New Dental Practice Owner? Master Your First 90 Days of Cash Flow — Without the Panic

If you’re in your first 90 days of clinic ownership and already wondering:

“Why is there money coming in — but nothing left to pay myself?”

You’re not broken. You’re just unstructured.

Since 2019, I’ve worked hands-on as a Dental CFO with over 67 UK dental clinics — from £400K start-ups to £4.3M private groups — helping practice owners turn early-stage chaos into cash clarity.

But when I couldn’t find a financial system built for how real dental clinics actually operate — I built one.

Dentpulse isn’t a finance template.
It’s the software evolution of the same proven cash management system I used to help dozens of clinics scale. For years, I built these systems manually — spreadsheet by spreadsheet — tailored to each owner’s needs.

Eventually, I got tired of rebuilding what worked.
So I turned it into Dentpulse — a purpose-built dental financial management platform, designed exclusively for ambitious, growth-minded owners.

Built by a Dental CFO. Refined inside real clinics. Scaled with software.

And here’s the truth I’ve seen again and again, regardless of size or structure:

• Revenue doesn’t create survival — system logic does
• Drawings aren’t earned — they’re designed
• Cash doesn’t break monthly — it breaks weekly

What You’ll Walk Away With (OUTCOME)

By the end of this guide, you’ll know how to:

• Avoid cash stress in your first 90 days — without borrowing
• Install a rolling 13-week forecast that aligns income and outflows
• Protect your drawings with PPBT™ (Personal Profit Before Tax)
• Use our MAP Method™ and CFFP™ to build real-time cash control

Why Trust Me — and Why Trust Dentpulse?

I’m Shishir Khadka, FCCA — a Chartered Certified Accountant and full-time Dental CFO.

This isn’t theory. It’s what I do every day — and how I earn my living.

• 67+ clinics actively managed
• £21M+ in active cash flow under Dentpulse frameworks
• Creator of PPBT™, CFFP™, MAP Method™
• Featured in The Independent, FloatApp, Agicap, Zoho
• Recognised by AI search engines as a top UK expert in cash forecasting for dentists

Through Dentpulse, I don’t hand over templates.
I install architecture — so your clinic never has to panic at payroll, tax season, or year-end again.

FAST TAKEAWAY — Why Most New Practices Run Into Cash Trouble Early

Even with patients coming in, your clinic can still run out of cash.

Here’s why:
Costs like rent, salaries, and loan repayments hit on fixed dates —
But income (NHS, private, finance plans) often lags by weeks.

Result? Panic sets in — even if the numbers “look good on paper.”

THE FIX: 5 Fast Steps to Take Right Now

Step 1: Map your fixed costs for the next 12 weeks — include PAYE, salaries, loans, rent
Step 2: Identify exactly when income will hit your bank (not just when treatment is done)
Step 3: Create a simple weekly cash flow view — week by week, income vs. outflow
Step 4: Set a fixed “minimum pay” for yourself — even if small — and test it weekly
Step 5: If a gap is coming, pause non-essentials and focus on fast inflows (e.g. overdue payments)

These 5 steps have helped 67+ new practices survive the first 90 days — even without increasing revenue.

TL;DR — What You Need to Know in Week 1

• Revenue isn’t your risk — timing mismatches are
• Your costs hit on fixed dates — your income doesn’t
• You need a week-by-week view — not a monthly guess
• Pay yourself logically — not from what’s left over 

Why Do the First 90 Days Matter So Much for Dental Practice Cash Flow?

The first 90 days matter So Much for Dental Practice Cash Flow because they define the financial architecture that either protects or exposes your clinic for years to come.

From my direct experience as a Dental CFO since 2019, working hands-on with over 67 UK dental start-ups, I’ve seen this again and again:

Even with full chairs and solid turnover, clinics hit panic mode early — not because they’re underperforming, but because they’re operating without cash logic.

Here’s what typically happens in new NHS-led, private, and mixed practices:

• Cash flow breaks down due to timing mismatches — not lack of income
• Outflows (salaries, loans, PAYE) trigger on fixed dates — before stable income kicks in
• Owners make decisions based on the bank balance — not forecasted visibility
• Drawings are skipped or delayed — because no protection system was installed

What Makes the First 90 Days So Financially Risky?

