This study investigated the use of the FDI tooth notation system in UK dental schools. In addition, the notation system used by dentists referring patients to Manchester Dental Hospital was recorded. A questionnaire was sent to the Deans of all Dental Schools in the UK and letters of referral to Manchester Dental Hospitals Paediatric GA Service were monitored for 1 month. The results showed that only Manchester University Dental School used the FDI system but 6 other schools instructed students in its use. The Palmer system was used by all the other schools for recording clinical information. 136 referral letters were received, only one used the FDI notation, 15 used both FDI and Palmer and the remainder (120) requested extractions using the Palmer notation. The FDI notation system is not used in the majority of UK dental schools. Despite the fact the Dental School in Manchester has been teaching and using the FDI system for over 10 years, it has not been adopted by General Dental Practitioners referring patients into the hospital. The FDI should review the use of their system in other countries, to ascertain whether it has fulfilled its role as an international notation system.