A landmark performance report from Planet DDS, analyzing more than 8,500 dental practices and $6.79 billion in gross production, confirms that the dental industry is splitting into clear winners and losers in 2026. One-third of practices grew revenues by more than 10% last year, while nearly 14% declined by the same margin — and the middle ground is shrinking fast.
As of May 2026, the data paints an increasingly urgent picture for dental practice owners across Canada and beyond. The Planet DDS 2026 Dental Industry Outlook: Deep Dive, presented for the first time at the inaugural Dental Capital Forum in New York City on May 12, is the most comprehensive operational benchmarking study the industry has seen this year. For Canadian practices — particularly those in the GTA navigating rising overhead costs and shifting patient expectations — these findings offer both a warning and a roadmap.
What the Report Covers
The Deep Dive draws on operational data from 8,500+ practices running on the Planet DDS platform throughout 2024 and 2025. It spans 497 dental support organizations (DSOs), 3,294 same-store year-over-year comparisons, and more than 2,500 orthodontic practices. The report includes 16 analytical sections covering same-store growth, production benchmarks by specialty, appointment operations, the revenue cycle waterfall, AR aging benchmarks, and a complete set of warning, target, and elite zone metrics.
For practice owners who rely on gut feeling rather than data to gauge performance, this study provides the clearest available benchmark of what "good" actually looks like — and how far behind the average practice is falling.
The Performance Gap Is Widening
The headline finding is stark: the dental industry is bifurcating. The top-performing third of practices posted growth exceeding 10%, driven by consistent operational discipline and patient acquisition strategies. Meanwhile, nearly 14% of practices saw revenues decline by more than 10% — a contraction that suggests structural problems, not temporary market softness.
What makes this finding particularly relevant for Canadian dental professionals is the middle: the practices that are neither thriving nor collapsing. That middle band is compressing. Practices that coast on legacy patient bases without investing in operational efficiency or marketing are drifting toward the declining cohort, often without recognizing the slide until it accelerates.
New Patient Acquisition: The 75-Patient Threshold
One of the report's most actionable findings links new patient volume directly to growth trajectory. Practices attracting 75 or more new patients monthly average 9% year-over-year growth. Those acquiring fewer than 35 new patients monthly typically stagnate or decline.
For dental practices in Toronto, Mississauga, Brampton, Markham, and other GTA markets, this threshold matters. These are highly competitive markets where patient choice is abundant. Practices that rely solely on walk-ins and legacy referrals without actively managing their digital presence, Google Business Profile, and online reputation are falling below the 35-patient floor faster than their owners realize.
Pro Tip: Track your new patient count monthly — not quarterly. By the time a quarterly review reveals a downturn, you've already lost three months of compounding growth.
Operational Consistency Drives Revenue
The Deep Dive found that operationally consistent practices — those maintaining stable scheduling, predictable workflows, and reliable billing processes — produce 28% more daily revenue than their less-organized counterparts. The most volatile 10% of practices are shrinking by 3.4%, while the most consistent practices are growing by 6.1%.
This data reinforces what practice management consultants in Ontario have emphasized for years: clinical excellence alone does not build a sustainable practice. The practices widening the performance gap are doing so through systems, not heroics. They schedule predictably, follow up on treatment plans systematically, and collect payments consistently.
Chair Productivity Over Chair Count
In a finding that challenges the "grow by adding operatories" mindset, the report revealed that nearly 1,050 practices operate an average of 44 chairs but generate only $56,000 in annual revenue per chair. Smaller practices with higher per-chair efficiency consistently outperform larger ones that have scaled capacity without proportionally scaling utilization.
For Ontario practices considering expansion — whether adding a second location in Vaughan or building out additional operatories in an existing Scarborough clinic — this data suggests focusing on maximizing existing capacity first. Filling your current chairs more effectively yields better returns than adding empty ones.
Case Completion: The Industry's Biggest Leak
The report pegs the industry-wide case completion rate at just 47%. Nearly half of all treatment presented to patients goes unfinished. Practices with the worst performance show a jarring disconnect: 77.2% treatment acceptance but only 19.7% completion. Patients agree to treatment and then never follow through.
This represents the single largest revenue opportunity for most practices. The report identifies a collective $545 million opportunity that requires no new patients to capture — just closing the gap between what patients accept and what they actually complete.
Pro Tip: Implement a 48-hour follow-up protocol for all treatment plans exceeding $1,000 CAD. A brief phone call or text confirming next steps can dramatically narrow the acceptance-to-completion gap.
The $890,000 EBITDA Opportunity
For a DSO generating $10 million in gross production, the report estimates that closing the average operational billing gap alone adds approximately $890,000 in annual EBITDA — without touching the top line. This isn't about attracting more patients or raising fees. It's about collecting what you've already earned.
While Canadian practices may not operate at the same scale as large American DSOs, the principle applies directly. A solo practice in North York generating $1.5 million in production likely has $100,000 or more in uncollected or under-billed revenue hiding in its workflow gaps. AR aging, incomplete insurance claims, and unbilled procedures compound quietly.
What Canadian Practices Should Take Away
The Planet DDS Deep Dive is built on American practice data, but the operational dynamics it describes mirror what Ontario dental practices face daily. The Royal College of Dental Surgeons of Ontario (RCDSO) does not regulate business efficiency, but it does set standards that require documented workflows — and practices that meet those documentation standards consistently tend to perform better operationally as well.
Three priorities emerge for Canadian practice owners:
- Measure relentlessly. Track new patients monthly, case acceptance and completion rates weekly, and AR aging daily. If you don't have these numbers at your fingertips, you're flying blind.
- Fix the completion gap. If your practice accepts treatment at 70% but completes at 40%, that 30-point gap is your single biggest growth lever.
- Optimize before you expand. Adding chairs, staff, or locations without first maximizing existing capacity amplifies inefficiency rather than resolving it.
Pro Tip: Schedule a 30-minute "performance gap review" with your office manager every Monday morning. Focus on one metric from the list above — new patients, case completion, or AR aging — and track it for the full week before moving to the next.
Frequently Asked Questions
Q: How many new patients per month does a dental practice need to grow?
According to the Planet DDS 2026 Deep Dive report, practices acquiring 75 or more new patients monthly average 9% annual growth. Practices below 35 new patients per month typically stagnate or decline. For Canadian practices in competitive GTA markets, actively managing digital marketing, online reviews, and referral networks is essential to reaching and maintaining these thresholds.
Q: What is the average case completion rate in the dental industry in 2026?
The industry-wide case completion rate stands at approximately 47% as of 2026, meaning more than half of accepted treatment plans go unfinished. The worst-performing practices show a 57-point gap between acceptance (77.2%) and completion (19.7%). Closing this gap represents the largest untapped revenue opportunity for most dental practices.
Q: How can a dental practice increase profitability without adding new patients?
The Planet DDS report identifies approximately $545 million in industry-wide revenue that could be captured by closing the gap between treatment acceptance and completion. For a practice generating $10 million in gross production, addressing operational billing gaps alone adds an estimated $890,000 in annual EBITDA. Focus areas include systematic treatment follow-up, AR aging reduction, and eliminating unbilled procedures.
EBIKO Dental will continue monitoring industry performance data and reporting on trends that affect Canadian dental practices. For the latest dental industry analysis and practice benchmarks, visit ebiko.ca.