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Deferred Maintenance | Dental Practice Due Diligence

One of the most overlooked risks in a dental practice acquisition is deferred maintenance.

It’s easy to focus on production, collections, EBITDA, and patient flow during diligence. But if the physical dental office, equipment, technology, and infrastructure have been underinvested in for years, those hidden costs can dramatically affect performance after closing.

Deferred maintenance shows up in many ways:
• Aging compressors and vacuum systems
• Outdated electrical and plumbing infrastructure
• Worn chairs and delivery units
• Failing HVAC systems
• Poor IT and network systems
• Roof, flooring, cabinetry, and plumbing issues
• Neglected sterilization and operatory workflows

On paper, a practice may appear profitable. But if the buyer has to immediately spend hundreds of thousands of dollars post-close just to stabilize operations, that “great deal” can quickly become a major drag on cash flow and growth.

Even more importantly, deferred maintenance impacts the patient and dental team experience:
• Increased downtime and repairs
• Frustrated staff
• Reduced efficiency
• Lower case acceptance
• Difficulty recruiting doctors and team members
• A practice environment that no longer reflects the level of care being delivered

This is why proper underwriting matters so much. During acquisitions, operators should carefully evaluate:
• Equipment age and service history
• Facility condition
• Mechanical systems
• Future capex requirements
• Technology infrastructure
• Compliance and code risks

A dental practice acquisition is not just buying cash flow — it’s buying systems, infrastructure, culture, and future liabilities.

The best operators understand that disciplined underwriting and proactive reinvestment are essential for long-term success. Deferred maintenance rarely gets cheaper with time, and eventually every practice has to decide whether to reinvest or slowly lose operational efficiency.

At LADD Dental Group, we’ve learned that protecting the patient and team experience requires continual reinvestment into our facilities, technology, and equipment. Those investments are not expenses — they are foundational to sustainable growth. 



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