How to Get Multiple Offers for Your Dental Practice
The most expensive sentence I hear from dental owners is four words long. “They came to me.”
It is usually said with some pride, and I understand that. Somebody studied the practice you spent twenty-five years building and decided they wanted it.
That is a compliment.
It is also the moment the price stops being a market price and starts being a number one party chose on its own.
How do you get multiple offers for your dental practice? You prepare the materials once, identify every buyer who would realistically want your practice, approach them under confidentiality at the same time, and hold them to one shared deadline. Offers arriving together can be compared.
Offers arriving one at a time cannot.
Key takeaways
- A single offer is priced without a benchmark. That is a fact about the situation, not a criticism of the buyer who made it.
- Competition moves far more than the headline. Cash at close, rollover, earnout definitions, your hours, your team and the closing date all become negotiable once alternatives exist.
- Simultaneity is the whole mechanism. Talking to buyers one after another leaks your position and lets the first number set the anchor for every number after it.
- A controlled process is more confidential than shopping around. A named list under written obligations beats an informal conversation that travels.
- Sometimes one buyer really is the answer. An internal sale to an associate, or a genuinely unique strategic fit, does not need a field.
One definition before anything else, because the acronym does a lot of work in this market.
A DSO is a dental support organization. It owns the non-clinical side of a practice and runs everything outside the operatory, while a licensed dentist keeps ownership of the clinical entity.
That split exists because most states restrict who may own or control a practice. A congressional survey of state law counted 22 states plus the District of Columbia barring non-dentist ownership outright.
Nothing here is a criticism of the groups doing the buying. A buyer who approaches an owner privately, without competition, is behaving exactly as any rational purchaser would.
My argument is about the seller’s side of the table, where there is no reference point at all.
Why a single offer cannot be evaluated
You can learn a great deal about one offer on your own. What it converts to as a multiple of adjusted EBITDA, how much of it is certain money, what the terms will cost you over the years you stay.
I walked through that whole procedure in how to evaluate a DSO offer you already have, and I am not going to repeat it here.
Adjusted EBITDA is what the practice earns in pure operating profit after paying a market-rate dentist to do the work you currently do yourself. It is the figure every buyer prices from.
Here is what none of that analysis can tell you.
A single number has no distribution around it. There is no way to know whether it sits at the top of what your practice would attract, in the middle, or near the floor.
That is arithmetic, not a failure of diligence. One observation is not a range.
Owners try to solve this with comparison anyway. They ask a colleague what they got, they read a figure in a trade article, they search for a percentage of collections.
None of those describe your practice. Not your payer mix, not your hygiene depth, not your associate coverage.
The only benchmark that means anything is what other qualified buyers would pay for this practice, this year, with these financials in front of them.
Which you cannot obtain by thinking harder. You obtain it by asking them.
What competition actually changes
Owners assume competition is a lever on price alone. In my experience the price is the smallest part of what moves.
Becker’s put this plainly in a 2026 piece on where owners lose value in practice sales: purchase price is only one of the areas where value leaks, alongside the form of the consideration, working capital adjustments, post-sale employment terms and the indemnification process.
Every one of those is a negotiation. Every one of them changes character the moment a buyer knows somebody else is reading the same financials.
| Deal element | One buyer at the table | Several buyers at the table |
|---|---|---|
| Headline price | Set by the buyer’s own valuation method | Discovered through competing bids |
| Cash at close vs deferred money | Presented as a package | A dimension buyers compete on |
| Rollover equity | Amount and entity proposed by the buyer | Negotiable, including which entity it sits in |
| Earnout | Targets and definitions drafted by the buyer | Often reduced in scope, sometimes removed |
| Post-sale employment term | Standard term applied | Length, hours and compensation basis negotiated |
| Team pay, benefits and seniority | Rarely raised at all | Routinely written into the agreement |
| Practice name and signage | Buyer’s integration policy | A term you are able to ask for |
| Non-compete radius and duration | The buyer’s standard form | Negotiated deliberately |
| Timetable to closing | The buyer’s calendar | Set by the process |
Take the deferred-money row, because it carries the most cash.
Transaction counsel who handle these deals report that sellers commonly receive 60% to 80% of the purchase price in cash at closing, with the balance arriving as ownership in the buyer’s company.
On a practice priced at $4.8 million, that is the difference between $2,880,000 and $3,840,000 landing in your account on the day you sign.
Same headline. Same practice.
A gap of $960,000 in money that is certain rather than hoped for.
I have watched that specific row move under competitive pressure more often than the headline itself, because it costs a buyer less to improve than a higher price does. A buyer who wants to win without raising the number will restructure it instead.
Then there is the part of the agreement nobody puts a dollar sign on. Your Tuesday schedule.
