Principles of Practice Management: Why dental practices decline—and how to turn yours around

I had a fascinating conversation last week with a new client—one that echoed countless others I’ve had over the years. I first spoke with this dentist four years ago, when his practice had plateaued. At the time, he was confident he could reignite growth on his own. He believed his background and business knowledge would be enough to identify weaknesses, correct course, and move forward.

But as many dentists know, it’s rarely that simple.

Four years later: From stagnation to decline

Fast forward to today, and this doctor’s practice isn’t just flat—it’s down 13%. While he had identified some of his practice’s weak points, he fell into a common trap: trying to solve the problem in isolation. Like many practice owners, he was too close to the situation and hadn’t sought enough outside input or expert guidance.

So what should a dentist do when their practice starts to decline?

1. Ask your dental team to identify weaknesses

Your team members are your most underutilized resource—and in many cases, your overlooked experts. Meet with your staff and ask them to list every area of weakness they see in the practice. These are the people working in the system every day.

Their insights can uncover blind spots, inefficiencies, or patient experience gaps you might miss. And while the volume of feedback might surprise you, it’s a good thing—it means you’re gaining clarity.

2. Study dental practice management best practices

The business of dentistry is complex, but you don’t have to start from scratch. There’s a vast amount of dental practice management content available—including articles, books, courses, and webinars.

As you explore these resources, ask yourself:

• Are your no-shows below 2%?

• Have you conducted procedural time studies in the last three years?

• Can you schedule new patients within 7 to 10 days?

These are just a few performance indicators that can highlight where your dental practice might be falling short—and where improvements could lead to real growth.

3. Surround yourself with dental industry experts

The most successful practice owners I’ve met all have one thing in common: they build a network of experts early and often. When I founded Levin Group 40 years ago, the first thing I did was surround myself with experts—because they can do things you can’t do alone:

• Get you to your goals faster

• Help you grow bigger

• Prevent costly mistakes

This doesn’t just apply to practice growth. Dentists should have trusted professionals across all areas—accountants, attorneys, estate planners, financial advisors, and more.

Diagnosing a declining practice is the hardest part

Becoming a dentist is hard. Running a profitable dental practice is harder. And identifying the root cause of a practice in decline is often the hardest part of all. But once you have the problem clearly defined, the path to fixing it is usually straightforward.

Don’t wait another four years hoping for things to change. Start by listening to your team, investing in your business knowledge, and seeking the expertise that can help you build a stronger, smarter practice.

Editor's note: This article originally appeared in DE Weekend, the newsletter that will elevate your Sunday mornings with practical and innovative practice management and clinical content from experts across the field. Subscribe here.