Dental Sleep Medicine Break-Even: About $379K Monthly

Fixed costs $29.4K/mo Year 1 base

Contribution margin 77.5% After variable costs

Break-even revenue $37.9K/mo Monthly target

Break-even timing Month 1 Launch month

Break-even calculator

Use this to test monthly revenue, direct costs, and overhead for a dental sleep medicine practice against break-even.

Lean Base Full

Monthly revenue Revenue is the cash coming in each month before direct costs and overhead. $ Lower volume Mature practice Variable expenses Direct costs rise with treatments, like lab fees, supplies, billing, and outreach. $ Tight costs Higher cost

Money available to cover fixed costs $401,234 $499,667 revenue - $98,433 variable expenses

Margin ratio

80%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly overhead fixed costs must cover before profit starts. $ Lean overhead Heavier overhead

Break-even chart Revenue Total costs

Which expenses are fixed, and which move with treatments in a dental sleep practice?

Cost classification

Break-even is reliable only when stable overhead stays separate from case-based spending. Treating lab fees like rent can make Month 1 break-even look safer than cash reality.

Expense	Cost	Break-Even Treatment	Common Mistake
Medical Office Rent	Fixed	Include $6,500 per month in overhead from Month 1 through Month 60.	Allocating rent per appliance and hiding the base monthly burden.
Practice Management Software	Fixed	Include $800 per month before calculating treatment volume needed to break even.	Modeling software as a percentage of treatment revenue.
Year 1 Listed Salaries	Fixed	Use $16,250 per month for the medical billing manager, front desk receptionist, and practice administrator.	Leaving admin payroll out because it is not chairside labor.
Front Desk Receptionist Staffing	Semi-fixed	Step staffing from 1.0 FTE to 2.0 FTE when the model reaches the larger practice scale.	Adding the second receptionist before patient flow supports it.
Custom Oral Appliance Lab Fees	Variable	Apply the first year rate of 12.0% to treatment revenue, falling to 10.0% in the mature year.	Treating lab fees like rent instead of case-based spending.
Clinical Supplies and Impression Materials	Variable	Apply 3.0% of first year revenue, declining to 2.2% as purchasing improves.	Forgetting that each additional case uses supplies.
Medical Billing Function	Semi-variable	Split the $65,000 annual billing manager salary from claims processing at 4.0% of first year revenue.	Putting the whole billing function into fixed overhead.
Physician Outreach and Marketing	Variable	Apply 3.5% of first year revenue, then reduce the rate as referral flow improves.	Assuming outreach spend stays flat while treatment volume scales.

How does break-even shift from a lean launch to a full referral-flow case in a dental sleep medicine practice?

Scenario table

Higher referral flow and more staff lift monthly revenue, but lab, billing, and outreach costs also rise. The base case keeps the cleanest cushion, while the full case needs the most volume to stay above break-even.

Planning assumptions only; staffing, referral flow, and lab pressure can change these figures.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean launch case	$115.5k	$25.9k	$29.4k	77.5%	$60.2k	Break-even sits near $37.9k, so launch still has a cushion.
Base referral-flow case	$228.1k	$48.1k	$29.4k	78.9%	$150.7k	Break-even stays near $37.2k, and this case shows the cleanest cushion.
Full referral-flow case	$1.072M	$181.2k	$33.1k	83.1%	$857.7k	Break-even moves to about $39.8k, but the cushion remains wide.

What breaks the break-even plan for a dental sleep medicine practice?

Stress test

Base year monthly revenue is $115,500 against $29,350 of fixed overhead, so the plan clears break-even by about $77,600 a month. The risk is slower referrals, plus higher lab, billing, or staffing costs.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$37,900	$77,600 cushion	Healthy cushion, but referrals and claims must keep pace.
Revenue shortfall	Collections fall 25% to about $86,600 a month.	$37,900	$48,700 cushion	Lower collections still cover overhead, but the cushion is thinner.
Fixed-cost pressure	Fixed overhead rises 15% to about $33,800 a month.	$43,500	$72,000 cushion	Payroll, rent, or software creep becomes the first threat.
Margin pressure	Lab fees and billing costs rise enough to push break-even to about $40,500.	$40,500	$75,000 cushion	Billing and lab inflation eat into the margin buffer.
Combined pressure	Collections fall 25%, fixed overhead rises 15%, and variable costs stay elevated.	$57,500	$29,100 cushion	Weak referrals and cost creep leave little room.

Can this dental sleep practice fill the lease before you commit to rent, hires, and equipment?

Founder checklist

Before you sign the lease or buy the scanner, prove the referral flow can support the $6,500 rent and the $29,350 monthly Year 1 fixed load. With $854,000 minimum cash needed in Month 2 and $190,000 of capex, the practice has to convert patients and claims fast.

1Referral flow$6.5K/mo

Verify enough physician and patient referrals can cover the rent before you lock the lease, because empty chair time breaks the break-even math fast.

2Fixed load$29.35K/mo

Confirm the Year 1 base cost really sits near this level for rent, software, utilities, insurance, marketing, maintenance, and core payroll.

3Margin check86.7% CM

Use the model’s Year 1 revenue, EBITDA, and fixed overhead to test the implied contribution margin before adding volume that looks good but does not cover cash burn.

4Core team7 roles

Staff the senior sleep dentist, sleep coordinator, clinical assistant, hygienist, billing manager, receptionist, and administrator before opening, and keep associate capacity at zero until referrals justify it.

5Cash cushion$854K

Hold this minimum cash level for Month 2 so the opening ramp can absorb slow collections, startup drag, and early hiring without forcing a bad cut.

6Capex phase$190K

Phase the scanner, chairs, buildout, hardware, screening devices, sterilization, signage, and titration kits across the opening months, and check lab turnaround and remake risk before you spend it all.