Every DSO operator with a Colorado footprint is asking some version of the same question right now: do we pause? Stop signing LOIs, stop closing deals, wait until January 1, 2027 passes and the dust settles?

No. But the reasoning behind that "no" matters more than the answer itself, and it's not the...

By Pete Volk, founder of Dental Strategy Institute, with clinical review by Susan Volk, RDH.

You can scale a perfect root, read a full-mouth series, and catch early perio a dentist would've missed. And you have no idea how to form an LLC. That gap isn't a failing on your part — nobody taught you th...

By Pete Volk, founder of Dental Strategy Institute, with clinical review by Susan Volk, RDH.

There's a particular frustration in learning that your career ceiling was set by a state legislature you never voted for. A hygienist in Colorado can build something a hygienist in another state legally can...

You're sitting in the dental chair. The treatment coordinator slides a form across the desk: $1,800 for a crown. $2,400 for a root canal. $4,200 for two implants.

Your first instinct is to trust it. After all, this is a medical professional. Prices are what they are, right?

Not exactly.

Dental Pr...

Co-authored with Susan Volk, RDH

Every industry report this year has said some version of the same thing: recruiting hygienists has never been harder. Owners are describing it as "very" or "extremely" challenging at a rate north of 90%. Practices are raising wages, sweetening benefits, getting crea...

Adding an operatory to an existing practice typically costs $75,000 to $175,000 for a full comprehensive build, or $35,000 to $80,000 per room before equipment if you're doing a leaner renovation into already-plumbed space. Building new runs the full construction cost we cover in the pillar guide — ...

By Pete Volk, founder of Dental Strategy Institute, with clinical review by Susan Volk, RDH.

By year six, most hygienists have done a quiet kind of math. Not the paycheck math — the other kind. How many more years your neck and shoulders have in them. How many more identical Tuesdays sit between no...

Three numbers decide whether a dental office build actually pencils out: your debt service coverage relative to the new monthly payment, your realistic new-patient flow, and what your new operatories will actually produce compared to the benchmark for a healthy practice. Get any one of these wrong a...

Financing a dental office build almost always means stacking three separate loans — construction, real estate, and equipment — and the number your banker actually cares about isn't your total project cost. It's the monthly payment increase your production has to cover, starting the month the doors o...

Two dentists graduate the same spring. Same school, same $300,000 balance on the day they cross the stage. Ten years later, one is debt-free with money in the bank. The other still owes more than $240,000 and hands over a fifth of every paycheck to service it.

Same start. Very different endings. And...

Dental office construction runs $165 to $330 per square foot depending on finish level, before equipment. That's the range you'll hit whether you're building a lean, function-first practice or a design-forward flagship — the difference is entirely in what's behind that number.

Contractors and denta...

Opening a dental practice from scratch — a true de novo, no patient chart, no existing goodwill — costs most dentists somewhere between $650,000 and $1 million all-in in 2026, and the number that surprises first-timers isn't the construction bid. It's everything else stacked on top of it.

I've watc...