Dental and vet supply chain — Q1 2026 listed-cohort read.

01 The listed cohort, Q1 2026 read

Three listed distributors filed Q1 2026 10-Qs within the same week of May 2026. Their combined revenue base of roughly $5.4 billion is the closest thing the public market has to a direct read on US dental and veterinary practice activity, because all three sell into the same end customer: independent and corporate-owned practices, plus the DSO and vet-platform corporates that consolidate them. Idexx Laboratories (IDXX) posted Q1 2026 revenue of $1.141 billion, up 14.3% YoY against the comparable Q1 2025 quarter at $998 million. Henry Schein (HSIC) posted $3.368 billion, up 6.3% YoY versus $3.168 billion the year prior — the highest quarterly print in the eight-quarter trail. Dentsply Sirona (XRAY) posted $880 million, up 0.1% YoY — essentially flat versus Q1 2025, and roughly 7% below the Q1 2024 print of $953 million.

The dispersion between the three is meaningful and it lines up with the structural mix of each operator. Idexx is roughly 90% veterinary diagnostics — the consumables-rich, recurring-revenue subsection of the vet supply chain. HSIC is roughly half dental distribution, the other half medical and animal-health distribution. XRAY is the most equipment-weighted of the three — CAD/CAM, imaging, treatment centers — so its read is closer to a "dental practice capex" indicator than a consumables one. The fact that the consumables-heavy operators (IDXX, HSIC) are growing while the equipment-heavy operator (XRAY) is flat tells you most of what you need to know about the underlying practice activity: consumables intensification continues; equipment expansion does not.

02 Idexx and the vet-platform thesis

Idexx is the single most important leading indicator we have for private veterinary platform health, because its companion-animal diagnostic recurring revenue (CAG-DR) maps almost one-for-one onto US in-clinic activity at the consumables level. The 14.3% reported YoY growth in Q1 2026 is the strongest single quarter in the trailing two years, and it lands on top of an already-elevated 2025 base. Importantly, the growth is not coming from clinical-visit-volume expansion. US in-clinic visit volume has been flat to slightly negative through most of 2025 and into Q1 2026, consistent with the macro signal that pet ownership has plateaued post-pandemic and well-pet wellness visits have softened at the lower-income consumer end. The growth is coming from consumables-per-visit intensification: more tests per visit, premiumisation of test mix, and continued price/mix realisation in the 5-7% range against a clinical-services CPI backdrop running at 6-8% YoY.

For private vet-platform sellers and the sponsors underwriting them — NVA, Thrive, Pathway, Compassion-First, Southern Veterinary Partners, Encore, Heartland Vet, Mission, PetVet Care Centers — this is the single most important confirmation in the Q1 2026 cohort. The per-clinic revenue ramp that platform-acquirer models depend on continues to land. The bear case on private vet platforms always centered on whether the price/mix-led same-store-revenue growth could continue once the pandemic pet-ownership wave normalised. Idexx Q1 2026 says it can, at least for one more quarter, and that the consumables intensification mechanism is structurally robust to volume softness. The trailing eight-quarter Idexx revenue line below shows just how clean the compounding has been; it is the kind of growth profile that supports double-digit EBITDA multiples on private vet roll-ups even where same-store visit volumes are flat.

03 Henry Schein — the medical/animal-health mix is carrying the print

Henry Schein's 6.3% Q1 2026 YoY revenue growth is the highest of the trailing eight quarters, but the headline number masks meaningful segment dispersion underneath. HSIC reports roughly four segments — Global Dental, North America Medical, International Medical, and a smaller Technology/Value-Added Services line. Dental at HSIC has been running essentially flat to LSD-positive on a local-currency basis through 2025, with North America dental consumables roughly flat YoY and dental equipment LSD-positive (mostly digital workflow and small equipment, not capex-intensive items). The Medical and Animal Health segments — together roughly 40% of HSIC revenue — are doing the heavy lifting, growing MSD to HSD on the back of primary-care office distribution, home-health expansion, and the Schein Animal Health veterinary distribution franchise.

