Dental markets brace for Trump’s tariffs

Jeremy Booth, Dental Tribune International

Mon. 7. April 2025

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LEIPZIG, Germany: Fourth-quarter results from the world’s largest dental manufacturers showed signs of improved sales in North America, where lagging consumer trends had constrained profits and patient flows in the first nine months of 2024. However, for global dental manufacturers who rely on cross-border shipments, 2025 may be a case of out of the frying pan into the fire. US President Donald Trump’s escalating trade war has cast doubt on further market improvements. According to a coalition of dental industry groups, Trump’s tariffs will increase running costs for dental clinics and result in fewer patients seeking oral care.

Dentsply Sirona writes off Byte

Dentsply Sirona reported fourth-quarter net sales of US$905 million (€869 million*), down by 10.6% year on year. The company suspended sales of its Byte aligner system in the third quarter of 2024, and this accounted for an organic sales decline of 6.1%. In total, organic sales took a 10.7% year-on-year hit during the period.

Fourth-quarter sales slumped in all of Dentsply Sirona’s business segments except for Wellspect Healthcare, a business dedicated to urinary and bowel dysfunction solutions. Compared with the previous quarter, sales of connected technology solutions slipped by 8.3%, sales of essential dental solutions were down by 3.5% and those of orthodontic and implant solutions dropped by 28.6%. Fourth-quarter sales in Europe increased by 2.8% year on year, and those in the US fell by 29.8%. Combined sales in the company’s remaining markets were down by 3.4%.

President and CEO Simon Campion commented in a press release: “While we were pleased to see improvement in several areas of the business, Byte, persistent [macroeconomic] pressures and competitive dynamics negatively impacted [fourth-quarter] and 2024 full-year results.” Campion told analysts in an investor conference call: “In the fourth quarter, we were pleased to see green shoots in several areas of the business, including a return to organic sales growth in Europe of approximately 2% and global growth in imaging of nearly 13%.” Campion added: “[The] voluntary suspension of sales and marketing of Byte aligners resulted in a charge for customer refunds above what we contemplated on our November call. In total, Byte had a US$62 million year-over-year impact in [the fourth quarter].”

Dentsply Sirona CEO Simon Campion speaking at the International Dental Show 2025 in Cologne in Germany. (Image: Dental Tribune International)

Overall, 2024 was a challenging year for the dental giant. At US$3.8 billion, net sales for the full year represented a 4.3% year-on-year decline and a 3.5% decline in organic sales. The company posted net losses of US$430 million and US$910 million for the fourth quarter and full year, respectively. These were attributable to non-cash charges for the impairment of goodwill and other intangible assets totalling US$370 million and US$870 million for three- and 12-month periods, respectively. Herman V. Cueto, interim chief financial officer at the company, explained in the investor conference call: “These charges were largely the result of weakened demand from sustained macroeconomic and competitive pressures in implants and equipment. Also included in the charges was a full write-off of the Byte trademark, as we do not plan to use it in the future operating model of our aligner business.”

Business as usual at Straumann Group

Straumann Group has performed consistently well in recent quarters, despite challenging market conditions. The Swiss dental giant maintained this trend in the fourth quarter, banking CHF 645.2 million (€685.7 million*) in sales, which represented a 9.5% year-on-year gain. Straumann’s revenue by region showed year-on-year increases of 11.4% in Europe, the Middle East and Africa (EMEA), 3.8% in North America and 18.0% in Asia-Pacific. Together with Asia-Pacific, Latin America has been a prodigious post-pandemic performer for Straumann. In the fourth quarter, Latin America provided a rare year-on-year dip of 2.0% in revenue for Straumann, despite 17.1% organic sales growth. 

In its earnings statement, Straumann said that sales gains in Germany, Italy, Spain and Belgium had boosted its EMEA result. Describing the North American market during the quarter as a challenging operating environment, Straumann pointed to stabilised patient demand in the region, strong implant sales and a soft performance in orthodontics. Dynamic patient flow and implant sales in China formed the backbone of strong sales in Asia-Pacific, and Neodent sales in Brazil, Peru and Costa Rica led Straumann’s Latin American sales gains. 

Revenue for the full year at Straumann reached CHF 2.5 billion, a 10.0% gain compared with 2023. CEO Guillaume Daniellot said in the earnings statement that 2024 had been “marked by geopolitical tension and uncertainty in the macroeconomic environment”. The company described varied patient flow across its regions and stated that EMEA “showed strong resilience”. 

Align Technology invests in DSO business

Align Technology’s fourth-quarter results provided relief after a mixed performance in the prior quarter. The company banked US$995.2 million in sales for the period, a 4.0% year-on-year increase and a 1.8% increase compared with the prior quarter. Aligner shipments in the period numbered 628,730, up 6.1% year on year, and generated revenue totalling US$794.3 million, a 1.6% increase. Sales of imaging systems and CAD/CAM services reached US$200.9 million, an increase of 14.9%. Net income, at US$103.8 million, represented a year-on-year decline of 16.3%, owing to restructuring costs that were higher than expected. Late last year, the company announced a global restructuring plan that included redundancies in all operating regions. 

In an investor conference call, Align Technology CEO Joseph Hogan told analysts that regional aligner sales in the fourth quarter reflected year-on-year volume growth in Latin America and positive trends among general dentists in North America. In the Asia-Pacific region, Hogan pointed out that volume growth had been driven by sales in China and Japan, as well as emerging Asian markets such as India, Thailand and South Korea.

