Perfect! Good morning, everyone. This is Rachel Vatnsdal with the Life Science Tools and Diagnostics team here at JPMorgan. Thanks so much for joining us today. I'm joined on stage by the Dentsply Sirona team. So as we typically do with these sessions, it'll be 40 minutes, roughly 20 minutes of a presentation, followed by 20 minutes of Q&A. So if any of you in the room do have questions, feel free to either submit them via the portal, or you can ping me directly. With that, I will pass it off to Simon.
Thank you. Good morning, everyone, and thank you, Rachel. One year into our transformation journey at Dentsply Sirona, and following on the heels of our recent Investor Day, we're pleased to be happy to provide you all an update today. On stage, I'm joined by Glenn Coleman, our Chief Financial Officer, Andreas Frank, our Chief Business Officer, and our Head of Investor Relations, Andrea Daley. So please take a moment to read our forward-looking statements in our presentation. Our most recent SEC filings list some of the most important risk factors that could cause actual results to differ from our predictions. And additionally, some of our remarks will be based on non-GAAP financial measures, as detailed in the appendix.
Before we get started today, I wanted to share that yesterday we issued a press release indicating that our full- year 2023 sales are expected to be at or above the high end of our guidance range of $3.9 billion-$3.94 billion. For Q4 and for 2023, we expect to post year-over-year growth in three of our four segments, with growth in Essential Dental Solutions, in Wellspect, and in Orthodontic and Implant Solutions. We do expect Connected Technology Solutions to decline in line with our prior projections. We also reaffirmed our Adjusted EPS outlook for 2023, with a range of $1.80-$1.85, and still expect double-digit Adjusted EPS growth in 2024. So let's open with a snapshot of our business.
For those of you who are not familiar with Dentsply Sirona, this should serve as a helpful introduction. For all of you, it's worthwhile to recap some numbers to assess and measure our performance moving forward. Europe represents our biggest geography, heavily influenced by our presence in Germany, which disproportionately contributes to our revenue profile. We see the U.S. as a source of continued opportunity for our company, while disciplined and selective geographic and product expansion in LATAM and APAC creates the potential to accelerate our growth. With more than half of our sales coming from segments with long-term favorable dynamics, we think this positions us well to not only provide great solutions for our customers and their patients, but also bolsters our ability to generate results for our investors.
While we may have spoken anecdotally in the past about our strengths, we can now do so supported by robust data, and data-driven decision stands as a core tenet of this management team's philosophy. Now, here's what our customers have said: We have many of the most recognized brands in dental. We offer a comprehensive and complete product portfolio. We deliver unparalleled access to clinical education, and our extensive scale and breadth differentiate us. The dental market, a $30 billion global market, is quite balanced across its core segments. As an established leader in essential dental solutions, we must invest in such areas such as innovation, clinical education, and commercial footprint for this space.
Now, with that said, we do expect to improve our share and market penetration in areas like connected technology, aligners, implants, as well as certain geographies such as the U.S. and Asia Pacific. We have invested, and we will continue to invest in our aligners and implants business, and we believe that we are the best company to partner with on the journey to digitalization in dentistry. We have also demonstrated our commitment to our Wellspect healthcare business, a business that continues to grow, to innovate, and to drive profitability. As we've said, after carefully evaluating strategic alternatives presented for Wellspect, we decided to retain the business, as we believe that this will create the greatest shareholder value.
With a new industry- experienced general manager now in place, and growth investments approved for product innovation and capacity expansion, we are excited to see what's ahead for this part of our business. In a nutshell, as you may have heard me say before, we see areas of our business where growing with the market is acceptable, some areas where growing with the market is a stepping stone to greater performance, and others where we have the potential to achieve above-market growth with the right delivery and execution. We have a comprehensive end-to-end portfolio across our served markets. We aspire to be a customer-centric organization, informed by robust customer insights, and that's why we already conduct our own customer surveys, and I know that that resonates with all of you.
We're already much closer to our customers, using their insights to drive our investment decisions, and this customer centricity will continue to deepen. Our recently completed product portfolio and customer needs assessment survey informed us that we have no meaningful gaps in our portfolio, but that we need to improve our customer experience. This data will help us define our path forward to improve customer engagement and a better and improved new product development process.
