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The 9 Biggest Mistakes Dentists Make When Starting a Practice (and How to Avoid Them Like a Pro)

Written by Stephen Trutter | May 22, 2025 4:26:29 PM

Starting a dental practice is exciting—but also terrifying if you don’t have a clear roadmap. We’ve worked with over 900 doctors at Ideal Practices, and let’s just say we’ve seen what happens when good dentists walk straight into startup landmines.

The good news? You don’t have to.

If you’re planning to build from scratch—or even thinking about it—this guide will help you avoid the most common, most expensive, and most painful mistakes dentists make when opening their own practice.

Let’s dig in.

1. No Clear Vision or Business Plan (aka Flying Blind)

Opening your practice without a vision is like prepping a crown with no treatment plan. You're working... but it’s not going to end well.

Too many dentists dive into real estate, equipment, or lease negotiations without anchoring their decisions in a clearly defined vision. That’s your North Star. It guides your hiring, your culture, your marketing—everything.

What your business plan should include:

  • Your personal and professional goals (beyond “just open”)

  • Market analysis: Who are your ideal patients? What do they value?

  • Financial projections and cash flow

  • Patient acquisition strategy (not just “hope”)

  • Team structure and operational workflows

📌 Truth bomb: If you skip vision and planning, your practice might open—but it won’t grow with purpose. When you're starting a dental practice, this is where everything begins.

2. Underestimating Startup Costs and Cash Flow

Spoiler: it doesn’t matter how nice your buildout is if you run out of cash before your marketing kicks in.

Too many doctors think revenue will flood in immediately. Reality? It takes months to fill your schedule. And if you don’t plan for that, you’ll feel it in your bank account fast.

What to budget for (and not forget):

  • Construction, equipment, and IT

  • Marketing for 6–12 months pre- and post-launch

  • Staff salaries, insurance, and software

  • Loan repayments (yes, those start even if you’re not profitable yet)

  • A cash reserve to cover at least 6 months of operating expenses

📌 Smart strategy: Get real quotes. Build in cushion. Budget for a ramp-up, not a rocket launch.

3. Choosing a Location Based on Foot Traffic Instead of Vision-Backed Strategy

“I found a space next to Starbucks. So much visibility!”

That’s cute. But we don’t choose locations based on coffee proximity or foot traffic. This isn’t a smoothie shop.

Ideal Practices uses the Three Ds of Demographics:

  • Desirability – Do YOU want to live and work here?

  • Data – What do the growth and competition trends look like?

  • Demographics – Are your ideal patients actually here?

📌 Location rule: The best site is where your future patients live, your lifestyle thrives, and your clinical vision can grow. If you're serious about starting a dental practice the right way, your location must reflect your long-term goals—not just short-term convenience.

4. Waiting to Market Until You Open (Way Too Late)

If you’re not marketing months before your doors open, you’re behind.

This isn’t “build it and they will come.” It’s “build it, promote it, and give first.”

Here’s what smart startups do:

  • Start building a VIP list 3–6 months before opening

  • Host local events, meet your neighbors, collect emails

  • Create a “Founding Families” campaign that ties into your give

  • Partner with local schools, gyms, yoga studios—wherever your ideal patients go

  • Run geo-targeted ads and direct mail to get people EXCITED

Your goal? 200 people on your VIP list, ready to book, before your first chair is unwrapped.

📌 Marketing mindset: Build buzz early, connect with purpose, and open with momentum—not desperation. Starting a dental practice without a marketing runway is like drilling with no burs—nothing happens.

5. Hiring Too Fast… or Not At All (And Ignoring Culture)

You can’t do it all—but that doesn’t mean you need to hire a full team on day one either.

Early on, you might be answering phones and doing sterilization between patients. That’s okay. In fact, it’s necessary.

Because this phase is where you learn how to lead, how to run your systems, and how to build a culture that reflects your vision and your give.

As you grow, build slowly and strategically:

  • Hire for fit, not just experience

  • Train based on your values, not someone else’s habits

  • Document everything—your way is the right way for your practice

📌 Pro tip: You’re building a business, not a job. Lead from the beginning. The team culture starts with you.

