Dental Practice Valuation Multiples in Illinois (2026)

The most expensive sentence in an Illinois practice sale isn't the multiple. It's the one line that defines what it costs to replace you at the chair, and on a $1.4 million general practice, moving that number from a state-average salary to 30% of production erases about $121,000 of EBITDA. At six turns, that's roughly $726,000 of purchase price, gone before anyone has argued about whether the practice deserves a 6x or a 7x.

Here's our view, and plenty of owners will hate it: the multiple on your Illinois general practice is close to fixed the day you decide to sell, set by your EBITDA tier and your buyer type, while the EBITDA number itself is the part that's genuinely negotiable. Owners who spend their prep year interviewing brokers about multiples are optimizing the variable they don't control and ignoring the one they do. If you want a bigger check, you don't argue the multiplier. You build, document and defend the number being multiplied.

Nobody Publishes an Illinois Multiple, and That Tells You Something

Start with what doesn't exist. The transaction data that circulates in this market is national. CT Acquisitions' 2026 dental and DSO M&A report compiles 2024 through Q2 2026 adjusted-EBITDA multiples of 6.5x to 9.0x for $1 million to $3 million DSO add-ons, 8.0x to 11.0x for $3 million to $10 million regional multi-site groups, and 10.0x to 15.0x for $10 million-plus platform DSOs, and it says plainly that it does not break out Illinois or Midwest-specific numbers. Sorso's 2026 compilation of broker-sourced bands from FOCUS Investment Banking and McLerran & Associates runs 5x to 7x under $1 million of EBITDA, 7x to 9x at $1 million to $3 million, 9x to 11x at $3 million to $5 million, and 10x to 12x-plus above $5 million, with specialty practices commanding one to three additional turns. Again, national.

Anyone who quotes you a precise "Illinois multiple" is quoting a national band with a local anecdote stapled to it. That's not a scandal, it's just the state of the data, and you should price your expectations accordingly. What's actually local is everything underneath the multiple: your collections mix, your PPO fee schedules, your hygiene department's independence, whether a buyer can hire a replacement dentist in your ZIP code, and what that dentist costs. Illinois enters the valuation through the EBITDA line, not the multiple line.

That's not a new observation, either. Levin's 1990 analysis in JADA argued that standard practice-valuation models are "simplistic, arbitrary, and dependent on criteria... susceptible to substantial subjectivity," and that the capitalization-of-income method reduces that subjectivity. Thirty-six years later, the whole industry has converted to an income approach and the subjectivity simply migrated. It now lives in the recast.

The $504,000 Argument Over One Line Item

Run a practice that looks like a lot of good Illinois general offices. Collections of $1,400,000. Operating expenses excluding all owner compensation and owner perks: 62%, or $868,000. That leaves $532,000 of pre-owner cash flow, which is the pool everyone is about to fight over. The owner personally produces $1,000,000 of the $1.4 million; hygiene and an associate day cover the rest.

Now recast. A buyer capitalizes the income stream that survives your departure, so someone has to pay a dentist to do your $1 million of production. Version one, the seller-friendly recast: anchor replacement compensation to the BLS mean annual wage for general dentists in Illinois, $165,760 as of May 2023, load it 8% for payroll taxes, and you get $179,021. EBITDA comes out at $352,979.

Version two, the buyer's recast: an associate who will actually produce $1 million gets paid on production, and 30% is the number that shows up in letters of intent. That's $300,000. EBITDA drops to $232,000. The gap between the two recasts is $120,979 of annual EBITDA. At a 6x multiple, that single line moves the enterprise value by $725,874.

Settle in the middle, where most deals land: a real Illinois associate at roughly 28% of production plus a benefits load, call it $280,000 all-in. EBITDA of $252,000. Now apply the published band. At the 5x floor of the sub-$1 million tier, that's $1,260,000. At the 7x ceiling, $1,764,000. The spread inside one published band, on one practice, is $504,000.

Two things follow. First, a 7x outcome here implies a price of 126% of annual collections, which no lender is underwriting for a single-location general practice with one producing dentist. Second, the 5x outcome implies 90% of collections, which is a genuinely good result. The band is real. Your position inside it is not a negotiation, it's a reflection of how defensible your EBITDA is.

The Mistake: Pricing a Solo Office Off a Platform Table

The specific error we see most often comes from successful solo owners in their late fifties, usually with $1.2 million to $2 million in collections, usually in the collar counties or a strong downstate town, who have read the same multiple tables you just read. They see 10.0x to 15.0x for $10 million-plus platforms in the CT Acquisitions data, they see 9x to 11x at $3 million to $5 million of EBITDA in the Sorso bands, and they anchor somewhere around 8x because they believe their practice is better than average. Their practice probably is better than average. It's also generating $250,000 of adjusted EBITDA, which puts it in the 5x to 7x tier, full stop.

