This presentation provides a comprehensive overview of the U.S. denture market and it includes relevant market data, trends and competition.

1. Full Dentures:
Market & Customers in the U.S.
Author: Anna Kataoka
Senior Product Manager | Glidewell Dental Laboratories
Note: Sources indicated on each page. Complete list of the references can be found at the end of the document.
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2. ~40 million Americans are fully edentulous
(toothless)
in either the maxilla, the mandible, or both.
Source: American College of Prosthodontists (ACP). https://www.gotoapro.org/facts-figures/. Accessed on December 31, 2019. 2

3. What is a full-denture
• A full-denture is a removable
dental prosthetic appliance.
• Designed for completely
toothless (edentulous) patients.
• Intended to replace missing teeth
in either the maxilla, the
mandible, or both.
• Generally, available in two options:
• Conventional full-denture
• Implant-stabilized overdenture
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4. U.S. full-denture market
4
Crowns
$5.5B | 1.8%
Units: 2.4%
Bridges
$1.2B | -1.5%
Units: -0.7%
Dental
Prosthetics
Market
$10.3B | 1.4%
Veneers
$0.7B | -5.1%
Units: -3.5%
Dentures
~$2.7B | 3.4%
Crowns & Bridges
$6.7B | 1.3%
Units: 2.4%
Inlays/Onlays
$0.3B | -0.6%
Key Takeaways
• The U.S. dental prosthetics market
incl. dentures, C&B, inlays/onlays
and veneers. The market is valued
at $10.3B and 1.4% CAGR.
• The 2nd largest segment (25%)
of the market at ~$2.7B are
dentures, inclusive of full and
partial devices.
• Segmentation of the full-denture
market:
• Economy Dentures: “GOOD”
• 29% share
• Fastest-growing category
• Standard Dentures: “BETTER”
• 54% share
• Largest category
• Premium Dentures: “BEST”
• 17% share
• Highest-price dentures
Source: iData Research Inc. “U.S. Market Report Suite for Dental Prosthetics.” November 2017.

5. Denture-relevant market trends and their
implications on the denture business
• Demographic shift of 65+ year old to become
a 78 million cohort by 2035
• Improvement in oral health
• Longer life span of the denture population (65+)
• Growing immigration rate
• The power of consumerism
• Growth of dental implants
• Declining reimbursement (expect for the DSO-s)
and growing out-of-pocket spending
• Increasing presence of the DSO-s
 Overall increase of edentulism (full and partial)
 Lower full-edentulism and lower demand for full
dentures; while partials/flippers will be on the rise
 Greater proportion of dentures will require
replacement
 Increase in full edentulism
 Better esthetics at lower prices; more affordable
dentures with improved esthetics and durability
 Increased availability of implant-stabilized
overdentures
 Price will drive the buying decision; while patients
with broader coverage will seek premium solutions
 Low-cost, economy dentures will continue to thrive
Sources: iData Research. U.S. Market Report Suite for Dental Prosthetics. November 2017; The U.S. Census Bureau; Centers for Medicare and Medicaid Services; American Dental
Association Health Policy Institute; American College of Prosthodontists.
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6. Denture Patients
• Adults ages 65+ with highest prevalence among those 75+ years old.
• People in low socioeconomic strata,
• High correlation between poverty and edentulism.
• African-American and Hispanic populations are nearly twice as likely to
be fully edentulous.
• Immigrants are likely to be fully edentulous.
• Higher risk of edentulism in those with diabetes, obesity, smoking,
obstructive sleep apnea (OSA).
• OSA is 61% more prevalent in those with full edentulism.
• States with the highest prevalence of edentulism (≥8%):
• Between the Appalachian Mountains and Mississippi Delta,
• South of the U.S. twice as much likely as the West.
Source: William Ely Hill. “My Wife and
My Mother in Law.” Great Britain. 19th
century.
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7. Denture Patients: Race and Gender
Figure 1. Prevalence of complete tooth loss (edentulism) among adults aged 65 and over, by age, sex, race and
Hispanic origin: United States, in 2011–2012.
Source: B.A. Dye, G. Thornton-Evans, X. Li, T. J. Iafolla. “Dental Caries and Tooth Loss in Adults in the United States, 2011–2012.” NCHS Data Brief. No. 197. May 2015.
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8. Denture Patients: Complete Edentulism
Figure 2. Age-standardized edentulism prevalence among adults aged 25+ years old, U.S. states, in 2010.
Source: G.D. Slade, A.A. Akinkugbe, A.E. Sanders. “Projections of U.S. Edentulism Prevalence Following 5 Decades of Decline.” Journal of Dental Research. August 2014.
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9. Denture Patients: Edentulism and obesity
Figure 3. Obesity by state, in 2018.
Source: Center for Disease Control and Prevention; https://www.cdc.gov/obesity/data/prevalence-maps.html. 9