For DSO buyers and sellers, the implication is uncomfortable but important: the listed-distributor signal does not support a thesis that 2026 US dental practice activity is reaccelerating. It supports a thesis that consumables demand is stable and that medical/vet adjacencies inside the distributor mix are doing better than dental is. Private DSO platform underwriting against 4-5% same-store-revenue growth from a roughly 50/50 split of price and volume needs to lean more heavily on the price half going forward — which the FRED medical-services CPI data (covered in §4) supports — and less on the volume half.

HSIC also generated $489 million of operating cash flow in Q1 2026 against $428 million the year prior — a 14% improvement against 6.3% reported revenue growth. That cash-conversion expansion is consistent with the company working down inventory days post-cyberattack normalisation and tightening AR. For private DSO platforms watching the distributor data as a proxy for their own working-capital cycle, the implication is that distributor-side inventory tightening could start to compress the float DSO platforms have historically run on supplier credit. We have seen this start to land in client engagements over the trailing six months.

What HSIC is telling us about dental versus vet inside the distributor stack

The fact that HSIC's growth is being carried by medical and animal-health rather than dental is itself the most important second-order signal in the cohort. It confirms — from a different vantage point than Idexx — that vet practice activity has more underlying revenue momentum at the consumables level than dental practice activity does. Vet roll-up underwriting is meaningfully better supported than DSO underwriting on this Q1 2026 data, and the gap between the two is widening rather than narrowing.

04 Dentsply Sirona and the dental equipment read

Dentsply Sirona is the most equipment-weighted operator in the cohort and therefore the cleanest read on US dental practice capex. Its Q1 2026 revenue of $880 million is essentially flat against the prior-year quarter at $879 million, but the trailing eight-quarter trend is clearly negative: the quarterly revenue base in 2023-2024 ran in the $930-985 million range, and the company has stepped down roughly 7% from those levels with no meaningful sign of recovery. The Q2 2025 print of $936 million was the most recent quarter inside the historical band; every print since has stepped back down.

Dental practice capex on CAD/CAM, imaging, and treatment-center equipment is therefore not a 2026 story yet. It might be a 2027 story if the rate environment continues to normalise and DSO platform balance sheets free up. But at Q1 2026, the data says US DSO platforms and independent practices are sticking with the chairs and capital equipment they already have, and they are not racing to add capacity. For private DSO platform models that underwrote 4-6% annual chair-count growth as a same-store-revenue lever, that lever is materially compromised right now. The growth has to come from utilisation of existing chairs (where hygiene capacity is the binding constraint) and from price/mix (where the FRED medical-services CPI confirms pricing power is still strong).

The XRAY-versus-HSIC spread is the cleanest cross-cohort signal: HSIC (consumables-mix-heavier) at 6.3% YoY, XRAY (equipment-mix-heavier) flat — a six-point dispersion that says the consumables half of the dental-supply economy is meaningfully healthier than the equipment half. That dispersion is consistent with what we hear from clients: independent dental practices and smaller DSO operators are deferring big-ticket capital spend even as their consumables run-rate holds together.

05 The pricing power that underwrites the cohort

The single most positive operating data point for private DSO and vet platforms in the trailing twelve months is the medical-care-services CPI series from the FRED data. Through Q1 2026 it has been running in the 6-8% YoY range, with February 2026 printing 7.6%. That number sits two to three times above headline CPI (currently sub-3%) and confirms the price-realisation half of platform same-store-revenue growth is structurally supported. For a typical DSO or vet model that assumes 3-5% SSRG split roughly half-and-half between price and mix/utilisation, the price half is well-supported by the index.

The medical-care-commodities CPI series runs slower, in the 3-4% range, which is why distributors like HSIC see flat-to-LSD revenue growth in their dental segment despite slightly soft volumes — the volume softness is being papered over by price/mix at the distributor revenue line. The 200-400 basis point spread between services and commodities CPI is also worth noting: it confirms that the value-add inside the clinical-service business (DSO and vet) is capturing more inflation than the manufactured-input side is. That is structurally favourable for clinical-service platform margins over the medium term.

For private platform sellers preparing 2026 or 2027 processes, the pricing-power data is the single most defensible underwriting input we can hand a buyer's diligence team. A platform showing 4-5% annual price realisation against a backdrop of 6-8% services CPI is not stretching; it is leaving room for additional realisation. Conversely, a platform showing flat or negative pricing against this backdrop signals operating discipline problems and is the kind of finding that compresses the multiple in diligence.