It also confirmed the importance of continued but meaningful innovation and digitalization to improve their clinical workflows and create efficiency for our customers.... Now we know that we can improve our execution. We see significant runway to grow organically through innovation and through strategic tuck-in acquisitions across our largely fragmented end markets. As I've said before, our go-to-market channels vary considerably by geography and by category.
We have both business-to-consumer and business-to-business capabilities, and we will continue to optimize our channel mix and sales force effectiveness to increase customer proximity and engagement. Now, you are no doubt aware of the significant changes in the direct-to-consumer aligner business since our Investor Day in November. We see significant opportunity in the aligner category overall, and we are moving swiftly to capitalize on this to accelerate profitable growth in the direct-to-consumer business. Some early indicators suggest that increased numbers of potential patients have shown interest in our aligner offerings.
Our strategy is clear to us: digitalize dentistry, innovate in products and services for our oral health and continence care businesses, be great partners, and do so through a committed and engaged team with ethics, compliance, and quality at the core. We are actively and continuing to operationalize and advance on all five of these strategies.
We cascade these objectives through our organization, and we've aligned our goals around them, from annual operating plans to annual bonus plans to individual work plans. We have moved deliberately to execute on these through our operating model, our processes, and our investments to transform Dentsply Sirona. We have made several intentional leadership changes over the past 12 months, including a new and tenured Chief Human Resources Officer with a track record of facilitating cultural change, and a new Chief Quality Officer, who is partnering closely with operations to heighten our focus on quality across our organization. Most recently, we added a new and seasoned leader as our Chief Technology Officer, which I'll speak about shortly.
I highlight these positions specifically because as we think about shifting the culture and transforming this organization into a stronger growth engine with the core tenets that we've spoken about in the past, these roles, together with an increased focus on compliance, stand as being central to these efforts. We've consistently spoken about 2023 as a transition year, a transition year for performance, for culture, for systems, and for people. We now have many of the building blocks to execute intentionally on our plans to transform this company across product families, across geographies, and across functions.
Our team focuses intently on execution and transformation. Execution so that we meet the first of our strategic goals, achieving annual growth and margin commitments. The organization realignment commenced earlier this year, together with the ongoing and comprehensive transformational work, has helped fuel the critical hygiene work needed across our company.
As we shared in November, we have completed all our consultations with all major employee groups and workers' councils, and we've since completed this realignment. We've spoken about unlocking efficiency across our company. We have commenced activity on all of these critical projects to refocus our resources, to streamline our organization, and to create value for our stakeholders. You'll note that we are investing in compliance to ensure that success occurs in the right way. Innovation is and will continue to be a cornerstone of our strategy. To this end, I'm pleased to announce that Kevin Boyle has recently joined our organization as our new Chief Technology Officer. Kevin brings a strong commitment to, and track record of, driving disciplined, insightful innovation and to solving unmet clinical and process needs through deep customer intimacy.
We plan to continue investing to build out a cohesive digital environment, connecting additional elements of our portfolio and moving clinical applications onto DS Core over the next 24 months. You can see a few examples here with a number of our launches in 2023, focused on digital workflows like orthodontic outcome simulations and additional functionality for DS Core, as well as expansion of our printing and milling materials. We also introduced some new products into our instruments portfolio, with improved ergonomics and integrated technology to locate the apex in endodontic procedures. Finally, our Wellspect business has launched new continence care products with several other innovative products also in the pipeline. Overall, we spend about 60% of our R&D dollars on product development, with much of this directed to connected technologies and workflows to drive long-term profitable growth.
Moreover, as we have previously noted, a simplified portfolio will enable us to allocate more to new product development over time. We continue to evolve our R&D capabilities. In software engineering, we've augmented our teams with external partners to accelerate our transition to cloud-based computing. Similarly, we're adding further capability to our team focused on AI. For our material science team, we are investing in manufacturing and processing know-how for digital materials. We've spoken before about our recently implemented new product development and prioritization process, focused on improving program management and greater ROI discipline.
With the addition of our new CTO, we expect to further refine and evolve these processes... Our teams in supply chain, quality, regulatory, as well as R&D, are collaborating cross-functionally with a shared set of metrics to ensure predictable launch performance and timing. Now, let me cover our three-year financial targets.
