Accounting for Dental Practices

You Run the Practice. We'll Run the Numbers.

Dental practices are high-income businesses with serious capital investment — chairs, CBCT, lasers, buildouts. The right accountant doesn't just file your return. They design a retirement plan sized for a dentist's income, structure your owner compensation to optimize taxes, and time your equipment depreciation strategically. We've been doing that for IL and WI dentists for over 40 years.

Serving IL & WI dentists since 1981 Accounting, tax & payroll under one roof High-income retirement plan design
Sound familiar?

The Accounting Challenges Dental Practices Actually Face

The tax bill keeps climbing — and nobody's actively planning

You're in the top bracket. Federal, state, Medicare surtax, NIIT. But your accountant only shows up in March, and by then the strategies that would have saved real money — retirement, equipment timing, entity structure — are already off the table.

Your retirement plan isn't sized for a dentist's income

A standard SEP or solo 401(k) caps out around $70K. For a dentist netting $400K+, that's a fraction of what's possible. A properly designed defined benefit or cash balance plan can shelter $200K–$300K+ per year — and most general firms never even raise it.

Owner compensation isn't structured strategically

How you pay yourself — W-2 salary, S-corp distributions, retirement contributions, fringe benefits — has six-figure tax implications. Without intentional structure, you're leaving money on the table every payroll cycle.

Big equipment purchases aren't planned for tax

A CBCT, a CEREC, a laser, an operatory buildout — dental practices spend heavily on equipment, and Section 179 plus bonus depreciation timing matters. Without a plan, deductions land in the wrong year and you write a bigger check to the IRS than you needed to.

The honest answer

What Goes Wrong When Dental Practices Use a General Accountant

Most general accounting firms are competent — for general businesses. But dental practices have economic dynamics that don't show up in retail or trades. Here's what we typically see when dentists switch to us from a non-specialist firm.

Tax planning happens once a year — too late

For a high-income dentist, tax strategy needs to happen quarterly at minimum — not in April. Equipment timing, entity structure, retirement contributions, charitable strategy. By the time most general firms look at your return, the planning year is closed.

Retirement plan design defaults to the simplest option

Most general firms set up a SEP-IRA or a basic 401(k) and call it done. For a dentist netting $400K+, that's malpractice. Defined benefit plans, cash balance plans, and 401(k)/profit-sharing combinations can shelter 3x to 5x more — but they require active design.

Owner compensation isn't optimized

S-corp salary vs. distribution split, fringe benefit structure, retirement contribution coordination — all of these affect what hits your personal return. A general firm files what's in front of them. A specialist firm tells you what it should look like before the year starts.

Equipment depreciation is reactive, not strategic

CBCTs, CERECs, lasers, scanners, operatory buildouts — dental practices have major fixed asset activity. Section 179 and bonus depreciation can compress deductions into the years they help most. Most general firms apply default treatment instead of asking, "what tax year does this deduction help you most?"

Payroll is run, not coordinated

For a dentist-owned practice, payroll isn't just a compliance task — it's the input that drives retirement contributions, S-corp reasonable compensation, and personal tax planning. When payroll and accounting and tax planning are three separate vendors, the coordination breaks down.

What we handle

Accounting Services Built for Dental Practices

Everything your practice needs — handled by one team that understands dental economics.

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Monthly Bookkeeping

Clean books every month, reconciled accounts, and P&L statements structured around how a dental practice actually performs — including production vs. collections visibility.

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Proactive Tax Planning

Multi-touch tax planning throughout the year — not just at filing. Entity strategy, quarterly check-ins, year-end optimization, and coordinated personal returns.

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Retirement Plan Design

SEP-IRA, Solo 401(k), 401(k)/profit-sharing, cash balance, and defined benefit plans — sized for dentist income, designed to shelter real money.

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Owner Compensation Strategy

S-corp salary vs. distribution, fringe benefits, retirement coordination — structured to optimize your total compensation and tax position.

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Equipment & Depreciation Planning

Section 179, bonus depreciation, and cost segregation strategy for CBCT, CEREC, lasers, scanners, and operatory buildouts — planned before you sign, not after.

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Payroll Services

Practice payroll through Payroll Freedom — coordinated with retirement contributions, S-corp comp, and your books in real time.

Practices we work with

We Work With Solo, Group, and Specialty Dental Practices

From solo general dentists to multi-doc group practices and every specialty in between — if you're a dentist-owned practice in Illinois or Wisconsin, we know your economics.

Solo General Dentists
Group Practices
Multi-Location Groups
Orthodontics
Oral Surgery
Periodontics
Pediatric Dentistry
Endodontics
Prosthodontics & Implant
Choosing the right firm

What to Look For in a Dental Practice Accountant

Not every CPA firm is set up to serve dentists well. If you're evaluating accountants — whether or not you end up choosing us — these are the five things worth checking before you sign anything.

1

Real experience with dentist-owned practices

Ask how many dental practices they currently serve, and at what size. A firm with one or two casual dental clients won't have the depth to design a cash balance plan or coordinate equipment depreciation strategy at the income levels dentists operate at.

2

Active retirement plan design — not just plan administration

Ask: "What retirement plan structures do you currently use for your dentist clients?" If the answer is just "SEP-IRA" or "401(k)," they're not designing for dentist income. The right answer mentions defined benefit, cash balance, or 401(k)/profit-sharing combinations.

3

Quarterly (at minimum) tax planning — not just annual filing

A high-income dentist needs tax strategy touched multiple times a year. Ask what their typical client communication cadence is. If the answer is "we do your return" and not much else, they're an accountant, not an advisor.

