Around the world we Brits are known for the poor state of our teeth. Compared to our cousins in North America we are generally way behind in whiteness and general dental health

So have you been to the dentist recently? Can you even find an NHS dentist taking on new patients in your area? What do you plan to do if you have an urgent problem? Some dental patients are having to use emergency dental services after one in 10 of England's 21,000 dentists left the NHS at the start of April 2006 after rejecting a new government contract. With local health employers struggling to replace them, patients are told to ring help-lines then told of dentists accepting NHS patients - in some areas this is a minority as many as four in five are not accepting new patients - or diverted to services aimed at out-of-hours care.
With the introduction of the new contract, the responsibility for commissioning dental services has been taken on by Primary Care Trusts but many dentists are unhappy with the deal offered, leaving Primary Care Trusts’ unable to open new practises in place of the ones that have gone private.
This could be explained as a simple workforce problem. Amongst the dental community there are just not enough dentists available to fill the posts. Although dental schools are full with dentists in training it could still take five years to resolve the current staffing problem. The Government insists Trusts are coping with the walkout where approximately 2000 dentists turned their back on the NHS after not signing the new contract, affecting nearly 1m patients, by recruiting graduates and using dentists from abroad. In all approximately a tenth of dental practises have closed their lists to new NHS patients, leaving 2 million unable to register with a dentist. In the short-term the new contract has not done anything to remedy this, although it is hoped that in time access to NHS dentistry will improve as primary care trusts use their new commissioning powers to encourage extra practises to open in under-serviced areas.
Early figures suggest that in England, Avon, Gloucestershire, Wiltshire, Hampshire, the Isle of Wight and the east Midlands have been the worst hit by the walkout of dentists .
The reforms were meant to introduce a simpler system of fees and reward dentists for carrying out more preventative work. But dentists have complained the deal did not live up to expectations. Dentists had said they disliked the previous system where they had to claim for every single item of treatment an outdated way of working that contributed to dentists reducing their commitment to the NHS. Under the new contract, dentists are being paid a guaranteed income for the next three years for doing 95% of the courses of treatment they have done in the past.
The number of dentists in England has actually risen; from 12,360 in 1976 to nearly 21,000 in 2006 and of that number almost all do a mix of NHS and private work. The problem is that many have reduced the amount of work they do for the NHS, complaining that they are not paid enough to make it worth their while. Instead, they have gradually increased the amount of the much more lucrative private work they do.
As a result, the value of private dental work rose from £289m in 1995 to over £1bn six years later. This drift away from NHS provision has led to some surgeries refusing to take on new NHS patients, and others scrapping their NHS commitment altogether. We have now reached the point about half the population - 17m adults and 7m children - are currently not registered with a dentist.
So what are we going to have to pay? Under the new contract this is the 3-scale fee plan:
£15.50 - Will cover a check up, diagnosis and preventative care such as scale and polish
£42.40 - Covers all treatment in £15.50 pay band plus fillings, root canal treatment and extractions.
£189 - Includes treatment in first two pay bands and also more complex procedures such as crowns, dentures and bridges
This could be seen as an improvement as it is simplified. With the old system patients did not know until their treatment was finished, exactly how much it was going to cost as there were hundreds of different charges for different treatments. And so, yet again, whatever the new charges or plans it seems that as patients, we will have to find our way around the complexities and shortcomings of another set of directives affecting our health. Perhaps this new system will, in the end, lead to more accessible dental treatment for us all. So now in 2010, how is it all going. Pretty well I think, I have recently moved home and had no trouble in signing on for an NHS dentist. Here's hoping!