A Q&A WITH PAUL KEEL

Paul Keel, CEO, leads Envista in living its mission of digitizing, personalizing, and democratizing dental care. Before Envista, Paul was CEO of Smiths Group plc, a FTSE 100 global technology company, where he led the organization to record growth and profitability. Prior to Smiths, he spent nearly two decades with 3M in various leadership roles including Group President of the Consumer Business, SVP Marketing & Sales, SVP Manufacturing & Supply Chain, President of 3M Medical, and President of 3M’s Specialty Dental business. Preceding 3M, he held positions of increasing responsibility at GE, McKinsey, and General Mills. He holds a BA from Carleton College and an MBA from Harvard Business School.

In May 2024, Paul Keel took the reins as the new CEO of Envista, one of the largest global dental products companies. Its family of more than 30 brands includes Nobel Biocare, DEXIS, Kerr, ORMCO, and Orascoptic, all united by a shared purpose: to partner with professionals to improve lives.

Keel’s experience in the medical and oral care markets made him uniquely qualified to lead Envista in its mission to digitize, personalize, and democratize dental care. "It's a great honor to lead Envista at this exciting time in our deep and rich history," Keel said upon taking on the new role. "I know and admire the company and industry. I am thrilled to build on Envista's strong foundation, doing ever more to serve all our stakeholders—our customers, their patients, our colleagues, our communities, and our shareholders."

Dental Product Shopper recently met with Keel to discuss the current state of the dental industry and how Envista is working to serve dental professionals and their patients around the world.

Q: What appealed to you about coming over to Envista and taking on this role?

A: First, it was just the underlying dental industry itself. It has two characteristics that make it such a rewarding place to work. No. 1, regardless of what portion of the industry you're in—whether you’re on the clinical side or on the business side—everyone is bound together by the same purpose, which is to broaden access to oral care, make it a better patient experience and a more efficacious treatment. No. 2, there is structural insufficiency of supply in dental. The demand for oral care far exceeds the supply. There's not enough accrediting agencies, dental schools, or residency programs anywhere in the world. And that's why you have a billion unfilled cavities in China alone. You have 4 billion people walking around who need a dental implant. So, from a commercial perspective, there is a structural imbalance between supply and demand. That makes it a commercially interesting market for clinicians. And, as suppliers, we only do as well as our customers do. When our customers do well, and they typically do pretty well, then there's an opportunity for us to do well.

The second piece of what attracted me to Envista is just the remarkable collection of businesses. Nobel Biocare, rooted in Dr. Brånemark’s osseointegration discovery, played a significant role in the innovation and democratization of dental implants. Ormco pioneered passive self-ligation and, in collaboration with Dr. Damon, developed the Damon System. A considerable amount of foundational IP for digital treatment planning comes from a Loma Linda orthodontist named Dr. Craig Andreiko, an innovator with Ormco. A good portion of the IP that is used today to capture digital images and scans and knit them together into an orthodontic treatment plan came from this company.

The third piece is, let's face it, the timing right now is pretty good for coming back into dental. The market is going through a very predictable, and I would say temporary air pocket. And it goes back to COVID. In 2020 and into '21, none of us went to a dentist. At the end of '21 and into '22, every single one of us went to a dentist. Everyone who had procedures backed up during COVID had them done. Every practice had record results in '22 and '23, and every supplier had record results. And, today, everyone's a little bit soft, certainly from a capital markets perspective, so that always creates opportunity. For those of us who've been around this industry for 20 years, over time, dental tends to grow in the mid single digits.

Q: What do you see as Envista’s greatest strengths in serving the dental market?

A: Well, Envista and our predecessor companies have been around for 133 years. It goes all the way back to 1891 when two brothers founded Kerr, our dental consumables brand. So, across that time and across the geographic spread of Envista, we've developed a lot of capabilities, but there are three keys that are particularly important to us. One is our purpose. Another is our portfolio. And, if you're going to be in business like we've been for over 100 years, the only sustainable competitive advantage is people.

Our purpose lines up with the purpose of the industry very well with one slight nuance. While all clinicians are propelled by the opportunity to help people and bring better and more access to oral care, that of course propels us as well, but we don't try to do the clinician's job. Across all of our businesses, we are solely focused on helping our customers fulfill their mission. So, we help hygienists, doctors, office managers do what they do best, which is serve patients. That's a very powerful purpose for us. We have 30-plus dental brands, and we're in 150 countries, so it takes a very powerful purpose to align all of that. And I think we have that.

