The Dental Boardroom

In this episode of The Dental Boardroom Podcast, we take a deep dive into the Q4 2025 State of the U.S. Dental Economy Report from the ADA’s Health Policy Institute to understand where dentistry stands heading into 2026.Using AI-powered analysis, we explore how dental practices are navigating rising costs, staffing shortages, flat insurance reimbursements, and shifting patient behavior. While many dentists are feeling financial pressure, the data reveal a profession that remains resilient, adaptable, and focused on long-term growth.Despite inflation and operational challenges, patient demand continues to rise, proving that oral healthcare remains a top priority. This episode highlights why 2026 may be a pivotal year for practice owners willing to rethink their business models and embrace strategic change.Key Topics CoveredQ4 2025 dental industry performancePatient spending trends and demandThe “fiscal squeeze” facing practicesInsurance reimbursement challengesStaffing shortages and labor market shiftsDifferences between private practices and DSOsTechnology vs relationship-driven growthDentist confidence and investment outlook for 2026Key TakeawaysPatient Demand Remains Strong: Dental spending is up 9% compared to pre-pandemic levels (inflation-adjusted), showing that patients continue to prioritize oral health.The Fiscal Squeeze is Real: Rising supply and labor costs combined with flat insurance reimbursements are shrinking profit margins across the industry.Confidence is Under Pressure: Many dentists are busy but earning less, leading to frustration and declining economic confidence.Staffing Remains a Challenge: Hygienists are still extremely difficult to hire, while assistant hiring shows slight improvement.Uneven Growth Creates Opportunity: Some practices have excess capacity, creating opportunities for better marketing and patient conversion.Fear Limits Major Changes: Although many dentists want to drop low-paying insurance networks, few actually take action due to uncertainty.2026 Shows Signs of Optimism: More dentists plan to hire, invest in equipment, and restructure networks—signaling belief in long-term demand.DSOs and Private Practices Differ in Strategy: DSOs rely more on technology and automation, while private practices emphasize relationships and personalized care.Patients Value Dentistry More Than Insurers Do: Consumer spending proves that patients recognize the value of dental care, even when insurance does not.

In this episode, Wes Reed continues his series on common financial mistakes dentists make, focusing on retirement planning and investing. He explains how poor decisions around 401 (k) plans, defined benefit plans, debt management, and private investments can significantly impact long-term financial success.Wes breaks down how the U.S. tax system works, why retirement accounts are powerful tax-saving tools, and how dentists can use smart financial strategies to accelerate their path toward financial independence. He also shares real-life examples of mistakes he has seen in his practice and offers practical advice to avoid them.This episode is designed to help dentists make informed decisions, protect their wealth, and build a sustainable financial future.Key Topics CoveredUnderstanding the importance of choosing the right 401(k) strategyHow progressive taxes impact high-income professionalsWhen to Consider a Defined Benefit (Cash Balance) PlanWhy paying off low-interest “good debt” too early can hurt growthRisks associated with private and non-transparent investmentsThe importance of diversification and due diligenceKey TakeawaysUse 401(k) Plans Strategically: A well-structured 401(k) is one of the most effective ways for dentists to reduce taxes and build retirement savings. When implemented at the right time, it benefits both the owner and the team.Consider a Defined Benefit Plan in High-Income Years: For dentists with strong cash flow and high tax exposure, defined benefit plans can allow much larger, tax-deductible retirement contributions. However, they require professional management.Don’t Rush to Pay Off Good Debt: Low-interest, tax-deductible debt used for assets like a practice or home should not always be paid off early. Investing that money can often produce higher long-term returns.Be Careful with Private Investments: Many private deals lack transparency and liquidity. Dentists should avoid investing based on hype and always perform proper due diligence.Think Long-Term, Not Emotionally: Financial decisions should be based on data, strategy, and long-term goals—not fear, pressure, or short-term emotions.Tax Planning Is a Key Part of Wealth Building: Understanding how taxes work and using retirement accounts properly can save tens of thousands of dollars over time.

In this episode of The Dental Boardroom Podcast, host Wes Read continues his series on common financial mistakes dentists make, with a deep dive into tax planning gaps that often lead to paying unnecessary taxes.Wes explains how many dentists rely on reactive tax filing instead of proactive tax planning, causing them to miss powerful deductions and make poor timing decisions. He breaks down practical, real-world strategies such as the Pass-Through Entity (PTE) tax election; overlooked deductions like kids on payroll, home office, vehicles, meals, and travel; and why depreciation must always align with cash flow.The episode also highlights the risks of overly aggressive tax strategies, why meeting with your CPA only once a year isn’t enough, and how a CFO-style, proactive approach can significantly accelerate a dentist’s path to financial independence.Key Topics CoveredCommon tax planning mistakes dentists makeHow the Pass-Through Entity (PTE) tax election worksWhy the timing of tax payments mattersLow-hanging tax deductions many dentists missKids vs. spouse on payroll (and when it makes sense)Home office, car, meals, and travel deductionsRisks of aggressive tax strategies like misused R&D creditsProper vs. improper use of depreciation (Section 179)The difference between reactive CPAs and proactive, CFO-style planningKey TakeawaysPTE tax election is a major opportunity: Dentists in high-tax states can significantly reduce federal taxes if payments are made correctly and on time.Cash timing determines deductions: Tax deductions only apply in the year money actually leaves your account.Small deductions compound: When combined, kids on payroll, home office, vehicle use, meals, and travel can create meaningful tax savings.Spouse on payroll requires retirement planning: Without a 401(k) or defined benefit plan, it can increase taxes instead of reducing them.Depreciation isn’t free money: Misusing Section 179 can create future cash flow problems.Avoid crossing the line: Aggressive or poorly justified strategies increase audit risk.Tax planning follows cash flow planning: Taxes are a subset of cash flow—not the other way around.Proactive advice matters: Dentists benefit most from advisors who specialize in dentistry and meet multiple times per year.CFO-style planning accelerates wealth: Integrated tax, cash flow, and financial planning lead to faster and more sustainable financial independence.

