How to Start an Orthodontic Practice: 8-Step Guide for 2025

Thinking about an orthodontic practice startup is a big leap. 

It’s a decision that many clinicians deliberate over for years. On one hand, you gain the clinical freedom to practice the type of dentistry that you were trained to provide. 

Free of corporate targets and contractual restrictions. 

But, it can be one of the biggest decisions you ever make. Between the legal paperwork and the financial risk, there is a lot to consider.

That’s where this guide comes in.

Whether you’re newly qualified or transitioning from general dentistry, we’ll walk through each step of the process of how to start an orthodontic practice. 

From writing your first business plan to choosing tools that help you scale, we’ll cover all the ground that you need to take your first steps. It’s a practical blueprint for starting an orthodontic practice from scratch.

Why Start an Orthodontic Practice?

Owning your own practice is about designing a career that works for you.

You decide how you treat patients. You decide who you work with. You decide how your team operates.

You don’t have to adapt to someone else’s system. You can build the vision that you always had in mind, and create your own practice culture. 

Although there’s a lot of hard work initially, you will reap the long-term rewards of having a sellable asset that will grow in the years to come. 

Here are some of the biggest benefits that you can get with an orthodontic startup:

• Autonomy – You set the tone. Clinical decisions, pricing, treatment protocols  —  they’re yours to own.

• Financial Growth – Orthodontics remains one of the highest-earning dental specialties. With smart systems in place, profitability can scale quickly.

• Work-Life Flexibility – Yes, startups are demanding. But ownership gives you more control over your hours, pace, and goals.

• Equity Over Time – Each year you grow the business, you’re building something valuable  —  an asset that grows in worth, not just workload.

• Stability Through Demand – There is evergreen demand for orthodontic treatment. Now, we are beginning to see the growth of aligner-based treatment and tech-forward workflows.

So if you’re looking for more than just another associate role, starting your own orthodontic practice might just be the smartest step forward.

Self-Assessment: Are You Ready to Start Your Own Practice?

Before you dive into planning, you need to understand what it is that you want. 

An orthodontic start up involves you playing the long game. It tests more than clinical skill  —  it’s the ultimate test of your business acumen. 

You’ll be wearing different hats from day one: clinician, manager, strategist. Some days will feel like a complete rollercoaster of emotions. A lot of the time, you will be forced to learn new skills on the job!

Here are a few questions worth asking:

• Have I had enough hands-on experience to work independently with confidence?

• Do I understand how to start an orthodontic practice? Do I understand all the roles of management?

• Am I financially prepared to handle my orthodontic practice business plan?

• Can I stay calm when the unexpected shows up  —  and make decisions under pressure?

There’s no perfect time to start. But there’s a big difference between feeling uncertain and being unprepared. 

If you cannot answer these questions confidently, that’s normal. No-one ever feels ready to ‘take the leap’. 

Answering these questions just means you’ve got a clearer picture of where to grow before you go all in.

Evaluating the Demand and Competition

Not every postcode is a good place to launch.

It’s tempting to go for the more lavish areas within your city. You can assume that there’s more demand in city centres; but actually for an orthodontic practice, you want to grow within an area of less competition. 

Before you put pen to paper, you need to gather enough data to make the smartest decision. 

Here are a few places that you could start:

• Demographics – Use tools like Census.gov or City-Data to get a sense of population size. You can gain an overall insight into key metrics such as average income, and family density. Areas with younger families tend to have higher demand for orthodontics.

• Competition – Search your area on Google Maps. How many other orthodontic clinics show up? Assess their reviews. See what patients are demanding more of. See what patients praise  —  and what’s missing.

• Treatment Trends – Is there a strong presence of aligner-only clinics? Are most offices still wire-and-bracket focused? Understanding where the demand lies can help you develop a USP early on. 

• Local Associations – Look into the local dental committee, or orthodontic societies near by, which can provide regional insights you won’t get online.

This kind of groundwork can feel tedious when you’re starting out. Most don’t think about this, when they think about how to start an orthodontic practice. However, you will thank yourself when you make the right decision. 

Sometimes, the best move is the least predictable move.

Starting Up or Buying an Existing Orthodontic Practice?

This is one of the first big choices you’ll need to make.

Do you build your orthodontic startup from the ground up, or buy one that’s already running?

Each option comes with its own trade-offs. Many clinicians place too much weight on the initial financial investment.