6. Overlooking Legal and Compliance (Because “I’ll Handle It Later” Never Works)

Compliance isn’t a side quest—it’s a core system in your startup. And it starts way before you open your doors.

At a minimum, you'll need to:

  • Secure proper licensing and permits

  • Set up OSHA- and HIPAA-compliant systems

  • Understand zoning and lease obligations

  • Get malpractice and liability insurance

  • Build a legal structure that supports growth

Too many dentists wait until the end and get burned by delays, rework, or worse—violations.

📌 Reminder: Just because something “looks” ready doesn’t mean it’s legally safe. When you're starting a dental practice, legal missteps are the most expensive ones to fix.

7. Overspending (or Underspending) on Equipment and Tech

Here’s the secret: you don’t need to equip all your ops right away.

Startups that succeed equip just what they need to launch well—and no more.

For most, that means:

  • 2–3 fully equipped ops to start

  • Everything wired/plumbed for future growth - you do NOT want to be digging up concrete to plumb those ops after you open

  • Core gear that’s ergonomic and reliable

  • Software that integrates your EHR, billing, and imaging

Avoid the trap of buying the fanciest, flashiest setup because your rep said “this is what everyone’s doing.”

📌 Startup math: Equip for today. Plan for tomorrow. Scale when you’re ready.

8. Not Knowing the Numbers (Until They’re a Problem)

Let’s cut to it: you can’t improve what you’re not tracking.

Yes, your clinical work matters—but if your practice is losing money every month, you’ll feel it fast. And fixing it gets harder the longer you wait.

You don’t need to be a spreadsheet genius, but you do need to know:

  • How many patients are coming in each week

  • What your monthly collections are

  • What it costs to acquire a new patient

  • What your overhead is doing to your profits

📌 What we teach during the StartupMBA phase of our 13 stage startup process: You’re not “just a dentist” anymore. You’re a practice owner. Know your numbers—or pay the price.

9. Doing It All Alone (The “I’ll Figure It Out” Trap)

We see it all the time. Talented, smart, passionate dentists trying to wear every hat at once: doctor, CEO, HR, marketing director, lease negotiator, IT.

It’s exhausting. And usually ends in burnout or backpedaling.

Here’s the truth: you don’t need to do it all. But you do need the right plan, support, and guidance.

That’s why Ideal Practices exist. We’ve built the systems, tools, and support to help you:

  • Open on time, with patients already booked

  • Create startup-specific business systems (not generic fluff)

  • Build your practice DNA before you open

  • Attract the team and patients who align with your mission

📌 Our belief: You only get one shot to open your dream practice the right way. Don’t wing it.

Final Thoughts: You’re Not Just Starting a Practice. You’re Building a Legacy.

Avoiding these mistakes isn’t about being perfect. It’s about being intentional.

  • Intentional with your vision
  • Intentional with your money
  • Intentional with your systems, your team, your give

Because this isn’t just about launching a business—it’s about building the life you’ve imagined since dental school.

You can do this. And if you want a team behind you who’s done it hundreds of times, we’d be honored to help.

🚀 Ready to Take the First Step?

Your practice, your path—let’s map it out together.

In your free Private Practice Strategy Session, you’ll meet 1-on-1 with a dental startup and acquisition expert to explore your options, identify hidden pitfalls, and walk away with clarity about what’s next.

Whether you’re dreaming of starting a dental practice or considering a smart acquisition, we’ll help you move forward with confidence.

👉 Click here to request your Private Practice Strategy Session

FAQs

Q1: How much capital do I need to start a dental practice?
The required capital varies by location, size, and services but generally ranges from $450,000 to over $800,000. Budget carefully for equipment, space, staffing, and marketing.

Q2: When should I start marketing my dental practice?
Start marketing at least 3-6 months before your opening day to build awareness, attract new patients, and ensure a full schedule from day one.

Q3: Can I acquire an existing dental practice instead of starting from scratch?
Yes, acquiring an existing practice can reduce startup risks and provide immediate patient flow. However, it requires careful due diligence and financing strategy.