NHS dental access: why the ORE is part of the solution

Neil Carmichael, executive chair of the Association of Dental Groups (ADG), explains why the group backs calls to reform the overseas registration exam (ORE) booking system.

The ADG is aligned with minister Stephen Kinnock when he says utilising our talent-pool of trained international dentists is the ‘low hanging fruit’ option. If the General Dental Council (GDC) can simply unblock the bottleneck that is restricting recruitment by allowing these overseas dentists to take the ORE, we would have an immediate solution to the crippling dental workforce issue that is paralysing our sector and preventing patients getting the access to a dentist that they need.

We have an urgent crisis in our dental workforce across all four nations. The latest figures show that we have 2,744 dentist vacancies across the UK, of which 2,516 are NHS and 228 are private. Then if we look at dental nurses, there are approximately 2,200 vacancies for qualified and/or trainee dental nurses in England.

Remember – dentists are not permitted to work without a dental nurse. So for us to be able to fill the gap in the dentist workforce, you need to add the 2,200 England nurse vacancies to the 2,744 UK dentists’ figure – and you are looking at a recruitment deficit of what will be well over 5,000 missing team members, once you’ve considered nurse vacancies in the other three nations. The numbers speak for themselves. And without a full and functional team, patient care is being impacted.

Alleviating the ORE bottleneck

Following the launch of the ADG’s ‘Dental Oases’ report in June, we were relieved to hear the minister say on record at the Health and Social Care Select Committee in July that he has demanded that the GDC must come back to him by October with a plan on how to alleviate the ORE bottleneck.

Whilst the recent news that UCL Consultants have been confirmed to manage the ORE process is welcome, it’s now November and we still don’t have a plan on how the queue for international dentists to take the exam will be managed, and importantly how it will be improved to be fairer and more efficient.

I would urge everyone who cares about getting NHS dentistry in this country back up and running, to sign the ‘Unlocking the ORE’ petition. The ADG is full force behind this campaign for fairer overseas registration in dentistry, so please do get involved.

We have to have a fairer booking system, so that the thousands of talented dentists who have moved to the UK already and are working in unskilled jobs such as flipping burgers in fast food restaurants can roll up their sleeves and put their talents to work.

Insufficient dental staff

A key issue when it comes to the GDC is that they are an independent body and we are concerned about their lack of accountability. In a recent announcement, we learnt that the GDC is to be back of the queue in terms of reform, something that we understand they themselves were disappointed to hear. Did you know that the last reform the GDC went through was in 1984 when Margaret Thatcher was in power?

Dentistry in the UK has changed massively in the last 40 years, and the governing council, which was meant to support the profession, has not. We are aware they are currently procuring a new service provider for the ORE but the delays in progressing this mean that the public continues to struggle to find a dentist and the dental practices cannot fulfil their contract with an insufficient number of staff.

The GDC must put in place a better IT system that does not fail and kick out those waiting for hours in the queue, which are stories we have heard from frustrated international dentists. We also need a ’smarter’ program that prioritises those who have been attempting for multiple times to register. It cannot continue to operate like a lottery.

Additional skilled worker challenge

Our profession faced an additional challenge in July 2025, when changes to the Home Office’s skilled worker route outlined in the immigration white paper meant that a fully trained dentist from overseas will now be denied sponsorship to work as a dental therapist in the UK. The ADG has called for the immediate postponement of this dentistry part of the skilled worker policy so that we can allow for proper consultation.

Cutting off this route, which UK dental groups have been able to take after exhausting the pool of UK-based dental therapists, will mean a huge gap in the dental therapist workforce. Since dental therapists are trained to carry out approximately 70% of the dental services that a dentist can, it will leave many patients without care.

ADG members are also voicing concern about the complexity of the sponsor licence requirements. The current lack of clarity can mean that sponsorship licences are suspended during a protracted investigation, which impacts their ability to recruit international staff, leaving them with an immediate gap in their workforce – for which patients who are unable to see a dental professional, are the ones who ultimately suffer.

This is a classic case of the Home Office not talking to the Department of Health, and visa versa. Policies that can have such a massive impact on how a profession can perform, must come from joined-up conversations. The two departments need to put their heads together.

Read more from our campaign

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