What Your Operatories Are Worth — Honestly
Here's the thing dental owners get wrong more than almost anything else when they start thinking about a sale. They count rooms.
"We've got six operatories." It comes out early in the first conversation, usually with the same tone you'd use to tell me the building has a new roof. And I get it — you paid for those rooms. You remember the build-out, the plumbing, the week the contractor disappeared. Six ops feels like a number that should show up in the price.
It doesn't. A buyer isn't paying for rooms. A buyer is paying for the production that runs through them. Six ops with four in use is a four-op practice with two expensive storage closets — and every experienced buyer and lender knows it within ten minutes of opening your schedule.
1. Understand How a Buyer Actually Prices a Practice
Let's get the math on the table first, because everything else in this post hangs off it.
In a private sale — one dentist buying from another — the price is driven by seller's discretionary earnings. SDE is your net income with your compensation, benefits, and the personal stuff running through the practice added back, less the cost of a replacement doctor to do your dentistry. Private-sale multiples typically land around 2.75x to 3.5x SDE. The second lens is percent of collections, which runs 70% to 85% of gross for a healthy general practice. A DSO or corporate buyer uses a different framework — EBITDA at 7x to 10x — but the point is the same. Every method starts with what the practice collects and what it keeps.
Notice what's missing. There is no line in any of those formulas for "number of chairs." Operatories show up in the asset approach, which values the equipment itself — and a used chair and delivery unit are worth a fraction of what you paid, whether or not anyone sits in them. The rooms aren't the value. The dentistry that happens in them is.
So when you say "six ops," what a buyer hears is: "Producing what?"
Action Items / Food for Thought:
Pull your trailing twelve months of collections and your SDE. That's your price, not your floor plan.
Run both private-sale lenses — 2.75x–3.5x SDE and 70%–85% of collections — and see where they overlap.
If a buyer only saw the P&L and never the office, what would they offer?
2. Measure Production Per Operatory — Because the Buyer Will
Here's the metric that matters, and almost nobody tracks it: production per operatory.
Take a $1.2 million practice. Spread that across six ops and you get $200,000 per room. Spread the same $1.2 million across four ops and it's $300,000 per room. Same collections, same SDE, same price under every method above. But a buyer reads those two numbers very differently.
$300,000 per op says the practice is tight, the schedule is full, and the rooms are earning their keep. A buyer with any ambition sees a practice that needs more capacity — and a lender sees efficient use of the space.
$200,000 per op says something else. It says two rooms are idle, or all six are half-booked, and either way the practice is carrying more overhead than it needs — rent, utilities, maintenance, a bigger footprint than the production justifies. A buyer looks at that and starts wondering what else in the practice is running at two-thirds speed.
Same $1.2 million. One version makes the buyer lean in. The other makes them reach for a calculator — and not in a good way.
Action Items / Food for Thought:
Divide your annual production by the number of operatories you actually use. Then divide it by the number you have. The gap between those two numbers is your problem.
Benchmark it: a well-run general practice typically runs $250,000 to $350,000+ per operatory. Where do you land?
Do the same math for hygiene rooms separately — we'll get to why in a minute.
3. Separate Hygiene Rooms From Doctor Rooms
Not all operatories are the same, and a buyer knows it.
A hygiene room booked solid is some of the most valuable square footage in dentistry. It generates recurring revenue on a predictable cycle, it feeds the doctor's schedule with restorative diagnoses, and it proves the patient base is alive and coming back. A hygiene room at capacity with a recall backlog is a buyer's favorite line on the whole report.
An empty doctor op is the opposite — a room with no provider, no demand, and a monthly cost. If you've got two overbooked hygiene rooms and a third doctor op that sees a patient on Tuesdays when the mood strikes, your practice isn't "six ops." It's two hygiene rooms that need a third, and the fix is a schedule change, not a sales pitch.
Owners lead with their doctor rooms because that's where the big cases happen. A buyer reads your hygiene production line before they read your name on the cover sheet. Lead with the room that's full.
Action Items / Food for Thought:
Calculate hygiene production per hygiene room and doctor production per doctor op. Report them separately.
