Patients are confused and unhappy about NHS dental treatment, according to a report from the Patients’ Association.

The dental contract introduced in 2006 has failed to solve longstanding problems, it says. Funding is short, dentists are unhappy and patients are confused about access to dentists and about dental charges.

The report was published as the Department of Health announced plans to increase the number of dentists. Ann Keen, the Health Minister, said that training places would be made available to graduates in areas where dentists were hardest to find.

The first 40 places in 2009 would be in Yorkshire, the North West, the South West and South Central, which covers Berkshire, Buckinghamshire, Oxford, Hampshire and the Isle of Wight, and 170 dentists graduating every year from 2010 would also be allocated places according to need or where demand was greatest, she said.

The Patients’ Association survey suggests that it will take more than extra training places to fill the gaps in NHS dentistry. Questionnaires were sent to the chairmen and dental commissioners of 150 primary care trusts (PCTs) in England and 112 replied. The report, The New Dental Contract – Full of Holes and Causing Pain?, found problems with funding, preventive dentistry and patient satisfaction.

It said: “PCTs complain there is widespread lack of funds for orthodontics and other specialist treatments and cite this funding gap as the reason for not implementing best practice.”

As for patients, the report said: “Despite regulations requiring information to be available, they remain confused about the new contract, the charges they are expected to pay and how to access regular [as opposed to emergency] care. This is a fundamental change in their relationship with ‘their’ dentist, which has not been explained to them.”

The report found that complaints had risen and more than half of PCTs admitted there had been an increase in the number of complaints. Of these 60 per cent were about charges, 37.6 per cent were about access and 28.2 per cent were about orthodontics. It added that there was “an unacceptably variable service depending on the PCT commissioning the services” which represented “another glaring example of the NHS postcode lottery”.

Katherine Murphy, the director of communications at the Patients’ Association, said: “Patients are taxed more than ever to provide their health services and so are entitled to the best service for that money. The new dental contract . . . has destroyed the previous relationship that existed between dentist and patient.”

Figures released last week showed that 500,000 fewer patients had been seen in the past two years than in the two years before the contract came into force. The British Dental Association said that this demonstrated the failure of the contract.

Mike Penning, the Tory health spokesman, said: “Extra training places are welcome but sadly it will only touch the surface of the problem.

“If Labour hadn’t botched the introduction of a new dental contract we wouldn’t be in this situation. It’s typical of their incompetence and short-term thinking that they only bother to take action when the media picks up an issue and they’re faced with a bad headline.” Younger dentists are deserting the NHS for private practice, according to a survey. The proportion of income from NHS work earned by dentists aged under 35 has nearly halved over five years, data from the NHS Information Centre shows.

Dental deals

— Under the old contract patients registered with a dentist, who was paid by the NHS on piece-rates for the work done. This created a “drill-and-fill” mentality

— The new contract gave primary care trusts responsibility for NHS dentistry. Patients no longer need to register: they can approach any practice offering NHS dentistry and ask for an appointment

— The trusts miscalculated what the service would cost and overestimated how much would come from patient charges. As a result, money is tight

— The new contract pays dentists on the basis of “units of dental activity” (UDAs). Many have found it impossible to complete the number of UDAs they were contracted for, or have found it a slog. In some cases they have been forced to give back overpayments to the trust. UDAs are a crude measure that discourages dentists from trying to save teeth

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