The European dental care landscape comprises businesses and public organisations that provide various oral care treatments. Such medical care includes preventive, remedial, restorative, emergency and cosmetic procedures. This research focuses on European businesses that operate multiple dental clinics under one or multiple brands. We segmented the market by geographic scope into: (i) international and (ii) domestic.

The European dental care market remains highly fragmented, with the penetration of dental chains varying significantly among countries. To illustrate, Germany positions itself on the lower end of the spectrum with ~5% of chain penetration, whereas the UK houses several acquisitive consolidators with >30% chain penetration. Overall, the industry remains poised for consolidation given the abundance of attractive acquisition targets and changing regulations opening previously restricted markets to external capital.

Sponsor-led interest has been significant, with ~75% of identified assets being backed by a financial sponsor (November 2022). Investors are attracted to the stable underlying demand for dental care and vast opportunities for value creation through buy-and-build, ranging from multiple arbitrage plays to operational improvements and service expansion. Following a slowdown during COVID-19, deal activity rebounded with clinics valued at ~10-15x EBITDA as of early 2021.

ESG topics primarily relate to social and governance issues. The structural shortage of new dental graduates paired with a wave of workforce retirements poses large operational threats to (especially smaller) chain operators. On the governance front, market consolidators face increased risks of managerial misconduct, potentially leading to significant legal and reputational damages (e.g. tax fraud at Vitaldent & PlusTerveys).