Hello. This is Ariana Porto Latin with the
Becker's Dental and DSO review podcast. I'm thrilled
to be joined today by Travis Sick, the
cofounder 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.
Thank you for having me, Arianna. I appreciate
it, and it's good to be here. 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?
Yeah. Absolutely.
So as as you mentioned, my name is
Travis Zick. I'm the cofounder
and director of mergers and acquisitions with Apex
Dental Laboratory Group.
I've been in the dental lab space since,
the the mid two thousands.
First first running labs and and
overseeing production and operations.
I've done it all, sales and marketing,
as well as as I said, running and
and overseeing,
you know, large dental labs. I
started Apex in 02/2015,
with with a group of industry veterans.
And, we started with a vision for what
we wanted to accomplish, which
really in 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 the company really took off.
What started with
four labs in the Midwest,
is now
16 dental labs across the country.
We we provide product services, dental restorations,
and
in essentially every
aspect, every arena, every specialty,
of dentistry across the country. So,
we're we're very proud of,
of what we do, but most importantly, we
are very appreciative and and enjoy,
what we do and being able to work
hand in hand with our dental partners and
and, you know, treat their patients.
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?
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 to watch
very, very closely.
I'm 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,
overtime with the ADA and 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 I think there's a few,
a few things, obviously, in dentistry,
that stand out to me overall. And,
you know,
in number one, in in looking back, I
mean, we've we've been dealt a fairly stagnant,
market for the past really for the past
several years with the exception of a a
of a boost, you know, after the 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 on a per,
per office or or per dentist basis.
So our our revenue has been fairly stagnant,
and and you hear that a lot, especially
from, you know, from practicing dentists.
You know? The other the other piece of
that, of course, is,
expenses haven't been stagnant
in any in in any area of our
lives and and certainly in our businesses over
the last five years as well. I mean,
we we feel it as well as 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 on patient acceptance
of of larger,
you know, cases.
So those those have been 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 I continue to
see the, you know, skepticism,
from from the practicing dentist, 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 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 of the dental practice and what that
looks like. And, you know, when I got
into the dental lab space, you know, twenty
years ago,
there were far more, you know, sole practitioners.
There were, you know, far more independent dentists,
and and, obviously, those those things are changing.
Still today, only about 16%
of dentists are 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 of how the practices are
functioning is is different, and and that impacts
us on the lab side as well as
far as how we interact with our with
our clients. And and the last piece really
on the demographic side, of course, is is,
you know, really the changing,
age and and experience level of of dentists
as over the past few years now as
as the the baby boomers, so so to
speak, have have, moved on.
You know, you the 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
and, certainly, you know, dealing with dealing with
a a different a different agent experience level
is is a diff is certainly a different,
challenges, but also different different advantages, different opportunities
in in how we all work together. So,
you know, those are those are some of
the issues on the dental side that that
certainly we're we're addressing and and working
through. In the lab space, you know, there's
there's a whole another
whole another level and a and a whole
another 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 to the mid two
thousands,
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 our twentieth 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 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
2024,
which was, which is kind of a stark
reality to see.
At the same time, you know, we are
we're 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 and fewer technicians, fewer employees,
But it's just it 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 have have allowed us to do that.
But,
you know, the other the other big, challenge
ongoing challenge on the lab side of things
is is really and this this goes both
ways, both in dental on the on the
dental practice side as well as the lab
side, and that comes back to,
transparency
and 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 US are not
produced in The US. They're produced overseas.
And,
there is a
general lack of 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
I did when I was NADL president
to 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 in today,
we still only have, Oregon state of Oregon
just passed the legislation reach 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 prod product is made.
The dentists that then are 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's seven states in
The US where
dentists are required to work with a registered
lab, a a lab that is registered to
do business in that state. And and there
again, you know, with the 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 in aural scanning,
usage.
You know, some of these, a lot of
these,
transparency
regulations are are not being followed. And,
so that that's an ongoing concern. I think
that we are you know, we wanna continue
to bring more education and more light to
that and,
really, again, so that that the doctors know
what they're getting,
what's in it, where it's coming from, and
and, you know, who's responsible if something goes
wrong.
Yeah. Thank you so much for providing all
that insight. A lot to cover there. I
love what you mentioned about the 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?
It's a it's a length any any type
of legislation is a is a lengthy and
expensive process, of course. Mhmm. 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
that passed legislation. That was back in 02/2019.
And, again, it comes down
to there has to be a, you know,
a group of stakeholders
within the individual state, first of all,
whether that's the, you know, people that are
involved in the dental dental,
board or the the dental, regulation within the
state.
You know, a group of lab lab folks
combined with with, you know, state dental society
folks that all get together and say we
need to champion this process. It it needs
to happen. And then, of course, you unfortunately,
in the political world, you know, you typically
have to spend tens of thousands of dollars
lobbying,
to be able
to get somebody on board with with writing,
with writing some type of legislation or to
get it to get it through.
And it's 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 that, you know, most people don't
have.
I will say as as an industry, the
National Association of Dental Labs, which, again, I
I served as president of in 02/2019.
You know, the the NADL
is very supportive
of any state and,
or yeah. Of any state, sorry, that wants
to 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, kinda guide folks
through this process. But,
I can tell you that I'm
in in 02/2019,
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. It's just
time and money to to see it through.
Wow. 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?
Yeah. I mean, it's a lot it's a
lot of the same answers, I suppose.
You know, I I'm very bullish on on
the industry as a whole. You know, I
just listed off a whole laundry list of
of concerns and things that, you know, have
been challenges for us going back.
You know, I I ran a dental lab
through the great recession. I ran obviously ran
a a large dental comp 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 we really enjoy on the
lab side.
Our role has transformed
so much from when I first started,
where, you know, we're
it it's a very collaborative relationship
between the lab and the dentist,
versus what it was twenty years ago.
And and, you know, a big part of
that and a big part of the excitement,
and also some of the concern or 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 in this
industry, but in the in the world in
the next, you know, five, ten, fifteen, twenty
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 and provides challenges. I I I truly
believe that, you know, we're we're gonna 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 gonna
continue, and I I think that,
you know, the the collaborative relationship between the
lab and and the dental office and,
you know, how we all work together over
the next ten, fifteen, twenty years is really
gonna be exciting to see how that develops.
Yeah. Well, great to hear about your optimism
there. And and, you know, despite some some
of the challenges and concerns that you shared
also, I think that there are a lot
of other dental leaders who kinda share the
same sentiments.
So, yeah, definitely interesting to 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 health
care health care leaders need to be successful
in the next two to three years?
Well, that's a great question.
You know, in the next two to three
years, I think,
the most successful health care leaders are are
going to need,
to be flexible, pliable,
and visionary. I think,
you know, over the next couple years, for
sure, I 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,
you know, we have to be
visionary to to try to see where and
and how we can fit some of those
things in and continue to improve and also
be flexible to understand that we we're gonna
make some mistakes in implementation
of of some of these things. And how
do we change? How do we continue to
to stay ahead?
Certainly,
you know, there's a lot of discussion and
a lot of concern about the overall health
care industry
outside of just dentistry in The United States.
And and, you know, obviously, there's gonna continue
to be ongoing discussions and challenges, and, you
know, we'll we'll see how if and how,
any any significant changes are legislated. But that's
why I say I think for us and
for anybody in in any health care field,
the biggest thing over the next two to
three years is is really gonna have to
be, you know, flexibility and and vision and
adaptability.
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.
Absolutely. I appreciate all you guys do and
and appreciate you inviting me on today. So
thank you, Ariana.
Yes. Of course. Enjoy the rest of your
day.
You too. Take care. Bye bye.