10. Denture Patients: Edentulism and diabetes
Figure 4. Diabetes by state, in 2017.
Source: Center for Disease Control and Prevention; https://www.cdc.gov/diabetes/library/reports/reportcard/incidence-2017.html. 10

11. Denture Patients: Edentulism and standard of living
measured by Human Development Index
Figure 5: Human Development Index in the U.S., in 2013-2014.
Source: Measure of America of the Social Science Research Council. http://measureofamerica.org/maps/.
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12. Denture Patients: Edentulism and the
immigration
Figure 6. U.S. immigration by state, in 2013-2017.
Source: Migration Policy Institute (MPI). https://www.migrationpolicy.org/programs/data-hub/charts/us-immigrant-population-state-and-county. 12

13. Denture Patients: Edentulism and the
immigration, cont.
Figure 7. Top 20 metropolitan areas with the largest number of immigrants, in 2017.
Source: Pew Research Center. https://www.pewresearch.org/fact-tank/2019/06/17/key-findings-about-u-s-immigrants/.
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14. Denture Patients: States with the highest
occurrence of full edentulism
Figure 8. States with the highest prevalence of full edentulism. Relationship between complete toothlessness and
the occurrence of obesity and diabetes, and correlation with the standard of living (Human Development Index)
and the immigration.
Source: Prepared based on the combined information from the preceding slides. Darker shade indicates a larger number or a higher percentage of the occurrence.
States with
high obesity
rate
States with high
diabetes rate
U.S.
immigrant
population
Human
Development
Index
States with high
edentulism rates among
adults >25 years old
Mississippi (MS) 57% 69,000 4.05
West Virginia (WV) 55% 30,000 3.94
Arkansas (AR) 55% 141,000 4.17
Louisiana (LA) 54% 194,000 4.41
Kentucky (KY) 53% 161,000 4.26
New Mexico (NM) 53% 201,000 4.47
Alabama (AL) 53% 168,000 4.21
Oklahoma (OK) 51% 230,000 4.45
South Carolina (SC) 51% 238,000 4.57
Tennessee (TN) 51% 327,000 4.41
States with the percentage of
households with income
<$50K
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15. Denture Patients: VoC
• Surveyed full-denture patients stated that they would pay more for
the dentures if their prostheses:
• Fit better (76% surveyed),
• Better resisted staining and plaque, odor sorption, and bacterial
growth (71% surveyed) ,
• Had a more natural appearance (63% surveyed).
Source: J. Nosti, “Myths about denture patients.” Dental Economics. November 20, 2014. https://www.dentaleconomics.com/practice/article/16390128/myths-about-denture-
patients; MoreThanADenture.com by Ivoclar Vivadent Removable. https://www.morethanadenture.com/.
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16. Denture Patients: VoC, cont.
• 48% of patients are unhappy with their current dentures.
• Only 5% of patients report complete satisfaction with their prostheses.
• 77% would like to improve the comfort of their dentures.
• 46% would like to correct the facial support of their current dentures.
• 42% would like to improve tooth positioning.
• 36% would like to get a new appliance within a year.
• 13% would get a new denture if their dentist recommended it.
Source: J. Nosti, “Myths about denture patients.” Dental Economics. November 20, 2014. https://www.dentaleconomics.com/practice/article/16390128/myths-about-denture-
patients; MoreThanADenture.com by Ivoclar Vivadent Removable. https://www.morethanadenture.com/.
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17. Marketing to the denture patients
• 52% of the U.S. population lacks the literacy and numeracy skills
needed to participate in a complex and demanding society:
• Inability to use health-related print materials and tools with
accuracy and consistency.
• Older adults are more than twice as likely to have health literacy
skills below the basic level of younger adults.
• Older adults who are recent immigrants often struggle with the
English language.
Source: R.G. Rozier, B.A. White, G.D. Slade. “Advancing Dental Education in the 21st Century: Section 2, How Many Dentists Are Needed in 2040? Trends in Oral Diseases in the
U.S. Population.” Journal of Dental Education. Supplement. August 2017; Pew Research Center. English proficiency among immigrants in the U.S.. Association of State &
Territorial Dental Directors (ASTDD). Best Practice Approaches for State and Community Oral Health Programs. “Best Practice Approach Report: Oral Health in the Older Adult
Population (Age 65 and older).” May 2018.
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18. Denture patients and dental insurance
• Medicare does not cover most dental care services incl. cleaning, fillings, tooth
extractions, dentures, dental plates and other dental devices.
• Medicare Part A (Hospital Insurance) may pay for limited dental services for
hospitalized patients.
• Some Medicare Advantage Plans (Part C) may offer select dental benefits to
qualified patients.
• Medicaid programs will cover dental services for children <21 years old.
• There are no minimum Medicaid coverage requirements for adults except for
Mandatory Categorically Needy Group and they vary state by state.
Source: Medicare.gov. https://www.medicare.gov/coverage/dental-services; The Medicaid and CHIP Payment and Access Commission (MACPAC). “Medicaid Coverage of Dental
Benefits for Adults. Report to Congress on Medicaid and CHIP.” June 2015. 18

