Buying an existing dental practice is an incredible milestone, but if that practice comes with a pipeline of active orthodontics cases, you need to tread carefully. Dental brokers and sellers often gloss over the specialty work to keep a deal moving smoothly. However, if you are a general or pediatric dentist who doesn’t know orthodontics backward and forward, taking on these mid-treatment patients blindly can lead to massive clinical and financial liabilities.
Before you sign a purchaser agreement, you must evaluate your own comfort level and skills. If you have no interest in ortho, you have every right to exclude active specialty cases from the purchase agreement. The seller must then arrange to transfer those patients to a local orthodontist or finish the cases before closing. Alternatively, if you plan to accept the existing ortho pool, you must perform exhaustive due diligence. Never just take the seller’s word for it. Require progress records for every active patient and audit each case individually. Spot-checking is not enough; it only takes one hidden liability to turn your dream acquisition into an expensive legal headache.
Be highly critical of the types of cases in the practice. While five-year Invisalign Comprehensive cases offer a safer buffer for refinements, limited options like Invisalign Go, Lite, or Express are immediate red flags because they require more out-of-pocket lab fees to fix if things go off track. Watch out for traps like fixed traditional braces if you only do aligners, and be wary of sellers promising to “come back once a month” to finish cases—scheduling conflicts almost always leave patients unsatisfied. If you are auditing a transition, bring in an orthodontic consultant to review the charts with you so you can step into your new practice with complete confidence.