by Patrick Doherty, Head of Licences Services, Cashflow
Investors and operators looking at the UK dental market today see a sector with significant momentum. Private equity continues to consolidate the market, with Bridgepoint’s recent acquisition of Mydentist and ongoing expansion from Rodericks and Portman underlining sustained interest.
Patient numbers are increasing, treatment fees continue to rise and Mintel forecasts almost 20% real-term growth between 2024 and 2029. Despite these positive indicators, practice owners and finance directors continue to report an ongoing challenge, as strong revenue growth doesn’t always translate into financial confidence. While practices may be profitable on paper, many operate with limited working capital. Much of that pressure is structural: the timing gap between delivering treatment and being paid, capped NHS reimbursement, and rising staff and material costs. What practices can more readily control is the infrastructure underpinning how they receive and reconcile payments, and this is often where slow settlement and fragmented, admin-heavy processes quietly tie up cash that should be otherwise working for the business.
The Regulatory Spotlight on Pricing
This year the conversation around dental pricing took a turn, with the Competition and Markets Authority launching a formal market study into private dentistry following a request from the then-Chancellor, prompted by sharp rises in prices. Initial consultations rose by more than 23% between 2022 and 2024 to an average of £80, while routine check-ups increased 14% to £55. With private dental services now accounting for more than two thirds (69%) of a market worth £8.4 billion, regulators are examining whether competition is delivering fair outcomes for patients.
What is often overlooked is how closely pricing transparency is linked to pricing transparency. A patient agreeing to a £2,400 treatment plan understandably expects clear information about when their instalments are due and precisely what they are authorising when making a payment.
The British Dental Association has highlighted that practices subsidise loss-making NHS work by more than £400 million a year through private income, which means that the integrity of private billing extends beyond the patient experience. As regulatory scrutiny intensifies, those practices with payment systems that create confusion, delayed invoices or reconciliation issues are likely to come under greater pressure than those with streamlined, clear audit-ready processes.
Profitability leaks
One of the least visible challenges for dental practitioners and management is the disconnect between revenue and cost. Costs for staff, lab fees, consumables, software subscriptions and rent all come out on a regular basis, predictably. But patient payments don’t adhere to the same regiment. Yes, a routine hygiene appointment might be paid before the patient leaves the building, but more complex cases like implants or orthodontics are usually spread out over the course of months.
Third-party patient finance, which now supports a substantial proportion of higher-value treatments, introduces additional timelines, while income from dental plans, card terminals, BACS transfers and account balances must all be reconciled, often through manual processes.
The cumulative impact is considerable. Specialist dental accountants at A4G regularly see practices restructuring borrowing facilities because cash flow timings no longer fit the way the company was originally financed. Forecasting becomes less reliable, while investment decisions are delayed and the working capital needed to support a growing business eventually deminishes.
The fallout then extends to valuation – practices that are preparing for sale or refinancing are increasingly expected to demonstrate not just EBITDA performance but the consistency and quality of cash conversion. LaingBuisson’s seventh Dentistry UK Market Report highlights continued investor interest in the sector, but experienced buyers also look at any operational inefficiencies they might need to address post-acquisition. For example, two practices that generate identical income can seek very different valuations if one reliably collects payments within a matter of days, while the other takes weeks.
Workforce Pressures
Cash flow stress is rarely confined to the finance team, as it impacts decisions across the business, from recruitment to retention. Dental nurse and hygienist salaries have risen over the past three years as NHS pressures and a growing demand for private treatment inflates the labour market. Associates, particularly those earlier in their careers, are becoming increasingly selective about where they choose to work, so if a practice isn’t able to invest in equipment, professional development, or facilities because cash is tied up in receivables is already at a competitive disadvantage.
There are regional differences at play too, LaingBuisson highlights variations across the UK, with the North West averaging 27.8 FTE NHS dentists per 100,000 population and the East of England just 24.3. Practices serving underserved areas often face higher patient demand and longer treatment pathways, amplifying the cash flow pressures.
Closing the Gap
Addressing the liquidity challenge does not require structural change, instead it needs the same commitment to operational improvement that practices have already invested in through digital imaging, intraoral scanning and patient communications software.
Modern healthcare payment infrastructure focusses on focuses on four practical outcomes: enabling new locations and services to begin trading quickly through rapid merchant onboarding; allowing balances to be collected securely via remote pay-by-link flows rather than manual chasing; providing practice managers with a single real time view of transactions across every payment channel; and reducing time between treatment completing and funds clearing by increasing card-based payments over bank transfers.
While these improvements are operational, their impact is strategic. Working capital that was previously tied up in receivables becomes available for recruitment, equipment purchases, marketing or expansion. At the same time, reception teams can spend less time chasing payments and instead focus on the customer experience. Forecasting becomes grounded in real-time financial data rather than spreadsheet guesswork. Most importantly, practices can show the robust payment controls and audit trails that strengthen enterprise value to regulators, lenders or potential acquirers.
UK private dentistry remains well positioned for growth, but market conditions don’t guarantee operational resilience. Those practices that distinguish themselves over the coming years by pairing clinical excellence with modern payment infrastructure will be those that translate today’s demand into long-term value.