19. Denture patients and dental insurance, cont.
• 86.2% of dental service
expenditures, including full
dentures can be attributed to
two sources:
• Out-of-packet spending
(41.1%),
• Private insurance (45.1%).
Source: The Medicaid and CHIP Payment and Access Commission (MACPAC). “Medicaid Coverage of Dental Benefits for Adults. Report to Congress on Medicaid
and CHIP.” December 2019.
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20. Full Dentures: Competitive Landscape
• The denture market is highly fragmented with
8 major competitors accounting for ~20% of
the total market.
• 5 large DSO groups led by Affordable
Dentures & Implants and Aspen Dental,
account for ~13% of the total units sold.
• The top three dental laboratories incl.
Glidewell Dental Laboratories represent a
combined ~8% of the units sold.
Company Category
Estimated
Market Share
[%]
Affordable Dentures &
Implants
DSO 3.60%
Aspen Dental DSO 3.40%
Glidewell Dental Laboratories
Dental
Laboratory
3.20%
Smile Brands DSO 2.50%
National Dentex Corp.
Dental
Laboratory
2.30%
Modern Dental Laboratory
Dental
Laboratory
2.20%
Dental Services Group
Laboratory
Dental
Laboratory
2.10%
Clear Choice DSO 1.10%
Others 79.60%
Source: iData Research Inc. “U.S. Market Report Suite for Dental Prosthetics.” November 2017.
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21. Full Dentures: Competitive Landscape, cont.
• With national presence, concentrated in edentulous states (Oklahoma, Arkansas, Tennessee, Kentucky, Louisiana,
Mississippi, West Virginia, South Carolina, and Alabama) corporate dental clinics promote fast and affordable
denture services with up to 7-year warranty.
• Vertically integrated for select denture services, these DSO-s can deliver to patients (directly) same-day economy
dentures at 350 for a single full-arch or ~$750 for a package of full upper and lower dentures.
• For patients seeking more functional denture solutions, these groups offer affordable acrylic dentures stabilized
with 2 (or more) implants at ~$3,000 (or more).
Source: AffordableDentures.com
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22. References
1. A.E. Sanders, A.A. Akinkugbe, G.D. Slade, G.K. Essick. “Tooth loss and obstructive sleep apnea signs and symptoms in the US population.”
Sleep and Breathing. September 2016. 20(3).
2. Affordable Dentures & Implants. https://www.affordabledentures.com/.
3. American College of Prosthodontists (ACP). https://www.gotoapro.org/facts-figures/. Accessed on December 31, 2019.
4. Association of State & Territorial Dental Directors (ASTDD). Best Practice Approaches for State and Community Oral Health Programs.
“Best Practice Approach Report: Oral Health in the Older Adult Population (Age 65 and older).” May 2018.
https://www.astdd.org/bestpractices/bpar-oral-health-in-the-older-adult-population-age-65-and-older.pdf. Accessed on December 31,
2019.
5. B.A. Dye, G. Thornton-Evans, X. Li, T. J. Iafolla. “Dental Caries and Tooth Loss in Adults in the United States, 2011–2012.” NCHS Data Brief.
No. 197. May 2015.
