The second NASDAL Scotland Forum brought together leading figures from across dentistry, finance, law and business to take stock of the Scottish dental sector and consider what the future might hold.
Following the inaugural forum in September 2025, this year’s discussion focused on what has changed, where the profession stands, and what delegates expect – and hope – to see over the coming years.
Held under Chatham House rules, the forum provided an open environment for delegates to share experiences, observations and concerns. The resulting discussion painted a picture of a sector that is, in many respects, in a better place than it has been, but where significant challenges remain.
Chair of NASDAL Scotland, Roy Hogg, commented:
“The purpose of the Scotland Forum is not to benefit NASDAL. It is about bringing together people with different perspectives so that we can better understand what is happening across Scottish dentistry and, where appropriate, contribute to the wider debate around its future.
“There was a real sense that NHS dentistry is in a relatively good place, but that doesn’t mean we can take our eyes off the ball. There are still important issues around access, recruitment, retention, regulation and the changing expectations of both dentists and patients. At the same time, there is considerable confidence in the independent sector and in the appetite of dentists to take ownership of their own businesses.”
NHS Dentistry – No News is Good News?
Perhaps one of the most notable observations was how much quieter the NHS dentistry debate feels in comparison with previous years.
Delegates felt that this relative “radio silence” should not necessarily be interpreted negatively. Instead, it perhaps reflects dentists and practices getting back to work following the disruption of Covid with a system that is functioning more effectively.
There remains, however, considerable work to do around participation – it currently stands at around 64% across Scotland, despite registration being 98%, and delegates felt there was scope to increase participation further.
Access is also closely linked to geography. Recruitment and retention become increasingly difficult the further practices are located from Scotland’s central belt, creating ongoing challenges for rural and remote communities.
The Public Dental Service will also have an important role to play in supporting those patients who cannot access high street dentistry, with an emphasis on moving more appropriate work into primary care.
Workforce Remains an Issue
While the overall mood around NHS dentistry was relatively positive, workforce was consistently identified as one of the biggest challenges facing the profession.
Recruiting dentists remains difficult in some parts of Scotland, but the challenge extends across the entire dental team. Practices continue to experience difficulties recruiting and retaining dental nurses, dental care professionals and other members of the wider workforce.
The changing expectations of younger workers is also having an impact. Part-time working and greater emphasis on work-life balance is increasingly common and some dentists are choosing not to work until traditional retirement ages. Delegates questioned whether current taxation arrangements and the higher-rate tax threshold bands may also be discouraging some dentists from taking on additional NHS work. For practice owners, the challenge is therefore not simply finding people. It is recruiting, retaining and motivating a workforce whose expectations of employment are changing.
The role of Gen Z, changing attitudes towards work and the expectations created through social media were all discussed, alongside the continuing pressure on principals who can find themselves doing more and more of the work themselves.
More Dentists Are Becoming Practice Owners
One of the positive developments identified at the forum was the continued appetite among associates to move into practice ownership. Banks are continuing to demonstrate a healthy appetite for lending to the dental sector, with delegates reporting that a number of lenders are actively supporting associate-to-principal transactions. This is creating a competitive lending environment, with more generous finance terms available in some circumstances.
There are clear advantages when an associate buys a practice in which they already work. They know the patients, the team and the business, and can therefore approach ownership with a greater understanding of what they are taking on. However, delegates also highlighted the importance of ensuring that younger dentists understand the realities of running a business. Clinical expertise alone does not prepare someone for the challenges of HR, recruitment, compliance, finance, management and the day-to-day demands of running a dental practice.
Corporate Divestment Creating Opportunities
Corporate activity was another area of considerable interest. While the corporate sector continues to have an important role within UK dentistry, the forum noted significant appetite among independent dentists to acquire practices being divested by corporate operators.
For entrepreneurial dentists, these divestments can create opportunities to acquire established practices and develop them under independent ownership. The practice sales market therefore continues to offer opportunities for both buyers and sellers, with financing availability helping to support activity.
Regulation, Policy and Political Uncertainty
The political environment remains an important consideration for Scottish dentistry.
At Holyrood, delegates discussed the implications of the new government, the Scottish Dental Access Initiative (SDAI), the Scottish Dental Remuneration system and the Government’s longer-term Programme for Government. At Westminster, employer National Insurance contributions, changes in government and wider economic uncertainty remain concerns for practice owners.