Check your recall: what percentage of active patients are scheduled for their next hygiene visit? Below 60% is a flag; above 80% is a selling point.
If hygiene is overbooked and a doctor op sits empty, consider reassigning the room. Yes, really.
4. Know When Unused Ops Actually Add Value
Now — I'm not saying extra rooms are worthless. There is a version of this where capacity is real money.
A buyer who plans to bring in an associate, run a specialist day for endo or perio, or merge a second doctor's patient base into your location can see those two empty ops as runway. That buyer will pay something for them — not full freight, but something.
Here's the trap: they'll only do it if you can prove the demand is there. "We could fill them" is a story. Stories don't finance. What finances is evidence — new-patient flow of 30 or 40 a month that you're booking out six weeks; a recall backlog you can't get to; a hygienist who could add a day if she had a room; a specialist who's already asked about renting a chair. Numbers, dates, a schedule screenshot.
If you have that, the empty ops stop being closets and start being a growth plan the buyer can underwrite. If you don't, the capacity argument evaporates the first time the lender asks for support.
Action Items / Food for Thought:
Track new-patient count monthly and time to the next available new-patient appointment. Both are the proof a buyer needs.
Document turned-away or delayed demand — specialist referrals you send out, hygiene patients booked more than four weeks out.
If a buyer put an associate in that room on Monday, would there be patients on Tuesday? If the answer is "eventually," that's a no.
5. Avoid the Renovation Trap
This one costs owners real money, so I'll be blunt.
Somewhere between "I'm thinking about selling" and "I've listed," a lot of dentists decide to build out. Add two ops. Finish the shell space. The logic sounds sensible: more rooms, more value, better first impression. The number I hear most often is $150,000 — and it's frequently higher once the plumbing, compressor, and nitrous lines are done.
Here's what happens at closing. The buyer values the practice on SDE and collections. The new rooms haven't produced anything, so they add nothing to either. The equipment inside them is used equipment the day it's installed. And the loan you took to build them is a liability you clear out of your proceeds.
So you spent $150,000 on rooms that generate no income, depreciate immediately, and don't move the multiple. Most of that money does not come back. A buyer who wanted more rooms would rather pay you less and build them to their own spec anyway.
Spend money before a sale on things that move SDE or collections — a recall campaign, a part-time associate, updated fee schedules, a long-overdue lease renegotiation. Don't spend it on plumbing.
Action Items / Food for Thought:
Before any build-out within 24 months of a sale, ask one question: will this room produce before I list? If not, don't.
Already mid-renovation? Finish it and fill it — an empty new room is worse than no room.
Put the same dollars against hygiene recall and marketing and watch collections.
6. Decide What to Do in the 12–24 Months Before You List
You've got two honest paths. Pick one and commit.
Path one: fill the rooms you have. Run the recall program hard — reactivate every patient who hasn't been in for 18 months. Move to block scheduling so the doctor's day isn't a quilt of 20-minute gaps. Bring in a part-time associate or a visiting specialist one or two days a week and give them the empty op. Twelve to twenty-four months of that and the production-per-op number starts to look like the $300,000 version. Now your six ops are six ops.
Path two: close them on paper. Present the practice as what it is — a four-op practice with room to grow. Report production per op on the four you use. Mention the extra rooms as expansion capacity with whatever demand evidence you have, and leave it at that. This isn't hiding anything. It's refusing to let one inflated number discount your whole practice.
What you shouldn't do is list "six operatories" at the top of the prospectus and let the buyer find out on their own. They always find out. And once they've caught one soft number, they go looking for more.
Action Items / Food for Thought:
Pick the path now. Twelve months out is the last point where path one still has time to show up in the financials.
If you're filling rooms, set a target: production per op up 20%–30% over the next 12 months, with the schedule to prove it.
If you're presenting as-is, make sure every number in the listing survives a lender's call.
Final Thought
Your operatories are not your value. They're where your value happens — and a buyer can tell the difference from across the room.
Six ops with four in use is a four-op practice. Say it that way, price it that way, or spend the next year making it untrue. Pretending is the only option that costs you money.
A buyer buys the production, not the plumbing. If you want to talk through what that looks like for your practice, the first conversation is on us.
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