A practice can be busy and still not be profitable, and from the inside the two look identical. The schedule is full. The team is good. The checks clear. What is missing is any way of telling whether the year is building something or simply staying even.
The arithmetic has not been kind lately. Since January 2021 the all-payer reimbursement index tracked by the ADA Health Policy Institute has risen 19%, against overall inflation of 27%, while the price of professional dental equipment and supplies rose 23% and the hourly earnings of dental office staff rose 23%. In the Institute's own survey of dental practices, comparing 2021–25 with the five years before it, general dentists' inflation-adjusted revenue per dentist rose 1.4% while expenses per dentist rose 4.9%, and average real income fell 8.1%. Costs went up faster than the money coming in, and the difference came out of the owner.
None of that is fixable in an afternoon. What is fixable is not knowing where it is happening. Six numbers will tell you, and all six are already sitting in software you own. Ten quiet minutes tonight, one page, and the practice stops being a feeling and becomes a set of figures you can act on.
- Why a benchmark will not answer this
- Number one: what you produced, against what you kept
- Number two: the write-off on your single biggest plan
- Number three: the total on your unscheduled treatment report
- Number four: how many active patients have no insurance on file
- Number five: the date of the last post on your practice's page
- Number six: last month's supply spend, divided by production
- Two leaks the six numbers miss
- Put the six on one page, and put the date on it
- How one practice did it
- Run your own numbers
- Sources
Why a benchmark will not answer this
The first instinct is to ask what the numbers should be. Ask that question and you will get an answer, then a different answer from the next source, and a third from the one after that.
The ranges disagree because the practices behind them disagree. A surgical practice and a hygiene-heavy practice do not spend alike. A practice that books lab fees one way and one that books them another are not counting the same thing. Some figures are shares of collections and some are shares of production, which alone changes the answer, because collections and production are not the same number. And a survey of what practices actually spend, on average, is a description, not a target.
So this guide sets no targets. It asks for something more useful: your own six numbers, measured the same way each time, moving in a direction you chose. A practice that improves its own figure by a point has done something real. A practice that matches an average has matched a group of practices it may not resemble.
Number one: what you produced, against what you kept
Put last month's production next to what the practice actually collected, after adjustments. The gap between them is the write-off — the share of the dentistry that was done and then discounted by contract before anyone was paid for it.
Where PPO participation is heavy, that gap runs 30 to 50 cents in every dollar of gross production. It is the largest single leak in this list by some distance, and the one owners are most likely to have made peace with, because it arrives as a line on a statement rather than as a bill.
This number is not an argument for dropping anything. It is the number that tells you whether the question is worth asking at all. If the gap is narrow, stop here and spend your attention on the other five. If it is wide, the guide on whether to drop a PPO walks through what a plan really pays and how to work out what leaving one would cost — and what going out of network does and does not mean, since it ends a contract, not a relationship with those patients.
Number two: the write-off on your single biggest plan
The first number is an average across every plan you take, and averages hide things. So take your largest plan by patient count and do one more piece of arithmetic: your own office fee against that plan's allowed fee, on the three procedure codes you bill most.
Plans vary far more than owners expect. One contract can sit twenty points below another on the same code, and because the practice sees only a blended figure at the end of the month, the worst plan stays comfortable inside the average. This is the number that finds it.
It is also the number the profession has started acting on. In the ADA Health Policy Institute's second-quarter 2026 survey of private-practice dentists, roughly one in four owner-dentists — 23.5% — had already dropped out of some insurance networks since the beginning of that year.
Number three: the total on your unscheduled treatment report
Every practice-management system will produce this report. It lists the treatment that was examined, diagnosed, explained and then never booked, and it carries a total.
There is no honest industry figure for how much diagnosed treatment goes unscheduled — the numbers in circulation trace back to vendors rather than to any primary source, which is why this guide does not repeat one. Your own report does not have that problem. It is the actual dentistry your actual patients actually need, and its total is the closest thing a practice has to a number for the work it has already paid to produce and has not yet been paid for.