Our long-term financial targets include growth in the 4%-6% range in normal macroeconomic environments, which is 1% higher than our total addressable market. We expect to deliver over 500 basis points of EBITDA margin improvement, with about one-third coming from gross margin and two-thirds coming from SG&A efficiencies. We plan to deliver growth and profitability while still investing in areas such as R&D and our commercial organization. The net result in 2026 is targeted EPS of $3, which represents a 60% increase over the next three years. Given our progress on the transformation initiatives, which are within our control, we are confident in our path to this target. Assuming the macroeconomic headwinds remain stable and don't worsen further, we believe 2024 will be an inflection point for our company and will enable us to deliver double-digit adjusted EPS growth.
Now, wrapping up, I would like to summarize our perspective as to how we can drive meaningful shareholder value over the next several years. Firstly, we are well-positioned in attractive industries with the largest end-to-end dental portfolio that is more than 45% digitally connected. This positions us well with dental macro trends such as favorable demographics, practice consolidation, and improved access to care. We've also carved out an attractive and financially accretive position in the continence care segment with Wellspect Healthcare. We have leading brands and strategic objectives that focus on high-growth areas like aligners, implants, our digitalization strategy enabled by DS Core, and continence care. Second, we have a clear and actionable plan to accelerate profitable growth, which includes a focused R&D strategy that delivers a regular cadence of new products and solutions for our customers.
This, coupled with our new DS operating model, will drive better accountability and execution. We have strengthened key elements of this model. Win as one team, grow through innovation, drive disciplined execution with the recent additions to our leadership team. We have already made great progress on our transformation journey, which is expected to drive robust margin over the next, over the near and long term. And lastly, we will remain disciplined with our capital allocation strategy by maintaining a healthy balance sheet and generating strong cash flows. As we noted at Investor Day, we know Dentsply Sirona is a show-me story. We have worked diligently to restore trust with many of our stakeholders, including with the investment community and with customers.
We believe that executing on our plans and transformation objectives will enable us to drive meaningful improvement in our performance and achieve our target of $3 Adjusted EPS in 2026. I thank you for your time and attention this morning. We look forward to sharing our progress with you throughout 2024, a year that we believe will be an inflection point for our company. Thank you.
Perfect. Thank you, and good morning, everyone. You know, you highlighted some of the key takeaways from the Analyst Day, but I wanted to dig a bit deeper off that. So, coming off the Analyst Day, you did a deep dive through a lot of information about Dentsply's long-term growth algorithm. So what do you think are the most important parts that you would emphasize as the key takeaways from the event?
Well, I think as we noted at Investor Day, Rachel, and just now, we do operate in attractive industries, dental and continence care. And given our portfolio, we believe that we are well- positioned to drive profitable growth by executing on a clear plan that we feel we have. Secondly, I think the transformation work that we are doing, have done, and continue to do is making us more nimble, more agile, and more responsive. You know, we've noted on a couple of occasions about the research that we've done on our portfolio. We feel that we have a winning portfolio.
Our customers say that we have an extremely robust portfolio with no meaningful gaps and with, you know, sustainable advantages, particularly in our digital portfolio. So it all comes down to execution. And this new leadership team that we've been bringing in is extraordinarily disciplined and intently focused on driving disciplined execution.
Perfect. Then, as you noted, you pre-announced yesterday with strong 4Q results, revenues coming in at or above the higher end of your guide. So, can you just walk us through how did you sidestep some of the worries this quarter? You know, we had the Henry Schein cyber incident. There was also some macro worries that you flagged on your 3Q calls. So just walk us through some of those puts and takes there.
Yeah, I think, we were surprised by some of the patient declines in September, and obviously, we had a disappointing third quarter. But we were pleased to see a pickup in patient volumes, especially in the latter part of the fourth quarter. As Simon mentioned, we did post growth in three of our four segments, and Essential Dental Solutions is one of those segments of growth. You know, around the Schein situation, we did factor in some level of disruption we were expecting. And keep in mind, you know, they're an important partner for us. We do about $500 million a year in annualized sales, most of that in consumables. I think the fact that we actually posted growth showed that we got through that situation, you know, without any significant, unexpected deviation.
