A severe backlog of people trained in dentistry outside the UK waiting to take the national registration exam is having a knock-on effect on dental practices across the UK.

The Overseas Registration Exam must be passed by those who have an international degree in dentistry if they wish to practice in the UK or take a postgraduate course in the profession involving clinical work on patients.

But the wait for the ORE, which in some instances has been up to three years, is “deeply concerning”, according to Claire O’Leary, director of external relations and partnerships at the College of Medicine and Dentistry.

The situation for international dentists has recently grown worse, she said, due to a combination of reasons including a registration exam backlog caused by covid and the closure in spring 2023 of a registration-by-application route for internationally qualified dentists. 

“This latter option afforded internationally qualified dentists the opportunity to register and practice, within the scope of a dental hygienist/therapist, whilst they waited to sit and pass their ORE or LDS [Licence in Dental Surgery – a longer test] dentist registration exams,” O’Leary told The PIE.

The decision to close this has “exacerbated things for international dentists who want to practice” in the UK. 

“We badly need [more dentists],” she noted. 

In terms of interim career opportunities, the College now provides additional training in Dental Nursing, which aims to ensure students “retain the opportunity to work in a UK clinical setting until they have cleared their registration exams”.

“As the regulator of dental professionals, the GDC’s primary purpose is to maintain patient safety and public confidence in the dental professions, ” a spokesperson for the General Dental Council told The PIE. 

“In May we announced the tripling of part one places for the Overseas Registration Exam… we launched a consultation on international registration and announced an increase in part two ORE places and a significant increase in staffing. 

“In terms of ORE numbers, we had a 600-candidate sitting of part one in August, which should have reduced the numbers significantly. We also opened bookings for the part two in November this week,” the spokesperson explained. 

Despite the closure of the dental therapist registration-by-application route and the continuation of backlog clearing for the ORE, the College’s one-year master’s in Advanced General Dental Practice remains “very popular with international dentists who are focused on securing registration and entering UK practice and want end-to-end support”, O’Leary explained.

In a small victory, the issue isn’t affecting EU students. In June, the decision was taken to recognise EU degrees for another five years – but that doesn’t completely erase the original problem.

“Part of the solution could be having more international relations”

“Legislation was changed to empower the GDC to be able to legally recognise international degrees for EU qualifications, but there is also politics involving a possible brain drain, which would have to be navigated sensitively and appropriately.

“Part of the solution could be having more international relations and more partnerships with overseas universities,” O’Leary said.

A consultation was launched in July by the GDC to discuss how to effectively recognise international dentistry degrees, but no legislative changes can be made until the current rules time out in March 2024, the spokesperson confirmed. 

The backlog has indirectly been felt in dentistry offices across the country, with a shortage of NHS dentist places on offer.

During the pandemic, the leading cause of hospital visits among children wasn’t Covid but tooth decay, largely because patients were unable to get places at an NHS dentist.

“I think we are seeing the UK sector and dental schools increasing their places and that’s really positive – but I think that alone is just not going to fill the gaps that meet patient demand,” O’Leary predicted. 

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