Whether your hygienist keeps her seniority. Whether the sign outside still says your name in three years.
Owners tell me those are the things they lie awake about, and they are the things almost nobody negotiates, because with one buyer there is nothing to negotiate with.
Why owners end up with one offer
Almost nobody chooses a single-bidder sale. They arrive at one, through a sequence that feels sensible at every individual step.
They answer the group that called. Somebody makes contact, a conversation starts, rapport builds. Nine months later the owner has a relationship with one organization and no idea what the others would have said.
They give away position on the first call. Becker’s reporting on this is uncomfortably accurate: dentists consistently make concessions during introductory conversations, and those concessions become the expected terms later in the negotiation. Nobody wrote anything down.
It still counts.
They sign exclusivity early. A letter of intent typically carries a no-shop clause, and the terms it establishes become the baseline for the definitive purchase agreement. Owners tend to read the LOI as a formality.
It is the opposite.
Exclusivity has also been getting longer across private equity dealmaking generally. Goodwin’s deal data found that roughly 6% of exclusivity periods ran 61 days or more in 2021, against nearly 40% the following year, with most of those extending past 76 days.
Two or three months of contractual silence, agreed before you ever learned what anyone else would pay.
And the market never hears about the practice at all. This is the quiet one, and it is the largest.
The buyer pool is not thin. The Association of Dental Support Organizations counts more than 80 member companies supporting over 8,500 practices across 48 states.
Roughly 130 private equity-backed DSOs were operating in the sector as of mid-2025, more than in any other healthcare vertical. Becker’s has reported more than 35 groups actively acquiring independent practices.
Activity is real, if uneven. Becker’s tracked more than 200 DSO affiliations across the states in 2025, and reported in 2026 that 69% of DSOs expect their sponsors to push for moderate or high increases in acquisition activity.
PitchBook counted roughly 340 US dental services transactions in 2024 and about 310 in 2025. One 2025 read of that data showed private equity dental deal counts falling sharply year over year, concentrated in the specialties rather than in general dentistry.
So the market cooled, then turned again. Becker’s described 2026 as a rebound after a slow stretch driven by expensive capital, heavier diligence and seller expectations that had not adjusted.
None of that reaches you if the only organization that knows your practice is available is the one that guessed.
What a competitive process actually looks like
It is not a listing with a bigger mailing list. The sequence is the product.
Preparation happens once, before anyone sees anything. The financials get rebuilt to the standard a buyer’s accountants will apply, the add-backs get evidence attached, the lease and the entity structure get looked at. When we prepare a practice for sale, part of that work is a full pre-sale financial review on our side of the table, months before any buyer sees a number.
The reason is unglamorous. An adjusted EBITDA figure that falls apart during diligence turns into a re-trade, and a re-trade after you have gone exclusive with one buyer is the weakest seat in the entire transaction.
Then the buyer list gets built, and narrowed. Not everyone who would like a look should get one. Some groups are not funded right now.
Some have no strategic reason to want your zip code. Some have integration practices you would hate.
That filtering is what the Elite Selling System is built around. Think of a doorman working the rope line at a private club, deciding who comes in.
We hand-select and vet each buyer before any of them is allowed to bid, then run a private competitive window inside that group.
Then everyone gets the same package, on the same day. Identical financials, identical narrative, identical questions answered. Any asymmetry in what buyers receive becomes an asymmetry in what they offer.
Then one deadline for everybody. A common date is what makes offers comparable. It is also what tells each buyer, without anyone saying it out loud, that they are not the only conversation happening.
Then the terms get negotiated, not just the number. Cash at close. The earnout definition and who controls its inputs.
The length of your commitment and the hours inside it. What happens to your team.
This is the stage where the money that never shows up in the headline gets won or lost.
Then diligence, with a fallback. Buyers of dental practices have been walking away or restructuring over provider-concentration risk more than any other issue, and post-close employment terms of five years or longer have become more common. If your first-choice buyer moves the goalposts in week ten, having a second buyer still warm is worth more than any clause you could have negotiated.
Why running them at the same time matters
Sequential conversations feel more manageable. Talk to one group, see how it goes, talk to the next.
It is the intuitive way to do it and it destroys the mechanism.
Here is what goes wrong.
The first number becomes the anchor. Once an owner has heard a figure, every subsequent figure is judged against it rather than against the practice.
A second buyer offering slightly more feels like a win, even when the first number was low.
Information leaks in one direction only. Over weeks of conversation you disclose your timeline, your retirement plans, your worries about the associate.
The buyer discloses very little. By the fourth meeting they know what you will accept.
Time itself becomes a cost. Sequential means slow.
Slow means an owner who started the year energized signs in October because they are tired of the process, which is not the same thing as satisfied with the terms.
