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VAT is creeping into places UK dentists never expected and it is rarely obvious until the bill, the threshold, or the HMRC letter arrives. We sit down with Vanessa and VAT specialist Veronica Donnelly to make sense of why “dentistry is exempt” is no longer a safe shortcut, and what dental practices need to check before small edge cases turn into expensive problems.

We unpack the Invisalign VAT ruling and why it matters even if you never register for VAT: suppliers can charge VAT that you cannot recover, quietly raising your cost base. From there we widen the lens to the bigger risks, including reception desk retail sales, cosmetic dentistry services, teeth whitening, and how mixed treatments are judged using the principal purpose test. The key message is simple: VAT is standard rated by default unless you can prove an exemption applies.

Then we get practical on compliance. We talk reverse charge VAT on overseas services such as Google advertising, marketing and offshore “shared services”, and why those costs can count towards your VAT registration threshold on a rolling 12-month basis. We also cover what HMRC look for in patient notes, why written diagnosis and medical purpose matter, what “retrospective” can mean in real terms, and how confidentiality works if HMRC request records.

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