The market for dentists and dental practices - France (2023)

1.2 The global market: growth driven by emerging countries and an ageing population

The global dental care market is estimated to be worth US$***.* billion in ****, and should continue to grow at a CAGR (***) of *.*% over the period ****-****, reaching a value of US$***.* billion in **** . This market thus continues to grow, even after being hit by a sharp recession in ****. Growth is being driven by favourable government initiatives, an ageing population and growth in emerging markets.

Size of the global dental care market World, ****-****, in billions of US dollars Source: ****

The United States largely dominates the market, with a **.*% share in ****. However,Southeast Asia is forecast to grow the fastest between **** and **** (***).

1.3 The French market: accelerating growth

The Covid-** pandemic had a significant impact on the dental care market. Indeed, the two containment periods (***) led many patients to postpone non-urgent care, especially dental care. However, since these treatments were postponed rather than cancelled, there was a catch-up mechanism in the market in **** and ****. In the graph below, we can see that the sum of dental care fees rose by **% between **** and ****, then fell by *% in ****, beforerising again by **% between **** and ****, reaching around **.* billion euros. [***] What's more, the inability to travel has probably greatly reduced French dental tourism abroad. Some of these people may have opted for treatment in France, repatriating part of the value they would normally have relocated. Indeed, before the pandemic, international competition had increased for French dental players, due to computer-aided design (***) for prostheses, encouraging "dental tourism" for cheaper treatments.

Size of the French dental care market France, ****-****, in billions of euros Source: Drees With regard to the precise evolution of the market, the graph below highlights the annual variations in market value and volume.

Growth in dental care consumption France, ****-****, in Source : Drees Finally, structural growth in the dental care market is mainly driven by the ageing of the French population, the ...

2.1 Demand drivers: ageing and oral health

Dentists' patients: the age factor

In ****, **.*% of the French population will be working[***].

Composition of the French population France, ****, in Source: ****

However, in ****, **% of dentists' patients will be working, **% minors and **% retired. [***]

Typical dental practice patient base France, ****, in % Source : Fiducial It therefore appears that the older people get, the more they use dental care, hence the influence of an aging population on the dental care market. These figures are for ****, but the trend will be the same in ****.

The aging population: already a reality... Proportion of French population aged ** or over France, ****-****, in Source : INSEE ...which will continue to be a growth driver for the future of the sector Population projections to **** in millions of inhabitants, France, ****-****, % Source: CNSA (***) Source: CNSA (***) based on INSEE The aging of the French population is real, as this graph shows. While thoseaged ** andover will represent only *.*% of the population in ****, their weight in the French population will double to **.*% in ****. This aging is linked to longer life expectancy and the arrival of baby-boomers at retirement age: * factors favoring the number of potential consumers for dental care.

Deteriorating oral health Another factor behind the rise in dental care consumption is the deterioration in ...

2.2 Persistent obstacles to dental treatment

Harris Interactive carried out a study commissioned by Eurodentaire en **** entitled Les Français, les soins dentaires et la mobilité médicale (***) on a sample of *,*** people, representative of the French population aged ** and over. A total of **% of French people said they had had toforego dental treatment over the past * years, the vast majority for economic reasons. Explanatory factors for foregoing dental care In ****, **% of French people believe that access to dental care in France has deteriorated in recent years (***).

French people's view of access to dental care France, ****, in Source: ****

The main reason for not seeking dental care is the high cost of treatment, cited by **% of respondents. In addition, the difficulty of obtaining an appointment without too long await and geographical remoteness also come into play (***).

Reasons for foregoing dental care France, ****, in Source : Ifop The profile of individuals who have already given up on dental care reveals that the older and wealthier individuals are, and the more recent their last visit to the dentist, the less likely they are to give up on dental care, and vice versa.

Medical mobility: an alternative to foregoing dental care

According to the same survey, **% of French people have already resorted ...

3.1 Dentist profile

Identity On January *, ****, there were **,*** dental surgeons registered in France[***] In ****, **% of dentists will be men and **% will be women. The feminization rate of the profession has thus increased, since in ****, **% of dentists were women. Furthermore, in ****, **% of dentists in the **-** age group are women, compared with **% in the **-** age group, **% in the **-** age group, **% in the **-** age group, **% in the **-** age group and **% in the ** and over age group, reflecting the increasing feminization of the profession.

Proportion of female and male dentists France, ****, in Source: ****

Furthermore, in ****, the average age of dentists was **.*. [***]

However, the two most represented age groups are **-** and **-**, with **.*% and **.*% of dentists respectively. Next, the proportions of dentists in the **-** age categories are relatively similar, ranging from *.*% to **.*%. Dentists under ** and over ** are logically in the minority. [***]

Distribution of dentists by age France, ****, in Source: ****

Status

In ****, **.*% of French dentists were working exclusively as self-employed dentists, and *.*% as mixed self-employed dentists. Exclusively salaried dentists account for **% of the total, and *.*% are hospital employees.

