Collections multiples for general practice, EBITDA for specialty, and the four buyer-side factors that move the number five points in either direction.
Texas dental practice valuations split cleanly along two lines: how the practice operates, and who's likely to buy it. The split determines whether you're looking at a collections multiple or an EBITDA multiple — and the wrong frame costs sellers real money.
Collections-based: the general-practice default.
Most Texas general dental practices sell on a percentage of trailing-twelve-month collections. The range in 2025 sits between 65% and 80% of collections, with the midpoint near 72%. What moves a practice toward the top of that range: hygiene production above 30% of total, low owner-doctor production concentration, strong recurring patient base, and a lease with at least seven years remaining (or owned real property handled as a separate transaction).
EBITDA-based: the specialty premium.
Ortho, oral surgery, pediatric, and endo practices price on EBITDA multiples ranging from 3x to 6x. Practices that exceed $1M in EBITDA with documented procedure-mix stability and provider continuity reliably reach the upper half of that band. Below $1M, the multiple compresses fast unless there's a clean DSO acquirer match.
The DSO factor.
Texas DSO multiples peaked in 2021 and have compressed since. Practices above $1M in collections with clean hygiene-driven recurring revenue still attract competitive DSO bids — often structured as recapitalizations where the doctor stays on for two-to-five years. The numerical multiple is sometimes the same as a general buyer would offer, but the structure (cash at close versus equity rollover, employment terms, post-close production targets) differs materially.
What kills the multiple.
Four things, in order: owner-doctor production concentration above 70% of total revenue, hygienist turnover risk during transition, lease assignment uncertainty, and undocumented add-backs. Each one is fixable in twelve months of pre-market work. None are fixable in diligence without taking a price hit.