Dentistry’s ‘Silver Tsunami

The Association of Dental Groups (ADG) has launched a new whitepaper predicting three seismic shifts that will impact the provision of dental services in the UK over the next 15 years.

Futurism & Dental Dynamism: The next 15 years of dentistry was unveiled to MPs including health minister, Stephen Kinnock, as well as Rakhee Patel, deputy chief dental officer for England.

They heard that the industry needs to prepare for ‘dentistry’s silver tsunami’ as older people’s oral health needs are failing to be met.

But, with smart use of AI and digital tech, plus full deployment of the skill mix among the dental workforce, the ADG predicts that the next 15 years of dentistry is bright.

We will be facing a Dentistry Silver Tsunami if we are not careful, so it is important now for all healthcare professionals – from dentistry, to health and social care – to work together to deliver the solutions 

The three ‘tectonic shifts’

1. Demographic shifts: The overarching societal change

The UK’s low birthrate and our burgeoning elderly population will have a significant impact on all aspects of oral health care, from workforce considerations to the complexities of caring for an ageing population.

2. Artificial intelligence and digital innovation
With the move from analogue to digital, the report examines how oral healthcare providers need to ensure that developments benefit patients, as well as allowing professionals to improve patient care in a safely regulated environment.

3. Skill mix and workforce

Smart working will ensure all dental professionals are enabled to deploy their full scope of practice. This will provide professional development, encourage loyalty to the profession, as well as speed up processes to improve patient access.

Elderly oral healthcare

The operational reality of delivering oral healthcare in care homes is a challenge, says the report.

Supervised toothbrushing models, successful in nurseries and primary schools, do not readily translate into elderly settings.

But residents entering care homes often have rapidly-changing health status, cognitive impairment, and declining manual dexterity.

This landscape is overlayed with workforce instability in social care with high staff turnover, making training initiatives a repetitive and expensive task.

The ADG’s report details that, without meaningful reform of pay to support retention and staffing stability in the care sector, oral health preventive programmes struggle to embed, and there is no substitute for daily supervised toothbrushing support.

The report says policy ambition must be matched by stable funding, realistic workforce planning, and alignment with social care reform.

Neil Carmichael, executive chair of the ADG, said: “Today oral healthcare provision is already stretched with gaps in the workforce.

“Tomorrow, this will become even more acute.

“The ADG’s report predicts a massive increase in the demand for dental treatments by those who are in their 30s and 40s now, who are currently having cosmetic dentistry and implants.

“Some are going abroad for these cosmetic dental treatments – for so-called ’Turkey teeth’ – where the quality of the work cannot always be guaranteed.

“When they become elderly, their oral health needs will become even greater since cosmetic dentistry treatments need care by the individual and from the dental team.

“Elderly people can lose dexterity, making it a challenge for them to look after their own teeth and currently care in nursing homes does not have the provision to manage supervised toothbrushing that is working so well for children as an intervention.

“This even-larger group of elderly patients will be presenting with increasingly-complex oral healthcare demands. This must be a priority and ADG members stand ready to advise policymakers on how best to ensure support for this growing population group.

“We will be facing a Dentistry Silver Tsunami if we are not careful, so it is important now for all healthcare professionals – from dentistry, to health and social care – to work together to deliver the solutions.”

Lord David Willetts, president of the Resolution Foundation, adds: “An ageing population is rapidly increasing demand for health and social care, as more people live longer with multiple, complex conditions.

“After peaking in 2012, the birth rate has fallen significantly so in future the number of younger adults entering the workforce will shrink, leaving fewer staff to deliver this care.

“This imbalance is exacerbated by growing spending on state pensions and low economic growth so resources available for the NHS are constrained.

“These forces place growing pressure on healthcare systems, stretching capacity, raising costs, and making it harder to sustain high‐quality services without significant changes to funding, workforce planning, and service models.”

We must continue to equip patients, their carers, and health and social care staff with the support they need to maintain good oral health at home, in care settings, and in hospital 

And Dr Patel said: “As our population ages, more people are retaining their natural teeth, often with increasingly-complex dental needs.

“When social, behavioural, or medical challenges arise, the risk of oral disease increases and delivering comprehensive care becomes more difficult.

“Poor oral health can affect a person’s ability to eat, speak, and socialise, and can cause significant pain and distress.

“Prevention must therefore be our priority.

“We must continue to equip patients, their carers, and health and social care staff with the support they need to maintain good oral health at home, in care settings, and in hospital.”

Glen Taylor, chief operations officer at Community Dental Services (CDS-CIC), said it was already seeing the ‘silver tsunami’, particularly within sheltered housing and nursing homes.

He added: “As more older adults retain their natural teeth, maintaining good oral hygiene becomes more challenging, as the complexity of their dental need increases.

“Looking ahead, the next generation of older adults – those currently in their 30s to 60s – will present even greater challenges.

“Many will have implants and cosmetic dentistry that require lifelong maintenance and are vulnerable to the effects of medications such as bisphosphonates and blood thinners, or the impact of medical interventions and dementia-related illnesses.

“Cosmetic treatments, while beneficial, will not last a lifetime without sustained high standards of oral hygiene, and ongoing repairs will be inevitable.

These forces place growing pressure on healthcare systems, stretching capacity, raising costs, and making it harder to sustain high‐quality services without significant changes to funding, workforce planning, and service models 

“To meet this rising complexity, the dental workforce must be supported and strengthened.

“Closer integration with other healthcare professionals and pro-active planning will be essential if we are to respond effectively to the demands of dentistry’s silver tsunami, which is already on our shores.”

15 years of the ADG

2026 marks 15 years of the Association of Dental Groups (ADG) shaping UK dentistry.

And, more than ever, dental reform is on policymakers’ agendas, with stakeholders coming together to action change, embrace technology, and maximise the workforce skills mix.

Taking inspiration from the Futurism movement that originated in early 1900s Italy, which celebrated dynamism, energy, as well as the speed and efficiency of the machine to drive change, the ADG predicts that the next 15 years of dentistry will see a ‘new-world’ of dentistry, super-charged by AI and digital technology.

Technology boon

Despite the challenges of the demographic shift, dentistry is well-placed to navigate the challenges, says the report.

A ‘Futurism’ approach and a dynamic mindset enabled by advances in technology and smart deployment of the full dental workplace can ensure that the next 15 years of dentistry are on track to excel.

Rapid advances in digital, the speed with which AI and digital tech is evolving will bring efficiencies, opportunities, and patient benefits.

However, there will be practical and ethical quandaries ahead and the ADG sees this as an emerging area requiring careful governance.

Working smart

While dentistry skill mix has seen some changes over the years, the ADG believes that the full workforce should be enabled to fulfil their training scope better.

Dental professionals are not being used to their full capability. The ADG wants to ensure dental training includes exposure to skill mix training.

The ADG published the Creating Dental Oases report in June 2025 describing the challenges facing the dental workforce with over 2,700 dentist vacancies, and the impact on patient care.

Over the next 15 years stakeholders must ensure that dentistry is delivered with the ‘mixed economy’ landscape in mind.

Purely planning for the NHS workforce in dentistry will not work, and this has been part of the problem for many years, it states.

Embracing this moment

The report concludes that interaction between demographic change, intelligent technology and a fully-deployed workforce will determine whether dentistry over the next 15 years becomes constrained by pressure or transformed by opportunity.