Step-by-Step Outline: Opening Your First Dental or Orthodontic Practice

Phase 1: Planning and Preparation (6–12 months before opening)

1. Clarify Your Vision

• Decide on type of practice: General Dentistry, Orthodontics, or both? Your choice will need to take into account your training and expertise, or the type of doctors that you wish to find to operate in your practice.
• Define your target patient demographic (e.g., families, high-end cosmetic, pediatric). The more specific you can get about your target audience, the better as this target demographic should be considered in all aspects of your business. What is the median income of families or individuals? What is the median age? What motivates the customers you hope to serve? Will you be working with Medicaid or private insurance only? Will you treat children, adults, or both?
• Choose between solo practice, partnership, or joining a group practice. This decision may be informed by your working style, goals, location, capital, and your personal training and certifications.

2. Conduct Market Research

• Analyze demographics and competition in potential locations. The office location is a critical factor in the success and production of your office. Look for a city, town or area where your target demographic is located. You might consider local and state taxes. When looking for an actual building, do you want to purchase, rent or lease an existing structure, or build on a lot? Consider the visibility of your business. If your practice is located on a main drag where your sign is clearly visible to computers and passersby, that’s less you’ll have to spend on marketing. How easy is your business to access by car or public transportation? Is the building on a busy street or divided highway that will make it difficult to enter and exit the premises? Is the building or location attractive and desirable to your target demographic? 
• Look at population growth, insurance coverage, and dental/ortho needs. If you have a few areas in mind, how are they trending? Areas that are growing mean a growing pool of potential patients. If you’re looking at pediatric dentistry and the area you’re considering has a shrinking population because younger residents are moving away, you’ll have a limited number of potential patients. Similarly if the area is largely retired folks and you’re a pediatric dentist, the population doesn’t match your business. 
• Insurance is a consideration if you’re looking at a specific area or building. Is the lot or building in a flood plain or in an area that is at high-risk for fires? If so, you’ll have higher insurance premiums to add to your monthly costs. 
• Visit existing practices to benchmark. If you have your eye on a certain city or area, visiting any nearby practices may help you decide if your practice can fit into the market. Seeing what is being offered gives you an idea of gaps in the market and how you might be able to fill them.

3. Create a Business Plan
Your business plan is crucial for guiding you on your new practice journey. It’s also often a critical step in securing business funding. Before a lender is prepared to back your business, they need to see what your business is and how you plan to make it profitable. Here are some crucial parts of your orthodontic business plan. For more details on creating a business plan for your orthodontic or dental practice, check out our Business Plan Checklist resource. 

1. Executive summary
2. Services offered
3. Market analysis
4. Operations plan
5. Marketing plan
6. Financial projections (3–5 years)
7. Startup cost breakdown

4. Choose a Legal Entity & Register the Business

• Choose legal structure (e.g., LLC, S-Corp, PC)
• Register business name and file with your state
• Obtain EIN from IRS
• Consult with healthcare/dental attorney and CPA

Phase 2: Financing and Site Selection (4–8 months before opening)

1. Secure Financing

• Estimate startup costs ($250K–$750K typical for new dental practices)
• Approach dental-specific lenders (e.g., BMO Harris, Bank of America Practice Solutions)
• Prepare loan application with business plan, credit history, and resume

2. Find and Secure a Location

• Choose between leasing vs buying
• Hire a commercial real estate agent experienced with healthcare properties
• Negotiate lease with clauses for build-out and signage
• Check zoning laws and ADA compliance

3. Hire Key Professionals

• Dental CPA
• Dental attorney
• Commercial real estate broker
• Architect/interior designer (preferably dental-specific)
• Dental equipment consultant

Phase 3: Design, Buildout, and Procurement (3–6 months before opening)

1. Design the Office

• Create floor plan with workflow in mind (reception, operatories, sterilization, etc.)
• Plan for future expansion if possible
• Choose interior finishes that reflect your brand

2. Order Equipment and Supplies

• Dental chairs and delivery systems
• Sterilization units
• Digital x-rays, CBCT (especially for orthodontics)
• Lab equipment, software, IT/networking
• Instruments and materials
• Work with vendors like Henry Schein, Patterson, or Darby

3. Get Insured and Licensed

• Malpractice insurance
• General liability, property, worker’s comp, disability, business interruption
• State dental/ortho license
• DEA registration
• OSHA and HIPAA compliance setup

Phase 4: Staffing and Systems (1–3 months before opening)

1. Hire and Train Your Team

• Front desk staff
• Dental assistants, hygienists, treatment coordinator
• Office manager
• Conduct interviews and background checks
• Train on software, workflows, OSHA/HIPAA

2. Implement Systems and Software

• Practice management software (Dentrix, Eaglesoft, Open Dental)
• Imaging systems
• Patient communication tools (e.g., Solutionreach, Lighthouse 360)
• Billing and insurance setup
• EHR and charting templates