Private equity’s dental land grab is one big toothache for patients

If you have toothache in the Suffolk town of Leiston, your options are limited. Although there are several local dental surgeries, none have provided NHS-funded services since 2021, after practices owned by the UK’s two largest dental chains, MyDentist and Bupa, closed down. These days, the only option for locals is to pay for private dental care – and campaigners say a flood of private equity (PE) into the market is exacerbating the situation.

Some 97% of new dental patients in the UK don’t have access to NHS dental care, according to the British Dental Association (BDA). Instead, they are forced to pay for private care, the cost of which is rising. In March the Competition and Markets Authority (CMA) launched a review into the £8.4bn private dentistry market, complaining that between 2022 and 2024, the average price of initial consultations had risen by almost a quarter to £80, while routine checkups for existing patients had risen by more than 14% to £55. Meanwhile, NHS-funded care is steadily decaying: in 2024, it made up just 31% of the market. The rest was covered by private dentists.

Not surprisingly, the PE sector has spied an opportunity. Figures compiled for The Observer by Pitchbook show that the past five years have been a golden era for dealmaking in UK dentistry, with 110 PE and venture capital (VC) deals worth $6.3bn (£4.7bn) taking place between 2021 and 2025. The year 2022 was particularly busy, with 39 deals worth $1.75bn. Last year was a little quieter, with just seven deals worth $1.26bn – but one of those was Bridgepoint’s acquisition of a majority stake in MyDentist, the UK’s largest dental chain, from Palamon Capital Partners in September for a reported £800m.

Investors like dentistry because of its reliable, recurring revenues, says Diederik Stadig, a healthcare and technology economist at ING Research: “It is relatively easy to create ‘economies of scale’ if you acquire multiple dentistry practices: you can pool administration and procurement, leading to higher margins and efficiency gains,” he adds.

But critics have argued that PE’s interest in the sector is affecting both the cost of care and its provision. Large corporate dentists, they say, are winning NHS contracts by lowballing tender offers, promising to provide ultra-cheap NHS care. This is creating a “race to the bottom” on NHS contracts. And when those practices become unprofitable – because, for instance, the local population can’t afford the private care that offsets the cheap NHS rates they are promising – they are closed.

These closures are a particular trend in rural areas, said Mark Jones, who started the campaign group Toothless in England following the closures in Leiston. “PE-owned chains [are] aggressively dumping NHS contracts, slashing access for vulnerable patients, and pushing costly private treatments instead,” he said. “The result is a two‑tier dental system where your postcode and your wallet decide if you get seen.”

The chains acknowledge that some NHS contracts are unprofitable – but they also blame a recruitment crisis in the sector. In the year to March 2025, MyDentist, the UK’s largest PE-backed chain with more than 500 practices, closed 11 of them “due to reasons such as low… contract values or recruitment issues due to geography”. In the year to September, PortmanDentex, which is backed by Core Equity Holdings and other institutional investors and operates more than 300 practices, closed five surgeries “as result of a project… to review location and performance of the group’s practice”. Among them were one in Taunton, in Somerset; two in St Agnes in Cornwall; and two in London.

These closures came after Bupa, the UK’s second-largest dental chain, which is not PE-backed, had announced the closure, sale or merger of 85 practices in 2023, blaming staff shortages and the NHS contract model.

PE has also been blamed for price gouging, although the BDA says it has found no evidence for these claims. Instead, it argued that costs for dentists have risen sharply in recent years: in real terms, the average cost of dental appliances, such as dentures and crowns, increased by 4.9% between 2023 and 2025, the hourly pay of dental nurses increased between 4% and 9% between 2024 and 2025 – and the average private fees charged to patients have, it said, declined by approximately 8%.

But the organisation’s chair, Eddie Crouch, told The Observer he was nevertheless concerned about PE’s inroads. “The principal aim [among PE investors] is maximising returns for investors, not necessarily the best interests of patients or the professionals working for them,” he said.

“Dentistry is gradually being taken over by being unavailable on the NHS,” said Tony O’Sullivan, a co-chair of the campaign group Keep Our NHS Public. He said private investors are “seeing the opportunity for super-extraction of profit. More and more sections of the NHS are being cherry-picked as lucrative.”

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