Tier 2 Oral Surgery Accreditation

What is Tier 2 Oral Surgery?

Tier 2 Oral Surgery refers to intermediate level oral surgery procedures that go beyond routine extractions performed in general practice (Tier 1), but do not require hospital-based specialist care (Tier 3). These services might be provided by specialists, dentists with enhanced skills (DES) or accredited performers in primary or community dental care settings.

Which Procedures Are Included in Tier 2 Oral Surgery?

Surgical extractions (e.g. non-complex impacted wisdom teeth)
Removal of buried or fractured roots
Exposure of impacted teeth (for orthodontic purposes)
Minor soft tissue surgery (e.g. cyst removal, biopsies)
Apicectomy (surgical root-end resection)
Management of dental trauma and related complications
Management of patients needing IVS for their oral surgery procedure
Management of some patients with more complex medical histories

Why Does Tier 2 Oral Surgery Exist?

Reduces patient waiting times by offering complex treatments in community settings
Alleviates hospital pressures, ensuring that Tier 3 hospital-based services focus on the most complex cases
Enhances patient access to specialized care without needing hospital referral
Supports professional development, allowing dentists to expand their skillsetand career opportunities

The Tier 2 Accreditation Process

Tier 2 posts will tie into local NHS commissioning needs and so, as much as we’ll try to keep the information below as relevant as possible, there is a lot to be gained from tapping into local knowledge by speaking to the Local Dental Network (LDN) or other existing local performers.

Application & Eligibility

To apply for accreditation, a dentist must:

Hold a valid GDC registration
Provide evidence of postgraduate training or substantial clinical experience
Demonstrate knowledge and skills aligned with Tier 2 oral surgery competencies

Portfolio Submission

Curriculum Vitae (CV) with details of qualifications, clinical experience and any relevant teaching or research
Clinical Logbook documenting a variety of Level 1 and Level 2 cases treated in the last three years (potentially, these might have to have been witnessed or at least verified by a colleague)
Reflective case studies showcasing complex procedures performed
Evidence of Continuing Professional Development (CPD), including relevant training courses and mentorship activities
References from consultants or specialists supporting the applicant’s clinical abilities
Audit and peer review feedback, demonstrating quality assurance in patient care

Local Accreditation Panel (LAP) Review

A Local Accreditation Panel (LAP) assesses applications, ensuring that practitioners meet the required competencies. The LAP consists of oral surgery specialists, MCN members, NHS commissioners, and LDC representatives. The panel may grant full accreditation, partial accreditation or request further training.

Maintaining Accreditation

Once accredited, practitioners must:

Undergo revalidation every 5 years, ensuring continued competency
Engage in ongoing CPD to stay updated on best practice
Participate in clinical audits and peer reviews

Provider Assurance & Facility Requirements

In addition to individual accreditation, dental providers offering Tier 2 Oral Surgery must meet NHS England’s Provider Assurance Framework. This ensures that:

The practice environment is suitable for surgical procedures
The necessary surgical equipment and sterilisation protocols are in place
The staff are adequately trained and experienced in assisting with oral surgery
The facility complies with infection control, decontamination and waste disposal standards