Dramatic rise in dental patients having teeth taken out - because it is cheaper than fillings

More patients are having teeth taken out since the Government's 'botched' dental contract came in two years ago.

The number of dentures fitted has gone up, following warnings that the new system favours quicker, old-style dentistry over complex procedures.

Figures from the NHS Information Centre released on Thursday also show for the first time that more than 1.1million fewer patients are seeing NHS dentists in England.

But it is the changes in patterns of treatment that are causing most concern, with the British Dental Association (BDA) calling for an urgent investigation into the crisis.

Dentists used to be paid a fee for individual treatments but now get an annual income for carrying out an agreed amount of work organised into three bands.

Since the contract was introducedin April 2006 there has been a continuing fall in the most complex 'Band 3' treatments such as crowns and dentures, against a 10 per cent rise in treatments across the board.

Treatments that included dentures increased from 38 per cent to 48 per cent between 2003/4 and 2007/8, while extractions have gone up from 7 to 8 per cent.

The number of crowns fell from 40 to 35 per cent and fillings from 28 to 26 per cent in England.

Treatments classified as 'urgent' have also shot up by almost nine per cent in the last year, suggesting more people are leaving their dental care to the last minute.

Similar trends were reported in Wales, although there was no increase in denture work.

In a highly critical report, the Commons Health Select Committee last month claimed dentists have no financial incentive to give appropriate treatment that is more complex and takes longer.

Indeed, it is feared people are having their teeth pulled out because it is quicker than prolonged treatment yet attracts the same fee.

The number of patients seeing an NHS dentist during the two years since the contract started was 27,049,000, down from 28,145,000 in the two years prior to March 2006.

The figures show 20,815 dentists offering some level of NHS work during the second year of the contract, up 655 on the first year. However, the

British Dental Association estimates that more than 1,000 quit the NHS when the contract came in.

Costs to the NHS for dental treatment increased by £56million to £531million in 2007/08, an increase of 12 per cent over the previous year.

Susie Sanderson, chairman of the BDA's Executive Board, said: 'These reports provide further evidence of the persisting problems with the 2006 NHS dental reforms. 

'More than a million people have now lost access to NHS dental care.

'Those that are able to access care are confronted with a system that discourages modern, preventive care by placing targets, rather than patients, at its heart.

'This is difficult for dentists, who want to focus on providing the best possible care for their patients.

'The apparent change in treatment patterns is also of concern and requires further investigation so that the impact of the new contract is fully understood.

'The Government must take note of what these reports, patients and the profession and even the Health Select Committee have told them and act to resolve the issues facing NHS dentistry in England and Wales.'

Tory health spokesman Mike Penning said: 'Since Labour introduced its botched, untested new contract, well over a million people have lost access to their NHS dentist. Despite Labour's claims, the decline is continuing.

'It is a shocking display of incompetence by the Government. Labour Ministers need to stop dithering, admit that their new dental contract has been a complete failure, and take action to make good their pledge to give everyone access to an NHS dentist.

'The figures indicate that even where people can find an NHS dentist, they are now increasingly likely to have teeth removed or be fitted for dentures.'

Liberal Democrat health spokesman Norman Lamb said: 'The crisis in NHS dentistry is Labour's hidden legacy.'

But the Government's Chief Dental Officer, Dr Barry Cockcroft, said: 'The latest figures show that NHS dentistry is on the road to recovery.

'We have more NHS dentists this year compared with last year.

'The critics who claimed there would be a mass exodus of NHS dentists under the new contract are being proved wrong.

'Oral health of the nation has improved dramatically over the last ten years thanks to fluoride toothpaste, fluoridated water and greater awareness of the importance of oral hygiene.'