Dental

Your EBITDA Is Wrong: The Hidden Adjustments That Add (or Subtract) Millions from Your Dental Practice Valuation

Discover the hidden EBITDA adjustments that can significantly impact your dental practice valuation and learn how to maximize your exit value before selling.


Thinking about selling your dental practice — or just want to know what it’s really worth?

Before a buyer ever sees your numbers, make sure your EBITDA is calculated the way they calculate it.

Contact Managing Director, Dr. Azza Diasti-Kennedy, for confidential guidance: azza@evergreenforfounders.com


If there’s one truth every dental owner needs to hear, it’s this:

Your EBITDA — the number you believe determines your valuation — is almost never accurate. 

Not because you did anything wrong. But because buyers calculate EBITDA differently than sellers, accountants, or even industry
consultants.

At Evergreen, we regularly uncover 15–30% more EBITDA simply by recalculating your financials the way private equity and PE-backed DSOs actually do it.

Here’s what most founders don’t realize until it’s too late.


1. Buyers Recast Your P&L Their Way — Not Your

Buyers don’t trust QuickBooks. They don’t trust generic add-back lists. And they definitely don’t trust tax-based financials.

Their job is to determine:

  • What is truly discretionary
  • What is truly recurring
  • What becomes more efficient under their platform
  • And how much risk exists in your transition

This is why two buyers can look at the same practice and produce two wildly different EBITDA numbers.


2. The 10 Hidden Add-Backs Sellers Almost Never Claim

Most owners only account for the predictable items — CE, travel, auto, owner perks.
But sophisticated buyers dig deeper.

Here are the most commonly missed adjustments that can dramatically change your valuation:

  1. Excess owner compensation (spread between actual vs. market)
  2. Family members on payroll (if unnecessary or overpaid)
  3. One-time renovations, repairs, and equipment
  4. Above-market rent when the owner is the landlord
  5. Temporary associate or locum coverage
  6. Legacy vendor contracts that buyers will terminate
  7. Personal insurance and non-operational expenses hidden in GL codes
  8. Credit card processing fee inefficiencies
  9. Clinical calibration and training expenses (treated as one-time)
  10. Corporate-level management fees DSOs won’t continue

Each of these increases EBITDA — and each directly increases enterprise value.


3. Small EBITDA Errors = Massive Valuation Gaps

Every $100,000 of EBITDA adds:

  • $400,000 at a 4× multiple
  • $700,000 at a 7× multiple
  • $1,200,000 at a 12× multiple

If your EBITDA is understated by $200,000 – $300,000,  you could lose $1 – $2.5M in exit value.


4. Why You Never Want the Buyer Calculating Your EBITDA First

Once a buyer sets the valuation frame, it’s almost impossible to change.
The seller must own the narrative:

  • Clean financials
  • Documented add-backs
  • A defensible EBITDA bridge
  • A strong valuation story

This is exactly what Evergreen prepares before any buyer ever sees your practice.


5. The Bottom Line

Your valuation is not based on what you think your practice is worth — it’s based on the story your numbers tell and how well that story is defended.

Done right, accurate EBITDA becomes your greatest source of leverage. And done early, it can add millions before you ever enter the market.


Contact Us

If you’re a dental practice owner considering a sale—or simply want to understand what your practice is really worth—Evergreen can help. Our team specializes in recalculating EBITDA the way buyers actually do, identifying defensible add-backs, and positioning your practice to maximize valuation before you go to market.

To learn how accurate EBITDA adjustments can materially increase your exit value, contact Managing Director, Dr. Azza Diasti-Kennedy, for confidential guidance:
azza@evergreenforfounders.com

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Why  Evergreen M&A?

Expertise: With a decade of experience in orchestrating successful acquisitions, we understand the nuances of the process, providing unparalleled guidance and support.

Founder-Centric Approach: As former founders, we empathize with the emotional and strategic intricacies involved in selling a business. Evergreen M&A is committed to minimizing stress and maximizing outcomes for founders.

Comprehensive Solutions: We offer end-to-end solutions, from strategic planning to negotiation and finalization, ensuring a holistic and tailored approach to each unique business.

Results-Driven: Evergreen M&A is dedicated to delivering results that exceed expectations, empowering founders to achieve their goals with confidence. Your goals are our mission, and your success is our success.