Start a Dental Practice or Buy One? Ontario Costs Compared (2027)

By Jatin Dua · Broker of Record, RE/MAX Quantum Realty · Updated 2 November 2026 · 9 min read — What it costs to start a dental practice in the GTA versus buying one in 2027, how banks finance each, and which path fits you.

This guide is for associates and new owners in Ontario who are deciding whether to build a dental practice from scratch or buy one that already has patients. You will see what each path costs in the GTA, how banks finance them, and which risks come with each choice in 2027.

Is it cheaper to start or buy a dental practice in Ontario?

Neither is cheap, and the totals can end up closer than people expect. A start-up spends its money on construction and equipment and then has to find patients. A purchase spends more of its money on goodwill, but patients and collections come with it from the first day.

Source: Renohouse Toronto dental office build-out pricing (2026, contractor estimates); BMO Nesbitt Burns buyer guide (May 2026); RBC and CIBC dental and professional financing pages. All financing is subject to credit approval.

The contractor figures are marketing estimates from one firm, not an independent survey, so treat them as a starting point and get your own quotes. Other sources come in lower or higher. A California dental law firm’s June 2026 guide gives a total US start-up budget of about $300,000 to $600,000 or more, while a Vancouver-area dentist writing in Oral Health Group described a start-up build-out as costing a million dollars or more.

What does it cost to start a dental practice from scratch in the GTA?

A start-up budget has more lines than most new owners expect. The big ones are:

• Space. Lease deposit and rent during construction, unless you negotiate a rent-free fixturing period.
• Construction. Plumbing for suction and air lines to each chair, an amalgam separator, electrical, HVAC, x-ray shielding where needed, and finishes.
• Equipment. Chairs, delivery units, imaging, sterilization, compressor and vacuum, computers and software.
• Approvals. Building permit, x-ray plan approval and, for some spaces, a change of use. My dental office space guide explains which approvals are tied to the room, and my change of use guide covers the permit side.
• Working capital. Payroll, supplies and your own living costs while the schedule fills.
• Marketing and a contingency. The California guide suggests holding back 10% to 15% of the budget for surprises.

How much space you need

Size drives cost. A planning article from a large US dental supplier suggests about 110 square feet per fixed operatory, and a total office size of about 325 to 400 square feet per operatory once you add reception, sterilization, washrooms and staff areas. By that formula, a 4 operatory office needs about 1,300 to 1,600 square feet. Extra space you do not use is extra rent and build-out every month.

What the landlord may contribute

Landlords sometimes pay part of the build-out through a tenant improvement allowance. The same Toronto contractor lists typical allowances of about $80 to $130 per square foot in downtown AAA medical buildings, $50 to $80 in suburban professional buildings, and $30 to $60 for plaza retail converted to dental. Allowances are negotiated, never automatic.

What does it cost to buy an existing dental practice?

A purchase is mostly goodwill. EBIKO’s May 2026 Canadian guide says goodwill is about 80% to 85% of a practice’s value, with equipment and other assets making up the rest. GTA dental practices have been trading at roughly 100–150% of annual collections, with large dental groups (DSOs) keeping demand high, which is the benchmark my estimator uses, drawn from published broker and lender guides.

As a simple illustration, a practice collecting $800,000 a year at 130% to 150% points to about $1,040,000 to $1,200,000 before adjustments. Add legal fees, a formal valuation (about $5,000 to $15,000, according to EBIKO), and money for any equipment you will need to replace soon. For what you actually acquire and the College steps after closing, read my guide to buying an Ontario dental practice.

Comparing a real practice against a start-up budget? Run the practice’s numbers through the estimator below.

How do banks finance a dental start-up compared with a purchase?

The big banks advertise high financing for dentists on both paths, but they underwrite them differently.

