The Association of Dental Groups (ADG) has launched its ‘Creating Dental Oases’ report to MPs in the House of Commons, showing that 4.5m[1] patients are going untreated annually due to the 2,749 shortfall in the dental workforce – whilst at the same time, fully trained dentists from overseas who are living in the UK, are having to make ends meet by working in McDonald’s and Subway fast food restaurants because of the registration system’s ‘bottle-neck’.
Neil Carmichael, Executive Chair, Association of Dental Groups said: “We need to unlock the barriers preventing the 6,000 fully-trained overseas dentists in the registration queue to practice as dentists in the UK, as a matter of urgency. Many of these dentists are here working in unskilled roles. The General Dental Council must reform the Overseas Registration Examination, since currently each exam sitting only has capacity for 600 students. At that rate, it will take years to get them qualified!
“The ADG has been speaking to fully-trained dentists, such as Ahmed who has come to the UK from Egypt. He is having to work in McDonald’s cleaning the lavatories because he can’t get through the ORE! This is crazy and should be our number one priority.”
The ADG’s ‘Creating Dental Oases’ whitepaper examines the key issues behind the dental crisis and how shoring up the total dental team is the solution. In 2022, The ADG launched its first report into the dental workforce crisis, identifying and coining what the Association called ‘Dental Deserts’, areas of the country where patient access to a dentist is almost impossible. Now the ADG presents its ‘Dental Oases’ report offering solutions. The priority intervention needs to be reform by the General Dental Council (GDC) to allow trained dentists from overseas to practice.
Ahmed, a trained dentist from Egypt currently working in McDonald’s & as a part-time dental nurse said: “Despite holding a postgraduate masters’ degree in dental implantology and being a fully qualified Egyptian dentist, I am currently working in the UK at McDonald’s. I am frustrated by the ORE system and have been trying since 2022 to complete the GDC registration to practice here in the UK.”
Shoaib Saiyed, a trained dentist from India employed at Subway fast food restaurant said. “I am a fully- trained dentist with 10 years’ experience – but right now my job title is ‘Sandwich Artist!’ I have been making sandwiches at a Subway fast food outlet in Birmingham for over 9 months. I am very frustrated that I can’t get a place on the ORE. I don’t understand why the GDC doesn’t create provisional registration, so that we can be tried and tested. I just want to prove myself!”
Linda Colla, 75 on pulling out her own teeth (Guardian, Feb 2025) said: “It took me a couple of weeks to get each one out, because they just loosened and loosened and loosened. I used a tissue to get a better grip.”
Eni Shehu Muco, a trained dentist from Albania employed as a dental hygienist said. “I’ve tried unsuccessfully four times to register for the ORE. I am about to try for the fifth time, but I don’t hold out much hope. It feels like a lottery because it is such a frantic scramble to get one of the few places as they become available. I’ve even been told that I might have been unlucky due to the speed of my internet connection! Why should my career be down to luck?! And why should patients in need be denied access to a fully trained dentist?”
Sayed Bilal Bukhara, a trained dentist from India employed as a care home co-ordinator and part-time dental hygienist said. “Currently I work 60 hours a week – 40 in a care home as well as 20 as a dental hygienist – so I am certainly contributing to the UK as a taxpayer! This April, I have just tried again to get registration for the ORE, but with no luck. That is twice now. Once the places open on the system they are gone in just two minutes! A couple of my friends in the same situation have given up and moved to Dubai, where they can register in one year and the pay is good. This isn’t an option for me – I love the UK. But I just don’t want my dentist training to go to waste!”
Neil Carmichael said: “Constituents are telling their MPs that the main issue when it comes to dental care in their area is their inability to get access to a dentist. The ADG has been banging on about the huge gap in the dental workforce for some time now – and the only way to improve this access issue is through the recruitment and retention of dentists. There are four different NHS contracts across the devolved nations, and yet ONE key problem for them all: a critical lack of dentists. The solution is clear: we need more dentists – plus more DCPs. Part of this is addressing the red-tape limiting talented dentists from overseas from registering to practice as a dentist here in the UK. It is a shameful waste to have them flipping burgers in our fast food restaurants when they could be caring for patients!”
The issue: patient access to a dentist
Neil Carmichael said: “The ADG knows that by filling the dentist gap, we could serve 4.5m more patients a year. According to NHS England we are lacking over 2,700 dentists. This is significant and is having a huge impact on the number of patients who can’t get access to a dentist. Each year 87m Units of Dental Activity or UDAs are commissioned in England. Typically, a patient needs three UDAs and a dentist delivers 5,000 UDAs a year. So, if these 2,749 vacancies were filled it would mean that a further 13.5m appointments could be given for the 4.5m patients who are currently going untreated. Frankly, the figures speak for them themselves. We need more dentists now!”
The solution: prioritising recruitment
There are three actions that can come together to address the gap in the dental workforce. These interventions can be put to work in the short-term, without legislative change, and with no extra cost to the Government – since the current dentistry underspend provides sufficient funding:
- Commit to supporting recruitment: Unlock the barriers preventing the 6,000 fully-trained overseas dentists in the registration queue to practice as dentists in the UK, as a matter of urgency. Many of these dentists are here working in unskilled roles. GDC must reform the Overseas Registration Examination (ORE), since currently each ORE sitting only has capacity for 600 students.
- Integrated Care Boards (ICBs) to use their full commissioning powers:Fully utilise the current dental workforce team available, and spend all of their dental budget on dentistry.
- Improve workforce planning: Recognise the skills mix across the full dental team and how best it can be deployed within the ‘mixed economy’, as well as supporting dental school improvements.
Private and NHS affected by workforce gap
There are currently over 3,000 unfilled vacancies for dentists across the NHS and private sectors. Data published by NHS England for the period to March 2024, show there were 2,749 full-time equivalent (FTE basis) NHS dentist vacancies. These are roles that have been open for an average of 180 days per post. Furthermore, with 411 (FTE basis) vacancies in private practices still open, it is clear that irrespective of the need for NHS contract reform, there is a system-wide shortage of dentists in the UK across the profession’s ‘mixed-economy’.
Compounding this, alarmingly few dentists are claiming to be looking for work. Survey data released by the General Dental Council (GDC) on dentists’ working patterns, reports that just 0.8 percent (241) of the 30,066 who completed their questionnaire said they were actively seeking work as a dentist. This does not bode well when it comes to filling the current 3,000+ dentist vacancies.
Reference
[1] Approximately 88m Units of Dental Activity (UDA) are commissioned per annum, 72.5m were delivered 23/24 (18.4m adults / 6.7m children) which equals on average 3 UDAs per patient. With an approximation of 5,000 UDAs per FTE basis dentist and NHSE vacancies at 2,749, this totals a gap of 13,745,000 UDAs. Divide this by the 3 average UDAs per patient per annum – and that implies 4.5m patients treated per annum could be treated if all vacancies were filled.
