June 2026 Benchmarking Report: Top-Quartile Gap Continues to Widen
The gap between top-quartile and average practices is operational, not geographic: growth, case acceptance and retention. What separates the top quartile, with the math.
An earlier summary of this report listed headline benchmark figures (median and top-quartile collections, overhead and hygienist wage) that came from a projection model, not measured data. We have removed them. The analysis below cites its sources directly.
The distance between a top-quartile dental practice and an average one is no longer a matter of a few points of overhead. It's a 9.5-percentage-point swing in annual production growth, a 33-point gap in case acceptance, and a 24-point gap in patient retention. The Planet DDS 2026 Dental Industry Deep Dive, built on 8,593 practices and 497 DSOs, found that the most consistent practices grew 6.1% last year while the most volatile 10% shrank 3.4%. Same procedure codes. Same fee schedules. Same labor market. Wildly different outcomes.
If you're running a practice that grew 2% or 3% this year and calling it flat but fine, this report is the bad news: flat is now losing ground, because the top of the market is moving and the cost side is moving faster than your revenue. Here's what the gap is made of and what it costs you in dollars.
The Market Split Into Two Piles
The most useful finding in the Planet DDS data isn't the average. It's that the average stopped describing anybody. Roughly one-third of practices grew more than 10% last year, while nearly 14% declined more than 10% (Planet DDS, 2026). That's close to half the market sitting in one extreme or the other. The middle is thinning out.
This matters for how you read your own numbers. When you benchmark against "the average practice," you're measuring yourself against a statistical artifact that blends a practice compounding at 12% with one bleeding 11%. Neither of those is a target. The only comparison that tells you anything is against the top quartile, because that's the group setting the price of an eventual sale, recruiting the associates you want, and absorbing the patients who leave you.
The Gap Is Operational, Not Geographic
The easy explanation is market. Better zip code, better payer mix, better luck. The benchmarking data doesn't support it. The Henry Schein One 2026 Catalyst Index breaks out top-10% practices against the average on four metrics, and every one of them is a front-office or treatment-presentation behavior:
Henry Schein One 2026 Catalyst Index
Source: Henry Schein One
- Case acceptance: 75% for the top 10%, 42% for the average practice.
- Patient retention: 94% versus 70%.
- No-show rate: under 1% versus 4%.
- New patients per month: 81 versus 30.
Read those as a chain, not a list. A practice at 30 new patients and 42% acceptance converts about 13 new-patient treatment plans a month. A practice at 81 and 75% converts about 61. That's not a 2.7x difference in marketing spend. It's a 2.7x difference in new patient flow multiplied by a 1.8x difference in what happens after the patient sits down, and the second half costs almost nothing to fix compared to the first.
The retention number is the one most owners underweight. Losing 30% of your active patients a year versus 6% means you're running your entire new-patient engine just to replace what walked out the back. Top-quartile practices aren't better at acquisition because they spend more. They're better at acquisition because they don't have to spend it on replacement.