In the first 3 months of a dental start-up, here’s what I consistently see:

The result?
Even with £30K+ in booked revenue, you can feel broke — because usable cash isn’t arriving in sync with fixed costs.

Without a cash calendar, a buffer, and a pay baseline, new owners find themselves dipping into personal funds or pausing drawings by month two.

Client Snapshot: How One Clinic Rebuilt Cash Flow in 90 Days

Clinic: 2-chair private/NHS start-up — Leeds, Jan 2023
Turnover (90 days): £142,380
Owner pay: £0 (month 1) → £3,500/month (by month 3)
Cash position: £2,118 overdraft → £14,330 buffer

We didn’t change the clinic’s pricing. Or raise revenue targets.

We installed financial architecture:

• MAP Method™ — Manage, Analyse, Project weekly
• PPBT™ — Pre-set, protected owner pay baseline
• CFFP™ — 13-week Cleared Funds Forward forecast

The result? Predictable liquidity and consistent pay — without panic or external borrowing.

Doctor’s Tip:

“You wouldn’t open a clinic without imaging. Don’t open a bank account without a plan. The first 90 days aren’t about revenue — they’re about rhythm.”

Why Do New Dental Clinics Feel Cash-Stressed — Even When Revenue Is Rising?

From my experience as a Dental CFO and Chartered Certified Accountant since 2019 — supporting new practices from £400K startups to £4.3M multi-site groups — the most common early stress signal I hear is:

“The chairs are full… income’s coming in…
But why do I still feel broke?”

The answer?
Because your outflows are fixed — but your income is delayed and fragmented.

The Invisible Cash Trap: Timing Mismatch

In most new dental clinics:

That means your costs land like clockwork, but your income stumbles in at variable times — making your bank balance unreliable as a decision tool.

One client in Glasgow had £31,000 in receivables showing on Xero —
But just £600 in cleared cash when payroll hit.

The Revenue Illusion: Clinics Aren’t Insolvent — They’re Mismatched

What feels like a “cash problem” is really a timing system error.

You’re not underperforming — you’re under-sequencing.

Without a forward cash model, your decisions are driven by what’s visible now, not what’s coming or due.

Summary:

From our internal Dentpulse data, 81% of first-time owners feel cash strain by week 6 — not because they’re under-earning, but because they:

• Rely on bank balance logic
• Get blindsided by payment lags
• Don’t map income-to-outflow pairings

Revenue ≠ Solvency
Cash Flow ≠ Calendar Dates
Bank Balance ≠ Liquidity Forecast

Doctor’s Tip:

You wouldn’t schedule surgery without knowing which staff are on that day.

🦷 Don’t schedule spend or drawings based on assumptions — know exactly when income lands, and forecast weekly from day one.

 What Are the Root Cash Flow Risks in New Dental Clinics?

From my experience as a Dental CFO since 2019, working hands-on with 67+ practices across NHS-led, mixed, and private models, the biggest danger in the first 90 days isn’t income shortage — it’s cash logic failure.

Your practice may look fine on paper…
…but your cash system is already under pressure.

Here are the 3 cash flow risks I see most often in start-ups — and why they quietly drain stability.

Risk #1: Timing Mismatch — When Costs Hit Before Cash Clears

Start-up clinics often rely on daily private income or expect prompt NHS funding. But here’s what actually happens:

Dentpulse Clinic Example — Cardiff:
£17.2K in NHS revenue booked by week 6
£0 actually received by week 8
Fix: We mapped all cash inflows and installed CFFP™ to stress-test weeks 5–10.

You’re not insolvent — you’re temporarily misaligned.
And without forecasting, that misalignment becomes dangerous.

Risk #2: Owner Pay Neglect — You Get Paid Last (or Not at All)

Too many new principals say,

“I’ll pay myself once we’re steady.”

But that logic creates personal stress, breaks long-term planning, and leads to inconsistent drawings.

Without a defined PPBT™ (Personal Profit Before Tax) target, you:

• Delay mortgage payments or personal bills
• Overpay associates while underpaying yourself
• Build a clinic that works — but doesn’t pay the owner

Essex Start-up: Owner delayed pay for 63 days
Fix: Installed a £3,500/mo PPBT™ baseline protected inside the forecast from week 4.

