Written by Luke Moore of Dental Elite

Dental practice valuations are often shrouded in mystery but they needn’t be; here we give you an insight into the process behind the numbers.

It’s true that since the introduction of business-focused stakeholders into the dental profession, as well as a more concerned credit team in lending banks; the computations behind goodwill valuations require more logic.

Demand for dental practices prior to the 2006 NHS contract and the relaxation of the Dentists Act 1985 was far more limited than in the present market. The NHS contract change installed a scarcity value in NHS contracts, restricting competition significantly. With one of the main concerns business owners previously had removed, practice values doubled if not tripled by August 2007.

Valuing a dental business is now much more of a thought-provoking process and solely using percentages of turnover as a method of calculation is no longer satisfactory.

Alternatively, EBITDA modelling can be used to provide the true operating profit of a dental practice, however, multiplication of a practice’s existing EBITDA does not serve as an accurate calculation of practice valuation either.

EBITDA or Earnings Before Interest, Tax, Depreciation and Amortisation, is an accounting acronym that does exactly as it says. The process of calculation involves removing all of the non-cash costs in your accounts such as depreciation and anything that a new practice owner would not continue to incur. Once the EBITDA figure has been established, this is then multiplied depending on the company, market and economic climate.

Currently, dental practices are being sold for between four and seven times their EBITDA. This can vary depending on a number of factors, however, generally the lower the perceived risk and the more sustainable the profit is (or is perceived to be) the higher the profit multiplier.

Unfortunately calculating this is not as simple as one might think and many practices are far less clear-cut. Practice A and B are radical examples, but even a small difference of £20,000 in projected EBITDA terms can be the equivalent of £140,000 in value.

It is also important to remember that your profit and loss EBITDA calculation will not be the same as the buyer’s EBITDA. This is because EBITDA and multiples rely on each other to make the valuation work, for example, five times profit and loss EBITDA might not be as attractive as a purchaser’s adjusted net income at four times. Furthermore, the EBITDA used may not always be your actual EBITDA. When analysing the valuation, it could be that the amount of money you spend on associates, materials, labs, staff and other areas is higher than what other buyers would spend. Therefore the higher valuation may come from a lower valuation multiple, multiplied by a higher projected EBITDA.

Calculating the valuation of your dental practice is not a simple procedure and a number of variables need to be taken into account. Working with trusted experts, such as Dental Elite, who can offer you the necessary advice and support is crucial.

Dental Elite is the second largest specialist practice sales agency in the country, offering a comprehensive and transparent service. The experienced and knowledgeable team can provide you with a free and non-committal valuation. Following a visit to your dental practice they will provide you with a Healthcheck Report, which demonstrates exactly how they have calculated your practice’s value and how it could be improved.

Although dental practice valuations remain as much a work of art as they are a science, understanding the process will reduce the mystery surrounding the calculations. By working with professionals who are experienced and current in dental practice valuations an accurate and transparent valuation will be achieved.

For more information and to find out how Dental Elite can help you, visit www.dentalelite.co.uk, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 01788 545 900

Principal and Founder of AURA Centre of Dental Excellence and Facial Aesthetics in Kingston upon Thames, Dr Nadine Skipp asks, ‘Where to begin?’ when taking up the provision of facial aesthetics.

It’s exciting times for dentistry. We have all seen the growing interest and popularity in non-surgical cosmetic anti-ageing treatments in recent years. But how do we make the most of this in our dental practices?

There is no doubt that the provision of facial aesthetics is perfect for dental practitioners looking to expand their practice and develop their businesses. It stands to reason that dentists are particularly suited to offering this, especially when you consider the years of training and experience in facial anatomy and familiarity with various injection techniques.

Of course, many dentists recognise the enhanced opportunities available through expanding into this growing lucrative market, but do not know how to bring this into their practice. It all begins with training and building up confidence. The first thing would be to explore the entire range of treatments available, considering all the areas and fields that initially appeal to you. From Botulinum Toxin and Dermal Fillers to Dermaroller (microneedling) and Chemical Peels, there are a wealth of options available and the more disciplines you can learn, the more likely you will be able to accommodate all your patients’ potential needs and requirements.

In any dental clinic, unless you’re performing a specific procedure all the time, it will take a while to build up your competence. Following my own initial training, a dental colleague told me that a great way to gain practical experience, increase my confidence and build upon the foundations of my education was to work for a larger provider of facial cosmetic treatments. So that’s exactly what I did. I worked part-time as a sessional non-surgical practitioner at a leading facial aesthetic clinic. It was perfect for building up my skill levels and completing a diversity of facial aesthetic treatments throughout each day.

