A new age of compliance – the impact of immigration policy on the UK dental sector
Migrant workers play a crucial role in sustaining the UK dental profession. Current figures indicate that for the first time, overseas‑qualified dentists account for over half of all new dentist registrations in the UK. Against this backdrop, professional bodies such as the British Dental Association (BDA) and the General Dental Council (GDC) have increasingly raised concerns about the impact of shifting immigration policy on workforce stability.
Registration in the UK – a challenge for overseas-qualified dentists
Overseas‑qualified dentists face significant barriers to entering the UK workforce. To practise in the UK, all dentists and dental care professionals must be registered with the General Dental Council (GDC). For many non-European Economic Area nationals whose qualifications are not recognised for full registration with the GDC, this involves taking and passing the GDC’s Overseas Registration Examination (ORE) or the Licence in Dental Surgery Examination (LDS), an exam awarded by the Royal College of Surgeons of England. Across the sector, it is widely known that both exams are significantly oversubscribed. At the end of 2025, approximately 7,000 overseas dentists were waiting to sit the ORE.
To address the waitlist, governing bodies pledged to expand the capacity for both the LDS and ORE, with new government funding estimating that 2,400 more overseas-trained dentists could be registered annually from 2028 to 2029. In 2026, 1,000 Part 1 places are to be made available to new LDS candidates and there is also to be a surge in Part 2 and Part 3 places to assist candidates in moving through the process as quickly as possible. This should increase places on the final part of the exam tenfold from 180 to 1,800 by 2028. Meanwhile, the GDC aims to significantly increase the capacity of the ORE from autumn 2026 meaning more than 1,000 overseas-trained dentists are expected to join the register annually through this route by 2028 to 2029. Furthermore, The Office for Students has stated it will prioritise new places in “dental deserts”, rural and coastal areas with the poorest access to NHS care.
Immigration Rule changes – reshaping Scotland’s dental workforce
On 22 July 2025, the UK Government implemented changes to the Immigration Rules which had a significant impact on the dental sector. Central to these reforms was the rise in the minimum skill level required for visa sponsorship under the Skilled Worker route, rising from Regulated Qualifications Framework (RQF) level 3 (equivalent to A-level) to RQF level 6 (degree level).
As a result of the changes, key dental care professional roles, including dental technicians, hygienists and dental nurses, were removed from the list of eligible occupations for visa sponsorship under the Skilled Worker route. The revised rules apply to both individuals applying from overseas and those seeking to switch from another visa route in the UK (e.g. student or graduate routes). This development represents a significant shift in workforce pathways within the dental sector. Previously, many overseas-qualified dentists worked in such positions as interim roles whilst waiting to take their professional exams. The removal of sponsorship eligibility for these roles may therefore have wider implications for skills shortages.
Following the changes, the BDA expressed concern that the removal of the above key roles from visa sponsorship would cause an even bigger shortage of dental professionals who are essential to providing safe and efficient care in the UK. Since last year, many practices, particularly those based in remote and more NHS-dependant areas, face even more recruitment and retention challenges.
Despite the changes, visa sponsorship for the above roles is still possible in specific circumstances. Individuals who were already sponsored before 22 July 2025 can continue in their role, extend their permission and switch employers under available transitional arrangements. Other key dental roles, such as dental surgeons, dentists, orthodontists and periodontists continue to meet the new skill threshold and remain eligible for sponsorship. The challenge for many practices now lies in understanding the full extent of last year’s changes and complex transitional provisions, to enable continued sponsorship where possible.
Evolving compliance landscape
Along with a tightening of the visa sponsorship route, there has been an increased focus on immigration compliance and enforcement. The stark rise in activity has focused on both employers’ compliance with their duty to prevent illegal working and, for organisations that hold sponsor licences, adherence to their corresponding sponsor duties.
Employers who fail to comply with their duty to prevent illegal working may be liable for a civil penalty of up to £60,000 per worker under Section 15 of the Immigration, Asylum and Nationality Act 2006. Up until now, liability has been limited to employer/employee relationships. However, liability for civil penalties is to be extended under amendments being brought in by the Border Security, Asylum and Immigration Act 2025, which received Royal Assent at the end of 2025. The planned changes will extend liability beyond traditional employment relationships to include a broader range of working arrangements, including workers, individual sub-contractors and workers engaged through online matching platforms.
Employers can protect themselves against a civil penalty by carrying out Home Office compliant right to work checks. It will therefore be essential for practices to consider whether the changes to the civil penalty regime may affect their contractual relationships with individuals delivering their dental services to ensure continued compliance.
The importance of compliance with the right to work regime is of wider significance for sponsor licence holders. Failure to carry out proper checks not only risks liability for a civil penalty, but it is also a breach of an organisation’s sponsor duties. A breach of sponsor duties can lead to sponsor licence revocation and in turn, cancellation of a sponsored worker’s permission to stay in the UK, and right to work. Whilst the statutory civil penalty regime has thus far been limited to employer/employee relationships, a sponsor has been required to carry out right to work checks on all sponsored workers regardless of whether they are employed or self-employed. This is particularly important for the dental sector where many dentists, including sponsored dentists, are typically self-employed. This duty has recently been extended by the Home Office.
On 6 March 2026, the Home Office updated its sponsor guidance to require sponsors to check the right to work for all workers they intend to employ or directly engage, whether they are sponsored or not, before they commence work. Unhelpfully, the term ‘directly engage’ is not defined in the updated guidance. In light of these changes, sponsoring practices may need to review their onboarding processes to ensure compliance with the revised Home Office guidance and their sponsor duties.
Notwithstanding changes to the immigration landscape, visa sponsorship remains a viable and important recruitment tool for dental practices. To take full advantage of this, practices must keep up to date with changes to the Immigration Rules and sponsor guidance and take a proactive approach to compliance. Finally, it is crucial that all practices be alive to the wider changes to the right to work regime which are expected to come into force later this year.
Ashley Fleming is a partner, and Tsara Mirza-Reina is a trainee solicitor, in the immigration law team at law firm Harper Macleod.