And the moment you sign exclusivity with anyone, the sequence ends. There is no buyer four.
There is the buyer you are contractually forbidden from leaving.
Simultaneity fixes all four at once. Nobody anchors, because the numbers arrive together.
Nobody builds a private information advantage, because everyone gets the same package on the same day.
The timetable is yours. And exclusivity gets granted at the end, to a buyer chosen against alternatives, rather than at the beginning to whoever showed up first.
That is the entire trick. There is not a second one.
The confidentiality objection, taken seriously
This is the real reason owners hesitate, and it deserves a straight answer rather than reassurance.
The fear is specific. Your hygienist of eleven years hears you are selling and starts looking.
A long-standing patient hears it in the waiting room. The specialist who has referred to you for a decade quietly starts sending cases elsewhere.
That fear is legitimate. Confidentiality is a value-protection issue, not just a courtesy, because staff, patients, associates and referral relationships all react badly to rumors nobody is managing.
Now here is the part that surprises owners. A structured process is more confidential than doing it informally, not less.
Informal shopping around means telling people. You mention it to a colleague at a study club.
You ask your accountant, who mentions it to another client.
You contact three groups yourself, from your practice email, with no agreement in place. Each of those is an uncontrolled disclosure, and none of them is written down anywhere.
A controlled process works differently at every step.
Every buyer signs a non-disclosure agreement before receiving a single financial document. Counsel who handle these transactions treat that as the precondition for any exchange of confidential information, not a formality afterwards.
The practice is described without being identified in the first round. A region, a collections band, a payer profile, a doctor count.
No name, no address, no website.
Information releases in stages. Detailed financials go only to buyers who have signed and passed a first review.
The patient-level material and the team detail come later still.
Nothing is published. There is no listing, no advertisement, no public page that a curious patient or a competing practice down the road can find.
And the list is finite and known. You can see the name of every organization that has been approached, and you can strike any of them.
If the group your associate’s brother-in-law works for is on the list, it comes off the list.
Compare that to the alternative most owners default into. One buyer, no NDA, several months of conversation, and a due diligence request that eventually needs your office manager’s help to fulfill.
Confidentiality does not break because too many buyers were contacted. It breaks because contact happened without structure.
What makes several buyers want the same practice
This is preparation, and it is a long enough subject that it has its own article. I laid out the sequence and the timing in how to prepare a dental practice for sale.
So here I will only name what actually drives the number of interested parties up.
Buyers are pricing transferability. Not how much the practice earns, but how much of what it earns survives your departure.
Which means production spread across more than one provider matters more than almost anything else. It means hygiene depth, because recurring hygiene revenue is the part of the practice least attached to any single dentist.
It also means a lease with real term left on it, financials that reconcile without explanation, and a team that is not one resignation away from a crisis.
The demographics behind all this are worth knowing. Ownership among US dentists fell from 84.7% in 2005 to 72.5% in 2023, and DSO affiliation rose from 8.8% in 2017 to 16.1% in 2024.
The average retirement age has drifted up to 68.7, from 64.7 at the start of the century.
More owners will reach the exit in a market where fewer of the traditional dentist-to-dentist buyers exist. That is exactly the condition in which having a field, rather than a buyer, decides the outcome.
When one buyer genuinely is the right answer
I would not trust this article if it did not include this section, so here it is.
An internal sale to an associate. If someone in your practice wants to buy it, can finance it, and you want them to have it, a competitive process is beside the point. You are not looking for the highest bidder.
You are looking for continuity, and the buyer is already chosen. The work then is structure and financing, not price discovery.
A genuine strategic fit that nobody else can match. Occasionally one organization has a real, specific reason to want your practice that no other buyer shares. They already operate two offices in your county and yours completes the coverage.
They need your specific specialty mix to serve a payer contract. In those cases the premium comes from the fit, and a wide field mostly adds noise.
A practice below the size where funded groups compete. If the realistic buyer is an individual dentist or a small local group, there is not much competitive dynamic available to create. That is a brokerage transaction, and a broker is genuinely the right choice.
I worked through where that line sits in broker or sell-side advisor.
Circumstances that remove the timeline. Illness, a partner dispute, a family situation that requires the matter resolved this quarter. A process takes months.
Sometimes months are not available, and the honest advice is to take the workable deal in front of you.
What links those four is that each one either removes the field or removes the time. Where a field exists and time exists, running a process is not a preference.
It is the only way to learn what the practice is worth.
Where this leaves you
If you have an offer in hand, you know exactly one thing about the market and it is not enough. If you do not have one yet, you have more room than you think, and more control over the sequence.
Either way the question is the same. Would more than one funded organization genuinely want this practice, and has anyone ever asked them?
