Up to one million people in England are about to lose their NHS dentist after one in ten practitioners refused to sign up to new contracts with the Department of Health.

Around 2,000 dentists are to withdraw from providing NHS treatment in England after they refused to sign the new contracts, the government admitted today.

The British Dental Association (BDA) said the figures confirmed their predictions that one in 10 dentists would reject the contract, adding that "everybody" knows there is a problem.

But Rosie Winterton, a Health Minister, insisted that the effect would be limited as most of those rejecting the contracts had been treating only a small number of National Health Service patients.

She said that many local primary care trusts had already found other dentists to cover the resulting gaps in provision, and that others were in the process of commissioning extra dental services.

"Claims that dentists would leave the NHS in a mass exodus were unfounded," she added. "Around nine out of ten dentists have signed up to the new contracts, and these dentists make provide around 96 percent of current NHS dental services."

Ms Winterton admitted it would take a while for the new reforms to "bed down" but said she was confident the new system would see more people able to gain access to an NHS dentist.

The contracts, which had to be signed by the end of last month, are part of the most radical reform of NHS dentistry since the service was established in 1948. Instead of being paid for each NHS treatment they carry out, dentists are given a guaranteed income estimated to be about £80,000 a year for three years. Dental charges have also been simplified into three pay bands to replace the old system, which saw around 400 separate payments.

The changes are designed to tackle a shortage of NHS dentists which has left around 2 million people who want NHS dental care unable to obtain it. For the first time, primary care trusts have been put in charge of dental funding, meaning they have the ability to replace dentists who quit or move out of their area.

But many dentists say they are unhappy with new arrangements which require them to complete a target amount of work to get a fixed income. The BDA said the new terms were worse than the system being replaced, where dentists were paid for each piece of work.

The figures released today show that, to date in England, 8,323 of the new contracts were signed and 1,096 were rejected. Some contracts represent more than one dentist.

Avon, Gloucestershire, Wiltshire, Hampshire, the Isle of Wight and the West Midlands are the worst hit by the walk-out, the statistics suggest. Under the new system, the Hampshire and the Isle of Wight Strategic Health Authority currently has service provision of 87.5 per cent. In Kent and Medway, and the West Midlands South area, the level is 90.3 per cent.

Health officials say that overall, dentists in England have rejected around 11 per cent of the NHS contracts it had offered, and a further 30 per cent of the contracts have only been provisionally agreed, with some terms in dispute. The BDA believes that the proportion of disputed contracts is closer to 60 per cent.

Dr Barry Cockcroft, the acting chief dental officer, tried to allay fears, saying that it was "utterly unlikely" that the 30 per cent of contracts which the Government admits are in dispute would end up being rejected by dentists. He acknowledged there had been a degree of anxiety about the new contract but said some of it was due to "misleading and inaccurate impressions" of the reforms.

The BDA said however that it was "astonishing" that losing one in 10 dentists could been seen as a good thing. "Only Pollyanna could see this as a vote of confidence in the new system," said Susie Sanderson, the chairman of the BDA’s Executive Board.

Andrew Lansley, the Shadow Health Secretary, said that 24,203,150 people were registered with an NHS dentist as of last September.

"The 4 per cent decline in NHS dental provision revealed today by Rosie Winterton represents a decline of almost one million in the number of people registered with an NHS dentist, and a decline of almost three million in the number of dental treatments offered on the NHS," he warned.

"Even those patients lucky enough to find an NHS dentist will find themselves paying three times as much for a basic check-up under the new contract."

Steve Webb, the Liberal Democrat health spokesman, said: "If the Government thinks that NHS dentistry is in a good state, they are living in cloud-cuckoo land.

"The long-term future of NHS dentistry looks bleak unless the Government urgently review the new contract. Without a change of heart by the Government, NHS dentistry will be entering a terminal decline."

Michael Summers, chairman of the Patients Association, said he hoped the new system would make it easier for people to find an NHS dentist. "Patients have to travel many many miles sometimes to find an NHS dentist who will give them treatment," he added.

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