6. Center for Disease Control and Prevention (CDC). National Diabetes Statistics Report, 2017 Estimates of Diabetes and its Burden in the
United States.
7. C.W. Douglass, A. Shih, L. Ostry. Will there be a need for complete dentures in the United States in 2020? The Journal of Prosthetic
Dentistry. January 2002.
8. Department of Health Care Services (DHCS). California Medi-Cal Dental Denti-Cal Bulletin. January 2018. https://www.denti-
cal.ca.gov/DC_documents/providers/provider_bulletins/Volume_34_Number_01.pdf. Accessed on January 3, 2020.
9. G.D. Slade, A.A. Akinkugbe, A.E. Sanders. “Projections of U.S. Edentulism Prevalence Following 5 Decades of Decline.” Journal of Dental
Research. August 2014.
10. iData Research Inc. “U.S. Market Report Suite for Dental Prosthetics.” November 2017.
11. J. Nosti, “Myths about denture patients.” Dental Economics. November 20, 2014.
https://www.dentaleconomics.com/practice/article/16390128/myths-about-denture-patients. Accessed on December 31, 2019.
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23. References, cont.
12. Kaiser Family Foundation (KFF). “Medicaid Benefits: Dentures in 2018.” https://www.kff.org/medicaid/state-
indicator/dentures/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D. Accessed on
December 26, 2019.
13. M.R. Savoca, T.A. Arcury, S. A. Quandt at al. “Impact of Denture Usage Patterns on Dietary Quality and Food Avoidance among Older
Adults.” Journal of Nutrition in Gerontology and Geriatrics.” January 2013. 30(1).
14. M. Scherer, “Lost your teeth but not your appetite? How dental implants can change your life by giving you the confidence to eat again.”
Advantage Media Group. 2015.
15. Measure of America of the Social Science Research Council. “Human Development Index in the U.S., in 2013-2014.”
http://measureofamerica.org/maps/. Accessed on December 27, 2019.
16. Medicare.gov. https://www.medicare.gov/coverage/dental-services. Accessed on December 26, 2019.
17. MoreThanADenture.com by Ivoclar Vivadent Removable. https://www.morethanadenture.com/. Accessed on December 31, 2019.
18. Pew Research Center. “Top 20 metropolitan areas with the largest number of immigrants in 2017.” https://www.pewresearch.org/fact-
tank/2019/06/17/key-findings-about-u-s-immigrants/.
19. Pew Research Center. English proficiency among immigrants in the U.S.. https://www.pewresearch.org/fact-tank/2019/06/17/key-
findings-about-u-s-immigrants/. Accessed on December 26, 2019.
20. R.G. Rozier, B.A. White, G.D. Slade. “Advancing Dental Education in the 21st Century: Section 2, How Many Dentists Are Needed in 2040?
Trends in Oral Diseases in the U.S. Population.” Journal of Dental Education. Supplement. August 2017.
21. The Medicaid and CHIP Payment and Access Commission (MACPAC). “Medicaid Coverage of Dental Benefits for Adults. Report to Congress
on Medicaid and CHIP.” June 2015.
22. United States Census Bureau. “Older People Projected to Outnumber Children for First Time in U.S. History.”
https://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html. Accessed on December 26, 2019.
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