Podcasts

How Do You Read A Dental Market? Ratios, Density, and The Character of Competition

Ask Kevin Klingshirn what his company does and he’ll gently correct the industry’s favorite word first. Everyone says “dental demographics.” He prefers dental market research — because a demographic table doesn’t tell you where to put a practice, and answering that question is the entire job.

Klingshirn is co-owner of Dentagraphics, the firm he’s helped run for eight of its ten years alongside founder Kent Miller — college friends from Ohio State who built the company from a two-man Austin operation into the market-research shop that’s now analyzed locations in all 50 states for thousands of doctors. Their lane is precise: they don’t do real estate and they don’t do marketing. They answer one question — where are the best submarkets for your practice — and hand the answer to people like us to go find the actual buildings. We had Kevin on the Dentelligentsia podcast for the numbers behind that answer.

The three-factor test

Dentagraphics evaluates every area against three things, and how they combine matters more than any single score.

Competition. The working benchmark: seek a minimum of 2,000 residents per dental practice, with 3,000-to-1 the more conservative target. Mature metro submarkets often run 1,200 to 1,500 to one — genuinely competitive. Measured properly, this is always within a defined scale of analysis: in most metro areas, a three-mile radius around the site; five-plus miles for specialists, because patients will drive across town for an endodontist and won’t cross the street for a cleaning. GPs are convenience businesses. Specialists have geography.

Density. More people packed nearby means more at-bats for every marketing dollar, better ability to absorb the competitor who opens next year, and enough patients of every type to support whatever you want to specialize in. A hundred thousand people in three miles behaves differently than ten thousand — and forgives more.

Demand. This is the branch with the most nuance, because raw income deceives. Klingshirn’s example is the young-professional neighborhood: median household income $115,000, median age 32, mostly renters. Looks wealthy; behaves poorly for restorative dentistry, because young, transient, healthy-toothed renters don’t buy crowns — and they move to the suburbs at the first kid. Real demand analysis reads income alongside age, homeownership, educational attainment, and growth: are these people committed to the area, aging into dental needs, and here in five years?

His advice when the three factors disagree is refreshingly ungreedy: you won’t always hit all three. Two strong out of three, with eyes open about the compromise, is how most good locations actually look. And he’d never tell a doctor to abandon a dream community purely over a competition ratio — just to walk in knowing the number.

The character of competition

The most useful idea of the episode is the one raw counts miss entirely. Klingshirn’s team looks at what they call the character of competition: not how many practices surround a site, but what those practices are.

In mature Midwest markets — metro Detroit, Chicago, Cleveland — a startling share of the nearest twenty competitors are owned by dentists 60 and up, some without websites, some hard to confirm as open at all. Compare that to Austin, Raleigh, or Las Vegas, where the average competitor is young, aggressive, growth-minded, and going nowhere for thirty years. The same ratio means two different things in those two places. A “saturated” Michigan submarket full of late-career practices without an online presence is, read correctly, a market where the patient bases are about to come loose — and, as Remy noted on the episode, nothing terrifies an incumbent like a new doctor opening a state-of-the-art practice down the road.

The same character lens applies to specialists sizing up referral bases. The rule of thumb: 30 or more GPs per specialist nearby signals a healthy referral pool; a dozen signals scarcity. But count them honestly — the multi-specialty corporate office with an in-house GP, orthodontist, and oral surgeon is never referring anything out, no matter what the map says. (For a free gut check, Dentagraphics’ public map shows statewide residents-per-practice figures for every specialty; match or beat your state’s number and you’re doing fine.)

The right order of operations

Klingshirn is candid about the chicken-and-egg problem every startup hits: the data can name the perfect corner, and the perfect corner can have nothing for lease. His prescribed sequence mirrors what we run with clients: define where you’d actually live and practice — a 30-minute drive radius is the typical brief — have the market research rank the submarkets inside it, then hand the ranked list to the real estate team to find what actually exists. From there it’s iterative: bring back three or four live properties, get a quick read on each, and balance three things that never perfectly align — what the data says, what the deal terms say, and how the doctor feels about the community. All three get a vote. None gets a veto.

That workflow is also why the firm built its software platform — a self-serve membership where doctors run unlimited searches on their own schedule (usually, as Kevin acknowledged, in the twenty minutes after the kids are in bed). The philosophy is DIY tools with un-metered human help: onboarding calls, then screen-shares whenever the property list gets real. No call limits. And underneath it sits the asset he’s proudest of, dull as it sounds: a competition database in which every practice in the country has been verified by a human on their research team and re-verified annually, with automated flags when a website dies or a Google listing goes dark. Ratios are only as good as the counts underneath them.

One capability worth knowing exists even if you’re years from using it: for owners adding locations, their patient-plotter maps an existing practice’s patients at the address level — where they actually come from, how far they drive — so a second site can be placed close enough for staff efficiency but far enough not to cannibalize. The team can even run the analysis with an invisible do-not-touch radius drawn around location one, like a self-imposed non-compete.

Where the puck is going

Two trends from his vantage point. Geographically, the migration is real: practices closing in the mature Northeast and Midwest and opening in the Sun Belt — the Atlantas, Raleighs, Charlottes, Phoenixes, and all the Texas metros — following the same U-Haul routes as everyone else. And in the last few years, more doctors arrive saying “I want to buy a practice” as their opening line rather than “I want to start one.” Many end up doing a startup anyway when the right acquisition never surfaces — a pattern our transition-specialist guests have described from the other side — but the first-choice shift is unmistakable.

On consolidation, his take matched nearly every guest we’ve asked: DSOs will keep growing, the locally owned practice isn’t going anywhere, and the interesting question is only the mix.

Never fully ready

Klingshirn’s parting advice came from his own seat as a small-business owner who learned everything on the fly — and, charmingly, from a man twenty weeks from his first child. Arm yourself with knowledge and the best team you can, and then accept the truth: “If you want to wait until you’re fully ready to start the startup process, you’ll probably never start. It’s like becoming a parent. You just have to jump in, do the best you can, and not lose sight of the prize.”

The banker’s line his brother used to deliver in presentations makes the risk honest: the most successful business in America that never fails is the funeral home. Number two is dental. Keep a helmet on, keep moving, and the odds are extravagantly on your side.

The full conversation with Kevin Klingshirn is on the Dentelligentsia podcast. And when the ranked submarkets are ready for actual addresses — the inventory, the landlords, the deals — talk to us.