition.