Tune in to our podcast series: The Dental Board Room
Listen Now
For many dentists, owning and operating a thriving single-location practice is a major professional milestone. After years of hard work building a loyal patient base, a great team, and a profitable operation, it’s natural to think, “Why not do this again?” The idea of expanding to a second location is tempting—and on paper, it often seems like a smart next step. But in reality, the transition from one successful office to two is one of the most difficult moves a dentist can make.
Here’s why: A dentist can only be in one place at one time. And in most practices, the success of the business is directly tied to the presence and leadership of the owner-dentist. When that presence is split, the ripple effects are immediate. The original location, once the hub of daily energy and attention, can start to suffer—declining collections, reduced staff morale, and patient attrition are common symptoms. Meanwhile, the new location rarely launches at full speed. It takes time to ramp up patient volume, recruit and retain a capable team, and iron out operational kinks.
Adding to the challenge is the cost structure. Dental practices carry substantial fixed overhead—rent, payroll, insurance, and equipment leases—that don’t go away just because the doctor is off-site. Opening a second location can nearly double the fixed expenses, while the practice owner can still only produce at one location at a time. Most associate dentists, while skilled clinicians, rarely have the same ownership mindset. It’s difficult—if not unrealistic—to expect them to drive a new business with the same passion, accountability, and hustle as the founder.
What’s more, managing multiple practices requires an entirely different skillset than running one. It’s not just about dentistry anymore—it’s about systems, delegation, leadership development, and financial management across a more complex structure. These business muscles take time to build, and missteps are costly.
That’s why so many dentists who pursue multi-location ownership eventually feel overwhelmed and undercompensated. One of the most common outcomes is that the first location ends up subsidizing the losses of the second. And if a third office is attempted before the business model is truly scalable, the problems compound.
This isn’t to say that multi-location success is impossible. Some dentists do pull it off—but only after years of preparation, a strong team, excellent systems, and a high tolerance for risk. Even then, many who’ve succeeded will admit: it was far harder than they imagined.
For most, the best path to increased profit and satisfaction is not opening more doors, but growing within your existing four walls. Maximizing operational efficiency, expanding patient services, and investing in marketing and training can often yield better returns with far less risk.
Expansion may still be the right move—but go into it with eyes wide open. The business side of dentistry is a discipline all its own, and mastery takes time, intentionality, and humility.
Wes knows what's best for dental practices. He's been doing this for a long time and he sees lots of practices. He can tell me how our practice is doing, and what we can do to increase our productivity. With past CPA's, there were no ideas. It was all coming from me, saying "I think I can do better, but I don't know how." I come in to meet with Wes and he says "You CAN do better, and I know how."
PracticeCFO is in hundreds of dental offices around the country. They know what numbers should look like. They know what percentages of payroll, rent and supplies should be, and they will hold you accountable to those numbers, which will really help you stick to your plan and your path of growth and savings. That is invaluable
Whenever something comes up, whether it's building or practice related and we weren't sure where the numbers would go, PracticeCFO has been instrumental in helping us figure that out. I can't say enough of how important that is - that it goes beyond that initial partnership. They make sure this business marriage works.
When I go home from work, I don't spend a whole lot of time stressing about what my books look like, or how much I owe in taxes. By using PracticeCFO, the burden of keeping track of a lot of the big financial numbers and metrics are taken off my plate.
PracticeCFO helped me develop a plan for the future. I have colleagues that work with other accountants that don't have a plan - they just look at the numbers of the practice and that's it. There's no plan for 10, 20 years from now. But with PracticeCFO, you get that. PracticeCFO makes you feel like you're they're only client.
(In reference to his practice sale) What could've been super stressful, wasn't! When picking John and Wes, it was from word of mouth recommendations and other people's experiences from the past that really did it for me. And it turns out that those recommendations were right on the line.
Wes knows the business side of dentistry. His comprehensive plan will organize your personal and professional finances so you can focus on taking care of patients. Massive ROI.
I can’t say enough good things about everyone at PracticeCFO. Everyone on the team is professional, organized, knowledgeable, helpful and kind. They also respond to emails and phone calls immediately and are always happy to help. They have helped me navigate year-to-year as a business owner. PracticeCFO gives me peace of mind that my business is in good hands.
I love Practice CFO! They have helped me obtain a practice and maintain a practice. They are incredible people who are on top of everything and make owning and running the business portion of a practice easy. They couldn’t be better for my business and my sanity. They have every detail of the business and taxes taken care of where all I have to do is show up and follow their easy steps to success!
Practice CFO has the best tools I’ve seen for personal tax and financial planning in addition to top-tier corporate tax and accounting services. I have been very pleased with the level of quality service. They manage my monthly bookkeeping and accounts payable. It is a great system and saves me a ton of time, and it allows us to have monthly financial statements within a week of month end.
This will close in 0 seconds