What it usually is not is a wealth problem. In the CDC's National Health Interview Survey for 2023, about one in five adults — 21% — delayed or went without dental care because of cost, more than for any other kind of care measured. The guide on recovering unscheduled treatment covers what to do with the list, and why a nine-week follow-up brings back cases that a single phone call does not.
Number four: how many active patients have no insurance on file
Pull the count of active patients with no insurance recorded. Then look at it as a share of the whole list.
Nationally, 27% of US adults — about 72 million people — have no dental coverage at all, and the gap in behavior is stark: in the CDC's National Health Interview Survey, three in four working-age adults with dental insurance had seen a dentist in the past year, against fewer than half of those without it. A twenty-seven-point difference in whether someone comes in at all.
Those patients are already on your list. They are not waiting for a benefit to renew in January, no third party writes off their treatment, and they come back when there is a reason to. When we pulled data on ninety thousand US practices, only about one in six offered any kind of membership plan — which makes it the leak with the least competition around it. The guide on starting an in-house membership plan covers what to charge, what to include, and the line between a plan and insurance.
Want the six numbers kept for you — the write-offs, the treatment nobody scheduled, the patients with no insurance, the supply rate — instead of a page somebody has to remember to update? The 100 Day Profit Reset Protocol is free for your first hundred days — every tool, no credit card, nothing to cancel.
Number five: the date of the last post on your practice's page
This one takes fifteen seconds and no software at all. Open the practice's Facebook or Instagram page and look at the date on the top post.
Seven in ten US adults use Facebook and half use Instagram, according to Pew Research Center's 2025 survey, so the page is where a good share of a neighborhood will end up. They arrive by way of the reviews: 97% of consumers read reviews for local businesses, and after reading positive ones, 54% go on to visit the business's own website. The feed is what they find when they get there.
A page whose last post is from eighteen months ago is not neutral. It reads as closed, careless, or both — not because a study says so, but because that is the inference a stranger draws with nothing else to go on. The guide on social media for a practice with no marketing budget covers what to post and how to keep it going without anyone having to remember.
Number six: last month's supply spend, divided by production
Take last month's supply spend from the ordering system or the accounting software, and last month's production from the practice-management system. Divide the first by the second.
Write down which denominator you used — production or collections — and use the same one every time, because the trend is the point and the level means nothing without it.
Then the arithmetic that makes it matter: every point of that rate, on a million dollars of production, is ten thousand dollars a year, every year, for as long as the point stays off. Supplies are also the only line in the squeeze an owner can move this quarter, without a hiring decision or a contract negotiation. The guide on cutting supply costs covers the ten-to-twenty-item weekly count that does it.
Two leaks the six numbers miss
Two things worth knowing do not show up as a figure in any report, so they get a line on the page of their own.
The first is referrals. A practice's happiest patients are not counted anywhere, and satisfaction does not convert to referrals by itself — somebody has to ask, at the right moment, and almost nobody does. The guide on turning happy patients into referrals covers the two-question survey that finds them and the rules on rewards and reviews.
The second is what happens when a patient says they cannot afford it. In the Federal Reserve's 2025 survey of household economics, dental care was the most frequently skipped form of care for cost — 18% of adults went without some of it — and "I can't afford it" usually describes the month rather than the total. The guide on in-house payment plans against third-party financing covers both routes and what each costs the practice.
Put the six on one page, and put the date on it
Write the six figures on one page. Put today's date at the top. That page is worth more than any advice on this site, because it is about your practice rather than somebody else's.
Then keep it, and run the same six in six months. The second page is the one that pays, because it is the only way of knowing whether anything you tried actually worked — not whether it felt better, whether the number moved.
As Dr. Prachi Deore puts it in the protocol's own training: "A hundred days from now, you'll put your day-one-hundred numbers next to what you entered today — and the difference will be your answer, in your own numbers, to 'did this work?'"
Estimates are fine. A number you can get in ninety seconds and refine later beats a perfect number you never sit down to find.