06 The wage and labor backdrop is moderating

The BLS healthcare and social assistance wage data (series CES6562000003) confirms what we hear in every DSO and vet platform engagement: clinical-labor wage inflation is moderating. Average hourly earnings in healthcare and social assistance ran $36.49 in March 2026 (preliminary), up from $35.53 a year earlier — a 2.7% YoY increase. That compares to roughly 4-5% YoY through 2023-2024 and 5-7% YoY for dental hygienists and vet techs specifically during the post-pandemic squeeze. Healthcare employment continues to grow at roughly 2.9% YoY, slower than the 3.6% YoY pace of a year earlier.

For private platforms underwriting margin expansion in 2026, this is the operating tailwind that buyers have been pricing in but that has not yet shown up in same-store EBITDA growth at most platforms. Labor is the largest cost line at almost every DSO and vet platform — typically 28-35% of revenue at DSOs, 32-42% at vet platforms after DVM compensation. A 100-150bp deceleration in labor inflation against a backdrop of 4-5% price realisation translates to roughly 80-120bp of EBITDA margin tailwind, all else equal. We have not seen most platforms convert this tailwind into reported same-store EBITDA expansion yet; some of it is being eaten by ongoing recruitment-and-retention bonus structures left over from the 2023-2024 wage spike, and some is being eaten by continued specialty-staff scarcity that limits chair and exam-room utilisation regardless of wage moderation.

The credentialed-clinical-staff shortage — dental hygienists, RVTs, vet techs — remains the binding constraint on capacity expansion even as wage growth moderates. Platforms with sub-80% hygiene chair utilisation or sub-75% exam-room utilisation are leaving 200-400bp of same-store-revenue growth on the table that the listed-distributor data implies should be capturable.

07 What the listed cohort means for private DSO and vet platforms

Translating the Q1 2026 listed-cohort read into operating implications for private DSO and vet platforms, three observations stand out, sequenced by how actionable they are for sellers and buyers in process right now.

1. 01
   Vet platform sellers have a more defensible 2026 underwriting story than DSO sellers do. The Idexx 14.3% growth + HSIC medical/animal-health acceleration says vet practice consumables intensification continues, even as visit volumes are flat. DSO platform underwriting at the same growth assumption needs to lean more heavily on price and mix (well-supported by the CPI data) and less on volume or capex-led capacity expansion (unsupported by the XRAY data). Vet platform sellers can run a 2026 process to a tighter multiple band than DSO sellers can.
2. 02
   For DSO sellers, the consumables-heavy operating envelope is the defensible story. Practices with strong hygiene utilisation, premium-mix shift, and proven price realisation in the 4-5% band are pricing well in the current process environment. Practices reliant on chair-count expansion or capex-led growth assumptions are getting marked down in diligence. The XRAY data gives buyers air-cover to push back on capex-led same-store-revenue growth assumptions, and they are using it.
3. 03
   For buyers underwriting 2026 platforms, the operating tailwind from wage moderation is real but not yet earned. The BLS data confirms labor inflation is decelerating. Most platforms are not yet converting that into EBITDA expansion because retention bonuses, specialty-staff scarcity, and hygiene-capacity constraints are absorbing it. Buyers willing to underwrite the margin expansion as a 2027 unlock — not a 2026 unlock — are pricing more accurately than buyers expecting same-store EBITDA acceleration in the current year.

08 What we are watching into Q2 and Q3 2026

Three signals matter into the rest of 2026. First, whether the Idexx-versus-Dentsply Sirona spread narrows or widens — a narrowing would say dental practice activity is finally catching up to vet practice activity at the consumables level; a continued widening would confirm the structural divergence. Second, whether HSIC dental segment growth steps up from LSD into MSD — if it does, that is the signal that DSO platform consumables run-rate is accelerating, which would support a more aggressive DSO process calendar for 2026 sellers. Third, whether the medical-care-services CPI sustains the 5-8% range or moderates further toward headline CPI — the price-realisation half of platform SSRG underwriting is most exposed to the CPI trajectory. Each of these three signals moves the practical multiple bands for private DSO and vet platforms by 0.5-1.0 turns of EBITDA. We publish this read quarterly; the Q2 2026 update is scheduled for August 2026.