Of course, it’s not always possible or practical to move into such an environment, especially if you already work in a demanding dental practice, but it is crucial to get as much experience early on as possible. This really helps to cement what you have learnt and build up your confidence.

Regardless of where you apply your newfound talents, the ideal starting point is to undergo the procedures yourself. After all, you can’t expect to be able to adequately explain, understand or empathise with your patients, unless you have experienced the procedures first hand. In fact, I still have my ‘before’ and ‘after’ pictures prior to embarking on my very first treatments, and I regularly use these for educating patients and marketing. This has a real wow factor for my patients and builds valuable confidence in my skills.

Also essential is to ensure that every member of staff is well educated in the treatments being offered. To help with this, it is worth encouraging staff members to undergo various treatments, where appropriate, and to use the products themselves. Your practice team can be the ultimate advert for your services and this will help to increase their knowledge and familiarity with the processes. It will also allow them to provide reliable, honest advice and assurance to patients, while also promoting the excellent results on offer.

Encouraging interest in your facial aesthetics offering is all down to your marketing and the way you spread the word about the fantastic treatments you provide. Using e-shots and leaflets that detail the procedures and outcomes patients could expect, as well as offering promotions on certain treatments will help to do this. As will talking about it during routine dental appointments. It is important not to be afraid to mention these or to hesitate when suggesting a facial aesthetic treatment to your patients. There’s nothing wrong with saying, “Have you ever thought about having this done?”

Ultimately, the best way to advertise is by ensuring the provision of high quality services. Patients that are happy at your clinic will always promote you to other people, so it’s crucial to show each patient consistently high standards of care and support to encourage this right from the start. As important as any marketing technique is, a lot of the early interest comes from word of mouth. So, by nurturing existing patient relationships and with the support from your whole practice team, you can be sure to get your facial aesthetics practice off to a great start. 

To find out more visit www.auradental.co.uk, call 020 8549 5710, or contact This email address is being protected from spambots. You need JavaScript enabled to view it.

The concept of digital dentistry is a three-legged stool. In no particular order, those legs are digital equipment, the tools used to make teeth; digital smile design, the way you treatment plan; and digital marketing, the way you get people in through the door.

I frequently speak about what is known as the ‘adoption cycle’. This is a bell-shape curved graph, and working from left to right you have ‘innovators’, ‘early adopters’, ‘late adopters’ and ‘laggards’. At the far left hand-side of the curve, you have the few people who are keen to try something new without any concrete evidence. The ‘early adopters’ are those who will try new things once some evidence of their success is made available, and the ‘late adopters’ will only jump on the bandwagon once solutions are tried, tested and refined. The ‘laggards’ tend to be those who are open to very little change, if any at all.

As a group, dentists are not brilliant at moving through the adoption cycle. The majority of dentists operate at the ‘late adoption’ stage of the curve, with the next largest group ‘early adopters’ and an ever-diminishing number of ‘laggards’. There aren’t, unfortunately, many dentists working in the ‘innovation’ phase either, although this is somewhat understandable – as trained medical professionals, they want to see clinical evidence of new products or technologies working effectively before they employ them in their own businesses. This does, however, make the process of innovation and development quite difficult in dentistry, as suppliers and manufacturers have limited options regarding who will trial their latest products.

Digital equipment

There is a growing range of dental technologies available on the dental market designed to facilitate the reproduction of natural-looking and functional dentition. Equipment has been advanced and refined over time to now produce clinical results of previously unparalleled accuracy and quality, enhancing the standard of dental treatment provided to patients, increasing their satisfaction and therefore helping businesses to grow. Technologies have also been developed to streamline the clinical and management workflows within practices, allowing more efficient daily processes for happier and more relaxed staff.

The umbrella term of ‘digital equipment’ now includes everything from milling machines to CAD/CAM software and 3D printers, but its place on the adoption cycle varies between countries. In the USA, for example, digital equipment is in the ‘early adoption’ phase, but the UK is slightly behind in the ‘innovation’ stage. This is an opportunity for the manufacturers of digital technologies in the UK and Europe to expand their market reach, and we will continue to see the arrival of more new equipment on British shores in the near future for this reason.

Digital Smile Design (DSD)

Here we start to get into the territory of Christian Coachman – a kind of ‘Photoshop on steroids’ for enhanced treatment planning. Once again, much of the developed world is currently moving into the ‘early adopters’ stage with regards to DSD, while the UK remains in the ‘innovation’ step of the curve. Deployment of the DSD concept may be somewhat slow here at the moment, but it offers huge potential for those who invest.