So, on the whole, I think things are improving, but it's still a very challenging environment. We're still seeing our equipment business down year- over- year. It's challenging markets in places like Germany and Australia. These are heavily equipment markets, and so that's probably gonna take us some time to still recover. But on the whole, we were pleased with how we ended the year.
... helpful. Maybe just as we dig into next year or this year, I guess, on 2024, you've clarified to your analyst today that you do not expect to grow revenues at 4% organic or higher. So, you know, regardless of this macro backdrop that we're seeing as we start off on 2024, what portions of the business do you currently view as best positioned to drive the greatest growth upside?
Well, I think, you know, we've spoken quite a bit in the past year about the investments that we've made in our implants business. We certainly expect to begin to turn the corner on that business in 2024. I noted, and Glenn has noted, performance in our Wellspect business and some of the product launches that we've had in 2023, and will continue in 2024. We expect to help drive growth there. And then I would say, finally, both of our aligner brands are well- positioned to continue the growth trajectory that they've had since we arrived in September of 2022. So they're, I think, the key areas that we'll be focusing on in 2024.
Helpful. And then maybe just moving down the P&L for 2024. You're assuming 100 basis points of Adjusted EBITDA margin growth in 2024 and double-digit EPS growth, which also assumes that similar stable macro environment. So that said, can you shed some light for investors on how should we think about the range of margin outcomes, given the range of revenue growth outcomes for 2024?
Yeah, I don't think we're going to comment much further on 2024 relative to anything above and beyond what we announced yesterday in the press release. So I think in a stable macro environment, even with little revenue growth, given all the things we've done in 2023 around restructuring the business, around moving forward with a number of transformative initiatives like our SKU optimization work, closing four facilities, taking our cost structure down, you know, we're confident to say at this point, even with minimal revenue growth, we can deliver 100 basis points of EBITDA margin expansion and double-digit EPS growth. I think that's kind of where we're going to limit ourselves to at the moment.
Obviously, I think if we see a better top-line recovery and organic growth is faster, it's gonna help us get leverage across the P&L, and we'll talk more about what that means, when we get to our February earnings call.
Perfect. Maybe just digging into the long-term targets laid out at the Analyst Day. You noted that you expect long-term revenue to grow 4%-6% from 2023 through 2026. Can you kind of walk us through what are the biggest drivers that get you to that growth algorithm in the solid mid-single-digit level?
Yeah, I think, a lot of the points that Simon made earlier, if you look at the orthodontic market, clear aligners, we're very confident we can grow double digits and approach that 20% range in a normal macro environment. We've got some tailwinds and favorable dynamics in our direct-to-consumer business with Byte, given we've had a large competitor exit that space, on the in-office side, seeing very positive trends with SureSmile. So in the ortho area, we feel very confident over the long term, we can grow double digits and approach that 20% range. Implants, again, China, an area of growth for us this year. That was somewhat surprising in that we had to take a haircut on pricing with VBP, but the volumes we've seen on implants have been meaningful.
So we're very excited about the opportunity there for implants in China. We do expect to see a recovery in our U.S. implants business with the investments we've made during 2023.
Got it.
Outside of that, obviously, the digital area with CTS, all connected by DS Core and then Wellspect with continence care. We just put up 7% growth in the third quarter, driven by new product launches. That ramp is continuing, and I mentioned on the earnings call in Q3 that we expect double-digit growth in Q4. So, that should be a nice growth driver for us as we move forward.
Great, that's helpful. And then just digging into this $3 EPS number that you had laid out, can you kind of walk us through how should we think about your confidence, and what are each of the moving parts that really get you to that $3 EPS number?
Yeah. So if you look at where we are today, $1.80-$1.85, going to $3 over the next three years, it's a 60% increase, and we're very confident we can get there because two-thirds of that improvement is really things in our control. So the restructuring program would generate about $0.30 of that improvement. That's well underway, mostly complete in terms of the headcount actions. We have some non-headcount work to still do, but by mid-2024, that plan will be completed, and we feel very confident we'll generate $200 million of annualized savings once that plan is done. We've also got plans to reduce the amount of SKUs across the organization. We laid out during the Investor Day that in our endo and resto portfolios 15% of our SKUs drive 90% of our revenues.