Structure of dental surgeon workforce by mode of practice France, ****, in Source : Drees Location The following graph illustrates the uneven territorial distribution of dentists in ...

3.2 Macroeconomic structure of dental practices

It also appears that the proportion of self-employed dentists has been falling steadily for several years(***). Growth in the number of dentists France, ****-****, in units Source : Drees Dentists and dental practices are registered under NAF code **.**Z : Dental practice. As shown in the graph below, the number of establishments registered under this code was down from **** to ****, with *** fewer establishments. The dental care market is therefore seeing a concentration of players, given the parallel rise in the number of dentists (***), and dentists are increasingly coming together in practice groups. However, since ****, the trend has been reversed, and the number of establishments is increasing, with *** more in **** than in ****. Growth in the number of dental practices France, ****-****, in units Source: ****

There are * main types of establishment in which dentists work: group practices (***).

Distribution of dentists by type of structure France, ****, in Source: ****

Dental practices are predominantly small and medium-sized enterprises. Those with ** or more employees generate almost */* of sales , despite representing only **% of the total number of companies in the sector. [***] There are * main types of practice group for dentists, as summarized in the table below.

SCM Pluriprofessional SCP Monodisciplinary SELARL Single-disciplinary SISA Pluriprofessionnelle Purpose Pooling of professional resources (***) to ...

3.3 Financing current healthcare expenditure

The chart below describes the players financing the DCS (***), which accounts for three quarters of current healthcare expenditure, as well as long-term care, daily allowances, individual and collective preventive expenditure, expenditure on the healthcare system and the cost of managing the healthcare system.s, individual and collective preventive spending, spending on the healthcare system and the cost of managing the healthcare system.[***] In ****, dental care consumption will amount to **.* billion euros. Current healthcare expenditure on dental care is mainly financed by complementary organizations (***). Social Security covers **%, households **.*% and the State *.*%. Current healthcare expenditure on dental care by funder

France, ****, in Source: ****

The year **** saw an increase in dental care activity of *.*%, although this growth was less pronounced compared to ****. That year was characterized by a recovery from the health crisis and the gradual implementation of the ***% healthcare reform. This reform also helped to accelerate the steady reduction in the out-of-pocket dental expenses rate, which fell by **.* points over a period ofriod of ** years, from **.*% in **** to **.*% in ****, including a reduction of *.* points between **** and **** thanks to the implementation of ***% health. [***]

3.4 Geographical distribution of dentists

The graph below shows the density of dentists in each region per ***,*** inhabitants in ****, i.e. the average number of dentists per ***,*** inhabitants. Provence-Alpes-Côte d'Azur(***) have the lowest densities. The density of dentists is therefore higher in the south of France and in the Paris region, and lower in the north of France.

Source: ****

3.5 Microeconomic structure of a dental practice

TheFiducial Observatoire des chirurgiens-dentistes provides an overview of the structure of a dental practice on a microeconomic scale, based on a sample of *** dental practices surveyed in ****. On average, the revenues of dental practices break down as follows: purchases of dental prostheses and supplies are the main cost(***) account for **% and **% respectively . Finally, taxes, property rentals and other expenses represent *%, *% and *% of revenues respectively. Finally, operating income averages **% of revenues.

Revenue breakdown France, ****, in Source: ****

The table below provides a typical income statement for different sales ranges, based on the average income statements of the *** dental practices in the sample, in ****. It provides an overview of the breakdown of costs and net income by practice size.

Band * *-***K€ **% of panel Band * ***-***K€ **% of panel Band * ***-***K€ **% of panel Band * ***K€ and over **% of panel Average **** Average **** Fees received *** *** *** *** € *** ***€ *** *** € *** *** € *** *** € Retroceded fees and other income *** € * *** € * *** € * *** € * *** € * *** € Other income and extraordinary income *** € * *** € * *** € * *** € * *** € * *** € Total operating income *** *** € *** *** € *** *** € *** *** € *** *** € *** *** € Dental prostheses and supplies ** *** € ** *** € ** *** € *** *** € ** *** € ** *** € External expenses ** ***€ ** *** € ** *** € ** *** € ** *** € ** *** € Taxes * *** € ** *** € ** *** € ** *** € ** *** € ** *** € Personnel expenses * *** € ** *** € ** *** € ** *** € ** *** € ** *** € Personal social security contributions ** ***€ ** *** € ** *** € ** *** € ** *** € ** *** € Depreciation and amortization * *** € * *** € * *** € * *** € * *** € * *** € Total operating expenses *** *** € *** ***€ *** *** € *** *** € *** *** € *** *** € Operating income ** *** € ** *** € *** *** € *** *** € *** *** € *** *** € Source: ****

4.1 Types and prices of dental procedures

There are different types of dental care, broken down as follows. In ****, **.*% of dental care provided by dentists will involve dentures. Dental and conservative treatments account for **.*% of consumption. This is followed by orthodontics(***).