The forum also considered the Competition and Markets Authority (CMA) and the importance of recognising the significant differences between the four UK nations when considering dentistry policy. Delegates were clear that Scotland has its own systems, circumstances and challenges, and that these need to be properly understood when national-level reports or recommendations are developed.
Overseas Dentists – Opportunity and Responsibility
Changes to the Overseas Registration Exam (ORE) and pathways for overseas dentists were discussed as potential ways of increasing the number of dentists available to the profession. There is an obvious opportunity to improve workforce capacity, but delegates also stressed the importance of patient safety and appropriate pathways into practice.
The challenge is to make it easier for suitably qualified overseas dentists to enter the profession while ensuring that the necessary safeguards, training and support remain in place. Other issues associated with overseas recruitment were also discussed, including modern slavery concerns.
AI
Perhaps one of the biggest differences between the 2025 and 2026 discussions was the prominence of artificial intelligence and technology. AI is already being used by dental practices in a variety of ways, including reception services, note taking, clinical software, diagnosis checking and other administrative functions.
There was recognition that these technologies can deliver significant efficiencies, but delegates also highlighted a growing range of risks. One concern is the increasing amount of inaccurate or misleading information being generated by AI. Practices may find themselves having to spend considerable time correcting information that patients have obtained from AI platforms.
Cybersecurity is another growing concern. Delegates reported instances of practices in Scotland being hacked and held to ransom, highlighting how the increasing reliance on technology can create new vulnerabilities.
IT budgets are now significantly higher than they were a decade ago, while questions remain around data security, where patient information is stored and the differences between open and closed AI systems. There was also concern that if sophisticated AI tools become increasingly expensive, their benefits could be concentrated among larger practices, potentially creating another divide within dentistry.
The forum also noted a 25% increase in complaints to the GDC in one year, with delegates questioning whether AI-generated complaints and information may be contributing to the increase.
Making Tax Digital and a More Financially Astute Profession
The introduction of Making Tax Digital was also discussed, particularly in relation to associates. There was a sense that increased financial reporting requirements could encourage more dentists to become financially aware and commercially minded.
More broadly, delegates felt that dentists are becoming increasingly financially astute and recognise the importance of planning for the future. With fewer dentists necessarily intending to work through to traditional retirement ages, financial and succession planning are becoming increasingly important.
The message from the forum was that dentists cannot make these decisions in isolation. Accountants, lawyers, financial advisers and other professional advisers all have an important role to play in helping practice owners and associates make informed decisions.
Looking Ahead – What Might Happen?
The forum concluded by considering two different questions: what delegates expect to happen and what they would like to see happen.
Looking ahead, delegates identified a number of potential developments:
- Continued growth in dentist-led practice ownership, including second and third practices.
- Further opportunities arising from corporate divestments.
- Continued appetite from banks to lend to the dental sector.
- Greater use of therapists and the wider dental team, potentially including changes around direct access.
- Greater opportunities for career progression and enhanced skills for dental nurses and other DCPs.
- More work moving into primary care, supported by the Public Dental Service.
- Continued pressure on the profession from changing workforce expectations and part-time working.
- Increasing adoption of AI and digital technologies, alongside growing concerns about cybersecurity, data and patient safety.
- Further changes to pathways for overseas dentists.
- Continued political and economic uncertainty, both in Scotland and across the UK.
There was also a recognition that Scotland cannot operate in isolation from wider economic conditions. Global economic shocks, UK economic performance and changes in government policy could all have an impact on the sector.
A Profession in Transition
The 2026 NASDAL Scotland Forum demonstrated how much can be gained from bringing different parts of the dental ecosystem together.
Compared with the inaugural forum in 2025, there was a sense that Scottish dentistry has continued to move forward. NHS dentistry is quieter, practice ownership is attracting a new generation, banks remain willing to lend and independent buyers are showing significant appetite.
But the challenges have not disappeared. Workforce, access, retention, technology, regulation and the changing economics of practice ownership will all shape the next chapter of Scottish dentistry. As the sector enters a period of potentially significant change, the ability to share information, understand different perspectives and work together will become increasingly important.
The NASDAL Scotland Forum will continue to provide a forum for those conversations – helping its participants understand not only what is happening, but what might happen next.