So there's a huge opportunity for us to reduce SKUs, reduce cost. That's part of our three-year plan, coupled with a reduction to our manufacturing sites, streamlining our distribution centers. And I'll just classify kind of the overall SKU optimization and global operations transformation as $0.20 improvement over the three-year window. And then we've got a couple other areas, like our ERP benefits, we're expecting towards the tail end of the three-year window, improvements in our ortho profitability, our especially our direct-to-consumer business with Byte, which we've already seen an improvement, but we expect a further improvement.
And then a number of things just around our capital structure with share buybacks, net investment hedging, which is already in place. And so two-thirds of that in our control. The other one-third is really subject to our ability to grow organically at least 4%.
And we're not counting on 4% growth in 2024, but we are expecting to see an acceleration of growth as we go into 2025 and 2026. And so that's a bit of a wild card in terms of the macro environment, but if the macro environment gets back to a normalized state, we're very confident we can grow in that range, and then you could see a path to the $3 of EPS.
Great. That's helpful. Then maybe digging into some of the segments and what's embedded into that long-term guidance. First up, on Essential Dental Solutions, you're projecting low single-digit growth there. Can you walk us through what are some of the key products that have potential to drive upside to that number, and kind of what's the range of outcomes on how you get there?
... Sure. So Essential Dental Solutions is a really important foundation and anchor point of our portfolio. We serve more than 500,000 dental practices around the world. We have many of the leading brands. We're category leaders across a number of areas, in endodontics, in preventive solutions, in a number of the restorative businesses. So this will continue to be an important part of the portfolio. We're expecting to grow with the market. We know we have a comprehensive set of offerings, and we are leveraging an unparalleled clinical education footprint that we have around the world with our academies, with our university relationships, that we're continuing to invest behind. As well as a number of, you know, engagements with clinicians, with our KOLs around the world, together with a really broad commercial footprint, right?
Both through distribution and through our direct sales forces.
Helpful. Maybe shifting over to Connected Technology Solutions. You're projecting that that will grow at or above mid-single digits. You hold some key products there, including CAD/CAM, IOS, mill print, you know, some of the imaging pieces as well. So which of these applications do you really think could also drive the greatest upside to that segment?
So on Connected Technology Solutions, I think of that segment as the infrastructure backbone of the dental office. The market is really going through a rapid digital transformation right now, and that's what we're looking to capitalize on to accelerate growth. The key element for us is our cloud-based DS Core solution. It really has three elements to it. It's a collaboration platform. It will power our next generation of devices, and will also link all the technology with digital workflows, whether that's in aligners, whether that's in implants, or also in the restorative side. It sort of crosses, not just in the dental practice, but it's also a very important connectivity point into the lab and to the patient.
With DS Core at the center, at the hub, you know, it becomes a force multiplier, really, between our digital workflows and the equipment infrastructure that we have. So obviously, intraoral scanning is a key area of growth. Penetration is still around the 30% mark in many markets, so there's a lot of runway there. We have a leading position in 3D imaging. That is an important base for us that we're looking to continue to grow. And ultimately, you know, the digital solutions in both milling and printing that we believe are highly complementary are. You know, we're the largest manufacturer, actually, that has the ability to leverage both of those technologies across the portfolio, so that will be an important part of the growth story as well.
Great. That's helpful. Then shifting over to Orthodontic and Implant Solutions. I wanted to dig in more deeply just on this implant piece. You know, that combined segment is expected to grow mid-single- digits long term. But given how much of a focus has been on implants recently, can you talk about your portfolio there? How should we think about this value implant segment that's been coming into focus in recent quarters?
Sure. So we serve both the value and the premium segment in implants. We see the growth on the value side. We're capitalizing on that. But at the same time, there's still a lot of innovation, a lot of technology, a lot of new digital products that people value, that connect into imaging applications, into treatment planning, into the connectivity with the lab, that will continue to support also a very good growth rate on the premium side. And so we have launched a number of new products. We have consolidated our platforms within our premium portfolio, and we are continuing to innovate there to serve our customers.
In addition to the commercial investments that Simon touched on that we made, that are really important, recommitting to clinical education, our specialist platforms and supporting working with our KOLs, with our specialists. So I'm really excited about what we can do on the premium side, but value is definitely an important part of the growth story there.
