A U.S. dental practice can put off replacing an imaging unit or buying a new intraoral scanner for a year without turning away a patient. Composite resin, impression material and endodontic files get used up every week and have to be reordered. The difference between those two kinds of spending showed up across the second-quarter results of four of the largest publicly traded dental companies, and it helps explain why Dentsply Sirona reported falling sales while the largest dental distributor and two of its competitors grew.
Four Reports, One Pattern
StockStory’s review of the quarter grouped four dental names together. Henry Schein, the largest dental distributor, reported revenue of $3.46 billion, up 6.7%. Envista, which owns the Nobel Biocare implant and Spark aligner brands, reported about $731 million, up 7.1%. Align Technology, the Invisalign maker, posted $1.06 billion, up 4.3%. Dentsply Sirona’s sales went the other direction, down 4.1% to $898 million.
The headline figures mix very different businesses. Broken into equipment and consumables, the results line up more consistently.
The Equipment Side
Henry Schein’s numbers give the clearest read on dentist purchasing because the company sells products from many manufacturers. Its global dental equipment sales rose 3.8% in the second quarter, with internal growth of 2.2%. In the United States, equipment sales declined 1.1%. International equipment rose 8.7%.
Align described the same conditions from the manufacturer’s side. Revenue from its Imaging Systems and CAD/CAM Services segment, which includes iTero intraoral scanners, fell 10.8% to $185.3 million. “In Systems and Services, Q2’26 revenue performance reflected persistent softness in the capital equipment market,” Chief Executive Joe Hogan said.
Dentsply’s Connected Technology Solutions segment, which sells CEREC milling systems, Primescan intraoral scanners and Orthophos and Axeos imaging units, reported $239 million in sales, down 1.5% as reported and 3.8% in constant currency. Within the segment, CAD/CAM fell at a mid-single-digit rate while equipment and instruments held level with a year earlier, according to a Yahoo Finance recap of the call.
One-third of dentists reported insufficient patient volume in the fourth quarter of 2025, and only one-third said they were confident in the U.S. economy, according to the American Dental Association’s Health Policy Institute. Equipment and supply costs had risen 5% since the start of 2025, while insurance reimbursement rates had plateaued, the institute found. About a quarter of dentists said they planned major equipment purchases in 2026. Other plans were more common. More than one-third intended to drop some insurance networks, and about 40% planned to add staff.
Confidence then weakened further. The institute’s third-quarter 2026 update, based on responses from 750 dentists, found about half confident in their own practice’s economic performance, compared with nearly 70% in the fourth quarter of 2024. Confidence in the U.S. economy fell to about 26%.
Dentsply’s first quarter had already been weak. Over the first three months of 2026, reported net sales were essentially flat at $880 million but fell 6.7% in constant currency, and adjusted EBITDA margin dropped to 14.7% from 19%. Regionally, the second quarter’s weakness was concentrated at home. Constant-currency sales fell 11.6% in the Americas, against declines of 3.6% in Europe, the Middle East and Africa and 1.2% in Asia-Pacific. Henry Schein’s split between a 1.1% drop in U.S. equipment and an 8.7% gain abroad points to the same geography.
The Consumables Side
Supplies held up better at the distributor level. Henry Schein’s global dental merchandise sales rose 9.7%, with internal growth of 5.9%. U.S. merchandise grew 6.5% internally and international merchandise 5.4%. Practices kept restocking.
Envista’s Equipment and Consumables segment posted core growth of 8.5%. Its Specialty Products and Technologies segment, home to implants and aligners, grew 3.1% on a core basis. Envista raised its full-year core sales growth forecast to 3.5% to 4.5% from 2% to 4%.
“We built on our fast start in Q1 with continued good performance in Q2,” Envista Chief Executive Paul Keel said.
Envista’s profit grew faster than its sales. Adjusted EBITDA rose about 28% to $107.7 million, and the margin widened 230 basis points to 14.7%, an expansion Envista attributed to the Envista Business System. Free cash flow reached $105.1 million in the quarter, and Envista repurchased 2.4 million shares for about $59 million.
Henry Schein also raised its outlook. The distributor lifted its 2026 non-GAAP earnings forecast to $5.29 to $5.39 a share, from $5.23 to $5.37, and its total sales growth forecast to 4.5% to 5.5%, from 3% to 5%. “We delivered strong sales performance and margin improvement in the second quarter,” Chief Executive Fred Lowery said.
