The world of corporate dentistry is about to undergo a massive shake-up, thanks to the recent announcement of the planned merger of Portman Dental and Dentex. The combined company would be the largest private focused dental corporate in the country, running over 350 practices, with over 2,000 clinicians providing care for around 1.5 million patients.

figure 1

© hofred/iStock/Getty Images Plus

Until now, the big corporate players in the dental market have been focused on delivering NHS care. This has led to a small number of large companies holding sway over millions of pounds' worth of NHS contracts, influence over the dental materials market, and an enormous influence on the career progression and success of large swathes of the dental workforce. The new Portman/Dentex behemoth is here to disrupt the private market.

Received wisdom says that the best-quality care, as well as the best working environment, is found in independent practices. The close-knit nature of the workforce and the patient base aligns well with the values traditionally associated with family-style practices. But general practice has changed over the last generation. Despite independent practices, especially in the private sector, apparently thriving, the old de facto career progression of associates becoming practice owners is no longer a given. Fewer dentists have ambitions of ownership, partially fuelled by the change in gender mix in dentistry, with female practice principals being the exception rather than the rule.

This leaves current practice owners with a dilemma when it comes to retirement. Do they try and find a younger, fitter dentist to take over their existing patient base, or do they sell to the corporate market, with seemingly infinitely deep pockets to buy up and invest in practices? Of course, there are pros and cons to each option. Still, one of the strongest arguments for independence has historically been that practices should be run for the benefit of dentists, their staff and patients rather than to make a profit for shareholders and venture capitalists. But again, this is changing. Many dentists just want to focus on their dentistry without the hassle factor of running a business on top. And while corporate dentistry may bring with it a different set of problems, these can, by and large, be left at the practice door.

The Portman/Dentex deal will appeal to many practice owners without a solid exit plan. But more than that, the merger comes during great economic uncertainty. Energy prices are rising at an unprecedented level, with many practices seeing a three-fold increase in projected bills. Increases in other overheads are outstripping the general inflation rate, which is already into double figures and predicted to rise to levels most of us will have never seen. The current cost-of-living crisis may price many independent practices out of dentistry and into the arms of the larger corporations. They are the only ones with enough reserves to weather the upcoming economic storm relatively unscathed. Given this background, the Portman/Dentex merger looks like a genius piece of business strategy, at least for those at the top.