The dental sector in 2025 sees ongoing consolidation trends, technological innovation and more areas for M&A investment amid macroeconomic uncertainty.

Dental M&A’s Attractive Downside Protection for Investors

Lincoln International is uniquely positioned to guide clients through the complexities of today’s evolving dental sector, from traditional M&A to bespoke capital solutions. Our global service offerings include comprehensive coverage spanning the dental supply chain and worldwide geographies, supported by over 100 dedicated healthcare M&A and capital advisory bankers. Lincoln’s multi-faceted deal teams further enhance dental advisory processes, offering proprietary insights and tailored, strategic-oriented strategies to help clients achieve their unique goals.

With a proven track record of over 40 successful dental transactions and a robust network of key industry decision-makers, our clients benefit from actionable, strategic guidance to navigate regulatory and economic complexities with confidence. Read ahead to learn more about Lincoln’s global perspectives and actionable insights to empower your decision-making in the dental sector in 2025.

DSO M&A Activity Amidst the Multisite Healthcare Overhang

The global dental industry has undergone multi-decade consolidation, yet it remains highly fragmented and continues to offer significant opportunities for further roll-up. In the U.S., dentist affiliation with dental service organizations (DSOs) has been steadily increasing for over a decade, yet only about 25% of the nearly 200,000 dental practices are DSO-affiliated. With more than 120 U.S. DSOs—ranging in EBITDA from $5 million to over $300 million—the market is well-positioned for continued consolidation, including DSO-to-DSO M&A.

Over the past two years, more than 40 DSOs were brought to market in the U.S, yet fewer than 10 transactions successfully closed. While platform-level DSO deals have slowed, private equity-backed DSOs continue to consolidate the fragmented market through tuck-in acquisitions at attractive valuations, typically ranging from 3x to 6x EBITDA. In 2024 alone, the sector recorded over 120 add-on acquisitions, the highest volume among all healthcare services categories. Larger DSOs remain cautious about acquiring peer organizations, carefully balancing the potential synergies of such deals against the execution risks and integration challenges—often favoring the more manageable and lower-risk opportunities presented by smaller add-on acquisitions.

Against the backdrop of significant consolidation opportunities, operational excellence and a well-executed growth plan, both of which drive margin stability and expansion, remain the centerpiece for sponsors, existing platforms and privately owned businesses preparing for an exit. As consolidation continues in the U.S market, this can be achieved through volume increases, technological innovations and personnel solutions. When considering a transaction, acquirers specifically prioritize targets that demonstrate the following:

In addition to sustained practice-level performance across key metrics—such as post-acquisition revenue acceleration and margin stability or expansion—strong doctor alignment and retention are essential to building investor confidence and maximizing long-term value. Supporting these factors with robust data analytics and a compelling, well-articulated narrative further reinforces the long-term growth potential of the business.

Lincoln’s dental-focused team has established a strong track record of successful transactions, positioning embedded opportunities within businesses for strong margin expansion, along with supporting analyses that highlight practice-level performance metrics and ensure doctor alignment and stakeholder buy-in. Notable recent deals include the landmark March 2025 sale of myOrthos to Smile Doctors, the first scaled orthodontic services organization (OSO) acquisition by another OSO platform in the U.S. Another recent example is the December 2024 sale of Eastern Dental to Branford Castle, where Lincoln’s team applied its strategic guidance to drive success by effectively addressing concerns around utilization and profitability across different payor types, including capitation.

Contact us to learn more about the Eastern Dental and myOrthos transactions and how our expert bankers executed these deals with a high level of creativity to address recent challenges in physician practice management transactions. Leveraging in-depth analyses, Lincoln highlighted key business KPIs, including metrics such as practice-level performance, post-acquisition revenue growth acceleration, embedded growth potential, and doctor retention.

The dental sector remains underpinned by recessionary-resistant demand and stable long-term fundamentals that make it an attractive option for private capital seeking durable returns.

Pressure for Inorganic Growth 

Strategic buyers are expected to resume M&A activity as a key growth mechanism across European markets, driven by valuations that have softened since the market peak in 2021, when multiples were often in the teens. Add-on acquisition multiples, for example, have declined by 1–3x EBITDA, varying by geography. This recalibration has extended hold periods beyond five years for many financial sponsors, with several processes halted as seller expectations remain misaligned with current market realities. Despite recalibration across the market, similar pressure to return liquidity to investors and utilize high levels of dry powder exist in Europe as in the U.S. Europe’s buyers remain interested in key metrics for valuation, including margin improvement, operational streamlining, and organic growth.

Private market players seeking interest from strategic acquirers and financial investors have a clear strategy playbook, including attaining a strong and defendable market position, above-market growth and an attractive margin profile. Leveraging the three key growth drivers can help drive premium multiples, as sponsors seek to leverage these drivers during the investment period.

Dental MedTech as a Growth Path

Amidst larger market pressures to continue growth and provide returns to investors, dental MedTech is a uniquely promising vertical for investors. Several sub-verticals have seen enhanced operational efficiency and growing use cases. Technology has expanded margins by driving down equipment costs, streamlining processes and increasing patient engagement. The vertical will continue to drive growth across Europe through 2025 and beyond.

Sponsors and strategic buyers can optimize and enhance portfolios, streamline supply chains and strengthen go-to-market approaches with aligned acquisitions in the vertical. Meanwhile, strategic buyers can drive growth through accretive M&A, cross-selling synergies and R&D investments that solidify market leadership.

Lincoln’s expertise in the dental MedTech market was underscored by the rigorous buy-side advisory process to Proclinic, S.A., a leading specialized distributor and full-service provider of dental solutions across Europe. Proclinic’s acquisition of Meditrans, which distributed 20% of the dental consumables in Poland at the time, harnessed an impressive portfolio of aligners and other MedTech products to achieve substantial revenue growth.

Looking Ahead with Lincoln

Lincoln’s dedicated healthcare M&A and capital advisory bankers are uniquely positioned to guide clients through today’s evolving dental sector. With a proven track record of over 40 successful dental transactions and a robust network of key industry decision-makers, our comprehensive coverage spans the dental supply chain and worldwide geographies. Reach out today to empower your decision-making in the dental sector.