However, that’s not the only thing to consider when starting an orthodontic practice from scratch. It’s about how much control you want. 

Do you have a dream of your ideal practice layout? If so, this could be complicated to implement in a clinic with pre-existing workstations.

You may also need to consider how quickly you need patients coming through the door, and whether you’re prepared to take on someone else’s systems.

Starting from Scratch

Buying an Existing Practice

Ultimately, there isn’t a correct answer. You can ask several clinicians who have been on similar journeys, and they would all give you varying answers.

If you’re eager to start with stability and cash-flow from day one, buying might fast-track your goals. This is important to consider in your orthodontic practice business plan. 

However, if you have a concrete vision on your patient journey, building from scratch gives you the ultimate freedom.

How Much Does It Cost to Start an Orthodontic Practice?

Now, we get to the part that most dentists stress over. 

The initial outlay when starting an orthodontic practice from scratch isn’t cheap. However, if you plan well, you can keep it within a reasonable range. 

Your total cost will depend on a multitude of factors. 

For example:

• Location

• Size

• The level of investment in equipment and branding 

Here’s a general breakdown of what to expect:

Typical Startup Costs

Your total investment can range anywhere from $250K to $750K+, depending on the scale and setup.

Now, this is understandably a broad range; however, the demands of practice owners vary depending on their goals and ambition. Some may desire a small site, however, others may have patterns on building a multi-surgery clinic. 

💡 Pro Tip: Many orthodontists fund their startup with dental-specific loans or SBA (Small Business Administration) financing. 

Before spending a dollar, it’s worth creating a detailed orthodontic practice business plan. You want to seek pre-approval for financing, so that you’re not working from a hypothetical budget. 

How to Start an Orthodontic Practice: 8 Steps

There’s no shortcut to starting an orthodontic practice from scratch. 

However, there is a system that you can use to get you started. Below, I’ve outlined a practical roadmap for you to navigate in your journey.

If you follow these steps methodically, you can avoid a lot of the early stress (and expensive mistakes) that can derail a new orthodontic startup.

Step 1. Develop a Comprehensive Business Plan

Before you worry about logos or branding, you need to have a strong look at your financials.

The best way to do this is by developing a strong orthodontic practice business plan. 

A strong business plan helps you:

• Define your niche: general ortho, clear aligners only, family-focused, or teen-centered?

• Forecast costs and revenue

• Secure financing (banks and investors will ask for this)

• Create a timeline with real milestones  —  from signing he lease to your first booked patient
  It doesn’t need to be perfect. Lenders want to know that you have realistic projections, and that you’ve considered all mitigating factors.

As long as you keep your decisions specific, it will guide you effectively on your plans going forward. 

Step 2. Choose the Ideal Location

This is the most underrated aspect of starting a new orthodontic practice from scratch. The decor will not make a difference if your location choice isn’t ideal. 

Look for a space that’s:

• Accessible (public transport, parking, foot traffic)

• Surrounded by your target market  —  young families, schools, residential growth

• Underserved by existing orthodontic clinics (look for surrounding practice reviews and map density)

You want to take your time with this step. By selecting a good location, you can fast track your growth with less effort.

Otherwise, you risk having to invest a lot into marketing to get the initial footfall. 

Step 3. Comply With All the Legal Requirements

This part’s not glamorous  —  but it’s essential.

Here’s what you’ll need to tick off:

• Business registration and tax ID

• State-specific dental and ortho licenses

• Insurance (malpractice, property, employer liability)

• OSHA and HIPAA compliance

Employment contracts, policies, and staff handbooks
Seek adequate legal advice if you’re unsure. This is not something that you want to rush over. It’ll save you from costly missteps later in your journey.

Step 4. Design and Equip Your Office

Your practice environment will determine your patient journey. The patient experience means everything when it comes to starting up a new orthodontic practice. 

Design with both in mind:

• Clean, modern, calming interiors

• Separate zones for reception, clinical, sterilisation, and admin

• Ergonomic layout to support smooth daily workflow

Equipment will be one of your biggest expenses. Don’t be afraid to invest in quality.

It’s tempting to cut costs to stick to a budget, but buying cheap does often mean buying twice. Don't forget about patient comfort (the small things matter— smell, sound, and seating).

Step 5. Choose the Right Tools and Software

The right technology can make your team more efficient. 

With much of modern orthodontics going digital, the right practice management software decision can determine the success of your practice. 