Yeah, let me just add, too, you know, we just did a pretty extensive survey with customers, several thousand customers around our portfolio, and it came back that we don't have any significant gaps in our portfolio. Implants is quite strong and competitive, so that was a confirmation point for us, that really for us to be successful, it's around sales force execution and investing more in clinical education programs. So that's why we're investing a lot more in clinical education. We did add 40 additional sales reps in the beginning part of 2023 in our implants business. And so we think we've done the things we need to do, and now it's putting some runs on the board and actually getting some growth in our U.S. implants business.
Great. That's helpful. Then shifting over to that aligners portion of the portfolio. You're anticipating over 20% growth between SureSmile and Byte. So can you walk us through what gives you confidence in these above-market growth targets, and how achievable are they? And then when can we or where can we expect to see the highest growth in the next year, given one of your peers recently halted operations?
So maybe let me, let me hit both sides of our aligner business. So we have, with Byte, we have a direct-to-consumer platform. We've focused the last 12 months intently on profitably growing our direct-to-consumer business, focusing on the top of the funnel, on our conversion rates, on the financing offerings that we have for consumers. And that positions us really well now to take advantage of this major shift that we're seeing in that category, with the leading company exiting the space. So, I think we're really well set up to capitalize on growth, on the consumers that we can access, that we know we can serve profitably.
Secondly, we're looking to expand the offering with our Byte+ model, where we offer an alternative to the in-home impression taking by opening up dental practices where patients and consumers can go to get a scan. That's good for the practice in terms of practice growth. It's good for our Byte business, as it allows us to actually digitize more of the workflow, which is more efficient, and it opens up an additional patient and consumer segment that's more comfortable going to the dental office. On SureSmile, we have differentiated treatment algorithms. We know we have fewer refinements in our cases, and we continue to expand internationally and put more feet on the street. So, whether it's in Japan, whether it's in IOS, there's a lot of runway for SureSmile. In general, the orthodontic category is underserved.
We know that there's a lot of runway, and that's what we're looking to capitalize on.
Great, that's helpful. Maybe shifting over to Wellspect, at 7% of revenues, you've noted that you expect this to grow over mid-single- digits, backed by some of the key product categories in urology and andrology. So you've estimated that Dentsply only really holds about 5% of the total market share. So how are you retooling your strategy to address a larger share of this market?
Well, before Andreas makes a few comments, I'd just like to reiterate some of the comments we made previously. We are really pleased that we've held on to the Wellspect business. It's accretive to our revenue profile and our profitability profile. We brought in, as I noted, a new and industry- experienced leader, who's relocating to Sweden, where it's headquartered. We have a very robust R&D funnel. It is macro- insensitive in the sense that these patients always need these intermittent catheters. And, you know, we have a robust cadence of new product innovations slated for this category.
I'm rather pleased that we did not transact Wellspect, and we expect it to continue to be an accretive revenue driver and profitability driver moving forward.
So from a portfolio perspective, right? We serve the continence care segment, both with urology and andrology. Andrology was a new market entry a few years ago. It's been very accretive to the overall Wellspect growth. On the urology side, the team over the last 10+ years that the Wellspect business has been part of Dentsply and Dentsply Sirona has actually continued to very nicely improve the margin profile of the business. And we're now capitalizing on a number of new product launches that are in the funnel, in the pipeline, specifically, with the objective to penetrate further into the chronic care segments. That's a very attractive part of continence care.
And then secondly, to also expand more internationally, in particular in the U.S. market, where Wellspect historically, given sort of its presence, its footprint has been underpenetrated. I think, the way we go to market is both direct to patient and, through healthcare provider channels. And so that opens up also the opportunity to, you know, think through how do we go to market distribution direct, and, I think that will be part of the growth story for Wellspect.
Perfect. That's helpful. Maybe stepping back and looking at your geographic exposures, more broadly speaking, could you just give us an update on where you're seeing the most recessionary, you know, macro demand on pressure, versus some geographies that may be performing better than expected and kind of how that trended throughout 4Q as well?
Sure. I think we said on our third quarter earnings call that Germany was probably the market we were keeping our closest eye on. We had seen a couple of consecutive quarters of double-digit declines in that market. It's a heavily weighted equipment market, obviously, had gone into recession, and we had seen this coming because of our customer surveys. In the second quarter, surveys came back, Germany was very pessimistic in terms of what they were seeing in terms of dental volumes, the recessionary pressures, higher costs in these dental practices, shortages of workers. And so those dynamics ended up playing out, as the customers had indicated in their surveys. So that's probably the one market that we're seeing the biggest pressure.
