Dear Reader,

One of the things I notice every January is how many dentists talk about growth as if it’s entirely a matter of effort or intention. “We’re going to grow this year.” “We’re going to push production.” “We’re aiming for a record Q2.” And I love the optimism. I love the drive. But there’s something most dentists don’t see until someone points it out:

You can’t grow past the walls that contain you.

And I don’t just mean literal walls, although sometimes that is part of the problem. I’m talking about the invisible ceilings inside a practice that quietly limit growth long before you notice it happening. You look at your schedule, it feels full, and you assume the practice is performing at its peak. But a buyer looks at the same schedule and sees something entirely different: a business that has already run out of room.

I was sitting with a dentist not long ago who said, “Stan, I’m as maxed out as a dentist can be. There’s just no more room to grow.” His tone suggested he meant this as a compliment, like reaching the ceiling was proof of success. But when I pulled up his numbers and looked at the layout of his week, a different story came forward. He wasn’t maxed out. He was boxed in.

There was no hygiene support for expansion, no flexibility in the doctor’s schedule, no openings reserved for high-value cases, and no extra capacity anywhere in the week. Even the rooms told a story: two operatories were being used inefficiently, with one sitting idle during large chunks of the day because the assistant was being pulled in too many directions.

From his point of view, he was at full speed. From a buyer’s point of view, the practice had nowhere left to go.

Growth isn’t just about effort. It’s about space, physical, operational, and strategic.

A buyer pays for what the practice could be, not just what it is today. And when they look for future potential, they’re evaluating a few things that dentists almost never think about.

One is hygiene imbalance. Most doctors never question it because the hygiene schedule “feels busy.” But when hygiene gets booked out too far, or worse, too inconsistently, it becomes a bottleneck. A buyer notices immediately. They see limited reactivation potential. They see a restricted diagnostic engine. They see a practice that has unintentionally capped its own oxygen supply.

Another thing buyers look at is how the week is structured. You’d be amazed at how often I find wasted pockets of time, not because the team isn’t working hard, but because the schedule was built years ago and no one ever revisited it. A four-day work week that could easily support another hygiene column. A day where everyone leaves early because “that’s just how we’ve always done it.” A morning where the doctor starts late, but hygiene starts early, creating an unnecessary traffic jam later.

Patterns like that tell buyers the practice hasn’t fully explored its own capacity.

And then there’s the operatory layout. Some practices have the space for more dentistry but lack the staffing or systems to use it well. Others have rooms that are technically “open” but practically unusable because no one wants to bounce between rooms without enough support. Again, these are things the doctor often doesn’t notice because the practice still functions. But a buyer will see opportunity, or lack of it, within seconds.

The biggest surprise to many dentists is how little buyers care about today if they can’t see a future where the practice can grow. A practice that feels “maxed out” to you may actually feel suffocating to someone trying to step in.

And here’s the thing: hitting a ceiling isn’t a failure. It’s usually a sign that the practice has matured to the point where you’ve squeezed every drop out of your current structure. In some ways, that’s an achievement. But it’s not a growth strategy. And it’s not something a buyer can pay a premium for.

What buyers want to see is flexibility. Room to add a provider, expand hygiene, extend hours, or adjust them. Room to increase case acceptance without wrecking the schedule. Room for possibility. That’s what gives them confidence.

So if you’re looking at the year ahead and thinking, “I want more,” it’s worth asking yourself the question buyers ask the moment they walk in: “Where would the growth even go?”

Not from a place of blame. Not from a place of frustration. Just from a place of clarity. Because once you see your true capacity, you gain something incredibly powerful: the ability to expand it.

Maybe the solution is adding a hygiene day. Maybe it’s rearranging the doctor schedule so you have protected procedure time. Maybe it’s leveraging an underused operatory. Maybe it’s adding support staff instead of clinical staff. Maybe it’s opening early one day a week. Maybe it’s fixing bottlenecks that have been normalized for so long no one even sees them anymore.

Whatever the answer is, one thing is certain: Growth doesn’t happen because you want it.
It happens because your practice is built to allow it.

If you want a more valuable practice, and a practice buyers view as truly future-ready, this is where you focus your attention.

Not on working harder. Not on squeezing more dentistry into the same narrow space. But on creating room for your practice to become something larger than it is today.

Because your practice can grow. It just needs somewhere to go.

To your success,

Your Team at Everything DSO