How to Buy an Oral Surgery Practice
For many oral and maxillofacial surgeons, the decision to buy an oral surgery practice is the most direct route to ownership. An established office can come with a referral network of general dentists, trained surgical assistants, an equipped surgical suite and a location patients already know.
It is also a complex purchase. Oral surgery offices depend heavily on referrals, carry significant equipment and often bill both medical and dental payers. This guide walks through the main steps buyers typically work through. Rules vary by state and payer, and nothing here is legal, tax, billing or compliance advice.
Step 1: Define the Practice You Want to Buy
Oral surgery practices are not all alike. Before reviewing listings, think about the kind of practice that fits your skills and goals.
- Solo practices: often built around one surgeon’s referral relationships and reputation
- Group practices: may offer shared call, more staff depth and a partner track
- Implant-focused offices: may rely more on fee-for-service treatment and case acceptance
- Hospital-affiliated practices: may carry trauma, pathology or reconstructive work alongside office procedures
- Multi-location practices: can capture a wider referral region but require stronger management systems
A clear profile makes it easier to compare opportunities and explain your plan to a lender.
Step 2: Study the Referral Base
Most oral surgery practices receive new patients primarily from general dentists and other specialists. Those relationships are often personal to the selling surgeon. Buyers should understand which offices refer the most patients, how long those relationships have lasted and whether any referring dentists are retiring, selling or joining groups that keep surgery in-house.
Concentration matters. A practice that depends on a few referring offices may carry more risk than one with a broad base. Our article on how the oral surgery referral base affects practice value covers this in more detail.
Step 3: Evaluate the Anesthesia Setup and Facility
Office-based sedation and general anesthesia are central to many oral surgery practices. Buyers should confirm what permits and facility requirements apply in their state, how the current office meets them and whether anything must be renewed, re-inspected or obtained in the buyer’s name. Permits and licenses should not be assumed to transfer, and healthcare counsel can help clarify what applies.
Buyers should also review emergency protocols, monitoring equipment, staff training records and the layout of surgical and recovery rooms.
Step 4: Review Equipment Condition
Oral surgery offices are equipment-intensive. Imaging systems, surgical chairs, anesthesia and monitoring equipment, sterilization systems and implant instrumentation all affect both operations and future capital needs.
- Request an equipment list with age and service history
- Identify any leased equipment or existing equipment loans
- Estimate near-term replacement needs
- Confirm which software licenses and service contracts can be transferred
Older equipment does not have to rule out a deal, but it should be reflected in the price and the financing plan.
Step 5: Understand the Financials and Billing Mix
Request several years of tax returns, financial statements, production and collection reports and accounts receivable aging. Oral surgery practices may bill dental insurers, medical insurers, Medicare, Medicaid and patients directly. Each source has different payment timing and documentation requirements.
Buyers should understand true earnings after paying a market salary to the surgeon who will do the work. Proposed add-backs should be documented and reviewed by an accountant. Billing and documentation practices should be reviewed by qualified billing or compliance professionals. Our guide to oral surgery practice valuation explains which factors tend to drive price.
Step 6: Complete Due Diligence
Due diligence usually covers financial records, payer contracts and enrollments, the lease and landlord consent, equipment, staff and employment agreements, patient records and any past claims or audits. Payer contracts and enrollments should not be assumed to transfer, and the buyer may need to credential providers under the new ownership. For a detailed list, see our oral surgery practice due diligence checklist.
Restrictive covenants and employment agreements should be reviewed by counsel because enforceability varies by state. Worker classification should be reviewed by qualified professionals.
Step 7: Arrange Financing to Buy an Oral Surgery Practice
Most buyers finance a practice acquisition rather than paying cash. Depending on the transaction, options may include SBA-backed loans, conventional practice loans and, in some cases, seller financing.
SBA 7(a) loans can be used to help finance the purchase of an existing practice and, in some cases, working capital and related real estate. Eligibility and terms depend on the business, the buyer, use of proceeds, program rules and lender review. Conventional practice loans follow each lender’s own standards and may suit buyers with strong credit and experience.
Lenders generally look at historical cash flow, the buyer’s clinical training and experience, credit history, liquidity and the overall deal structure. Seller notes, if used, are typically subordinate to the senior lender, and lenders or programs may limit earnouts. Every loan is subject to approval, and nothing here is a commitment to lend. Our article on the oral surgery practice down payment explains how equity injection is often evaluated.
Step 8: Plan the Transition
The transition period can protect much of the value you are paying for. Buyers often ask the seller to stay on for a period to introduce the new owner to referring dentists, staff and patients. Terms of any transition period should be documented in the purchase agreement.
Buyers should also plan for working capital. Payroll, rent and supplies continue while payer enrollments are updated and claims begin to flow under new ownership.
Mistakes to Avoid
- Assuming referring dentists will automatically stay with a new owner
- Overlooking the age and condition of surgical and imaging equipment
- Assuming anesthesia permits, licenses or payer contracts will transfer
- Underestimating the time needed to update enrollments and credentialing
- Using all available cash at closing and leaving too little for operations
Final Thoughts
When you buy an oral surgery practice, you are buying relationships, equipment, a trained team and a cash flow history. Careful review of the referral base, anesthesia setup, equipment, billing and financing structure can help you make a sound decision and protect the value of the practice after closing.
US Medical Funding helps oral and maxillofacial surgeons finance the acquisition of existing practices. Learn more about our maxillofacial surgery practice acquisition financing and our full range of oral and maxillofacial surgery practice financing options.