• RBC advertises up to 100% funding of a practice purchase price, start-up or expansion costs, and lease financing on 100% of equipment value for amounts of $5,000 and up.
• Scotiabank advertises up to 100% financing for licensed dentists, covering practice acquisition, renovations, building purchase, equipment and leaseholds, subject to credit approval.
• CIBC says banks typically finance up to 100% of leasehold improvements and equipment, wants a business plan with three to five years of justified financial projections for a start-up, and says operating lines usually equal about 1.75 times monthly revenue.

With a purchase, the bank can study years of real collections. With a start-up, it is lending against your projections and your track record as an associate. BMO Nesbitt Burns’ 2026 guide adds that buyers should have savings of about 10% to 20% of the target price and should expect personal guarantees. Get pre-approved on both paths before you commit to either.

Which is riskier, a start-up or an acquisition?

They carry different risks.

Start-up risks

The Oral Health Group article points out that a start-up lacks the predictable cash flow of an acquisition, that fixed costs can climb fast, and that new owners often need extra income during the slow start, often from a part-time associate job. Construction delays and budget overruns are common, and a slow-filling schedule can last longer than planned.

Acquisition risks

When you buy, the risk is losing what you paid for. Patients may leave with the seller, key staff may move on, and an old lease or tired equipment can surprise you in year one. BMO’s guide flags overhead above 65% and hygiene under 25% of revenue as signs a practice may be overpriced.

Where does a dental start-up make sense in the GTA?

Location matters more for a start-up than for a purchase, because you have no patients to bring with you. The Oral Health Group author calls serving an underserved area the most crucial factor for fast, stable success.

That is why I suggest starting with data. My Business Maps show dentists per household across the GTA, so you can compare areas before you look at a single unit. Then look at plazas and buildings with parking, visibility and room for your plumbing. My list of Brampton shopping plazas is one example of how I map retail options in a growing city.

When is buying a dental practice the better choice?

• You need steady income soon, for example to carry student debt or a mortgage.
• You want a bank to lend against real collections rather than projections.
• You prefer to inherit a trained team and a working schedule.
• You want to practise in an established area where start-up space is scarce or rent is high.

Buying is not risk-free, but the risks are easier to measure before you sign, because you can read the financial statements, patient counts and lease.

Is there a middle option between starting and buying?

Yes. Many owners start with a buy-in. BMO Nesbitt Burns’ 2026 guide describes minority buy-ins of about 25% to 49%, and associate-to-owner paths that take about two or three years. It also suggests having about three years of stable associate income before you approach a lender. A staged buy-in lets you learn the practice while the seller is still there, then take over when you are ready.

I work on the deal and the real estate side, alongside your lawyer, accountant and lender. I am not a lawyer, an accountant or a practice appraiser, so confirm structure, tax and value with them.

What to do next

1. Write down your goals: income needed in year one, preferred area, and how many operatories you want.
2. Get start-up quotes from at least two contractors, and value two or three real practices for sale.
3. Meet a bank’s healthcare team to get pre-approval for both paths.
4. Check the density map for the areas on your list before you tour any space.
5. Have a lawyer review any lease or purchase agreement before you sign.

Frequently asked questions

Sources

• Oral Health Group: Start Up Success, Balancing Risk vs Reward When Building a New Dental Clinic
• Renohouse: Dental office build-out in Toronto (2026 pricing)
• Dental and Medical Counsel: Dental office build-out guide (US, June 2026)
• Floor Space Considerations for Dental Practices (US dental supplier planning article, 2020)
• RBC Royal Bank: Financial services for medical doctors and dentists
• CIBC: Dental finance guide
• BMO Nesbitt Burns: The Complete Guide to Buying a Dental Practice in Canada (2026)
• EBIKO: How to Value Your Dental Practice, a 2026 Canadian Guide

Related reading

• How to Sell a Dental Practice in Ontario: A Step-by-Step Guide (2027)
• How Much Is a Dental Practice Worth in Ontario? (2027)
• Dental Practice for Sale in Toronto and the GTA: How to Find One (Including Off-Market)
• How Much Does a Dental Office Build-Out Cost in the GTA? (2027)