Breakdown of private dental procedures France, ****, in Source: ****

More specifically, the table below provides a detailed overview of the main types of dental care provided by dentists in France in ****.

Type of dental treatment Examples of dental treatments Standard rates Reimbursement rates Conservative care Scaling **,** € **% Caries treatment **.** € for a *-sided cavity, **.** € for a *-sided cavity and **.** € for a *-sided cavity or more **% Devitalization **.** € for an incisor or canine, **.** € for a premolar and **.** € for a molar **% Radiology procedures Retroalveolar *,** € **% Prosthetics Ceramic crowns Price ceiling: €*** * possible baskets of prosthetic procedures that determine reimbursement level: "***% Santé" basket, basket with controlled fees, basket with free fees Zirconia crowns Price limit: €*** Metal crowns Ceiling price: €*** Ceramic bridges Price limit: €*,*** Consultations and visits Consultation with a dental surgeon ** € **% Surgical procedures Tooth extraction ** € for a baby tooth, **.** € for a permanent tooth **%   Orthodontics Treatment per half-year (***) Free fees (***) ¨***% Monitoring session (***) Free fee (***) **% Contention *st year Free fee (***) ¨***% Contention*nd year Unlimited fees (***) **%

Details of the fees charged by dentists and reimbursements are provided by the ...

4.2 Price trends for dental care

As previously stated, dental care consumption will reach **.* billion euros in ****, up +*.*% on ****. In that year, dental care had already risen sharply (***), boosted by the ***% healthcare reform and the resumption of post-confinement activity. In ****, the increase can therefore be explained by the rise in volume (***), following the upward revision of prices for dental prostheses and conservative care procedures. In ****, growth in the price of dental care was higher(***), the end of the DIPA having been more than offset by higher prices for procedures. [***]

Evolution of dental care prices France, ****-****, in Source: ****

Indeed, in April ****, the ***% health reform introduces three choices for patients, with the aim of controlling out-of-pocket expenses and making prosthetic procedures accessible to all. [***]

The "***% Santé" basket is fully reimbursed and covers essential and most common prosthetic needs with no out-of-pocket expenses. The "basket aux tarifs maîtrisés" (***) includes prosthetic dental care at controlled fees to ensure moderate out-of-pocket expenses. The free-fee basket allows the practitioner and patient to freely choose the most innovative techniques or to meet specific aesthetic requirements, with no ceiling on fees.

5.1 Regulations

General conditions of practice

To practice as a dental surgeon, you must be registered with the Order of Dental Surgeons. Registration must be requested from the Conseil départemental de l'Ordre.

TheOrdre national des chirurgiens-dentistes provides further information on the conditions of practice.

The main conditions are as follows:

Hold a diploma, certificate or other qualification mentioned in article L. ****-*. Be a French or Andorran national, or a citizen of a member state of the European Community, a member state of the European Economic Area, a country linked to France by an establishment agreement, or of Morocco or Tunisia. Registered with a dental surgeons' association, subject to the provisions of articles L. ****-* and L. ****-*

Obligations of a dental practice

Dental centers are governed by the regulations governing the activities of health centers set out inarticle L.****-* of the French Public Health Code. These rules have changed slightly following the ordinance of January **, **** and the decree of February **, ****.

Like any establishment open to the public (***), a dental practice must comply with the safety rules set out here.

The main rules governing dental practices thus concern the following subjects[***] :

posting of fees mandatory employee signage smoking bans restrictions on ...

5.2 New features of the 2018-2023 and 2023-2028 national dental surgeons' agreements

On June **, ****, a national agreement for dental surgeons had already been reached between the Union nationale des caisses d'assurance maladie (***). The full text is available here.

The main objectives of the measures adopted were to rebalance the activity of dental surgeons over the long term, byin the direction of increasing the value of conservative procedures, and to focus on prevention and easier access to dental care.

The * main thrusts of the agreement are as follows:

Routine dental care has been considerably upgraded (***), whereas the economic model favored prostheses.

Ceilings have been introduced for **% of prosthetic procedures. A large proportion of these procedures (***) will eventually be fully reimbursed by the Assurance Maladie and complementary health insurance schemes, with no out-of-pocket expenses for the insured.

Numerous preventive initiativeshave been launched to safeguard oral health, particularly among children and young people.

Measures have also been taken to provide better care for more fragile populations, such as patients with diabetes, anticoagulants or mental disabilities.

Source: ****

On July **, ****, the ****-**** convention was signed in turn by the same players. The convention sets out a roadmap for national ambitions for dentists over a five-year period, with a budget of over *** million euros over this period. The provisions ...

6.1 Segmentation

6.2 Financial analysis of companies in the sector

• Clinadent
• Dentego
• Dentylis
• Espace Médico-Dentaire Paris Batignolles
• Dentimad
• Studio Smile
• Henry Schein Group
• Nobel Santé +
• Gsmile
• Cabinet dentaire BLR120
• TBR Dental Group