Tom Smith, former Legal Director at the Competition and Markets Authority, offers his unique insight into the CMA’s review of private dentistry and the potential implications
The decision by the Competition and Markets Authority (CMA) to launch a market study into private dentistry marks a key moment for the sector. While not unexpected – given mounting political and public concern over affordability and access – it represents an escalation in regulatory scrutiny for the profession.
For dental practices, the implications are far-reaching. This is not merely a policy exercise: it is a resource-intensive process that is likely to reshape how dentistry is priced, marketed and delivered across the UK. History shows that CMA market studies result in some significant changes to how a sector does business.
What is a CMA market study and why does it matter?
A CMA market study is a formal investigation under the Enterprise Act 2002 designed to assess whether a market is working well for consumers. There is no allegation that anyone is breaking the law or even that they are necessarily acting badly. Nevertheless, the CMA has extraordinarily wide powers to reshape the sector if it identifies features that distort competition or harm consumers.
For the next few months, the CMA will consider views on the scope of its investigation, and engage in evidence gathering, consultation and analysis. The final market study report is due by March 2027. However, that may not be the end of the process. At that point, the CMA may issue recommendations to government for regulatory reform, take direct consumer or competition enforcement action, issue guidance to the sector, or escalate the matter into a full market investigation, which carries powers to impose legally binding remedies. The process can take more than three years from start to finish.
In the case of private dentistry, the CMA has set itself a broad remit. It will examine the full ‘consumer journey’, from how patients find a dentist to how they understand pricing and treatment options, alongside competition between practices, pricing trends, profitability, and the role of regulation.
There is a wide range of possible outcomes. At the mild end of the spectrum, the CMA’s work may result in some recommendations to Government about regulatory reform and some measures that increase pricing transparency for consumers. At the severe end of the spectrum, the CMA has the power to break up corporate groups, impose price caps, or otherwise fundamentally change how practices operate.
A cost-of-living lens: why dentistry, and why now?
The CMA’s intervention cannot be understood in isolation. It sits squarely within the UK government’s broader focus on cost-of-living pressures and “everyday spending”.
The private dentistry study forms part of the CMA’s 2026–2029 strategy to prioritise markets that are essential to households and where consumers may be vulnerable. The CMA is particularly worried that prices have risen sharply. The CMA says that the price of initial consultations has increased by over 23% between 2022 and 2024, and routine check-ups by more than 14%. These increases have attracted political attention. With the Chancellor having called for action last November, the CMA had little choice but to acquiesce.
Lessons from the veterinary sector
To understand where this process may lead, dental practices should look closely at the CMA’s recent work in the veterinary sector, which bears some similarities with the dentistry sector.
The CMA has been investigating the veterinary sector for nearly three years, and its final report is due imminently. It has identified a large number of concerns around issues such as price increases, unduly high levels of profitability (which suggest a lack of competition between practices), market concentration, the lack of information being given to consumers, and an out-of-date regulatory system.
It is proposing a suite of remedies to address each of its concerns, including:
- Mandatory provision of clear, itemised pricing and written estimates, and explicitly notifying consumers that they can buy medicines cheaper online
- Publication of prices for standard services, and a periodic customer satisfaction survey to help consumers to choose their vet
- Greater transparency around ownership structures (e.g. different brands that are owned by the same corporate group)
- A cap on prescription fees (£16)
- Measures to facilitate comparison shopping, including easier access to prescriptions
- Significant updates to the regulatory regime and the role of the Royal College of Veterinary Surgeons
In sum, these remedies will significantly change the way the vets sector operates. However, even more draconian remedies were previously mooted. For example, the CMA stopped short of widespread price controls. It had also voiced concerns about increased levels of private equity ownership, but in the end did not force groups to sell any practices.
At first glance, there are some parallels with dentistry. Both sectors involve complex, trust-based professional services; both have seen consolidation and rising prices; and both feature information asymmetries between provider and consumer. Admittedly, the level of private equity ownership is higher in the veterinary sector than the dental sector.
Possible outcomes for private dentistry
While it is too early to know the CMA’s conclusions, we can speculate about some possible outcomes.
The CMA is likely to impose measures around pricing transparency. For example, practices may be required to publish standardised price lists, provide written treatment plans and cost estimates upfront, and/or offer clearer explanations of optional versus necessary treatments. Such measures would aim to address concerns that patients struggle to compare providers or fully understand costs.
The CMA is likely to scrutinise how treatment options are communicated, particularly where there may be perceived incentives for “upselling” higher-value procedures. This could lead to guidance around fair commercial practices and informed consent.
The CMA may recommend changes to the regulatory framework governing dentistry, particularly where inconsistencies across the UK or gaps in oversight affect competition or consumer outcomes. This was a large part of the vets case. The CMA could also seek to address barriers to entry that restrict the number of new dentists entering the profession in the UK.
If the CMA identifies specific practices that breach consumer protection or competition law – such as misleading pricing or anti-competitive agreements – it can take direct enforcement action. The CMA has recently been given the ability to fine businesses who breach consumer law up to 10% of their turnover.
Although not inevitable, the CMA may escalate to a full market investigation, as it did in the vets case. This would significantly raise the stakes, introducing the possibility of legally binding remedies, including structural interventions.
The hidden cost: regulatory burden on practices
For many in the profession, the most immediate impact of the CMA’s study will not be its eventual conclusions, but the process itself.
Market studies are intensive. They require sustained engagement from industry participants over many months. Many will engage competition lawyers to help them to nudge the CMA in the right direction, to deal with the burden of detailed information requests, to prepare written responses to the various consultation documents, and to prepare for meetings and formal hearings.
Perhaps most significantly, the study introduces a period of uncertainty. Practices must make commercial decisions – on pricing, investment, and business models – without knowing what regulatory changes may follow.
The CMA has emphasised its commitment to pace, predictability and proportionality, but the reality remains that such investigations impose a burden on the sector.
Preparing for the road ahead
For dental practices, the key is not to wait for the final report. Practices should consider making their views known to the CMA, either to explain why significant interventions are unnecessary or to point towards certain changes they believe should be made. The best time to influence the outcome of a CMA investigation is right at the start. The CMA’s initial call for views ends on 2 April 2026.
Practices could also consider reviewing their pricing structures and ensuring transparency is robust and defensible, and auditing their patient communications to ensure clarity and compliance with consumer law.
In short, the sector should buckle up and prepare for a long and bumpy ride.
About the Author
Tom Smith is the London Managing Partner at Geradin Partners, a specialist competition and regulatory law firm. He was formerly Legal Director at the Competition and Markets Authority.
