The British Dental Association has highlighted the seismic change in approach to the dental workforce signified by the Government's plans to deliver a tenfold increase in places for the Licence in Dental Surgery (LDS) exam. The professional body believes that these plans to massively expand routes for overseas dentists to practise in the UK do not form a coherent response to the current crisis in the NHS and could leave applicants facing both uncertainty and exploitation.
The issues with the current waiting lists for the General Dental Council’s (GDC’s) Overseas Registration Exam (ORE) and the LDS are well-documented, and dentist leaders say today’s announcement, as well as the expected changes to the ORE, will be helpful in addressing the current backlog.
The policy will see the total number of dentists potentially joining the UK dental register through any route could rise from around 2,100 to up to 4,200 per year from 2028, with a potential for up to three-quarters joining through international routes.1 The professional body has expressed the view that recent proposals to the immigration and settlement rules will inevitably make it much harder for these dentists to stay in the UK long term,2 which suggests this does not represent a sustainable long-term approach. The BDA warns that the inevitable insecurity over status in the UK will open these dentists up to far greater risk of exploitation.
The BDA maintains that overseas-qualified dental professionals make a huge and welcome contribution to the sector, and that wrap-around support must be in place for applicants. In the mid-2000s, the then Labour Government attempted to proactively bring over a significant number of overseas dentists to the UK. Needed support was unavailable for many who gave up livelihoods in their home countries, with some ultimately left unable to practise in the UK.
The BDA stress there will be no automatic boost to the supply of NHS dentists, as registration alone is not enough to be able to work in the NHS. Any new registrants will need to get on the NHS performers list or equivalent, requiring a structured conversation to assess the individual applicants' knowledge, skills and experience, and most likely some time with in-practice support.
Moreover, the BDA has stressed that overseas qualified dentists are no more willing to work within England’s failed, underfunded NHS dental system. It has reiterated that any solution to the current crisis rests on meaningful reform, underpinned by sustainable funding,3 together with a long term, genuinely sustainable approach to workforce planning.
In England, the funding allocated to NHS dentistry is now nearly all being spent on care. Therefore, if there is to be any additional NHS care provided by new registrants, it will require further investment that the Government has so far been unwilling to provide. Otherwise, there will be no NHS work for these dentists to perform. The changes include a rather modest increase to UK dental student numbers – which will not start to impact until 2032 – but the BDA has also expressed concern that there needs to be the academic workforce within UK dental schools and NHS training places to support this expansion. It warns that it will be challenging to upscale to address all these issues for both UK students and overseas qualified dentists.
BDA Chair Eddie Crouch said:
“This seismic change to the dental workforce feels like a quick fix.
“This is a radical break from approaches taken to every other health profession. More new dentists will come through this pipeline than will graduate from UK dental schools.
“These dentists will need wrap-around support to enable them to deliver NHS care. We certainly don’t have an immigration policy that offers real certainty they can build a future here.
“But ultimately, it doesn’t matter whether a dentist qualifies in Manchester or Mumbai. We won’t keep talent working within a failed, underfunded NHS system without real change.”
Notes to editors
1. The 1,350 overseas qualified dentists who are set to take the LDS exam and a total of 1,500 taking the ORE compare to around 1,100 UK graduates who typically join the General Dental Council register per year.
In total, around 47,000 dentists are currently on the register. At present around 2,100-2,200 dentists from all sources join the register annually, with overseas qualified dentists from all sources making up 47% of new registrants.
This policy could see total new joiners - factoring exam pass rates - rise up to as much as 4,200 per year in total, of which overseas qualified could rise to over 3,000, or close to 75% of the total. This assumes a continuation of the automatic recognition route for EU-qualified dentists, which is currently due to end in the summer of 2028.
2. The Government has recently consulted on significant changes to the rules governing settlement. Currently, those on skilled worker visas can apply for settlement after five years. This wait is to be extended to a minimum of 10 years, with potential for even longer timescales depending on certain circumstances, and no recourse to public funds even when settlement is achieved. Businesses providing sponsorship will therefore hold significant responsibility but also power over individuals for longer. At the time of writing, the outcome of the consultation is not known.
3. While the Government has pledged reform of the discredited NHS dental contract in England, it has not pledged a penny of new investment to support the rebuild or meet huge unmet need for care. Typical NHS contract holders are now delivering items of NHS care at a loss and are reliant on a cross subsidy of over £400 million a year from private activity to break even. BDA analysis of the GP Survey, 2025, by Ipsos, extrapolating data in line with ONS midyear population estimates, places unmet need at close to 14m adults or over 1 in 4 of England’s adult population. Unmet need figures for 2025 were almost unchanged on 2024 levels, at around 13.8m. 5.7m adult patients tried and failed to secure NHS care in the last 2 years – a fall of 700,000 on the previous year’s figures, but with a corresponding surge in the number of people who had effectively given up trying, with the number of people not even attempting to make appointments as they didn’t think they could secure care up by over half a million to 5.9m. The costs of care pushed 1.3 million away, and 880,000 indicated they were on waiting lists, all up on the previous year’s figures. Prior to Covid, levels of unmet need hovered consistently at around 1 in 10 of the adult population.