Digital Marketing

This embraces the lifecycle marketing concept that is now working its way through the dental arena. Following seven proven principles, digital marketing involves attracting new patients, encouraging them to return and encouraging referrals for new business from them. When considering Google, pay-per-click, adwords, search engine optimisation and effective website design, most dentists in the UK are probably towards the top of the curve, moving from ‘early’ to ‘late adopters’. Even the most cantankerous principals now widely accept that a practice website is necessary for the growth of a modern business. When you look at elements such as Facebook advertising, however, most practices will slide back down to the ‘innovation’ stage very quickly. This is a similar story when you consider CRM software, such as that available from InfusionSoft, and automated email marketing.

Don’t break a leg

It is essential for dental practices to look at all three legs of the digital stool in order to successfully adopt the concept and technologies and use them to enhance the patient service provided. This is particularly important for independent practices – corporates and large groups of practices will take more time to innovate and implement the changes needed as they have more management levels to work through. Independent, single practices have the opportunity, therefore, to get ahead of the game and distinguish themselves from the competition.

We at 7connections can provide any bespoke advice or information you might need to make sure you remain at the cutting-edge of dentistry, while also helping you optimise your business for maximum long-term success.

For more information about 7connections and the business coaching opportunities available, please call 01647 478145,

email This email address is being protected from spambots. You need JavaScript enabled to view it.. or visit www.7connections.com

November this year sees the 12th BACD Conference play host to some of the world’s foremost dentists. Delegates will have the chance to learn from leading national and international experts across a range of specialities, as well as the opportunity to network with peers and like-minded professionals over the course of the three-day event. 

Speaking at the conference will be a number of renowned practitioners who will focus on helping clinicians achieve the optimum balance to help them become the best dentists they can. Among the presenters will be Dr Andy Toy, who will be delivering his lecture, Posterior-guided occlusion.

Andy qualified from Bristol University in 1980 and in 1982 he attended Roy Higson’s first ever occlusion course and visited the Pankey Institute for Advanced Dental Education, USA.  He has since made a life-long study of occlusion and its application to practice. In recent years he has been working with the innovative posterior-guided occlusion model. This model references an extensive anthropological evidence base, along with more recent published studies from the Faculty of Health and Sport Science in Loughborough University. Andy is also the co-author with Dr Presswood of ‘Is there such a thing as a healthy occlusion?  Lessons from history’ Primary Dental Care 2008;15(2):65-69. 

Andy says, “The whole field of occlusion is very often misunderstood and there are significant elements of the profession that ignore occlusion altogether, including many academics. This is because the evidence for the models up to this point has been so poor. But clinicians working in day-to-day practice appreciate that understanding occlusion is vitally important. What is more, as dental techniques change and evolve, and we employ less invasive dentistry, understanding occlusion becomes ever more significant. More minimally invasive dentistry is less able to resist some of the forces of occlusion, so we urgently need to understand it better.

“In my lecture I will be challenging the accepted thinking on occlusion, reviewing the evidence on some of the traditional models and presenting evidence for an updated model. Examining the various models of occlusion currently in use and critically exploring their historical evidence base, the lecture will introduce an alternative model of occlusion based on anthropological studies, along with a quick summary of the evidence to support it. Finally, the application of this new model to aspects of clinical care will be discussed, including orthodontics, prosthodontics and TMD treatment.

“The session will be aimed at all practitioners who are involved in altering people’s occlusion, especially those who work in orthodontics, restorative dentistry, or those who treat patients with jaw-joint and TMD problems. If professionals have a better understanding of the evidence surrounding occlusion, they will be able to apply their professional judgement much more successfully. This will not only immediately benefit their patients, but they will also find they have less problems further down the line with less patients returning with deteriorated dentitions or jaw-joint problems.

“Whilst I will be challenging old thinking and offering some new thoughts on the subject, I will welcome any discussions around the new approach. The development of the new methodology is always on-going and we are hoping to build a positive dialogue around this subject.”

Whatever stage of your dental career, the BACD Annual Conference will have something for you. Book your place today and enjoy three days that will help you raise standards, refine your clinical technique and achieve your aesthetic equilibrium.

The BACD’s 12^th Annual Conference runs from 12^th - 14^th November 2015 at The Hilton London Metropole Hotel. Go to www.bacd.com, email Suzy Rowlands at This email address is being protected from spambots. You need JavaScript enabled to view it. or call 0207 612 4166.