We will build the buyer list with you, tell you honestly whether a field exists, and say so plainly if it does not. That last part happens more often than you would expect, and it saves owners a year.
Start with a free, confidential practice value estimate and we will tell you what we see.
Our fee varies depending on the value of the practice and is entirely success-based. If we do not get you a result, we do not get paid.
Frequently asked questions
How do I get multiple offers for my dental practice?
Prepare the financials and the information package once, identify every buyer who would realistically want the practice, approach them together under confidentiality, and set one shared deadline for offers. Simultaneous approaches produce comparable offers.
Sequential conversations produce one offer and an anchor.
Does asking for competing offers hurt my relationship with the buyer who approached me?
Rarely, in my experience. Acquisition teams run competitive processes constantly on their own side and expect to encounter them.
What damages a relationship is surprise, not competition, so the buyer who contacted you should be told the practice is going to market.
Will my staff and patients find out if I run a process?
They should not. Every buyer signs a non-disclosure agreement before receiving financial information, the practice is described without being identified in the first round, detail releases in stages, and nothing is publicly listed.
Informal shopping around leaks far more than a structured process does.
How many buyers should be in the process?
Enough that genuine competition exists, few enough that each is a serious candidate. That usually means a hand-selected group rather than a wide mailing.
The point is that every organization approached would actually want your practice, not that the list is long.
How long does a competitive process take?
Preparation is normally the longest phase and can run months before any buyer is contacted. The competitive window itself is comparatively short, and the timetable is set by the process rather than by whichever buyer is slowest to respond.
What if I have already signed a letter of intent?
Read the exclusivity clause before doing anything else. Most letters of intent contain a no-shop provision that legally prevents you from talking to other buyers for a defined period, and those periods have been lengthening across private equity dealmaking generally.
Does competition change anything other than the price?
Yes, and often more. The proportion paid in cash at close, the earnout targets and how they are defined, the length of your post-sale commitment, your hours, team pay and benefits, brand retention and the non-compete are all negotiated.
They move most when alternatives exist.
Is there ever a good reason to sell to a single buyer?
Yes. An internal sale to an associate, a genuinely unique strategic fit, a practice below the size where funded groups compete, or circumstances that remove the timeline entirely.
In each case there is either no field to create or no time to create it.
Sources
Transaction process, negotiation and legal analysis
- Becker’s Dental Review. “Where dentists are leaving value behind in practice sales.” beckersdental.com
- Mandelbaum Barrett PC. “The Four-Phase DSO Transaction Process: What to Expect When Selling a Dental Practice.” mblawfirm.com
- Mandelbaum Barrett PC. “Navigating Types of Dental Transactions & the Financial Terms to Know.” mblawfirm.com
- Cranfill Sumner LLP. “Selling Your Dental Practice to a DSO: What to Expect Before, During, and After the Deal.” cshlaw.com
- Goodwin. “Durations in M&A Exclusivity Periods Increased Significantly Since 2021.” goodwinlaw.com
- Nixon Peabody. “Five Issues Dentists and DSOs Should Address Before Signing a Transaction.” nixonpeabody.com
- Benesch, Friedlander, Coplan & Aronoff LLP. “Dental/DSO Industry Newsletter, May/June 2026.” beneschlaw.com
- US House Committee on Oversight. “Survey of State Laws Governing the Corporate Practice of Dentistry.” oversight.house.gov
Buyer pool, deal volume and market activity
- Association of Dental Support Organizations. “About ADSO.” theadso.org
- Becker’s Dental Review. “200+ DSO affiliations in 2025: State-by-state breakdown.” beckersdental.com
- Becker’s Dental Review. “69% of DSOs plan to boost acquisitions in 2026: Report.” beckersdental.com
- Becker’s Dental Review. “The DSO rebound.” beckersdental.com
- Becker’s Dental Review. “How dental M&A is evolving in 2026.” beckersdental.com
- Becker’s Dental Review. “Private equity deals decline in dentistry: Report.” beckersdental.com
- PitchBook. “Q4 2025 Healthcare Services Report.” pitchbook.com
- Group Dentistry Now. “DSO Deal Roundup — July 2026.” groupdentistrynow.com
- DrBicuspid. “Dental practice values hold, but these shifts are changing who sells and for how much.” drbicuspid.com
Ownership, affiliation and workforce data
- ADA Health Policy Institute. “Practice Ownership Trends in Dentistry: A New Look at Old Data.” ada.org
- ADA News. “More dentists affiliating with DSOs.” adanews.ada.org
- ADA Health Policy Institute. “Dentist Retirements Increase.” ada.org
Melani Seymour, co-founder of Transitions Elite, helps veterinary practice owners take action now to maximize value and secure their future.
With over 15 years of experience guiding thousands of owners, she knows exactly what it takes to achieve the best outcome.
