Oral Appliance Therapy Break-Even Analysis: 16 Cases Per Month

Fixed costs $41.4K/mo Monthly base cost

Contribution margin 77.5% After variable costs

Break-even revenue $53.5K/mo Monthly target

Break-even timing Month 1 Opening ramp

Break-even calculator

Test how monthly revenue, variable expenses, and fixed costs shape break-even for an oral appliance therapy practice.

Lean Base Full

Monthly revenue Revenue sets the pool that covers variable costs and fixed overhead. $ Low revenue High revenue Variable expenses Use direct costs that rise with treatment volume and claims. $ Low costs High costs

Money available to cover fixed costs $399,432 $498,667 revenue - $99,235 variable expenses

Margin ratio

80%

Covers fixed costs

Yes

Fixed monthly costs Use monthly overhead that stays in place as volume moves. $ Low overhead High overhead

Break-even chart Revenue Total costs

Which oral appliance therapy expenses are fixed, variable, semi-variable, or semi-fixed at break-even?

Cost classification

Break-even is reliable only when case-linked expenses stay out of overhead. In the first operating year, lab fabrication at 12.0% of revenue and supplies at 2.5% directly reduce margin on each treatment.

Expense	Cost	Break-Even Treatment	Common Mistake
Clinical Facility Rent	Fixed	Include $6,500 per month in fixed overhead for the planning range.	Spreading rent per case and hiding the true monthly hurdle.
Utilities & High-Speed Internet	Fixed	Use $850 per month as recurring overhead unless a new site or major expansion is added.	Treating small usage swings as a sales-driven expense.
Malpractice & Liability Insurance	Fixed	Include $1,200 per month before calculating treatment volume needed to break even.	Leaving insurance below the break-even line because it is not tied to a specific patient.
EHR & Sleep Management Software Subscription	Fixed	Carry $600 per month as fixed overhead while the subscription level stays unchanged.	Modeling software as a per-treatment charge without usage pricing in the assumptions.
Custom Laboratory Fabrication Fees	Variable	Deduct 12.0% of first-year revenue before contribution margin; this is direct per-case margin pressure.	Treating lab fees like overhead instead of a cost that rises with treatments.
Clinical Impression & Sterilization Supplies	Variable	Deduct 2.5% of first-year revenue as volume-linked clinical supply spend.	Using a flat monthly supply budget when more cases require more materials.
Digital Marketing & Physician Outreach	Variable	Model 5.0% of first-year revenue as demand-generation spend tied to treatment volume.	Locking outreach at one monthly amount while patient acquisition needs rise.
Clinical Staffing Additions	Semi-fixed	Add salaries in steps as providers and assistants are hired; registered dental assistants rise from 1.0 FTE in the first year to 5.0 FTE by the fifth year.	Assuming staffing moves smoothly per case instead of jumping when capacity is added.

How does break-even change from a lean launch to a base case and a full schedule for oral appliance therapy?

Scenario table

The model clears break-even in Month 1 in all three cases, but the cushion widens as revenue rises and variable costs fall as a share of sales. The lean launch is the tightest; the full schedule has the most room if referrals, chair time, billing speed, and provider capacity hold.

Planning assumptions only; actual break-even will move with referral flow, chair time, billing speed, and provider capacity.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean launch	$118.5k	$26.7k	$35.6k	77.5%	$56.3k	Break-even is met, but the cushion is thinnest.
Base case	$238k	$50.5k	$61.5k	78.8%	$126.1k	Break-even holds with a steadier operating buffer.
Full schedule	$1.06M	$182.6k	$109.4k	82.7%	$763.4k	Strongest cushion, so referral swings hurt less.

What breaks the break-even plan for oral appliance therapy?

Stress test

The base plan clears break-even with a solid cushion, but referral slowdown and reimbursement cuts can pressure both sales and margin. Even then, the model stays above break-even unless revenue and cost both move the wrong way.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	Revenue is $1.185M and variable expenses stay at 22.5%.	$535k	$650k cushion	Healthy cushion, but volume has to hold.
Revenue shortfall	Revenue falls 20% to $948k.	$535k	$413k cushion	A slower referral funnel still leaves profit, but the buffer shrinks.
Fixed cost up	Fixed overhead rises 15% to about $476k.	$615k	$570k cushion	More rent, staffing, or admin spend pushes the hurdle up fast.
Margin pressure	Variable expenses rise 5 points to 27.5%.	$571k	$614k cushion	Lab fees or billing drag can move break-even without warning.
Combined pressure	Revenue drops 20%, variable expenses rise 5 points, and fixed overhead rises 15%.	$657k	$291k cushion	Still profitable, but the cushion falls fast and room for error narrows.

Will this oral appliance therapy practice break even before you lock the lease and hire?

Founder checklist

Only commit if referral flow, staffing, and cash can support the launch curve before you sign the lease and buy equipment. The model shows Month 1 break-even, $1.422M Year 1 revenue, and a $775K cash low in Month 2, so the real test is whether demand and fixed costs still line up.

1Referral Flow16 cases/mo

Verify referral flow can sustain about 16 dentist-led cases a month, because the practice only breaks cleanly if starts keep up with the fixed payroll and lease.

2Fixed Load$41.4K/mo

Check that rent, utilities, insurance, software, waste, admin, and base payroll stay near $41.4K a month, because that is the fixed load the model must clear.

3Margin47.5% EBITDA

Protect the Year 1 47.5% EBITDA margin by keeping lab fees, billing fees, and collections tight; if that margin slips, break-even moves fast.

4Staffing Ramp65% / 50% / 50% / 40%

Year 1 assumes one senior sleep dentist at 65% capacity, one dental sleep technician at 50%, one clinical assistant at 50%, and one patient care coordinator at 40%, so verify the schedule matches real patient flow and no one sits idle.

5Launch Stack$218K

Month 1 to Month 4 capex totals about $218K, so verify the scanner, lab partner, sterilization, appliance delivery, follow-up, and billing flow are ready before the spend.

6Cash Cushion$775K in M2

Hold at least $775K of cash by Month 2, because the model's minimum cash point hits early and a slow referral ramp will strain working capital.