Most dentists I work with are technically excellent. They went to school, learned their craft, and built a practice. What they didn’t get was an education on how to run the financial side of a business.

The reality is that if you want to build a successful practice and use it to create your ideal life, your financial acumen needs to match your clinical acumen. You don’t need to master this all at once, but you do need to make sure you’re asking yourself the right questions at the right times.

Here are five questions to ask yourself as you grow your business. Work through them honestly, and they’ll help you determine where to focus your efforts.

Stage 1: Am I fulfilled?

Before we talk about money, we need to start here. There’s a Japanese concept called ikigai that literally translates to “a reason to wake up in the morning.” It involves finding something in life that checks four key boxes—passion, vocation, mission, and profession.

You can gauge where you’re at by asking yourself the following questions:

• Am I passionate about what I do?
• Am I good at it?
• Does the world need it?
• Can I get paid well to do it?

If you’re able to give an emphatic “YES” to all four of those questions, you’re in the right place. (And as a dentist, the last two are automatic yeses.)

If you can’t, that’s important information. A “no” or a “meh” doesn’t necessarily mean you need to leave dentistry entirely. It might mean you need to adjust your practice—shift your focus to a different patient base, add a specialty you’re genuinely excited about, or restructure how you spend your clinical time. The goal is to get to a place where all four answers are unambiguous.

Additional reading: Your mindset matters for the success of your dental practice

If you can achieve ikigai, you will almost surely be successful in anything you do, and you’ll have a great time doing it. There’s nothing better.

That said, my goal is to help dentists build multigenerational wealth—and that requires a more precise approach.

Stage 2: Am I managing my debt correctly?

Dentists today often graduate somewhere between $500,000 and $1,000,000 in debt. And dental school, for all its strengths, doesn’t teach you what to do with that number.

Debt isn’t inherently bad, but unmanaged debt is a wealth killer. So, the question isn’t just “how do I pay this off as fast as possible?”; it’s “how do I structure this debt so it doesn’t consume every dollar I generate?”

Sometimes paying a slightly higher interest rate over 30 years is smarter than aggressively paying down a loan over 10, if the difference in monthly cash flow allows you to invest elsewhere.

Additional reading: Build these 2 income streams: When you have paychecks and "playchecks," you have financial freedom

One way to think of it: When you pay cash for something, there’s no interest, but what you’re really doing is replacing interest with lost opportunity cost. What else could you have done with that money?

The goal is to make your debt work for you, not against you. Don’t let it lock up your capital and kill your options.

Stage 3: Am I protected?

The uncomfortable truth about building wealth as a doctor is that the more you accumulate, the more you have to lose. The critical part is that you need to get the right protections in place well before you need them.

What am I talking about exactly? Things like disability insurance, life insurance, a properly structured entity, and separating your personal assets from your business assets. As your balance sheet grows, you can add wills, trusts, and asset protection strategies.

This is foundational stuff, but I see too many dentists skip it. I get it—no one likes looking at insurance policies. But let me be clear: cutting corners here could be the most expensive mistake you ever make.

Stage 4: Am I growing?

A lot of dentists assume that once their practice is stable, the financial work is done. Unfortunately, that’s not the case.

If you’re not growing at 10%–12% per year, you’re shrinking. Inflation in dentistry runs 5%–7% annually (think: payroll, supplies, and rent). Add in the fact that many insurance companies haven’t raised reimbursements in years, and you can have a practice that looks fine on the surface but is actually costing you money year over year.

Analyze your production. If you’re not hitting meaningful growth, you need to figure out why. Is it marketing? Case acceptance? Capacity? The answer will tell you where to invest next.

And if you’re not yet a practice owner, the same principle applies. Can you increase your dollars per hour by adding a skill set? Can you cut a 90--minute procedure down to 40 minutes? Can you improve your treatment acceptance rate by 10% or 20%? Growth is growth, whether you own the practice or not.

Stage 5: Am I investing correctly?

When most people think about investing, they think about stocks, bonds, 401(k)s, and money market accounts. That might be part of a wealth--building strategy, but it is just that—a part. And a small part, at that.

If I’m working with a dentist who only has one dollar to invest, the first thing I’ll tell them to do is invest it back into themselves. I call it “feeding your money machine.” For most dentists, the highest--returning investment available isn’t in the market—it’s in themselves and their practice.

This can take on so many different forms. It might mean making an equipment upgrade that increases production or a marketing investment that brings in new patients. Maybe it means investing in continuing education to do more complex dental cases, implants, or specialty surgery that will allow you to generate more per hour. Or maybe it’s learning better communication skills to increase treatment acceptance.

This is just scratching the surface, but you can see how any of these investments would be far more fruitful than throwing your money into the S&P 500 and waiting. You are sitting on a money machine—you just have to feed it.

If any of these questions gave you pause, it might be a sign that you need to reexamine the financial side of your business. Luckily, you don’t have to do this alone. Working with a financial advisor who understands the dental industry is one of the quickest ways to get your finances under control and start building the life of your dreams. 

Editor's note: This article appeared in the July/August 2026 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.