The General Dental Council (https://www.gdc-uk.org), which registers all dental healthcare professional produces monthly registrants reports with UK-wide and regional figures for each category of dental registrant. In May 2020 (https://www.gdc-uk.org/about-us/what-we-do/the-registers/registration-reports) the GDC reported a total of 114,108 UK registrants of which 41746 (36%) were dentists and 72362 (64%) were Dental Care Professionals (DCPS) – 53% dental nurses and 11% other DCPs (dental therapists, dental hygienists, clinical dental technicians, dental technicians, and orthodontic therapists). Prior to registration all dental healthcare professionals must successfully complete a rigorous programme of training and complete final examinations inspected from time to time by the General Dental Council. And to satisfy the requirements for reregistration each year, all dental healthcare professionals must, amongst other expectations, undertake prescribed amounts of continuing professional development.
Fifty percent of registered dentists and 93% of DCPs are female.
Dentistry is one of the longest (five, 40+week years) and most demanding university undergraduate degree programmes. At qualification dentists must be competent in assessing, diagnosing and treating all common oral and dental conditions in patients of all ages. Similarly, the education and training of all dental care professions is demanding and overseen by the General Dental Council.
The General Dental Council reports also include a profile (number, age and gender) of the registrants (4348 in total in May 2020) in each of the thirteen dental specialities. Dental specialists are individuals who have successfully completed extensive (minimum of three-years full time) postgraduate training in distinct branches of dentistry, work in hospital, academic and dental practice settings. This accounts for just over 10% of all dentists, the other 90% being general dentists working in general dental practice.
There is a searchable register on the General Dental Council home page to look for a dental healthcare professional, i.e. confirm an individual is registered with the General Dental Council and licensed to practise. Also, there is a facility to raise concerns about the conduct of a registrant.
Dental services in primary care are largely provided in general dental practices. A small proportion of primary dental care is also provided by the Salaried Dental Services in community settings, where there is a focus on the care of disadvantaged groups and individuals with special needs.
Specialist services are available in many dental practices and in secondary care, hospitals across the UK. There are 18 dental hospitals in the UK, 16 linked to dental schools and two associated with postgraduate dental institutes, one in London and the other in Edinburgh.
In 2019 there were approximately 12,500 dental practices in the UK.
Unlike medical practices, dental practices are privately owned and managed – 69% by individual “Principal Dentists” (self-employed dentists, partners or directors of small limited companies), 12% by large Dental Body Corporates and 20% by smaller (usually incorporated) groups.
Although dental practices operate in the private sector, most provide a mixture of public (NHS) and privately funded dental care. The size of the NHS contract held by practices depends on historic (pre-2006) activity and varies widely, accounting for anything from under 20% of total revenues to over 80% of revenues.
Dental practices provide dental services for patients by licencing fully serviced facilities to “Associates Dentists” (dentists operating as self-employed contractors or through personnel companies).
Most dental practices have very high overhead costs accounting for up to 80-90% of fees earned. Such high overheads are linked to associate fees of 40-45%, laboratory and consumables costs of 10-15%, employee costs of 18-22% and fixed costs of 5-10% depending on size and location.
The dental ‘market’
The dental ‘market’ in the UK was valued in 2018 to have a total value of £10.1bn, comprising £3.9bn of government (NHS) funding across primary and secondary care and £6.2bn from private care paid for directly by patients.
Most patients seeking NHS dental care are subject to patient charges (https://www.nhs.uk/using-the-nhs/nhs-services/dentists/understanding-nhs-dental-charges/) which return £0.7bn of NHS funding per annum, limiting government spending to around £3.2bn/annum.
The dental market was projected, prior to the COVID-19 pandemic, to grow by an average of 4.1% p.a. until 2022, driven by an ageing population and the growing interest in health, wellbeing, and enhancement of self-esteem, which have all contributed to an expanding demand for cosmetic and specialist treatments. In the wake of the pandemic, the dental market will take possibly two or more years to fully recover.
Private care fees, including locally organised dental insurance scheme fees. vary across the UK depending on market forces such as premises costs, availability of personnel, local demographics and local competition .