4

Accounting, payroll, and tax under one roof

Owner comp, retirement contributions, and reasonable compensation all depend on three things talking to each other — books, payroll, and tax planning. When those are three different vendors, the coordination breaks down. Look for a firm that handles all three internally.

5

Transparent pricing

You shouldn't have to wait through three discovery calls to find out what something costs. A firm that publishes its pricing structure (or at least gives you a clear estimate after one conversation) respects your time and is confident in its value.

Why Accounting Freedom

How Accounting Freedom Stacks Up Against That Checklist

We've been working with dental practices in Illinois and Wisconsin for over 40 years. Here's how we score on the five-point checklist above — judge for yourself.

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Decades of dental practice experience

Dental practices have been a core client base since we opened in 1981. We understand dentist economics, S-corp structure for professional practices, and the planning cadence high-income dentists actually need.

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Real retirement plan design

We work across the full spectrum — SEP, Solo 401(k), 401(k)/profit-sharing, cash balance, and defined benefit. We start with your income and goals, then design the structure that shelters the most. Not the other way around.

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Year-round, not just March–April

You're assigned a dedicated Client Advisor who knows your practice. Quarterly tax planning touches, mid-year strategy reviews, and proactive outreach when something needs your attention.

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One firm for accounting, tax, payroll & planning

Through Accounting Freedom and Payroll Freedom, you get every back-office service under one roof — coordinated by one team, with no dropped handoffs.

Transparent pricing

What Does Dental Practice Accounting Cost?

We believe you should be able to estimate what working with us costs without filling out a form or waiting for a sales call. Here's how our pricing works for dental practices.

Three tiers — Core, Core+, and CorePro

Dental practices typically fit into our Core+ or CorePro packages because the planning load is heavier than most small businesses. Core covers monthly accounting and business tax compliance. Core+ adds quarterly tax planning, retirement plan design, owner compensation review, equipment depreciation strategy, and proactive advisory — where most solo and group practices land. CorePro adds 90-day cash flow forecasting, KPI dashboards, full annual business review, and deeper planning — typical for multi-doc groups and specialty practices.

Your final price depends on practice size, number of dentists and partners, transaction volume, payroll complexity, and the depth of planning you need. Solo dentists typically land in Core+; group and specialty practices typically land in Core+ or CorePro, plus complexity adjustments based on your specific setup.

The fastest way to get a real number for your practice is the Pricing Calculator — it walks through the same questions we'd ask on a discovery call and gives you a customized estimate in under three minutes.

Common questions

Dental Practice Accounting Questions We Hear Often

Do dentists really need a specialized accountant, or will any CPA do? +
Most general CPAs can technically handle a dental return. But dentists are high-income, capital-intensive taxpayers, and the difference between a general firm and a specialist firm typically shows up as five-figure annual tax savings — through retirement plan design, S-corp compensation optimization, and proactive equipment depreciation strategy. The cost of those misses usually exceeds what you would save going with a non-specialist firm.
What retirement plan structures do you recommend for dentists? +
It depends on practice structure, age, income, and employee mix — but the spectrum runs from SEP-IRA (simplest, lower contribution limits) up through Solo 401(k), 401(k)/profit-sharing combinations, cash balance plans, and defined benefit plans (most complex, highest contribution potential). For a dentist netting $400K+ with the right design, you can often shelter $200K–$300K+ per year. We start by understanding your income, goals, and employee situation, then design the structure that fits.
How do you handle owner compensation for a dentist-owned practice? +
For an S-corp dental practice, the goal is balancing reasonable W-2 salary (required by the IRS) against S-corp distributions (which avoid payroll tax) and retirement contributions (which reduce taxable income). The right split depends on income level, retirement plan design, and personal tax position. We model this annually and adjust as your situation changes — instead of leaving it on autopilot.
How does depreciation planning work for dental equipment? +
Dental practices have meaningful capital investment — CBCT, CEREC, lasers, scanners, chairs, operatory buildouts. Section 179 and bonus depreciation can compress deductions into the years that help your tax position most. For larger buildouts ($500K+), a cost segregation study can accelerate even more. The key is planning before the purchase, not after the fact — which means actually talking to us before you sign the financing.
Do you work with specialty dental practices (ortho, oral surgery, perio, pedo, endo)? +
Yes. Specialty practices typically have different economic profiles than general dentistry — higher per-procedure revenue, different equipment intensity, sometimes referral-based patient flow. We work across all major dental specialties, and we structure tax planning, retirement design, and entity strategy around how your specific practice actually generates revenue.
Do you handle the practice tax return AND my personal return? +
Yes — and you want them under one roof. The practice return drives K-1 or W-2 income, retirement contributions, fringe benefits, and S-corp distributions, all of which flow to your personal return. When practice tax and personal tax are two different firms, the coordination almost always breaks down. We handle both together so the planning is actually integrated.
How long does it take to switch from my current accountant? +
For most dental practices, onboarding takes about three to six weeks. We collect your prior-year business and personal returns, retirement plan documents, and partnership or shareholder agreements. We get access to your QuickBooks file (or migrate you to QuickBooks Online), set up your monthly workflow, and coordinate with your existing accountant directly so nothing falls through the cracks. You do not have to wait until year-end — mid-year transitions are common.

Let's Talk About Your Practice.

Schedule a free consultation. We'll walk you through how we can take the accounting and tax planning burden off your plate — so you can stop reacting in April and start managing your tax position year-round.

Illinois: 847-949-8373  |  Wisconsin: 262-375-2440