The Competition and Markets Authority is looking into the private dental market – a move the BDA said is ‘perverse’. Does their review have any merit, and what will it mean for grassroots dentists? Sophie Borland reports
Two months ago, the UK’s £8 billion-worth private dentistry industry became the subject of a review by the Competition and Markets Authority (CMA), over what it claimed were ‘significant’ price rises. Figures highlighted by the CMA showed that fees for an initial consultation had risen by 23% to £80 in two years, while routine consultations had gone up by 14% to £55. Meanwhile, growing numbers of patients are now using private dentistry because they are struggling to access NHS clinics.
The CMA – a watchdog which aims to promote competition and protect consumers – had been pressed to look into the industry by chancellor Rachel Reeves. In a jarring attack on private dentists last November, Mrs Reeves had warned of a ‘scourge of hidden costs, lack of transparency and overtreatment’ which she claimed had ‘blighted families’ for too long.
But Dr Eddie Crouch, chair of the British Dental Association, tells GDPUK the review is ‘very much politically driven.’
‘This is a political gesture to try and make the Government look as though they’re putting money back in voters’ pockets at a time when they’re not spending any more money on the NHS,’ he says.
Martin Skipper, head of policy at the LDC Confederation, a representational trade association for Local Dental Committees in England, agrees, adding: ‘They’re trying to rectify underinvestment in the NHS by penalising a private market which is responding to demand and need, because of underinvestment in NHS dentistry.’
Media scrutiny
That said, dentists have been the subject of string of uncomfortable headlines in the past two years which have accused them of charging ‘eye-watering’ prices and ‘profiteering’ from the NHS crisis, while desperate patients reportedly pull their own teeth. One Daily Mail story last March claimed that a quarter of patients who had been unable to access an NHS dentist had resorted to DIY dentistry including using pliers. An article in The Guardian last January found that prices for common procedures had soared between 2022 and 2024 with patients now paying as much as £775 for root canal work, £435 for a tooth extraction and £325 for a white filling.
The CMA’s review will look at how treatment prices have changed as well as issues such as whether competition between private clinics is encouraging them to lower their fees, how easy it is for patients to complain and if dentists are engaging in so-called ‘unfair business tactics.’ The watchdog says it has been made aware of cases whereby dentists will only accept children as NHS patients if their parents register privately. It also says concerns have been raised about dentists ‘upselling,’ where they encourage patients to have higher-end treatments.
To gather evidence, the CMA asked patients and dental professionals to complete an online survey shortly after the review’s launch in March. Patients were asked questions such as which dental treatments they had paid for privately, what had influenced their decision in going private and what factors were important in choosing their dentists. Dental professionals – including technicians, practice managers and other admin staff, as well as dentists and nurses - were asked questions around the challenges they had faced while practising, the challenges facing the industry as a whole and whether there was anything affecting consumer choice.
The CMA will also engage with dentists at smaller independent practices as well as larger corporate groups, the chief dental officers of the four nations within the UK, the regulators and patient representatives, and other interested groups.
The watchdog has promised to update the public on any concerns regarding private dentistry in either October or November before publishing its final report next March. If the CMA finds significant problems with the industry before then however, it could launch a formal investigation, which may take longer and lead to tighter regulation of the industry.
Muddled figures
Although the review is in the early stages, the BDA is concerned about the figures underpinning it apparently show ‘significant’ price hikes. According to the CMA – which cites ‘independent sources’ - fees for initial consultations went up by 23% between 2022 and 2024 with the costs for a routine check-ups rising by per cent 14% over the same period.
But referring to these numbers, Dr Crouch says: ‘It was one market study carried out by an insurance agency and I think it’s probably an outlier survey rather than a more accurate representation of where we are. We believe that fees haven’t really kept pace with inflation.’
The BDA’s own figures show there has been a real-terms reduction in private dental costs against inflation of 8% between 2021 and 2025.
The trade union is also unhappy about the way the CMA describes patients as ‘consumers’, saying it misrepresents the patient-dentist relationship.
Dr Crouch adds: ‘We don’t believe that is the correct terminology to people who come through their door who are their patients. We believe the profession is quite annoyed by that word.
‘We don’t believe that this is a similar thing to going into a shop and buying something as a consumer. This is a different relationship altogether and it shouldn’t be described like that.’
But Dr Simon Thackeray, president of the British Association of Private Dentistry and a practising dentist in Mansfield, Nottinghamshire welcomes the review as a way of boosting the public’s awareness of how dentistry works.
‘If we can have some form of awareness brought to dentistry, that dentists are not price gouging, dentists don’t sit around, ringing each other up saying “how are you this morning, what are you charging for a crown, right I’m going to charge the same”.
‘Dentists are not setting their fees through greed, they are setting their fees because there are massive industrial pressures.’
What could the CMA actually do?
If the CMA finds serious concerns with private dentistry, it could decide to launch a formal investigation and impose legally-binding measures. This is what happened with the vets’ market and in March, the watchdog ordered practices to impose price caps on prescription fees and publish their price lists. Unsurprisingly, the investigation and media coverage has significantly dented public trust in vets. Some dentists are fearing the same consequences.
Dr Victoria Holden, president elect of the British Association of Private Dentistry says: ‘There’s a lot of concern within the dental profession about where it will go, having seen what’s happened with the vets’ situation.
‘What the dental profession really needs to do is really engage with it at this moment in time, give them clear comprehensive information,’ she says.
‘If the dental profession can really get on board with it and help them get the information that they need, then it’s more likely that the CMA will be able to understand the private dental market and go, “do you know what, there’s nothing to see here”.’
Dr Holden points out that private dentistry is different to the veterinary market and isn’t dominated by large corporate firms, which charged higher prices in the case of vets.
The CMA has until next March to decide whether to launch a formal investigation or publish the findings of its current market study and any recommendations for the Government. The Government will then decide which of these recommendations to take on, although it is not obliged to accept all of them.
Although the dental profession may be nervous of the review, leading private dentists tell GDPUK it could lead to positive changes.
Dr Holden says this could include issuing helpful advice on how much information practices need to give in their price lists and what details they should put in patients’ treatment plans.
‘Hopefully what might come out of it is maybe some advice and guidance which can help us run our practices better. That sort of thing may be very helpful for the profession. I don’t necessarily see it as a threat, at all.’
Dr Thackeray says: ‘What we think is that it could well be an eye opener for them. Once they get the data and they realise there isn’t collusion, there isn’t price fixing and that it represents the true cost of dentistry, hopefully it will come out that there’s nothing to be worried about with dentistry.
‘What I’d like to think with the CMA is that it may well show just how unbelievably good value dentistry is but also how massively, massively underfunded it really is.’