Dental support organisations increased their reach in 2024, and Align Technology announced in December that it had completed a major equity investment in Smile Doctors, the largest orthodontic-focused dental chain in the US. (Image: Trygve Finkelsen/Shutterstock)

Hogan stressed that Align’s dental support organisation (DSO) business had outpaced the company’s retail and clinical sales, driven by aligner and iTero intra-oral scanner purchases by its major DSO partners Smile Doctors and Heartland Dental. Hogan announced that Align had in December completed a US$30 million equity investment in Smile Doctors, the largest orthodontics-focused DSO in the US. He said: “Smile Doctors has a rich history of developing and growing affiliated practices by providing tools and technology that allow their orthodontists to focus entirely on patient care [...] Each DSO has a different strategy and business model. We’re focused on working with and encouraging the DSOs aligned with our vision, strategy and business model goals.”

Full-year revenue at Align reached US$4 billion, and aligner shipments were just shy of 2.5 million units—both results representing a 3.5% year-on-year gain.

On the topic of tariffs, John F. Morici, chief financial officer and executive vice president of global finance at Align Technology, commented in the investor conference call: “The US–Mexico tariff situation remains very fluid, and we are unable to predict whether new tariffs will go into effect in the future. We are monitoring events closely.” He explained that Align’s global operations had evolved to provide flexibility and that a 25% tariff on shipments to the US from Mexico would be more economically viable than production at its Polish factory. “Regarding China, we currently manufacture our products in China for the benefit of our customers in China,” Morici added.

Envista Holdings signs off on a transformative year

After a difficult third quarter, sales at Envista Holdings improved in the fourth quarter, reaching US$653 million—a year-on-year increase of 2.0% in core sales. Growth in sales of the company’s dental implant portfolio boosted its end result, as did market share gains achieved by the Spark aligner system. 

During an investor conference call, Envista CEO Paul Keel told analysts that the fourth quarter marked the end of a transitional year for the company, during which its North American implants business had been a focal point. Keel said that the global dental market during the fourth quarter “was flat to slightly up, with implants growing low single digits, [orthodontics] and consumables roughly flat and diagnostics down mid-single digits”. Demand for orthodontic products in China slipped sharply during the period, owing to the expected implementation later this year of volume-based procurement for orthodontic solutions. A dip in diagnostic sales in the country further contributed to a lacklustre result.

Sales for the full year at Envista totalled US$2.51 billion, down by US$55.9 million compared with 2023. Envista posted an operating loss of US$1.04 billion, attributable to a US$1.15 billion charge for goodwill and intangible asset impairment. 

“[We] aim to source materials in the same country or region where we manufacture.”—Eric Hammes, CFO, Envista Holdings  

Eric Hammes, Envista’s chief financial officer, told analysts that the company’s guidance of 1% to 3% core sales growth for 2025 does not hinge on significant improvements in the dental market. Speaking about the threat posed to Envista’s business by Trump’s tariffs, Keel emphasised the fluidity of the situation and added that the company was well positioned to respond. He explained: “[We have] long architected our supply chains with a local-for-local mindset, meaning we aim to source materials in the same country or region where we manufacture. And then we try to serve our customers in a particular country or region from local sources of supply. So, all of our big product categories, all of our largest supply chains have manufacturing on multiple continents. For example, we make Spark in Mexico, in the Czech Republic and in China. We make consumables in three different countries, we make implants in three different countries, etc. So, while the bad news is that uncertainty is high, the good news is that we’re fairly nimble and able to respond.”

“Liberation Day” brings looming tariffs into the light

On 2 April, Trump announced a sweeping 10% baseline tariff on US imports from all countries, effective from 5 April. Additional retaliatory tariffs were announced for goods imported from nations deemed by Trump to be actively restricting US imports. These included 20% for the EU, 32% for Taiwan, 26% for India and 24% for Japan. The 20% tariff previously announced on goods from China was increased to 54%. Certain pharmaceuticals and raw materials, as well as semiconductors, were excluded from the ad valorem import taxes, all of which are set to take effect on 9 April. 

As this article goes to print, the situation remains volatile, especially given that Trump has in the past variously rescinded or increased tariffs at a moment’s notice. US trading partners are expected to respond with their own retaliatory measures, which could lead to escalation. Despite the exclusion of semiconductors from the list of tariffed goods, Trump’s trade war is expected to rattle the medical device sector and dental supply chains. 

According to data analytics and consulting company GlobalData, 69% of medical devices marketed in the US are manufactured outside of the country. This means that demand for digital dental equipment may wane in the course of 2025. Crucially, tariffs on consumer and industrial goods are expected to shrink global economies, ultimately leaving consumers out of pocket and facing rising treatment costs. 

As the situation evolves, dental associations are advising their members and advocating for the exemption of dental-related goods from added taxes. The Dental Industry Association of Canada said in March that it was closely monitoring the situation, and that tariffs levelled at the country could impact dental supply chains. The American Dental Association and other industry groups have gone one step further by penning a letter to Trump warning him that planned tariffs on dental products could leave US patients facing higher treatment costs and reduced availability of oral care services. “Thus, patients, already confronted with ever increasing health costs for non-tariff reasons, will ultimately experience greater out-of-pocket costs because these additional duties are now being assessed on dental medical devices and other imported dental materials, tools and equipment,” the letter read. 

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