Modern dental technology, and pain relief, mean that these days a trip to the dentist is nothing to be scared of. But one aspect of the sector has until recently remained rooted in the past – ownership.
As far back as 2016 a report from KPMG identified the market here as ripe with potential for dental chains. Aside from the cost challenges associated with operating as a small business, the existing small practice model was under pressure, it said, with many dentists approaching retirement age and a lack of newly qualified professionals to replace them.
That created an opportunity for private equity and strategic investors, such as private healthcare providers already operating in adjacent sectors, to buy individual practices and groups and create chains to introduce economies of scale, it found.
In Finland at the time, chains accounted for 35 per cent of the market. Ireland had just two, Smiles Dental and Dental Care Ireland. In 2021 UK chain Portman Healthcare Ireland joined them. Today it operates five clinics and is on the acquisition trail for more.
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“The traditional model for most dentists qualifying in the last 20-plus years was to graduate from Trinity, UCC or Queens in Belfast, work in the UK or abroad to get some experience, and then return to Ireland to work as an associate, which is where you work for another dentist. Then the traditional pathway would have been to either buy out your principal or set up your own practice,” says Paul O’Dwyer, group clinical adviser for Portman Healthcare Ireland.
“That has worked very well for a long time but now, much like our GP colleagues, the trend is for people to get together and create kind of what we call a multiperson practice. That’s a really good, healthy thing, because it’s good to have more than one dentist on site, and it gives you the ability to talk with colleagues.”
Chains are simply the next step in that evolution, he says, and given the increase in population, and the number of delayed treatments as a result of the pandemic, dentists are busier than ever, so efficiency matters.
From a patient perspective, there are pros and cons to both chains and traditional dental practices, points out Sarah Flannery, who founded Azure Dental in Dublin’s Blackrock in 2021.
“It might be easier to get an appointment in a chain but you are likely to get a more personalised service,” in an independent practice, she suggests. You’re more likely to see the same dentist each time, which can be a source of comfort for patients, and smaller practices may offer greater accountability, she adds.
For some dentists, however, the advantages of a chain are clear. “If you’re working in general practice it’s really handy to be working with a group of professionals who have other qualifications, whether oral surgery or orthodontics or endodontics. It gives you support, which is what groups are all about,” says O’Dwyer.
There are advantages for patients too, including a wider range of specialisms and having that expertise to hand. Chains often offer longer opening hours as well. “It’s convenience and access too,” he says.
