Healthcare remains a popular long term investment theme. After all, keeping our aging and expanding population healthy will remain a top priority for policymakers. New innovations will require major amounts of spending from both the public and private sectors. Already, trillions are spent each year in the United States alone. To that end, investors have flocked to funds like the Vanguard Health Care ETF (NYSE:VHT) as a way to profit from these trends. However, despite the overall bullish long-term investment thesis, some sectors of the healthcare market are being ignored by investors. One such ignored sub-sector could provide outsized gains in the years to come.

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The Silent Epidemic
According to the American Dental Association, poor dental health is a silent epidemic facing the United States. Often ignored by investors and consumers alike, some of the most deadly and costly diseases such as heart disease, diabetes and kidney disease have been attributed to improper dental care. The growing trend of prevention instead of treatment could be the catalyst that the dental sub-sector is looking for outsized long term gains.

Even without that trend in place, the sector is experiencing the same expenditure and technological growth that regular healthcare is seeing. Annual expenditures for dental services in the United States grew from less than $2 billion in 1960 to over $70.3 billion in 2002. Analysts see that number rising to about $126 billion by 2013. Projections are similar for the rest of globe. The sector is also anticipated to see tremendous growth in demand for dental biomaterial and dental implants. Long-term global demographics bode well for the sector. In Japan, nearly 25% of the total population is age 65 and older. Nearly 40% of Japan's population to be in this group by 2050. In America, more than 70 million individuals are expected to become Medicare beneficiaries over the next two decades. Analysts predict that the global dental equipment market will be worth an estimated $26 billion by 2014.

However, just like overall healthcare sector, the biggest growth will come from emerging markets. Overall, the BRIC nations have extremely low dental care ratios when compared to the U.S., leaving plenty of room for growth. The deregulation of dental care services in both China and India has fueled growth of private dental clinics and the market for dental implants in both countries will exceed $400 million by 2017. Brazil and Latin America will see dental implant procedures more than double in volume to more than 2 million procedures in that time frame. (For more, see The Fab Five: South Africa Joins BRIC.)

Big Dollars in Bicuspids
For investors, many of the major dental related stocks are found in broad-based funds like the PowerShares Dynamic Healthcare (NYSE:PTH) or the iShares Dow Jones US Medical Devices (NYSE:IHI). However, there are plenty of ways to hone in on the sector. Here are a few picks.

With diverse product range and significant international presence, DENTSPLY International (Nasdaq:XRAY) could be seen as the leader in dental equipment sector. And that position is getting stronger. The company has recent offered to buy AstraZeneca's (NYSE:AZN) dental portfolio for $1.8 billion. DENTSPLY predicts the acquisition to increase revenues by 25% in the first year. Equally, dental imaging company Sirona Dental Systems (Nasdaq:SIRO) saw its fiscal third-quarter earnings more than double on the back of strong sales growth in the Asia-Pacific and Middle East regions.

Playing into baby boomers love affair with vanity, Align Technology (Nasdaq:ALGN) manufacturers those high-tech Invisalign clear braces. Overall, the company shipped 76 thousand cases of its products during the quarter.

Finally, with many emerging markets at their most basic levels of dental hygiene, necessities like tooth brushes and paste will see growth as incomes rise. Colgate-Palmolive (NYSE:CL) sells more products in Brazil and the rest of Latin America than here in the United States. Approximately 75% of total revenue stems from its international operations.

The Bottom Line
While healthcare remains a great long term portfolio position, many investors ignore the dental sub-sector. However, benefiting from many of the same demographic trends, the sub-sector is poised for tremendous growth. The previous picks along with dental supplier Patterson (Nasdaq:PDCO) make ideal picks to play the trend.

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