You want to aim for an all-round system that avoids having to invest in costly integrations with third-party manufacturers. Not only does this save on multiple subscription costs, but it also avoids the headache of software failing to integrate.

This is why SoftSmile is becoming the most popular solution for orthodontic practices.

Our platform is built specifically for orthodontic workflows. It combines 3D treatment planning, AI-driven staging, and seamless lab integration  —  all in one place.

You can:

• Import intraoral scans, CBCTs, and cephs with ease

• Simulate tooth movement with visual accuracy

• Automate aligner staging with built-in AI

• Share plans with patients via secure WebViewer links

It’s modern, intuitive, and built to scale with your practice.

Step 6. Build Your Team

You don’t want to overhire to start off with. A big team comes with more management headaches, and a risk of overcomplicating your decision making. 

Early hires might include:

• A patient coordinator (first impressions matter)

• A dental nurse or ortho assistant with cross-functional skills

A treatment coordinator to handle consultations and case conversions
You want people who align with your values. This is an advantage of starting a clinic from scratch. 

You aren’t forced to change someone’s pre-existing work ethic. 

You want to embed your culture and values early into your team. 

Step 7. Manage Bookkeeping, Financials, and Accounting

If you ignore the numbers, the numbers will catch up with you.

Whether you use cloud-based accounting software or hire a dental CPA, stay on top of:

• Cash flow

• Payroll

• Equipment depreciation

Tax deductions and quarterly filings
Set aside time each month to review your financials. It’s one of the best habits you can build as a new owner.

Step 8. Market and Grow Your Practice

No one can book with you if they don’t know you exist.

Start local:

• Build a clean, fast website that explains your services clearly

• List your practice on Google Business and dental directories

• Use paid ads to target nearby families and adults

• Build referral relationships with general dentists in your area

And most importantly — make it easy for people to say yes. Offer virtual consults. Create treatment videos. Use before-and-after visuals. Build trust, then follow through.

Common Mistakes to Avoid

Inevitably, you will hit some roadblocks in your journey. You are starting a business after all! 

I have outlined some of the most common pitfalls orthodontic startups can encounter, and offered a few tips on how to stay ahead of them.

Underestimating Startup Costs

It’s easy to overindex on the big expenses, such as the dental chairs or the lease.

However, neglecting your day-to-day expenses are an easy way to be caught off guard. You want to consider factors such as payroll, software licenses, disposables, repairs. 

Build a buffer into your budget. Double it if you can.

Neglecting Marketing Early On

Many new owners assume patients will “just find them.”

In 2025, you need to invest in visibility. Your reputation will build over time, but you need the initial footfall to build your schedules. Build your online presence before launch — and don’t stop once doors open.

Choosing the Wrong Location

You can have the best tech, the best staff, the best prices — but if no one can get to you easily, it won’t matter. Do your market research before signing anything. Don’t just go for cheap rent or prestige postcodes.

Hiring Without Vetting

The wrong hire can derail your plans massively from the get go. This is why it is important to take your time with the hiring process. 

Do your due diligence. Ensure that you ask for adequate references, and test for soft skills as much as possible during the interview phase.

Qualifications are nowhere near as important as soft skills. 

Ignoring Legal Compliance

You don’t want to deal with a fine or an investigation in your first six months. Make sure your licenses, insurance, staff contracts, and patient data protocols are all in place from day one.

Modernize Your Practice from Day One with SoftSmile

Building your own orthodontic practice can be one of the biggest decisions you make in your professional career.

However, your best bet is to make things as easy as possible. 

Software is one of the best ways to increase efficiency, and create a clinical workflow that is comfortable for your whole team. 

That’s why SoftSmile is a powerful choice for your orthodontic startup. 

From day one, your workflow is considered. The software was developed with the ideal clinical workflow in mind. 

You will be able to diagnose with ease, and handle your administrative tasks without any headache. With SoftSmile’s software, you’ll always stay one step ahead of the curve. 

Here’s what that looks like in practice:

• Upload scans, photos, and CBCTs in minutes

• Map out 3D treatment plans with intuitive controls

• Use AI-powered staging to streamline aligner production

• Share plans with patients or labs instantly with WebViewer

• Integrate with lab workflows through Portal

It’s built for orthodontists first. You want a software that will deliver precision without adding unnecessary complexity. Try SoftSmile free today

With the level of support given to you, you don’t need to be a tech expert to use it. You just need a clear vision for your practice  —  and the right tools to bring it to life.