Dentsply’s consumables unit diverged from that trend. Essential Dental Solutions, which sells restorative materials, endodontic instruments and preventive products, reported $376 million, down 2.7% as reported and 5% in constant currency. European dealers worked through stock they already held, management said, and Fortson pointed to a planned reduction in dealer inventory of about $8 million.
Those explanations place much of the decline in the supply chain rather than in dentists’ chairs. A distributor that sells from its warehouse instead of reordering reduces the manufacturer’s reported sales without changing how much product practices use. Henry Schein’s merchandise growth during the same quarter suggests end demand for supplies was intact in the channels it serves.
Implants and Aligners
The third category, specialty products, split by company. Align’s clear aligner revenue rose 8.2% to $870.9 million on a 7.4% increase in case volume, to 691,800 cases.
Wellspect Healthcare, Dentsply’s continence-care business and the one segment outside dentistry, grew 7.1% as reported and 3.8% in constant currency to $86 million. It was the only Dentsply unit to expand in the quarter.
Dentsply’s Orthodontic and Implant Solutions segment fell 13.2% as reported and 14.9% in constant currency, to $197 million. The wind-down of Byte, the direct-to-consumer aligner business whose at-home kits Dentsply suspended in late 2024, explains most of the drop. Excluding Byte, the segment declined 5.7%. Byte had already cost Dentsply 1.9 percentage points of constant-currency sales growth in 2025, when total net sales fell to $3.68 billion. The call recap put the implant decline in the mid-single digits and the drop in SureSmile aligners at more than 10%.
Dentsply’s Response
Chief Executive Dan Scavilla has addressed the equipment and channel problems through distribution. Since January, Dentsply has signed or expanded agreements with Benco, Patterson, Burkhart, A-dec, Atlanta Dental Supply, Nashville Dental and Medline Sinclair in Canada. Scavilla told analysts in August that two of the new dealers had grown by double digits so far.
The Benco agreement, announced Jan. 13, targets the equipment problem directly. Benco had sold Dentsply consumables for decades, and under the expanded deal it began carrying CEREC milling systems, Primescan intraoral scanners and Axeos and Orthophos imaging units, with demonstration space at three regional showrooms near Los Angeles, Dallas and the New York-Philadelphia corridor. Dentsply installed its first CEREC system through Benco in the first quarter.
The company is also cutting costs. A restructuring announced in February targets about $120 million in annual savings, with one-time charges of $55 million to $65 million expected mostly in 2026 and 2027. Dentsply eliminated its dividend and has used the cash to repurchase stock and reduce debt, which stood at about $2.22 billion at June 30.
Gross margin improved despite lower sales. GAAP gross margin rose to 54.9% from 52.4%, and adjusted gross margin rose to 56.4% from 55.9%. A $44 million tariff refund contributed to the GAAP figure and added 17 cents to earnings per share, Fortson said. Dentsply reported net income of $37 million, or 18 cents a share, compared with a $45 million loss a year earlier.
“2026 continues to be a year of decisive action as we execute our Return-to-Growth Action Plan,” Scavilla said.
The company kept its 2026 guidance for net sales of $3.5 billion to $3.6 billion and adjusted earnings of $1.40 to $1.50 a share. At the midpoint, the sales range implies a decline of about 3.5% from 2025’s $3.68 billion.
Where Investors Sit
Dentsply’s shareholders range from value managers to hedge funds. John Rogers’ Ariel Investments held the largest stake among managers tracked by GuruFocus, at 8,026,107 shares, or about 4% of shares outstanding at the end of June. First Eagle Investment Management held 1,702,694 shares and Brandes Investment Partners 1,127,712. Joel Greenblatt’s Gotham Asset Management reported 638,226.
Armistice Capital, a New York hedge fund concentrated in healthcare, added 672,000 Dentsply shares in the second quarter and held 3,672,000 shares, worth about $39 million, as of June 30, according to its 13F filing. The position sits alongside a portfolio weighted heavily toward biopharmaceutical companies, and it is roughly 0.5% of the $8.17 billion the fund reported.
Dental equipment purchases depend on practice confidence, and the ADA’s latest reading shows that confidence at a multiyear low. Henry Schein raised its 2026 sales growth forecast to 4.5% to 5.5% after the second quarter, and Envista raised its own outlook. Dentsply held its forecast steady.