Accounting and advisory for specialty dental practices.
Orthodontic and oral surgery practices share the financial foundation of every dental practice and add their own layer on top: treatment contracts collected over many months, medical as well as dental billing, larger equipment investments, and associate arrangements that often lead to ownership. We provide accounting, tax planning, and transition advisory built around those details.
Who we work with
Specialty practices come to us at different points in ownership, and each brings its own set of questions.
- Orthodontists with one office or several, whose revenue arrives through treatment contracts and payment plans rather than visit by visit.
- Oral and maxillofacial surgeons, whose practices bill both dental and medical insurance and carry substantial surgical, imaging, and sedation equipment.
- Associates considering a buy-in, and owners bringing in a partner, who need to understand the valuation, the terms, and the tax effect before signing.
- Multi-location specialty groups, where reporting by office and payroll across entities become central to running the practice.
What a specialty practice adds
Everything described on our dental practices page applies here as well: the gap between production and collections, a large clinical payroll, and equipment replaced on multi-year cycles. Specialty practices add several mechanics of their own.
In orthodontics, a case fee is typically agreed at the start of treatment and collected over eighteen months or more, so contracts receivable and the timing of collections shape both the monthly statements and the tax return. Oral surgery practices code procedures for medical as well as dental payers, and their equipment includes cone beam imaging, surgical suites, and sedation monitoring. In both specialties, associates are often hired with a path to ownership in view, which makes valuation and buy-in terms a recurring question. We build the books and the tax plan with each of these in view.
What we do for specialty practices
Practice Tax & Structure Review
A one-time review of how the practice is set up. We examine your entity structure, current-year tax projection, and payroll, and provide a short written list of what we would change and why. Depending on the practice, that may cover retirement plan design, an accountable plan for reimbursed expenses, entity elections, or the timing of equipment depreciation.
For practices that want a considered second opinion before committing to ongoing work.
Monthly Advisory for Specialty Practices
Monthly financial statements organized around how a specialty practice earns and spends, quarterly tax planning meetings, and cash flow forecasts that account for equipment purchases, associate hires, and additional locations. We also prepare the figures your lender, financial advisor, or practice broker requests.
For practices that want to plan around their numbers throughout the year.
Practice Transition Advisory
Buy-ins, partner buyouts, and sales. We review the valuation and the financial records behind it, explain how the price is likely to be allocated between equipment and goodwill and what that means for taxes on each side, and help you understand the terms before anything is signed.
For owners and associates facing a transition decision.
One firm for the whole practice
Our specialty work rests on the same dental practice experience described on our dental practices page, including the work of Tooth CPA, which is now part of Lang Accountants & Advisors. The bookkeeping, payroll, and tax preparation are the same, and the specialty work adds attention to treatment contracts, medical billing, larger equipment decisions, and ownership transitions. The firm works with practices remotely anywhere in the United States from its base in Woodstock, Georgia.
Common questions from specialists
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How does a treatment contract affect an orthodontic practice's taxes?
Most orthodontic practices report income for tax purposes on the cash method, so a case fee is taxed as payments are received rather than when the contract is signed. Monthly statements should still show contracts receivable alongside collections, because that balance is the practice's clearest view of revenue still to come. -
What should an associate review before buying into a practice?
The practice's financial statements and tax returns for several years, the basis for the valuation, how the purchase price is divided between equipment and goodwill, how compensation will change during and after the buy-in, and the terms of the partnership or shareholder agreement. The allocation of the price affects the tax position of both buyer and seller for years afterward. -
Do you work with specialty practices outside Georgia?
Yes. The firm is based in Woodstock, Georgia, and works with orthodontic and oral surgery practices throughout the United States. Document exchange, meetings, and signatures are handled remotely. -
Do you also work with general dental practices?
Yes. General practices, dentists starting or buying a practice, and multi-location groups are described on our dental practices page.
Let us take a look at your practice.
Send a short note about your practice and what prompted you to reach out, and we will arrange a time to talk.