BDJ In Practice spoke to Hannah Haines, Head of Healthcare Consultancy at Christie & Co, to discuss the findings - and the implications - of their Dental Market Review.

What implications does the report have for the dental market?

HH The report highlights a strategic recalibration of M&A activity in the market. The volume of transactions in the market is recovering, with higher levels of activity, including at corporate/investor level, particularly with Bridgepoint's investment in {my}dentist - the largest deal since it last transacted. Pricing has rebounded with increasing goodwill prices, which follows a more subdued transactional environment post ‘mini budget' in 2022 and subsequent pricing correction. Owners with effectively operated practices are well-positioned to capitalise on increased buyer interest and sentiment.

Furthermore, buyers have more access to capital with improved lending conditions and interest rate stabilisation, which makes funding more accessible and attractive to smaller groups, independents, and first-time buyers.

The NHS segment of the sector remains under pressure amid NHS contract reform and uncertainty. Overall, sentiment outlines that NHS-heavy practices are viewed with caution.

Which of these will have the biggest impact on the short, medium and long-term outlook for the market?

HH In the short-term, rising buyer confidence, improved lending conditions, and resilient EBITDA multiples will drive increased transaction volume.

Medium to long-term, the market's buoyancy is underpinned by a demographic shift, as patients are becoming more health and aesthetics conscious and are favouring practices that offer personalised, private care.

While NHS reform remains a wildcard, meaningful structural change could create new opportunities. A reformed contract could spark renewed interest in NHS revenue streams, but, until then, private and mixed-income models will continue to dominate and be favoured.

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Corporate dentistry appears to be making a bit of a resurgence. Is this a trend you're seeing based on previous Market Reviews?

HH Over the last two years, corporate activity has indeed been subdued. Early Christie & Co data and sentiment have highlighted that there is a greater response from this buyer group, which will likely come to fruition as increased interest teases more high-value and private revenue-led practices to the market.

Over the years, corporate and national group representation has grown. Since 2018, new groups of scale have emerged, from 13 groups with over 30 practices in 2018 to 17 groups today (which includes the merging of PortmanDentex and Dental Partners into Rodericks). Some portfolio shaping occurred between 2023 and 2024 in response to the ‘mini budget', but this increased again for 2025

Despite some shaping observed, national and corporate group market share has remained consistent at circa 18% over the last four years, compared with 12% in 2018.

What do you think the re-entry of corporates means?

HH Increased confidence in the transactional market and growth opportunities. More optionality for sellers, particularly those with higher value opportunities, where aggregate pricing typically exceeds the capabilities of the independent market.

For the consumer, in the midst of some smaller practices closing over the last 12 months due to operational constraints, growth through acquisition, including the consolidation of smaller practices to create ‘super hubs', ensures that communities continue to be serviced across different price points.

What difference to the market will the balance of ‘big corporates' vs ‘mini-corporates' make?

HH The emergence of mid-sized, or ‘mini-corporate' groups, has added depth and competitiveness to the market. These groups bring a variety of operating models and clinical specialisms, offering both sellers and patients a broader spectrum of services, brands, and price points. For the consumer, this translates to more choice, better access, and often an improved patient experience.

What are the biggest changes in the 2025 report compared to the 2023 and 2024 versions?

HH Corporate and national consolidators have re-entered the market after a period of subdued activity, which has increased buyer confidence. EBITDA multiples are trending upwards, which follows the period of pricing correction observed in 2023/24, currently representing a 2.9% goodwill price increase for 2025 year to date.

One of the key themes is the continued shift toward private and mixed income practices - what are the implications for the future of the NHS?

HH From a market perspective, the 10-Year Plan introduces a degree of uncertainty that practice owners and investors are watching closely with both a mix of hope and scepticism. The proposed NHS graduate tie-in may alleviate some workforce pressure in the short term, but it doesn't address the systemic challenges that continue to erode confidence in NHS-led dentistry. Buyer sentiment reflects this uncertainty. NHS-heavy practices, especially those underperforming on targets, are attracting less interest, and there is even more scrutiny on those practices that aren't fulfilling their KPIs. Many operators see the current environment as reinforcing a longer-term pivot toward private and mixed-income models.

Unless there is meaningful reform to the NHS contract and greater clarity on future funding streams, the appetite for acquiring NHS-led practices, especially those that are under-performing, may remain subdued. For many operators, the 10-Year Plan may reaffirm an already growing strategic shift away from the NHS model.

Operator sentiment outlines that patient demand for NHS dentistry has increased in the past six months and over half of respondents feel that changes to NHS dentistry introduced under the ‘recovery plan' have not facilitated improved delivery. Similarly, over half of respondents express the view that therapist-led NHS treatment has or will further increase. Recruitment and retention pressures are disproportionately higher in NHS practices than in those with private/mixed income streams. The NHS-graduate tie-in may relieve some of these pressures

Are deferred payment terms still an issue, putting potential sellers off corporates?

HH As corporate consolidators and private equity-backed groups re-enter the market, we can expect a greater focus on deferred offer consideration to also increase, especially with their focus on higher revenue private practices. For these types of opportunities, deferred payment structures are now commonplace, aligning post-sale incentives with performance. This is to protect the private income aligned to the principal dentist and should therefore be anticipated for any owner-operators nearing retirement or looking to exit in the next three to five years.

That said, onerous or overly complex terms can be a deterrent. Sellers are increasingly discerning and will walk away from a higher offer if the tie-in period or earn-out conditions are unattractive. Most deals are holding steady at a three-year tie-in, and we expect that to remain the norm.

Based on the trajectory of 2023, 2024 and 2025, what do you expect we'll see in 2026?

HH Greater transactional activity from all buyer types, particularly for private/mixed practices. It's hard to tell what the impact of changes in NHS dentistry will have on the market, but we hope it'll become a more positive environment to operate in, making it a better investment opportunity for groups.

To read the review in full visit https://www.christie.com/sectors/dental-practices/dental-market-review-2025/. ◆