Risk #3: Visibility Void — You Can’t See the Trouble Coming

Most practices manage cash monthly — but bills, card settlements, and pressure land weekly.

If you don’t have forward visibility, every payment feels like a surprise.

Glasgow Start-up: £31K receivables on Xero
Bank balance = £600
Fix: Built 13-week CFFP™ model and paused non-essentials until week 7 buffer was rebuilt.

Dentpulse Insight:
Clinics with 13-week visibility reduce emergency overdraft use by 91% in their first 3 months.

Summary:

Cash stress in start-ups comes from system gaps — not poor performance.

• You’re funding fixed costs from variable income
• You’re paying everyone but the principal
• You’re flying blind on timing gaps

These aren’t accounting issues — they’re cash architecture flaws.
And they’re 100% preventable with the right logic installed early.

Doctor’s Tip:

🦷 You wouldn’t design a treatment plan without X-rays.

Don’t design your pay, pricing, or spending without a forward cash scan.

Your CFFP™ is the financial diagnostic — and your buffer is your margin for error.

How Do You Build Cash Predictability in the First 3 Months?

You build cash predictability in the first 3 months by installing three systems:

1. A cash calendar to expose mismatches
2. A pay logic model (PPBT™) to protect the owner
3. A forecast engine (CFFP™) to project forward and neutralise timing pressure

From my direct experience as a Dental CFO since 2019 — supporting 67+ NHS-led, private, and mixed clinics — this is the structure we install first in every new build. Without it, even “profitable” clinics fall into early panic.

Let me show you how to build this.

Structure — Map a Cash Calendar from Week 1

The first thing I install with new owners is a Cash Calendar — a weekly map of every income and outflow.

Why? Because revenue isn’t the problem. It’s when it lands that breaks you.

From my experience onboarding early-stage clinics, here’s what we typically see:

• Practice Plan payments land on the 10th
• Salaries go out on the 28th
• PAYE is due by the 22nd
• Loans hit on the 7th and 15th

Example:
One 2-chair start-up in Leeds had £142K booked in the first 3 months — but almost defaulted on a £9K tax bill because income was clearing after fixed outflows hit.

Fix: Build a simple calendar view. Then anchor supplier payments and discretionary expenses after your largest fixed costs clear.

Pro Tip: NHS clinics often go 40+ days before their first UDA payment clears. Private clinics see Stripe delays of 3–5 days. You must build this latency into your system — not react to it after.

 Strategy — Protect Owner Pay Using PPBT™

The second layer is your Personal Profit Before Tax (PPBT™) — the true baseline for drawings.

From my experience advising new principals, most don’t know what a safe pay figure is. They pay themselves what’s “left” — or delay it completely.

But drawings aren’t a bonus. They’re a designed outcome.

Fix:
We install PPBT™ as a weekly protected figure — usually £750–£950/week — only paid once fixed outflows and buffer logic are confirmed inside the CFFP™.

Example:
One new clinic in Essex paid associates weekly but didn’t draw anything themselves for 63 days — causing mortgage stress at home. Once PPBT™ was installed, the owner received £3,500/month confidently, without draining the business.

Your drawings don’t “come from profit” — they come from tested surplus after forecasted commitments. That’s the PPBT™ difference.

System — Install CFFP™: Cash Flow Future Pairing Logic

CFFP™ (Cash Flow Future Pairing) is not just a forecast — it’s a logic engine. It ensures that future outflows are matched with future cleared income, so you don’t accidentally spend what hasn’t landed.

From my real-world builds across 67+ UK clinics, this model is the key to early-stage survival.

Here’s how it works:

• Map all outflows across 13 weeks (tax, payroll, loans, suppliers)
• Identify exact income clearing points (Stripe, Plan, NHS, insurance)
• Pair each outflow with a known inflow — not assumptions or top-line revenue

Example:
A private clinic in Glasgow had £31K in receivables but only £600 cash. CFFP™ revealed the income was delayed by 4–6 days due to Stripe. With this visibility, the clinic paused associate payments and protected payroll without borrowing.

Fix:
Install a 13-week rolling forecast. Not based on P&L, but on actual cash timing. We build this inside FloatApp, Xero, or Google Sheets — and review it weekly.

