Straight numbers, no pitch.
What dental office projects actually cost, how lenders actually decide, and the questions nobody selling you something will answer in writing. Written by Dan Ellyson.
Start with the guides
Eight sourced guides cover each part of a dental office project. The posts below go deeper on one decision each. See all guides, the free calculators, the cost benchmarks or the glossary.
Startup costs
Every line of an all-in startup budget, with the model ranges by office size and finish.
How to open a dental practice
The four phases and 13 steps from first idea to opening day, in the order that protects your money.
Build-out cost
What construction costs per square foot in leased space and ground-up, and how to read a bid.
Financing
Loan types, SBA 7(a), the 1.25x coverage test, monthly payments and the lender-ready package.
Office leases
Sizing, rentable vs. usable area, NNN rent, TI and the lease clauses that matter most to dentists.
Equipment cost
Per-operatory and whole-office equipment and imaging budgets, and how to compare dealer quotes.
Relocating a practice
Relocation costs, the backward timeline, patient retention and the notification list.
Building ground-up
Ground-up costs before land, site due diligence, SBA 504 and an 18 to 24 month timeline.
All posts by topic
Startup costs
Start with the guide: Dental practice startup costs: the itemized 2026 guide
Three sample dental startup budgets, line by line (2026)
Sample dental startup budgets, line by line: a 4-op leased office at $784,800, a 6-op premium office with CBCT at $1.35M and a 6-op ground-up build at $1.58M.
Read →12 hidden costs that ambush dental office projects
12 costs dental office bids leave out, from permits to working capital. The Alithos model adds $93,500 of cabinetry and soft costs to a 5-op leased build-out.
Read →How to open a dental practice
Start with the guide: How to open a dental practice: the step-by-step guide
The 13-stage dental startup checklist, in the order that protects your money
A dental practice startup checklist in 13 stages, in the order that protects your money. A leased 4-op startup plans at $746K–$824K, so the budget comes first.
Read →Startup vs. acquisition: which ownership path actually pencils?
Startup vs. buying a dental practice: a leased 4-op startup plans at $746K–$824K; an acquisition is underwritten on real cash flow at 1.25x. How to choose.
Read →Build-out cost
Start with the guide: Dental office build-out cost: what construction really costs in 2026
Financing
Start with the guide: Dental practice financing: loans, DSCR and what lenders approve
Inside the underwriting room: what dental lenders actually approve
Dental practice loan requirements for 2026: the five things underwriters check, the 1.25x DSCR many lenders look for, a worked example and a package checklist.
Read →Working capital: the budget line that decides whether you sleep
How much working capital a dental startup needs: the Alithos model sets $85,000, but size yours from a month-by-month ramp of overhead and collections.
Read →Office leases
Start with the guide: Dental office lease guide: space, terms and the clauses that matter
Build, lease, or condo: run the numbers before you fall in love with a building
Build vs lease vs buy a dental office: in the Alithos model a 5-op office costs about $933,500 leased and $1.45M built before land. See the math that decides.
Read →Tenant improvement allowances: negotiating the landlord's money
How to negotiate a dental office TI allowance: each $10/sq ft on 2,500 sq ft is $25,000 off your build-out. Straight vs. amortized TI, work letters, clawbacks.
Read →How many operatories, and square feet, do you actually need?
Size from your team: 1 dentist + 1 hygienist needs 4-5 operatories. Then plan about 500 sq ft per op for 3-5 ops, 450 for 6-7 and 425 for 8 or more.
Read →Equipment cost
Start with the guide: Dental equipment cost: the per-operatory and whole-office budget
CBCT, pano, or both? The imaging decision by the numbers
Is CBCT worth it? The Alithos model budgets $130,000 for imaging with CBCT vs $60,000 for sensors and a pano. See the $1,430/month break-even math.
Read →The "free" office design isn't free. Here's what it really costs.
Free dental office design is paid for in the equipment order. Set your op count and a $42,000-$58,000 per-op equipment budget first, then get 2-3 quotes.
Read →Choosing who plans your office
Start with the guide: Dealer design, design-build, startup consultant or independent planner: who should plan your dental office?
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