How one practice did it
Dr. Prachi Deore runs Coppell Smiles, a solo practice in Coppell, Texas, and hers was the first practice on Profit Smiles — the tools were proven there before they were offered to anyone else. Her six numbers moved in different directions and on different timelines, which is the honest shape of this work.
Supplies went from 11.3% of production to 9.8%, about $13,500 a year that stays in the practice. Six months after she dropped her unprofitable insurance plans, monthly production was $20,000 higher. Treatment acceptance went from 47% to 52% in the first ninety days of using the follow-up and payment-plan tools together, with monthly production up about $2,200 between them. Forty-eight patients joined her membership plan in its first ninety days. Monthly referrals roughly doubled, and inquiries from social media tripled over six months.
Her results are one practice's results, measured in the platform, and individual results vary. The point is not the size of the figures. It is that she knows what they are, which is the thing the six numbers buy you.
Run your own numbers
Four of the free calculators on this site put dollars on four of the six. The PPO write-off calculator turns the gap between production and collections into an annual figure and shows what one more fee cut would cost. The treatment acceptance calculator does the same for the unscheduled-treatment total, and shows what two more points of acceptance would be worth. The membership plan calculator prices a plan against the patients who have no coverage. The supply cost calculator puts a number on both halves of the supply leak — what expires and what gets rush-ordered.
Each one opens with an example practice's figures. Replace them with your own, and nothing you enter leaves your browser.
Sources
- ADA Health Policy Institute, The State of the U.S. Dental Economy, 2nd Quarter 2026 Update (552 private-practice respondents, fielded June 15, 2026): 23.5% of owner-dentists had dropped out of some insurance networks since the beginning of 2026; since January 2021 the all-payer reimbursement index is up 19% against overall inflation of 27%, with professional dental equipment and supplies up 23% and dental office staff hourly earnings up 23% (Bureau of Labor Statistics data reported by HPI).
- ADA Health Policy Institute, Trends in Dentists' Income, Revenue and Hours Worked (June 2026), from the Survey of Dental Practice: for general practitioners, comparing the pooled periods 2016–20 and 2021–25, inflation-adjusted revenue per dentist rose 1.4%, expenses per dentist rose 4.9%, and average income fell 8.1%.
- Peterson-KFF Health System Tracker, How does cost affect access to healthcare? (March 2026), analyzing the CDC's 2023 National Health Interview Survey: 21% of adults delayed or went without dental care because of cost, against 8% for medical care and 8% for prescription drugs.
- CareQuest Institute for Oral Health, State of Oral Health Equity in America (2024 survey of more than 9,000 adults): 27% of US adults — about 72 million people — have no dental insurance.
- CDC, National Center for Health Statistics, QuickStats: Percentage of Adults Aged 18–64 Years Who Had a Dental Visit in the Past 12 Months, by Dental Insurance and Year, MMWR 2022;71:582 (National Health Interview Survey, 2019): 75.0% of insured working-age adults against 47.8% of the uninsured.
- Pew Research Center, Social Media Fact Sheet (November 2025; 5,022 US adults): 71% of US adults ever use Facebook and 50% use Instagram.
- BrightLocal, Local Consumer Review Survey (2026 edition; 1,002 US adult consumers): 97% of consumers read reviews for local businesses, and 54% visit a business's website after reading positive reviews.
- Board of Governors of the Federal Reserve System, Economic Well-Being of U.S. Households in 2025 (May 2026; fielded October 2025): 18% of adults went without dental care because they could not afford it — the most frequently skipped form of care.
- The one-in-six membership-plan figure is Profit Smiles' own analysis of a database of ninety thousand US practices, not an industry statistic. "Every point of the supply rate on a million dollars of production is ten thousand dollars a year" is arithmetic, not a benchmark. There is no primary source for the share of diagnosed treatment that goes unscheduled, which is why this guide names none. Dr. Prachi Deore's results are those of one practice, measured in the platform; individual results vary.