Dental Construction Renovation: Should You Choose Character or Cost for Your Startup?

Dental Construction Renovation: Should You Choose Character or Cost for Your Startup?

If you're planning to open your own dental practice, there's a good chance you've considered a building with character—maybe even one that’s been standing for a century. Renovating a charming, historic space can sound like the perfect fit for your vision. But before you fall in love with exposed brick and original hardwoods, let's have a real conversation about dental construction and the tradeoffs involved.

At Ideal Practices, we've helped hundreds of doctors navigate these decisions. And we’ve seen firsthand how these choices can impact your timeline, your finances, and ultimately, the success of your practice.

Let’s unpack what really matters.

Renovation or Vanilla Box: What’s the Tradeoff?

This conversation comes down to one thing: Character vs. Cost.

That’s it. That’s the tension point.

Do you want a beautifully restored space that feels one-of-a-kind, or do you want to keep costs low and timelines clean with a “vanilla box” buildout?

There’s no universally right answer. But you do need to walk into this decision with your eyes wide open.

Why Dental Construction Renovations Often Cost More

You might assume renovating an old building would save money—after all, the purchase price may be lower, right? Not so fast.

Here’s what we’ve seen, again and again: dentists who choose renovations almost always end up paying more than they would in a new buildout. The surprises are real, and they can hit hard. If you’re considering this route, here are a few realities to factor into your planning:

3 Reasons Renovating an Office for Dental Use Gets Expensive

1. What’s Behind the Walls
   If you've watched any HGTV renovation show, you know this one: surprises lurk behind drywall. Mold, plumbing nightmares, structural concerns—they don’t show up on a tour, but they do show up on your bill. And they show up late in the process.

2. Retrofits Are Like Working Backwards
   Renovating for dental use means modifying an old structure to meet modern clinical demands. That means:

   • Demolition and reconstruction of interior walls

   • Extra plumbing and electrical for chairs and suction

   • Possibly adding an elevator or ADA-accessible ramp

   • Rebuilding bathrooms to meet modern code

   • Rewiring for digital tech and practice management systems

   We’ve seen renovation budgets run 1.5x to 2x higher than new builds—especially when it comes to second-floor treatment rooms or buildings that were never designed for healthcare.

3. Technology Doesn’t Like Old Buildings
   Want your ops wired for intraoral scanners, patient entertainment, and a modern phone system? In a new build, that’s seamless. In an old building? Those upgrades are often difficult and occasionally impossible without major workarounds (read: major dollars).

So, Should You Rule Out Renovation? Not Necessarily.

Let me be clear: we’ve helped clients create absolutely stunning practices in older spaces. One client turned a 1920s bank into a modern pediatric oasis. Another brought new life to a historic downtown storefront. And their practices are thriving.

But what did they all have in common?

They knew what they were walking into. They budgeted wisely. And they didn’t underestimate the time, money, or complexity of the project.

Here’s What You Should Ask Yourself Before Choosing a Renovation:

• Is this building in a location that sets me up for long-term success? (If not, start here instead: Startup Practice Blueprint)

• Am I okay with longer timelines and higher costs for the sake of design character?

• Have I built in at least 20% contingency for construction overages?

• Do I have a team that understands dental construction—not just commercial building?

Character Is Inspiring—But Strategy Wins

At the end of the day, your practice success won’t come from exposed beams or vintage tile. It will come from smart choices, clear vision, and a plan that reflects your values and goals.

We believe in helping doctors create offices they love—whether that’s in a new space or a repurposed classic. Just make sure you’re not seduced by charm at the cost of strategy.

Want help deciding what’s right for your vision?

Let’s talk it through. Schedule a complimentary consultation with our team and walk into your buildout with clarity and confidence:
Book your consult here

—Stephen Trutter