Those platform multiples aren't rewarding clinical quality. They're paying for scale, management depth, multi-site diversification and the fact that a platform survives any single dentist walking out. Your practice does not survive you walking out, and the recast proves it every time by charging you for a replacement. That's the whole reason the tiers exist.

The second version of the mistake is subtler and costs more: padding the add-back schedule. Owners load the recast with the car, the spouse on payroll, the family phone plan, the CE trip to Scottsdale, and a "one-time" equipment purchase that has happened in each of the last four years. Every one of those add-backs that a buyer's quality-of-earnings review knocks out doesn't just remove a dollar of EBITDA, it removes six dollars of price and, worse, it makes the buyer discount the add-backs they hadn't yet questioned. We'd rather see a clean schedule with $40,000 of genuinely non-recurring items that survives diligence intact than a $110,000 schedule that gets cut in half and takes the buyer's trust with it.

The Buyer Pool Changed Before Your Numbers Did

Who's on the other side of the table is now a bigger variable than what state you're in. ADA Health Policy Institute data puts DSO affiliation at 16% of U.S. dentists as of 2024, with private-practice ownership down to 72.5% of dentists in 2023 from 84.7% in 2005. That twelve-point slide is the story. Every point of it is a dentist who, thirty years ago, would have been a plausible individual buyer for your practice with a bank loan and a willingness to pay a percentage of collections for a job plus an asset.

That buyer still exists, and in much of Illinois outside the Chicago metro they remain the most likely purchaser. But the pool is thinner, and the thinner it gets, the more your exit depends on being large enough and systematized enough to interest a group buyer instead. This is why we keep telling owners in the $900,000 to $1.4 million collections range that their real valuation decision is made three to five years before the sale, not at the listing. Adding a second full-time producer and a third hygiene chair doesn't just grow EBITDA. It moves you out of the tier where the buyer is one nervous dentist and into the tier where two or three groups can bid.

Geography inside Illinois matters here in exactly one way that shows up in dollars: recruiting. Illinois employs 5,840 general dentists at a mean wage of $165,760, per the May 2023 BLS state data. In Cook, DuPage and Lake counties, a buyer believes they can hire, so a disciplined seller can argue replacement comp down toward the employed-dentist mean. Two hours south, where the buyer's honest read is that the practice dies if they can't recruit, they will underwrite replacement at a full production percentage and haircut the multiple on top of it. Same collections, same band, different check.

What We'd Actually Do, and What We Wouldn't

We wouldn't take a deal that reaches its headline number by way of an aggressive replacement-comp assumption combined with a long earnout. That structure hands the buyer both sides of the trade: they price your EBITDA as if a cheap associate exists, then make you carry the risk that one doesn't. If a buyer wants to recast your compensation at the state mean, hold them to a matching employment agreement at that rate. If they want to charge you 30% of production, then your post-close compensation should be written at 30% of production too. Symmetry in the recast is the single most useful thing you can demand, and almost nobody demands it.

We also wouldn't pay for a formal valuation until the trailing twelve months you intend to sell on are already clean. A valuation performed on a messy P&L just documents the mess at a professional letterhead, and now it's discoverable.

Four Moves in the Next Ninety Days

Pull your last twenty-four months of P&L and strip out every dollar of owner compensation, owner perks and anything you'd call discretionary, then write the replacement-dentist line twice, once at $179,021 and once at 30% of your personal production, and look at the gap. Build the add-back schedule now, with an invoice or a bank line behind each item, and delete anything you couldn't defend to a stranger with a spreadsheet. Get your hygiene department producing independently of your chair time, because that's the part of EBITDA that doesn't get charged back to a replacement dentist. Then price yourself against the tier you're actually in, not the tier in the headline.

What we're watching into 2027: whether the DSO affiliation rate keeps climbing past 16% and whether the sub-$1 million EBITDA band holds at 5x to 7x as debt costs move. If the individual-buyer pool contracts further without group buyers stepping down-market, the floor on small Illinois general practices falls, and the three-to-five-year growth plan stops being optional. If group buyers do step down, everything we've said about tiers gets more forgiving and we'll say so.

Before you talk to a broker, put your own recast through the math. Our valuation calculator runs the replacement-compensation swing, the add-back schedule and the tier bands against your actual collections, so you can see which number your price is really hanging on. Run your own numbers and find out whether you're arguing about the multiple or about the thing it multiplies.