Henry Schein One's 2026 Catalyst Index, released May 14, reveals that clinical performance — not practice size — is what separates the top 10% of dental practices from everyone else. Top performers achieve 75% case acceptance compared to 45% for the average practice, a gap that translates directly into revenue, patient outcomes, and long-term practice sustainability.
As of May 2026, the dental industry's most talked-about benchmarking report is back with a finding that should give every practice owner pause. The fifth annual Catalyst Index from Henry Schein One analyzed performance data from tens of thousands of DSOs, multi-location organizations, and private practices to answer a simple question: what do the best practices do differently?
The answer isn't what many expected. It's not more locations, bigger marketing budgets, or faster patient throughput. It's clinical execution — delivering more complete, more consistent care to every patient who walks through the door.
What the 2026 Catalyst Index Found
The report's headline metric is striking. Practices in the top decile achieve 75% case acceptance, meaning three out of four patients who receive a treatment recommendation proceed with care. The industry average sits at 45%, meaning more than half of recommended treatments go unscheduled.
That 30-percentage-point gap isn't just a number. For a practice producing $1.5 million CAD annually, moving from 45% to 75% case acceptance could represent hundreds of thousands of dollars in unrealized production — revenue that requires no new patients, no additional marketing spend, and no expansion of physical space.
The Catalyst Index also found that top performers outperform on collections efficiency, patient retention, and treatment completion rates. These metrics are tightly correlated: practices that present treatment effectively tend to also collect on that treatment efficiently and retain those patients over time.
Why Clinical Performance Matters More Than Scale
For years, the prevailing wisdom in dental industry circles held that scale was the primary growth lever. Add more locations, acquire more practices, expand the footprint. The 2026 Catalyst Index challenges that assumption directly.
The highest-performing organizations in the dataset consistently outperform their peers not because they are larger, but because they deliver more complete, consistent care. A solo practitioner with strong clinical execution can outperform a multi-location group that struggles with case acceptance and treatment follow-through.
This finding arrives at a particularly relevant moment. The Planet DDS 2026 Deep Dive Report, released just days earlier, documented a widening performance gap across the DSO industry, with one-third of practices growing more than 10% while nearly 14% declined by more than 10%. The Catalyst Index suggests that clinical fundamentals — not operational scale — explain much of that divergence.
What Drives 75% Case Acceptance
The Catalyst Index identifies several common patterns among top-performing practices:
- Visual treatment presentation: Top practices use intraoral cameras, digital radiographs, and chairside monitors to show patients exactly what the clinician sees. Patients who can visualize the problem accept treatment at significantly higher rates.
- Same-day treatment planning: Presenting a clear, itemized treatment plan before the patient leaves the chair reduces the drop-off that occurs when follow-up calls are needed.
- Financial transparency: Discussing costs, insurance coverage, and financing options during the appointment — not after — removes the uncertainty that causes patients to defer care.
- Team-based communication: In top practices, treatment coordinators and hygienists reinforce the dentist's recommendations, creating a consistent message across every touchpoint.
Pro Tip: Track your practice's case acceptance rate monthly. If you don't have a system to measure it, your practice management software likely has a report that compares treatment planned versus treatment scheduled. Even a 5% improvement in acceptance can add $50,000–$100,000 CAD in annual production for a typical Ontario practice.
How Canadian Practices Can Benchmark Their Performance
The 2026 Catalyst Index is available in two editions — one tailored for DSOs and multi-location organizations, and one for private practices. Both editions provide segment-specific benchmarks that allow dental leaders to compare their performance against peers in similar practice configurations.
For Canadian practice owners, these benchmarks offer a useful external reference point. While the data skews toward the U.S. market, the clinical fundamentals translate directly. A practice in Toronto or Mississauga faces the same case acceptance dynamics as one in Chicago or Dallas: patients need to understand their diagnosis, see the value in treatment, and feel confident about the financial commitment.
Where Canadian practices may see different dynamics is on the financial side. The Canadian Dental Care Plan (CDCP), which now covers over 6.3 million Canadians, has shifted the insurance landscape in ways that can either boost or complicate case acceptance. Practices that clearly explain CDCP coverage — including what it does and doesn't cover — are better positioned to present treatment effectively.
Pro Tip: Review your CDCP patient base and identify which common procedures require preauthorization. Building that workflow into your treatment presentation reduces surprises for patients and accelerates acceptance.
The Revenue Opportunity Hiding in Your Existing Patient Base
One of the Catalyst Index's most compelling insights is what it calls the "$545 million opportunity" across the practices it analyzed — revenue that could be captured without adding a single new patient. That figure comes entirely from improving care delivery to existing patients: better case acceptance, fewer incomplete treatment plans, and stronger follow-through on scheduled procedures.
For a typical Canadian general practice seeing 1,500 active patients, this math applies at the individual level. If 55% of your treatment recommendations are currently going unscheduled, every percentage point you recover represents real production. The investment required isn't capital equipment or new hires — it's clinical process improvement and team training.
Pro Tip: Schedule a team meeting to review your most commonly declined procedures. Identify the top three reasons patients give for declining, and develop specific responses for each. Role-play these conversations with your team quarterly.
What This Means for the Rest of 2026
The convergence of the Catalyst Index and the Planet DDS report paints a clear picture of where the dental industry is heading. In a slower economy, growth is no longer determined by scale or efficiency alone — it is driven by clinical execution. Practices that invest in treatment presentation, team communication, and patient education will pull ahead. Those that rely on volume alone will continue to see the performance gap widen.
For dental practice owners in Ontario and across Canada, the takeaway is both simple and challenging: the biggest growth opportunity in your practice isn't outside your walls. It's in the exam room, in the conversations your team has with every patient, every day.
EBIKO Dental will continue monitoring industry benchmarking reports and sharing insights relevant to Canadian dental professionals.
Frequently Asked Questions
Q: What is a good case acceptance rate for a dental practice in Canada?
The 2026 Henry Schein One Catalyst Index reports that top-performing practices achieve 75% case acceptance, while the industry average sits at approximately 45%. Most dental consultants consider 60% or above to be a healthy benchmark, with elite practices reaching 80% or higher for comprehensive treatment plans.
Q: How can dental practices improve case acceptance without increasing marketing spend?
The most effective strategies focus on clinical communication: using intraoral cameras and digital imaging to show patients their conditions visually, presenting treatment plans chairside before the patient leaves, discussing financial options proactively, and training the entire team to reinforce treatment recommendations consistently.
Q: Does the Henry Schein One Catalyst Index include Canadian dental practice data?
The 2026 Catalyst Index primarily analyzes data from tens of thousands of practices across its platform, which includes both U.S. and international users. While the benchmarks skew toward U.S. practices, the clinical performance patterns — particularly around case acceptance and treatment completion — apply equally to Canadian dental practices operating under similar clinical workflows.