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- [00:00]
A
Hello, this is Ariana Portolattan with the Beckers Dental and DSO Review podcast. I'm thrilled to be joined today by Travis Sick, the co founder and director of M and A and at Apex Dental Lab Group. Travis, thank you so much for being here today. It's great to have you.
- [00:15]
B
Thank you for having me, Arianna. I appreciate it and it's good to be here.
- [00:18]
A
Yes. To start us off, can you introduce yourself for our listeners and tell us a little bit about your background and your role at Apex?
- [00:26]
B
Yeah, absolutely. So, as you mentioned, my name is Travis Zick. I'm the co founder and director of Mergers and Acquisitions with Apex Dental Laboratory Group. I've been in the dental lab space since the mid-2000s, first running labs and overseeing production and operations. I've done it all, sales and marketing as well as, as I said, running and overseeing, you know, large dental labs. I started Apex in 2015 with, with a group of industry veterans and we started with a vision for what we wanted to accomplish, which really in our mind was trying to create a model that, that would allow us to best serve our dentist partners and their patients in going forward with a lot of the challenges that we were facing in the lab space at the time. And frankly, the company really took off. What started with four labs in the Midwest is now 16 dental labs across the country. We provide products, services, dental restorations in essentially every aspect, every arena, every specialty of dentistry across the country. So we're very proud of, of what we do, but most importantly, we are very appreciative and enjoy what we do and being able to work hand in hand with our dental partners and, you know, treat their patients.
- [02:01]
A
Thank you so much for that. I'm looking forward to learning more about some of your thoughts on some of the dental topics that we'll cover today. So first question for you here. What are some of the biggest issues that you're following in the dental industry currently?
- [02:15]
B
Well, I think, you know, for me, I mean that's, that's, it's a two part answer, I guess. First is, you know, really on the dental side of things, which I, I make it a point to watch very, very closely. I'm heavily involved with the National Dental Lab Association. I've been in many meetings in my role, previous role as president of the NADL worked hand in hand over time with the ADA and AGD and, and other dental organizations. So I stay very well in tune with what's happening on those fronts. And you know, I think there's a few, a few things obviously in dentistry that stand out to me overall. And you know, in number one, looking back, I mean, we've been dealt a fairly stagnant market for the past, really for the past several years, with the exception of a boost, you know, after the COVID shutdown. If you look at ADA statistics, I mean, you'll see that, you know, overall the last five years have been less productive than the previous five year stretch on a per office or per dentist basis. So our revenue has been fairly stagnant. And you hear that a lot, especially from, you know, from practicing dentists. You know, the other, the other a piece of that of course, is expenses haven't been stagnant in any, in any area of our lives and certainly in our businesses over the last five years as well. I mean, we feel it as well as the dentists do. As far as, you know, inflationary pressures, you know, high interest rates over the last couple years have certainly had a detrimental effect on, not only on growth in the industry in general, but also on, you know, on patient acceptance of larger scale cases. So those have been ongoing challenges. You know, I look at the, at the outlook for the future, again put out periodically by ada, and I continue to see the, you know, skepticism from the practicing dentists both in terms of the dental industry as well as, you know, the overall economy looking ahead six months. And so of course those are, those are certainly, you know, current, you know, challenges or current concerns that we're, we're following and trying to deal with, you know, another, another change or another really just change in how we operate is, is the changing demographic of the dental practice and what that looks like. And you know, when I got into the dental lab space, you know, 20 years ago, there were far more, you know, sole practitioners, there were, you know, far more independent dentists. And obviously those, those things are changing still. Today only about 16% of dentists are actually part of a DSO. And again according to the ADA, but over 50% of dentists are part of a multi doc practice or a small group practice. So the, you know, the model of how the practices are functioning is different and that impacts us on the lab side as well as far as how we interact with our, with our clients. And the last piece really on the demographic side of course, is, you know, really the changing age and experience level of dentists as over the past few years now, as the baby boomers, so to speak, have moved on, you know, the number of dentists practicing in the country has stayed fairly stable. But that's because we have so many young Dentists coming out of school to take their place and certainly, you know, dealing with a different age and experience level is a, is certainly different challenges, but also different advantages, different opportunities in how we all work together. So, you know, those are some of the issues on the dental side that certainly we're addressing and working through in the lab space. You know, there's, there's a whole nother, whole nother level and a whole nother list