INDUSTRY

A new deep dive into 8,500+ dental practices shows a growing winners-losers divide

The gap between the winners and losers in dentistry is growing, and the difference is in how well they are executing on the basics, according to an exclusive first look at data shared with The Morning Grind.

What's happening: Planet DDS just released a deep dive analysis of more than 8,500 practices and 497 DSOs operating on its Denticon and Cloud 9 platforms, which paints a picture of an industry bifurcating sharply. Top performers are running away from the field, the bottom is sliding, and the middle is eroding.

• The industry is splitting into winners and losers. A third of dental practices grew by more than 10% last year. Nearly 14% shrank by 10% or more.

• New patients are the single strongest growth predictor. Practices seeing 75+ new patients per month grew at 9.0%, nearly double the 4.5% rate of practices below 35. The report identifies 35 new patients per month as the threshold where momentum starts compounding. Below that, practices are essentially treading water.

• Operational consistency drives growth. The report found the most consistent 10% of practices grew 6.1% while the most volatile 10% shrank 3.4%. Consistent offices also produced meaningfully more per day ($9,927 vs. $7,189).

• Efficiency beats size. Practices generating more than $300,000 per chair grew 8.73% vs. 5.31% for those under $50,000 per chair. The report flags roughly 1,050 practices in its dataset as "big but inefficient," averaging 44 chairs but only $56,000 in revenue per chair.

• There's a danger zone in the middle of the DSO scale curve. DSOs with 26–50 offices grew just 2.8%, less than one-third the rate of smaller DSOs. Only 55% of their offices were growing, the lowest of any size tier. These DSOs appear to be experiencing an awkward adolescence: too big to be nimble, too small to justify enterprise-scale infrastructure.

• Case completion, not acceptance, is the bottleneck. Patients accept 58% of treatment plans on average but complete just 47%. Counterintuitively, practices with a moderate gap between the two (10 to 30 percentage points) grew fastest at around 7%, while those with no gap grew just 2.9% and those with massive 50 point or greater gaps grew only 1.1%. The data suggests healthy practices will typically have a mild acceptance-completion gap, but one that becomes too large likely signals operational problems.

• The billing gap is enormous. Across 499 DSOs analyzed, the report estimates that roughly $1.66 billion (24.5% of gross production) leaked between care delivered and cash collected, driven primarily by point-of-service collection gaps and insurance shortfalls.

And don’t forget the Friday opportunity: The report found than average Friday production runs 27% below Tuesday peak ($7,388 vs. $10,152), which is not a surprise, but interestingly the 9% of practices that flip the script—making Friday their peak day—grow at 12.0% vs. 6.2% for everyone else.

Why it matters: The data confirms what every baseball fan knows: The most important thing is fundamentals. Operators on the winning side of the sector are excelling on the basics like filling the top of the funnel, keeping consistent schedules, and closing the loop between accepted and completed treatment. 

Go deeper: Download the full report to get a complete breakdown of all the data and see how your business stacks up against benchmarks on patient acquisition, revenue per chair, cancellation rate, acceptance-completion gap, and more.