Orthodontic case studies

Getting back on the straight and narrow

This blog is a little different…the starting point is the predicament of two orthodontists who were facing difficulties due to a poor service from their previous accountant. The case studies illustrate what can go wrong if you are not using a specialist dental accountant and how we can help.

Case study 1– High grossing male orthodontist with significant NHS contract

An orthodontist who is advanced in his career and who has accrued significant NHS benefits had a previous accountant who did not understand either the annual allowance (AA) or the Lifetime Allowance (LTA). Furthermore, his independent financial advisor (IFA) had failed to alert him that he was at risk of a tax charge. The accountant had entered the wrong amount on the tax return because he did not understand the need to take into consideration the growth of the NHS pension pot in order to calculate whether the AA had been breached. We were happy to take on the orthodontist and sort out what he owed HMRC. When we spoke to the former accountant, he quoted some information on the HMRC website to justify his actions. Unfortunately, this simply confirmed his lack of understanding of the NHS scheme since the advice he quoted was not relevant to his former client!


The NHS pension is complex, especially when a dentist or orthodontist has a private pension. A specialist dental accountant is imperative.

Case study 2. Female orthodontist, mid-career, with NHS and private pensions.

We took on an orthodontist as a new client; her previous accountant had, to put it politely, not been proactive on her behalf. Looking back at her previous tax returns, we could see that there had been a query from HMRC about the lack of detail relating to her pension payments. The accountant had addressed this correctly and the client paid tax in arrears but the accountant failed to follow and address the pension payments in succeeding years.

When we took over, we noted the absence of pension declaration in her most recent tax returns. We queried this with the former accountant. His response was: “She did not tell me to enter pension information on the tax return or provide me with it.” It appears he expected the client to spoon-feed him with direct instructions on what should and shouldn’t be in the tax return! Since then, we have been working to get our new client on the straight and narrow, once again paying tax in arrears and working with her IFA to understand if there might also be LTA issues and how we might mitigate a breach of the threshold.

Further reading on the Annual Allowance and the Lifetime Allowance:

  • nhsnss.nhs.uk/member-hub/annual-allowance

  • nhsnss.nhs.uk/member-hub/lifetime-allowance

  • www.gov.uk/pension-schemes-protect-your-lifetime-allowance