of, of concerns and challenges in addition to, you know, some of the same that I mentioned. But the dental lab space as a whole has really been in a consolidation period, I guess, similar to dentistry going back to the mid-2000s. You know, the number of dental labs in the, in the United States has consistently declined. In fact, we, in, in 2024, we had the 20, our 20th year in a row of contraction in terms of the number of operating dental labs in the US So it's been a, you know, it's been a stark change. Since when, from the time I started to today, we actually are under 5,000 dental labs in the US as of the end of 2024, which was, which is kind of a stark reality to see. At the same time, you know, we are, as an industry, we're obviously, we're doing more work than ever. So that's, you know, that's the positive. There's, there's fewer, fewer labs and fewer technicians, fewer employees. But it's just, it puts more pressure on, on us to continue to find ways to be more efficient, be more productive. And certainly, you know, the utilization and increase in technology and things that have come along throughout the years have allowed us to do that. But, you know, the other big challenge, ongoing challenge on the lab side of things is really, and this goes both ways, both in dental, on the dental practice side as well as the lab side. And, and that comes back to transparency and disclosure, you know, over, roughly because this is an estimate, but a little over 40% of all the dental prosthetics sold by labs in the U.S. are not produced in the U.S. they're produced overseas. And there is a general lack of transparency in that process that goes all the way from the lab through to the patient. And you know, we've, as an, as a dental lab industry, we've, we've fought for years. I did, when I was NADL president to try to get more states involved with regulating the lab space and requiring disclosure and transparency from the lab to the dentist so that the dentists know what they're getting and where it's coming from. And you know, and unfortunately in today, we still only have Oregon, State of Oregon just passed some legislation recently which was great, but we still, we only have 11 states in the United States. So 11 states out of 50 where dental labs are required to disclose to the dentist where their product is made. The dentists that then are typically are required to have that information. So really they're, they're the ones that need to make sure they have it. But I know that that's not being done in as it, as it should be, especially with, you know, some of the larger players. And so there's, you know, there's some concern there as well. You know, there are seven states in the US where dentists are required to work with, with a registered lab, a lab that is registered to do business in that state. And there again, with the increase in competition across the country with dental labs in any state being able to work with dentists in any state because of, especially with the rise in interoral scanning usage, a lot of these transparency regulations are not being followed. So that's an ongoing concern. I think that we are, you know, we want to continue to bring more education and more light to that and really, again, so that the doctors know what they're getting, what's in it, where it's coming from, and you know, who's responsible if something goes wrong.
- [10:32]
A
Yeah, thank you so much for providing all that insight. A lot to cover there. I love what you mentioned about the need for transparency as well. I know you mentioned just, you know, only a few states have legislation to address that. What do you think has led to, I guess so few states passing that legislation. And why aren't there more states doing that now?
- [10:54]
B
It's a link. Any, any type of legislation is a, is a lengthy and expensive process, of course. And it really, I think it comes back to the states that we've seen successfully pass it, and again I mentioned, or the state of Oregon who just recently passed it. State of Washington was the previous one that passed legislation. That was back in 2019. And again, it comes down to there has to be a group of stakeholders within the individual state, first of all, whether that's the people that are involved in the dental board or the dental regulation within the state, a group of lab folks combined with state dental society folks that all get together and say, we need to champion this process. It needs to happen. And then of course, unfortunately, in the political world, you typically have to spend tens of thousands of dollars lobbying to be able to get somebody on board with writing some type of Legislation or to get it through. And like I said, it's expensive, it's time consuming, it takes a lot of, you know, a lot of stick to itiveness and time that, you know, most people don't have. I will say as an industry, the national association of Dental Labs, which again I served as president of in 2019, you know, the NADL is very supportive of any state and, or yeah. Of any state, sorry that wants to get this process going and see it through both financially as well as, you know, providing some leadership and, and know how to get it done. They have NADL has an in house counsel who, who helps, you know, kind of guide folks through this process. But I can tell you that I'm in, in 2019, I was in the state of Washington to speak to their dental lab association and I met with the folks from Oregon and they were excited to get, get a similar bill passed in Oregon to what Washington had just passed. And here we are six years later and it just finally happened. So that's, that's the biggest challenge is just time and money to see it through. Wow.