We called Germany out because it's 10% of our consolidated revenues, so it is a meaningful country, only behind the U.S. in terms of total revenues. In addition, you know, Australia would be another market to call out because it's heavily equipment. We're seeing pressures there with all the interest rate increases that have taken place over the last, you know, 12-18 months. On the flip side, we're seeing some positives in places like Brazil and Latin America. But, you know, it's different market by market. But on the whole, the equipment market across the globe has been very challenging for the last few quarters with interest rate rises, and I'm expecting it to be challenging at least for the next few quarters as we go into 2024.
Perfect. That's helpful. And then I just wanted to dig into China a little bit. That was a bright spot during 3Q. You saw 20% growth in the region, driven by that strength in implant, but also the pricing impact of VBP, which was offsetting those lower volumes or the volume differential there. So can you kind of walk us through what's your latest expectations for China going forward?
... Yeah, listen, we were very pleased with what we've seen here in China in 2023. We came into the year knowing we were gonna be taking a large price reduction on our premium implants. We took a small reduction on the value side with the intent of obviously making up a portion of that through volume. And at the beginning of the year, I said I expected China to be down year-over-year with the pricing reductions. And as we got into the year, because of the significant increase in volumes, both on the value and premium side, along with both private and public sectors, we now expect to post growth in China full- year 2023, which a few quarters ago, I said it was not gonna happen.
So it really shows the progress that we're making on the implant side. And we're able to actually make those statements knowing that our equipment market is down in China, right? So it just shows the strength of implants overall. To your point, we grew 25% in the second quarter, 20% in the third quarter, and obviously, we're expecting very healthy growth as we exit this year in 2023 and going into 2024. So it will be a growth market for us. I'm very encouraged by what we're seeing on the implant side, and if we can get a recovery on the equipment side, growth in China should, you know, accelerate and be accretive to our overall company average.
Perfect. And then just shifting over to capital deployment, and I wanted to ask, how are you thinking about some of these internal product investments versus M&A in 2024 and beyond? And then how should we think about the potential for share buybacks as well?
Yeah, I think, you know, we have a balanced approach towards our internal investments in R&D. We're spending a lot of R&D in software, on our digital portfolio, implants. Those are areas that are faster growing. Those are areas of focus in terms of our R&D portfolio. If you look at both software and what we capitalize in R&D expense, we've spent about 5% of sales, and we think that's right in terms of the level of spend to our overall portfolio. In terms of share buybacks, you know, the board authorized an additional $1 billion in the fourth quarter, coupled with our previous approved plan of $600 million, gives us $1.6 billion of share buybacks, that we could do.
We indicated during the Investor Day, we expect to buy back about $600 million of shares over the next three years. Key to that, though, is gonna be really around driving increased cash flow performance, and we'll have to see the level of M&A activity. I think for us, we've been very clear, in the next 12 months, we may do some tuck-in acquisitions, acquisitions that don't require a lot of integration. We still have a lot of work to do around integrating previous deals, including Dentsply and Sirona. And until we get through that work, we're not gonna do anything significant or complex on the M&A front. But we will do, I would expect, some M&A tuck-ins, and then as we get into 2025 and 2026, it could be, you know, more meaningful, we'll have to see.
That's how we're looking at our capital deployment strategy at the moment.
Great. That's helpful. And then maybe in the final minute here, Simon, I just wanted to ask you, what do you think is the most underappreciated part of the Dentsply story? And then, really, where do we go from here?
Well, I think, yeah, we have. As we've noted, we have an extremely comprehensive portfolio offering, and that's aided and abetted, shall we say, by our capacity to educate clinicians on a global basis. So we have invested there. We're continuing to invest there. The leadership team that we brought in is disciplined and execution-orientated. And that's why we're confident in the path that we are on, and our ability to achieve the targets that we've laid out from our Investor Day for 2026. So our confidence levels is high, are high, and our discipline is even higher.
Perfect. With that, we are out of time. Thank you so much, everyone.
Thank you.
for joining us today. Thank you.
Thanks, Rachel.
Thank you.
Thank you.