The second NASDAL UK Forum brought together key opinion leaders, dental accountants, lawyers and representatives from across the profession to discuss the challenges and opportunities shaping UK dentistry, from NHS funding and practice sales to workforce pressures, taxation and the future of dental business ownership.
Building on the inaugural forum held in October 2025, the 2026 meeting provided an opportunity to compare and contrast how the sector has evolved over the past year, share practical insights and consider what may lie ahead for dental practices across the UK.
The forum is a NASDAL initiative designed not to benefit its own members, but to support dentistry more widely. By bringing together people with different perspectives and expertise, the aim is to improve understanding of the issues affecting the profession and, where appropriate, help inform future policy.
Discussions took place under Chatham House Rules, allowing participants to speak openly and candidly. Members of the media were present, with reporting focused on the themes and issues raised rather than attributing individual comments.
The current landscape
Political environment and NHS dentistry
The political and NHS landscape remains complex, with delegates discussing developments across Westminster, Holyrood, Cardiff and Belfast. While there were signs of progress in some areas, the picture remained mixed, particularly regarding the delivery of NHS dentistry in Wales.
In Wales, the transition to new arrangements is continuing, with some contracts returned and uncertainty remaining over how the system will operate in practice. Changes to centralised access arrangements have also raised questions about potential unintended consequences for patients and practices. The impact of the reforms is expected to become clearer over time, with April 2027 identified as an important point for assessing progress.
The NHS discussion in regard to England was more encouraging in some respects, with delegates reporting that delivery had become easier and fewer practices were handing back contracts. However, the challenge remains how to make the best use of the funding available, alongside calls for additional investment to support the delivery of more NHS activity. Unscheduled care may also create further demand, adding to the pressure on practices already balancing capacity and contractual commitments.
Attendees highlighted the need to communicate the positive aspects of NHS dentistry more effectively, including the value of the NHS pension scheme and the opportunities available to dentists working within the system. There was a feeling that the profession needs more positive stories about NHS dentistry, particularly through mainstream media, to counter a narrative that can discourage younger dentists from pursuing or remaining in NHS practice. It was also noted that students particularly seemed to be frightened about a potential Fitness to Practice hearing and this again could be steering many away from the demands of NHS dentistry.
Private dentistry and practice sales
Practice sales activity remains busy, with delegates reporting that the pace of the market has accelerated. Some opportunities are attracting significant interest and may be on the market for only two or three weeks, with buyers prepared to make strong offers quickly.
Mixed NHS and private practices continue to prove popular, while larger dental groups are increasingly selective about acquisitions. Much of the current activity appears to be coming from smaller groups looking to build their portfolios by acquiring individual practices.
The financing environment has also improved, with more banks active in the dental sector and lending available over longer periods, potentially extending to 20 years. Some lenders are offering capital repayment holidays, allowing borrowers to pay interest only for a period, although the long-term implications of these arrangements require careful consideration.
Regulatory requirements remain an important factor in transactions. Delegates discussed the challenges associated with CQC registration and the increasing expectation that documentation should be available upfront. While this may encourage better preparation, it can also make transactions more complicated, particularly for squat practices.
The discussion reinforced the importance of being prepared from the outset, with buyers, sellers and their professional advisers needing to work together to keep transactions moving.
Corporate activity and the changing practice model
The corporate dental market continues to evolve. Delegates discussed renewed interest in practices located in dental deserts, where access to care and recruitment have historically been challenging. Some larger groups appear willing to consider opportunities in these areas despite workforce concerns, with different approaches being explored to expand clinical capacity.
There was also discussion of practices previously divested by corporates re-entering the market, alongside a growing interest in larger specialist centres and out-of-town locations that may offer improved access and operational efficiencies.
These developments raise questions about the future shape of the dental high street and whether a greater distinction will emerge between NHS and private provision, with different models developing around location, affordability and patient access.
Property ownership was another theme. Both corporate groups and individual buyers are increasingly questioning the value of acquiring freeholds, preferring in some cases to direct capital towards the practice business and future acquisitions. Delegates noted that the decision to buy a property or retain a lease will depend on the individual circumstances and long-term objectives of the purchaser.
Workforce and recruitment
Workforce pressures remain central to the profession’s future, although some delegates reported greater optimism in areas previously considered dental deserts. International recruitment continues to play an important role, with overseas-qualified dentists helping practices fill vacancies.
However, recruitment through sponsorship arrangements can involve significant investment, and the conditions attached to these arrangements vary. Delegates discussed the challenges of retaining recruited clinicians and the importance of ensuring that contractual arrangements are fair, appropriate and support sustainable employment relationships.
The discussion also highlighted the distinction between the total number of registered dentists and the number of full-time equivalent clinicians available to provide care. As more and more dentists look for a better work-life balance, many work part-time, meaning that headline workforce figures do not necessarily translate into sufficient clinical capacity.
Looking ahead, delegates considered the likely growing proportion of overseas-qualified dentists within the UK workforce. They also discussed the challenges of recruiting dental nurses, particularly in more affluent areas where the available remuneration may not be attractive enough to secure staff.