- [13:08]
A
Yeah. You might have some similar answers to this next question, but I'm curious to know what are you most excited about when it comes to dentistry right now and what makes you nervous?
- [13:18]
B
Yeah, I mean it's a lot, it's a lot of the same answers, I suppose. You know, I'm very bullish on the industry as a whole. You know, I just listed off a whole laundry list of concerns and things that, you know, have been challenges for us going back. You know, I ran a dental lab through the Great Recession. I ran, obviously ran a large dental dental lab company through Covid. So we've had a lot of challenges, but I'm very bullish on the industry. I think, I think the future is very bright and within dentistry and within, you know, on the lab side of things that we deal with, I think there's, you know, it's exciting to see the ongoing advancements in materials, in technology and the types of procedures that are being done. You know, we really enjoy. On the lab side, our role has transformed so much from when I first started where you know, we're, it's a very collaborative relationship between the lab and the dentist versus what it was 20 years ago. And you know, a big part of that and a big part of the excitement and also some of the concern or nervousness really I think comes from technology. You know, we're all, I think, you know, on the very, very, very leading or not leading edge. I should say the very, very precipice of, you know, what does AI technology do not only in this industry, but in the, in the world in the next, you know, 5, 10, 15, 20 years. You know, I think some of those things and some of the, some of the new, again, new procedures, new equipment, new technology, it keeps it exciting. It also, you know, again, also also makes you nervous and provides challenges. I, I truly believe that, you know, we're going to continue to see the same consolidation that we've been seeing. You know, that's why I mentioned earlier, you know, we continue to have fewer dental labs. We continue to have fewer people, fewer employees in the dental lab space, but we're doing more work than ever. We're treat, we're helping doctors treat more patients than ever. And, you know, I think that's only going to continue. And I, I think that the collaborative relationship between the lab and the dental office and how we all work together over the next 10, 15, 20 years is really going to be exciting to see how that develops.
- [15:53]
A
Yeah, well, great to hear about your optimism there. And despite some of the challenges and concerns that you shared, also, I think that there are a lot of other dental leaders who kind of share the same sentiments. So, yeah, definitely interesting to discuss that. With all the changes in mind that you mentioned and everything that the industry is going through right now, my next question for you here is what will the most effective healthcare leaders need to be successful in the next two to three years?
- [16:21]
B
Boy, that's a great question. In the next two to three years, I think the most successful healthcare leaders are going to need to be flexible, pliable and visionary. I think, you know, over the next couple years, for sure, I foresee, you know, ongoing challenges with the continuation of some of the things that we've talked about. So on the, in the, in the short term, you're, you know, you're worrying or dealing as a, as a leader of your, of your company. You're, you're dealing with these immediate concerns and immediate challenges. But at the same time, when we look out and see what's coming on the horizon, we have to be visionary to try to see where and how we can fit some of those things in and continue to improve and also be flexible to understand that we're gonna make some mistakes and implementation of some of these things and how do we change, how do we continue to stay ahead? Certainly there's a lot of discussion and a lot of concern about the overall healthcare industry outside of just dentistry in the United States. And obviously there's going to continue to be ongoing discussions and challenges, and we'll see how, if and how any significant changes are legislated. But that's why I say, I think for us and for anybody in any healthcare field, the biggest thing over the next two to three years is really going to have to be flexibility and vision and adaptability.
- [17:56]
A
Great. Well, that is all I have for you today. Travis, thank you so much for joining us. It's been a pleasure speaking with you and covering all these topics. I'm looking forward to connecting with you again in the future as well.
- [18:05]
B
Absolutely. Appreciate all you guys do and appreciate you inviting me on today. So thank you, Arianna.
- [18:11]
A
Yes, of course. Enjoy the rest of your day.
- [18:14]
B
You, too. Take care. Bye, Sam.