How to Determine the True Production Potential of Your Dental Practice

Introduction

Many dental practices feel busy, booked out, and stretched for time — yet still have no clear understanding of how much they are truly capable of producing. Without clarity around a practice’s production potential, it’s easy to assume that long days and full schedules mean the practice is operating near its ceiling.

In reality, many practices are limited not by effort, but by misunderstood or mis-measured factors. In this article, I’ll introduce the key indicators I use when evaluating a dental practice’s productive capacity and explain why some commonly relied-upon metrics can be misleading.

What Determines a Dental Practice’s Production Potential?

When determining how much a dental practice is capable of producing, multiple factors must be evaluated together. These include:

• Active patients

• New patient flow

• Number of operatories/chairs

• Fees

• Insurance participation (fee-for-service vs PPO heavy)

• Doctor’s hand speed

• How far the schedule is booked out

• Daily average production variance and deviation from the mean

No single factor tells the whole story. However, one indicator consistently matters more than the rest.

The Most Important Indicator: Active Patient Records

The most important indicator of how much your practice is capable of producing is the number of active patient records.

Dentists must be careful when relying on reports from practice management software such as Dentrix, Eaglesoft, Open Dental, Curve, and others. When asked how many active patients a practice has, these systems often return a highly inaccurate number.

In most cases, the software reports the total number of patients ever seen by the practice since the system was installed. This happens because very few practices formally inactivate patients. A patient who has not been seen in five or more years may still be counted as “active.”

How to Measure Active Patients Correctly

The most accurate way to determine active patient count is to ask the software how many unique patients have been seen in the last 12 months.

• Do not use visit counts — most patients come in at least twice per year for hygiene and may have additional doctor visits.

• Counting visits significantly inflates the number and provides a false sense of capacity.

Unique patients seen in the last 12 months provide a much clearer picture of the practice’s true patient base.

What Active Patient Numbers Really Mean

As a general guideline for single-doctor practices:

• New start-ups: 100–500 active patients

• Small, established practices: 500–1,000 active patients

• Solid patient base: 1,500–1,800 active patients

• Larger practices: 2,000+ active patients

Practices with 2,500–3,500 active patients can often produce $1.8 million to $2.5 million annually, depending on other variables.

It’s important to understand that production potential cannot be calculated from patient numbers alone. Factors such as whether the practice is urban or rural, fee levels, insurance participation, and available chairs all significantly affect outcomes.

When I perform a practice analysis — which we offer at no charge to general and pediatric dentists — I take all of these variables into account to determine a practice’s realistic productive capacity. In this series, I’ll walk through those factors in more detail.

Why New Patient Flow Still Matters

New patient flow is another major determinant of a practice’s potential, though its importance varies depending on the stage of the practice.

I divide new patients into two categories:

• New limited patients (typically emergency visits)

• New comprehensive patients (new hygiene/prophylaxis patients)

I pay the closest attention to new hygiene patients, as these are true practice-building patients.

New Patients and Practice Size

• A brand-new practice has a critical need for new patients.

• A large, established practice has a less urgent — but still essential — need.

New patients typically require more treatment on average than existing patients, making steady new patient flow important over time.

I have seen large practices with schedules booked out for months that slowly decline after giving all new patients to an associate or junior partner. That process can take years, but without new patients entering the primary doctor’s schedule, the outcome is predictable.

The Importance of Patient Retention

New patient numbers alone do not tell the full story.

I once worked with a father-and-son practice that averaged 60–70 new patients per month — yet the practice was not growing. They were losing roughly the same number of patients each month that they were gaining.

This practice was treading water.

Retention is critical. Without it, even strong new patient flow will not translate into long-term growth.

Stability Comes From Hygiene

Hygiene is what makes a practice more stable, consistent, and predictable.

• Hygiene typically accounts for approximately 35% of total production

• It also generates significant indirect revenue by identifying treatment that moves onto the doctor’s schedule

Practices that rely heavily on emergency patients tend to be more volatile, with production fluctuating based on how many toothaches and broken teeth occur in a given period.

There is nothing inherently wrong with being an emergency-driven practice — but those practices are generally less stable and more difficult to manage predictably.

Looking Ahead

In the next articles in this series, I’ll discuss additional factors that determine a dental practice’s productive capacity, including physical constraints, fees, and operational limitations.

Even though these factors are interconnected and complex, you will begin to develop a clearer sense of whether your practice has untapped potential.

If you want to know for certain, we offer a free, confidential practice evaluation with zero obligation.

About the Author

Russ Ledbetter is a dental practice management consultant with Dental Consulting Experts, The Ledbetter Group since 1989, helping dentists increase production, reduce stress, and improve team accountability—without changing diagnosis or fees. Learn more about Russ and our Dental Practice Consulting.

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