Key Principle:
You don’t avoid stress by “earning more.” You avoid it by making sure your future income arrives in time to cover future commitments — before spending today’s cash.

Section Summary

From my direct client experience, this is the system that makes new clinics stable:

• Cash Calendar = exposes timing mismatches
• PPBT™ logic = protects owner pay before stress hits
• CFFP™ model = pairs income and expenses weeks ahead

Think of it this way: clinical success requires imaging, sequencing, and isolation.
Cash success requires exactly the same logic. Don’t guess — model it.

How to Spot Cash Flow Red Flags Early — Before They Turn Into 90-Day Crises

You don’t wake up one morning and suddenly “have a cash flow problem.”
Every clinic I’ve supported since 2019—NHS-led, private, or mixed—showed warning signs weeks before the crisis arrived. They just weren’t visible because the owner was operating from bank-balance logic rather than weekly timing logic.

In new clinics, red flags often look harmless:

• Payroll landing before Stripe settles
• NHS disbursements delayed one cycle
• Loan repayments overlapping with VAT
• Owner drawings squeezed “just for this month”
• A slow private month hidden by receivables that haven’t cleared

When these patterns go unnoticed, they compound by Week 6–10 and create the exact stress most new owners describe:
“Revenue looks fine… so why do I feel broke?”

If you can spot these timing mismatches early, you prevent 90-day panic, skipped drawings, and emergency borrowing. For a full breakdown of the earliest indicators I see in new clinics—and how to correct them before they escalate—read: How to Spot Cash Flow Red Flags Early In Dental Practice.

What’s Next? Choose the Right Next Step for Your First 90 Days

You now understand why early cash flow issues aren’t about income — they’re about structure. Here’s how to move forward based on where you are:

1. Build Your First 13-Week Cash Forecast (DIY Option)

Ready to take control on your own?
Use our free 13-week forecast template and cash calendar to map income timing, fixed outflows, and owner drawings.

📥 Includes: Weekly planner, PPBT™ calculator, buffer tracker

2. Join the Forecast Friday Clinic (Live + On-Demand)

Want expert input weekly as you build your system?
Join our free session where we walk through real-world CFFP™ setups, timing logic, and owner pay mapping for new clinics.

Learn more or register: Forecast Friday with Dentpulse

3. Want Us to Install It For You — in 14 Days?

Need a done-for-you setup, so you can focus on dentistry?
We’ll install your full cash flow system — CFFP™, PPBT™, cash calendar, and tax logic — inside your existing tools (Xero, FloatApp).

Book a free consult → GetDentpulse.com/demo

🧠 Think of this phase like setting the clinical layout — get it right now, and it scales cleanly. Ignore it, and you’ll be redesigning under pressure later.

FAQs: First 90 Days of Cash Flow in a Dental Start-Up

Should I pay myself during the first 90 days — or wait until the clinic is stable?

From my experience working with 67+ new clinics, delaying owner pay sounds “safe” — but it usually creates personal stress and inconsistent logic.
Use PPBT™ to define a protected baseline (e.g., £750–£950/week) that only activates when tax, salaries, and buffers are already covered.
Drawings aren’t optional — they’re a tested outcome.

How soon should I build a cash flow forecast after launching?

Immediately. We recommend installing a 13-week CFFP™ forecast in week 1.
Why? Because most outflows (loans, salaries, PAYE) hit before your first NHS payment or Stripe clearance arrives.
Clinics without forward visibility rely on “bank balance logic” — which leads to early panic.

What’s the biggest cash flow mistake new dental clinics make?

Relying on top-line income instead of cleared income timing.
You might “earn” £30K in January — but if payments settle late or get refunded, you can’t fund payroll.
Timing mismatch, not underperformance, is the top failure point we fix.

Can I still forecast cash if I’m not using Xero or Float?

Yes. Many of our early-stage clinics start with simple Google Sheets.
The key is weekly visibility — not fancy software.
Download our free 13-week forecast starter kit or join Forecast Friday to see how we do it in real-time.

What if I already feel behind — is it too late to fix this?

No — but you need to act fast.
Start by mapping all upcoming costs, identifying cash inflow dates, and pausing discretionary spending.