Most dentists expect that a successful career will provide financial security. Yet a full schedule and strong production do not necessarily mean that a practice is operating efficiently—or that its owner is building lasting wealth. It is possible to work harder, produce more, and still feel as though your financial goals are moving farther away.

We have access to more data than ever before, but the numbers are only useful when we understand what they are telling us. Patient flow, staffing, procedure mix, overhead, and profitability are closely connected. When one part of the practice becomes a constraint, it can limit growth even when the office appears busy. Sometimes the answer is not adding more patients or working more hours, but identifying where time, capacity, or opportunity is being lost.

A practice is also one of the most valuable assets many dentists will ever own. The decisions we make about how we manage debt, invest in the practice, develop our teams, serve our patients, and prepare for an eventual transition all influence the value we are creating. Wealth accumulation does not begin shortly before retirement. It is the result of intentional decisions made over many years.

This month’s issue examines these decisions from several perspectives. Keith Nicholson explains how operations-management frameworks can uncover hidden constraints in capacity, scheduling, and profitability. Roger Levin outlines practical strategies dentists can use to accumulate wealth and work toward financial independence. Jason Auerbach challenges the tendency to treat EBITDA as the goal rather than a measure of a healthy organization, reminding us that clinical excellence, team engagement, and an exceptional patient experience are what drive sustainable growth. Beau Epperly examines another important component of practice value: protecting the goodwill that often represents the majority of a dental practice’s purchase price.

Together, these articles make an important point: building wealth is not about chasing every investment opportunity, cutting expenses indiscriminately, or focusing on one number. It requires a clear financial plan, a healthy and productive practice, and an understanding of what creates value over time. For me, that is an encouraging way to think about wealth. Financial success does not have to come at the expense of clinical excellence or the patient experience. In a well-run practice, they should strengthen one another. When we create efficient systems, empower excellent team members, and provide care that earns patients’ trust, we are improving the practice today while building an asset that can support our future.

As we move into the final months of the year, I hope this issue inspires you to take a closer look at how your practice is performing, where its greatest opportunities lie, and whether the decisions you are making today are moving you closer to your long-term goals.

Pamela Maragliano, DMD
[email protected]

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