In terms of our portfolio. I don't think you can name an interesting dental category—orthodontics, implants, endo, restoratives, diagnostics, etc—where we don't have a top three position. Then, you multiply the product breadth by the geographic breadth, and a company of our scope and scale is really, really unique in the dental world.

And then it brings you back to the people. I would describe our culture as having three DNA strands. DNA strand No. 1 for us is continuous improvement. This is a former Danaher company, and it's structurally built around being better today than yesterday, being better tomorrow than today. The second part is it's so diverse in terms of the segments and the countries we participate in, that it has to be highly inclusive. You need an environment where everybody can be their best—everyone, every day has to be committed to an inclusive environment where you welcome differences. And then the third DNA strand, super important to us, is performance. You have to perform for your customers each and every day. If you don't, they have other options. And over the last five years, we've been publicly traded, which is new for us in the span of our history. You have to perform for your shareholders as well.

Q: What is your view on how all of this rapidly advancing dental technology is changing the practice?

A: If I go back across my 20 years, I would give you two categories—what hasn't changed and what has changed, and how did the two connect? Across my time in dental, the underlying structure of the industry has been the same from a clinical perspective and a business perspective. It is an industry focused on bringing better and more care to patients. And, again, there is a structural insufficiency—there's more need than there is supply. That hasn't changed, but it leads to two things that have changed.

One stems from the question of, ‘How can technology allow clinicians to serve more, better, faster?’ Digitization. You’ve seen digitization in every healthcare segment, and dental was relatively slow to start, but now the pace of digitization relative to other healthcare verticals is very rapid. Once we figured out how to digitize diagnostic images, which came from medical, and how to move from mass standardization to mass customization, or personalized medicine, it launched this very steep improvement trajectory you see in dental today. Most of the world's history around manufacturing advancement has been focused on mass standardization. Going all the way back to Henry Ford and the Model T, it was, ‘How do you make one widget faster, higher quality, lower cost, and how do you get it around the world?’ The exact opposite is mass customization. In the clear aligner market, for example, we’re customizing not just down to an individual patient, not just to an individual tooth, but to the specific topography of an individual tooth in a specific patient. And to be able to do that at scale, that is remarkable technology.

The second change is in the business model. For a long, long time, almost all dental care was provided from that sole proprietorship business model—a passionate dentist or specialist who opened a practice or apprenticed in a practice and eventually bought the practice from their mentor. And still today, the vast majority of dental care is that sole proprietorship. But that is not the most efficient way to expand oral care, and that's given this rise to DSOs.

The DSO piece is still a relatively small portion of our industry, but the DSO is good for all the participants in dentistry. It's good for patients—there is more access to care. It’s good for doctors because it gives new doctors opportunities they otherwise wouldn't have, and even doctors later in their careers who want to keep serving their patients and monetize the assets they’ve built over decades. And DSOs are also very good for the supplier network because they cover such a large geographic span. Not many suppliers can service a thousand-site DSO that covers all of a continent. They're so diverse in terms of the number of segments that they provide—you can only think of two companies that do dental consumables, imaging, ortho, implants. And they are very demanding from a quality and consistency perspective that those of us who can serve DSOs, it's a good spot to be.

Q: Looking ahead, what are some areas in dentistry where we can expect to see new innovation?

A: Innovation broadly can take two forms—product innovation and process or business model innovation. On the product front, there's no question that the personalization of dentistry will continue. Twenty years ago, no one would believe you could have personalized orthodontic care down to the individual tooth like we described. But that personalization still doesn't exist in many parts of dentistry, so there's much more to be done in all of the categories.

The second part is the business model for how care is provided. It used to be a clinician needed a product, they called the supplier. The supplier mailed it to them or dropped it off. Now, many of the components of the care provision are created in the office, such as via 3D printing. And this creates interfaces for multitherapy treatment. Think about orthodontics. There are some tooth movements that are done better with the force dynamics of a bracket and wire, but there are some that work better with a clear aligner. The esthetic properties are different, and the comfort is different. Of course, the right answer is to combine the two, but that takes more personalization—creating a specific therapy for that specific patient need.

Q: What is something about Envista that dentists may not know, but you would want them to know?

A: Everybody knows Envista’s 30+ brands, but not everybody knows the brand "Envista." Envista exists as a home for all of our product brands, known for the same great quality, consistency, and innovation. As long as customers understand that connection, that is what’s important. The Envista brand also exists for two of our important stakeholders: our shareholders, as that is the stock that they buy, and our employees, providing all of us a very powerful employee value proposition. You can work in 30 different product categories inside dental and 150 different countries if you so choose, and you never have to change your employee status.

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