In regard to undergraduates, numbers remain pretty static – even when extra places are announced, e.g. Plymouth, they are still 7 years away and 50 isn’t many. Students are still learning on archaic tools and processes and it all comes back to funding – it costs £250,000 to train each student.
The possibility of expanding the role of dental nurses and other members of the dental team was raised, alongside examples of corporate groups investing in training. The broader question is how the profession can make better use of the whole dental team while ensuring that remuneration, training and responsibilities are aligned.
There was also discussion of the impact of taxation on working patterns and incentives. Delegates expressed concern that high marginal tax rates and loss of other benefits e.g. free childcare, can discourage some practitioners from increasing their working hours or taking on additional responsibilities. (In regard to childcare, It is said that 30 hours a week is worth approximately £8K per child (this will obviously differ from nursery to nursery)).
Competition and the CMA
The Competition and Markets Authority (CMA) investigation into private dentistry and the structure of the dental market were important topics for NASDAL lawyers and other delegates.
Questions were raised about how competitive the practice sales market really is, whether corporate groups are displacing independent buyers or acquiring opportunities that independents are less likely to pursue, and how the size of the corporate sector should be measured. (Possible measures include the number of practices owned, the number of surgeries operated or the proportion of overall dental activity delivered. Delegates also considered whether clearer definitions of corporate ownership could help improve understanding of market concentration, particularly in towns where a large proportion of practices may belong to one group).
A potential issue was the tightening up of ‘badging’ i.e. those towns where all/most practices are owned by one corporate and that isn’t clear to consumers. Pricing levels and Associates charging what they want as to be truly self-employed was a concern – it was felt that if Associates were forced to become employed, it would cause the devastation of NHS dentistry.
VAT and orthodontic contracts
VAT was another area of concern, particularly in relation to aligners and the potential implications for other orthodontic appliances and laboratory products.
Delegates discussed the possibility of wider consequences for the sector, including questions around cosmetic dentistry, VAT registration for associates undertaking significant amounts of cosmetic work, partial exemption and the potential application of reverse-charge arrangements. Any changes could have implications for practices’ costs, pricing and administrative responsibilities, making this an area that will require close attention.
Orthodontic contracts were also discussed in a more positive light. Delegates reported that contracts offered on a ten-year basis were creating greater clarity for orthodontic practices and could improve the ability to plan for the future. However, the possibility of increasing UOA rates to offset additional VAT costs was viewed as unlikely.
Making Tax Digital
The introduction of Making Tax Digital is beginning to affect particularly Associates with experiences varying according to how individuals manage their own financial affairs. Most see it purely as a cost – some are handling submissions themselves, while others are facing additional costs for professional support. For associates with multiple income sources, including UK or overseas rental income alongside self-employment, the reporting requirements can create additional administrative work.
Although awareness of the changes appears to be widespread, the full impact may not become clear until practitioners have worked through more reporting periods. The absence of penalties during the initial period may also mean that the practical consequences will only become apparent later.
Delegates questioned whether quarterly reporting would deliver meaningful improvements for all taxpayers, particularly where the process adds work without necessarily providing a complete picture of annual profitability.
The discussion reinforced the importance of clear guidance and appropriate professional advice as the system develops.
Looking ahead
The Budget and the wider financial outlook
Attention turned to the forthcoming Budget and the potential implications for dental practice owners, associates and investors.
Delegates discussed possible changes to Capital Gains Tax, Inheritance Tax, pension arrangements and National Insurance, alongside the potential impact of changes to the personal allowance and employer pension contributions. There was concern that measures intended to raise additional tax revenue could have unintended consequences if they discourage people from working more, investing in their businesses or pursuing growth opportunities.
The interaction between taxation, pension planning and remuneration remains particularly important for practice owners and associates making long-term financial decisions. The discussion also highlighted the need for policies that encourage investment and growth while addressing public spending pressures.
Although the detail of future fiscal measures remains uncertain, delegates agreed that the implications for dental businesses need to be considered carefully.
Technology, access and the future of dentistry
The forum also considered how technology is changing the way practices operate. Online appointment booking, centralised call-handling systems and more flexible opening hours are helping some businesses improve patient access and make better use of clinical time. These developments may become increasingly important as practices look for ways to manage rising operating costs and improve efficiency without compromising patient care.
The wider challenge is to ensure that innovation supports the long-term sustainability of dentistry and helps practices respond to changing patient expectations.
Continuing the conversation
The 2026 NASDAL Forum demonstrated the value of bringing together different perspectives from across the dental sector. From NHS delivery and workforce planning, to taxation, practice sales and the changing corporate landscape, the discussions highlighted how closely connected the profession’s challenges have become.
By creating a space for open and informed discussion, NASDAL aims to support better decision-making across dentistry and contribute to conversations that may help shape its future.
Chair of NASDAL, Heidi Marshall, commented: “The second UK Forum has again shown how valuable it is to bring people together from across dentistry to share their experiences and look beyond their own businesses. The challenges facing the profession are complex, but by understanding what is happening on the ground, we can make better decisions, identify opportunities and help build a stronger future for UK dentistry. Our aim is for these conversations to benefit the profession as a whole, and we want to keep turning shared insight into practical, positive change.”
