The dental market across Europe is also highly fragmented, presenting a significant investment opportunity for both private equity investors and strategic buyers from similar or adjacent healthcare clinical services.
Buyers are attracted by the valuations being achieved in the market, with a high volume of transactions reaching low to medium double-digit multiples, and even high double-digit multiples for the largest assets. Continued pan-European consolidation is therefore likely, with buyers expected to follow Colosseum Dental (headquartered in Switzerland) and Dentix (headquartered in Spain) by investing in high-quality UK dental businesses.
The UK is a hotspot for pan-European consolidators to consider in the near future due to a combination of favourable market dynamics and currency gains against the Pound, and we expect to see heightened overseas interest as shown by the following M&A activity.
Notable pan-European deals (UK activity):
Portman Dental Care (UK), a privately led dental group, was acquired by Core Equity a Belgian private equity firm in June 2018 for £300m (€353m), representing an estimated 15x EBITDA multiple based on a forward looking EBITDA or an estimated 20x historical EBITDA multiple.
In April 2017 Universal Partners Limited, a Mauritian investment firm, acquired a minority stake in Dentex Healthcare Group (UK), with the investment potentially reaching £15m (€17.6m) for a 49% stake in the company.
Notable pan-European deals (non-UK activity):
Bridgepoint Development Capital, a private equity firm that operates across the UK, France and Nordics, acquired Oris Dental Holdings AS (Norway) from Serendipity Partners, a Norwegian private equity firm, in December 2019. Oris Dental is a leading dental care provider with 25 dental clinics and 4 dental laboratories across Norway.
Advent International, a US private equity firm, acquired Vitaldent (Spain/ Italy) in June 2019 ahead of a possible IPO. Vitaldent is one of the largest dental chain networks in Europe, operating both owned and franchised dental practices across Spain and Italy. Advent is expected to continue consolidating attractive European players and is currently evaluating a number of UK assets including Mydentist.
Terveystalo, a Finnish healthcare company, acquired the Finnish healthcare operations of Attendo AB, a Swedish healthcare business for €233m in December 2018. The healthcare operations reported historical revenue of €235m and EBITDA of €20m, representing a historical EBITDA multiple of 11.7x.
European private equity firm Nordic Capital (Sweden) acquired three separate dental companies from Hesira (Switzerland/Netherlands) in February 2018 for €416m, representing a 16x EBITDA multiple. The acquisition included 88 clinics in the Netherlands, 22 sites in Switzerland, Germany’s largest dental laboratory, and six further clinics in Cologne.
EQT Partners AB, a Swedish private equity firm, acquired Curaeos B.V. (Netherlands) in December 2017 for a multiple of c.16-18x EBITDA. Curaeos is a vertically integrated dental services provider with 220 clinics spread across the Netherlands, Belgium, Denmark, Germany and Italy.
BC Partners, a UK-based private equity firm, acquired DentalPro (Italy) in May 2017 for €471m. On acquisition DentalPro operated 112 clinics across Italy with reported EBITDA of €30m representing a historical EBITDA multiple of 15.6x.
Independent healthcare investment firm Archimed sold the Italian dental services chain Primo Group s.r.l. to private equity company Aksia Group SGR S.p.A. (Italy), for an undisclosed amount. Primo Group is based in Turin, and has 50 directly owned dental clinics.
Synergy Dental Care acquired AR Fee Dental Practice, bringing the total number of practices in the group to nine.
Archimed SAS, a French private equity firm, acquired Medidental s.r.l (Italy).