In this episode of the Dental Boardroom Podcast, host Wes Reed introduces a brand-new subseries called The Executive Session. This interdisciplinary series brings together experts in finance, marketing, and practice management to discuss the real business challenges dental practice owners face today.Joined by co-hosts Megan Shelton (https://www.instagram.com/doctormeganshelton/ (Practice Management & Operations) and Michael from Wondrous Agency (instagram.com/wonderistagency/) (Dental Marketing), this kickoff episode explores how the definition of a “successful” dental practice has evolved over the last decade. The panel breaks down how marketing, operations, and financial strategy must work together to drive sustainable growth without burnout.From tracking real ROI in marketing to improving case acceptance and building systems that support both profitability and lifestyle, this episode sets the foundation for what modern dental leadership looks like.Key TakeawaysSuccess today is more than revenue A successful dental practice balances strong collections with profitability, lifestyle flexibility, and personal fulfillment.Top-line growth without bottom-line control is dangerous High revenue means nothing if margins are thin. Profitability and cash flow matter more than ever.Marketing must be measurable Website traffic and rankings don’t pay the bills new patients, collections, and ROI do. Integration with practice management software is critical.Operations make or break marketing Even the best marketing fails if front desk systems, case presentations, and patient experience aren’t aligned.Data visibility across the entire pipeline is essential From leads → appointments → case acceptance → collections, successful owners track every stage.Growth requires systems, not hustle Sustainable growth comes from leadership, team retention, clear communication, and predictable processes not longer hours.You can’t do it alone High-performing practices invest in expert support marketing, operations, and finance to scale efficiently.Seasons matter Balance looks different at different stages of ownership. Clarity, reflection, and intentional decision-making are key.

In this episode of the Dental Boardroom Podcast, host Wes Read, CPA and financial advisor at Practice CFO continues his series on common financial mistakes dentists make, this time focusing on tax planning gaps. Wes explains why many dental practice owners unknowingly overpay taxes and how poor tax planning often results from weak cash flow management, rather than bad intentions.This episode breaks down complex tax concepts into practical insights, helping dentists understand how smarter planning throughout the year, not just at tax time, can lead to tens of thousands of dollars in savings annually and faster financial independence.Key Notes:1. Tax Planning Is Not a Once-a-Year ActivityMany dentists believe tax planning is handled solely by their CPA at year-end.Real tax planning happens throughout the year, tied directly to business decisions.Waiting until December often means it’s already too late to reduce taxes effectively.2. Tax Planning Is a Subset of Cash Flow PlanningTaxes cannot be optimized in isolation.Every dollar flowing through the practice revenue, expenses, payroll, debt, and savings affects tax outcomes.Smart tax strategies must consider current and future cash flow, not just immediate deductions.3. Common Tax Planning Gaps Dentists MakeMissing legitimate deductions (leaving money on the table).Buying equipment just for a tax write-off without considering long-term loan payments.Poor timing of depreciation and capital purchases.Not coordinating payroll, distributions, and retirement planning.4. Understanding S Corporations vs. Sole ProprietorshipsBeing an S Corp does not automatically mean you’re saving taxes.S Corps come with higher administrative costs, so the tax benefits must outweigh them.In general:Under ~$150k income → Sole proprietor may make more sense.$180k–$200k+ profit → S Corp usually becomes beneficial.5. Reasonable Compensation: The Biggest Tax LeverAs an S Corp owner, you pay yourself in two ways:W-2 wages (subject to payroll/FICA taxes)Distributions (not subject to FICA)Paying too little W-2 can trigger IRS penalties.Paying too much W-2 can unnecessarily increase payroll taxes.Finding the right balance is critical to staying compliant and tax-efficient.6. Payroll Taxes vs. Income TaxesFICA taxes apply only to W-2 wages.Distributions avoid FICA but are still considered taxable income.Higher W-2 wages allow for:Larger retirement plan contributionsBigger income tax deductionsStrategy depends on whether you’re prioritizing tax savings now or retirement funding for the future.7. Retirement Plans Must Match Cash FlowCookie-cutter 401(k) plans often fail dentists.Retirement plans should be designed based on:Practice profitabilityOwner age vs. staff ageAbility to consistently fund contributionsPoorly planned retirement strategies can increase complexity without meaningful tax benefits.8. Financial Independence Requires DisciplineOverspending today steals from your future self.Automating savings and planning intentionally creates long-term freedom.Proper tax planning can realistically save:$30,000–$50,000 per year for well-run dental practicesEven more for higher earners with strong cash flow