Half of England's dentists cannot see unregistered patients urgently for toothaches despite a pledge by Tony Blair six years ago, a report says.
People could be left in pain or their general health threatened, says Which?
Consumer group Which? contacted 321 practices asking if they could get an NHS appointment within 24 hours.
Just under half were unable to offer one in this time frame, even privately.
Which? says many struggle to register with an NHS dentist, despite the pledge everyone would have access to one. The government said it was taking action.
But the British Dental Association said dentistry was chronically underfunded and understaffed.
Six years ago, the prime minister pledged that everyone would be able to access an NHS dentist.
But Which? found more than half of the people who tried to register with an NHS dentist in the last two years found it difficult, equating to more than 4m people.
Which? heard from one woman who was seven months pregnant when she suffered a severe toothache for a week.
She said she was unable to get an appointment and when she rang NHS Direct they said the nearest NHS dentist that could register her was 48 miles away.
She ended up being seen in A&E with a tooth infection which, if untreated, could have harmed her own health and that of her unborn child.
Frances Blunden from Which? said urgent action was needed.
"Unless these issues are tackled properly, there's a real danger that people up and down the country will be left in pain or their general health seriously threatened."
On the up
But Health Minister Rosie Winterton said things were being done to improve the situation.
"All primary care trusts have action plans to enable more people to see an NHS dentist, and some include the international recruitment of dentists.
"There are some 200 internationally recruited dentists already working in the NHS.
"This is a way of easing problems in the short term, but is just one part of a huge programme of reform which includes unprecedented investment, new ways of working, 1,000 extra dentists by October and 170 extra undergraduate training places starting this year."
John Renshaw, chair of the British Dental Association, said: "NHS dentistry is in crisis and... if anything, the situation is getting worse.
"While spending on the NHS overall has increased by 75% over the past 15 years, spending on NHS dentistry has increased by just 9%.
"With this chronic under-investment, alongside a shortage of around 3,000 dentists nationwide, it's hardly surprising that patients are experiencing such difficulty in accessing NHS care."
Steve Webb, Liberal Democrat health spokesman, said: "This report provides further damming evidence of Labour's failure to guarantee nationwide access to NHS dentistry.
"Urgent action is needed to prevent NHS dentistry becoming a thing of the past."
And Shadow Health Secretary Andrew Lansley added: "Access to NHS dentistry has collapsed and not just because of the lack of dentists. Labour have failed to establish a contract, which makes it worthwhile for a majority of dentists to offer NHS dentistry."
I have been going to the same dentist for nearly 20 years. My dentist recently sold the practice to the NHS so that he could spend more time treating patients instead of doing paperwork. However he has witnessed such an appalling lack of patient care, saying that it's all based around getting in as much money as possible and has reluctantly decided to leave and set up a new private practice some miles away.
I went to a dentist as a private patient and was told I needed extensive work to remove a wisdom tooth and have braces fitted. I agreed with the treatment as I was in pain. A month later I was made redundant and went back as an NHS patient. He barely looked in my mouth and decided everything was fine. I still need the treatment but know that as an NHS patient I am not worth spending any time on for these dentists who can earn so much.
Katy, London, UK
My dentist went private in April and I had no choice but to stay with the practice as there isn't a single practice in Cumbria accepting new adult NHS patients. Not much sign of the "action plans to enable more people to see an NHS dentist" round here!
GM, Cumbria, England
What is appalling is that there are many dentists coming through and then immediately going into private practice. The system is a shambles. In my area I think there are only three NHS dentists but non can offer a booking within two weeks let alone 24 hours!!!!
I was registered with an NHS dentist, and last week attempted to schedule a check up. Apparently they can't see me for 6 months, and by then my 15 month period will have expired (you must visit every 15 months), so effectively they have offloaded me, even though I attempted to make an appointment months before this limit.
Graham, Woking, Surrey
Use the economics and consider going abroad for dental care. Despite early misgivings I had treatment in Kiev, Ukraine for canal filling on 3 teeth at one tenth of the cost. The service was excellent, the clinic very new and the dentist very professional. Why wait and put up with poor quality and expensive treatment here?
Five years ago my dentist adopted a 2-tier system, excellent treatment if you paid for it, minimal treatment under the NHS. Since 2 years ago he ceased to undertake NHS work. Fortunately I am a pensioner so I am free to travel, I now visit a dentist in Slovenia who has a very modern surgery, is cheerful and friendly, and does excellent fast work at a fifth of the cost in the UK. Thanks in part to a well known low cost airline, I can now have a two week holiday every year in a beautiful country paid for by the difference in price between treatment here and treatment there.
If being a dentist is such a cushy number then why aren't all the taxpaying whiners signing up for training paid for by said taxpayer? Can't say that I would like to spend eight hours a day peering into foul smelling orifices, not even if I got a Porsche out of it. First dentist I called took me on as a NHS patient without any drama. He's only got a Mondeo so maybe he isn't any good?
Pete R, Bristol, UK
What has happened to NHS dentistry will be repeated for the NHS as a whole over the next 5 - 10 years. Enjoy your 'free' healthcare now as you'll have to pay privately for much of it in future.
Dr M, Bury St Edmunds, UK
My partner broke a tooth about 2 months ago, we cannot afford to go private and although he is in agony a lot of the time has to wait until the end of May for an NHS appointment. This is appalling treatment and my partner has even considered pulling the tooth out himself.
Heather Claase, Rushden UK
From what I read above there is a lot if ignorance. My wife is an NHS dentist. She needs a day off a week because standing in the same place working for 8 hours a day wrecks her back. She gets paid half of what a GP gets paid. She gets abuse from people with rotten teeth who blame her. It's like charity work and I am trying to persuade her to leave the NHS and earn a good salary and be able to provide a better service to patients.
There needs to be a fundamental review of just what we expect of our dentists. 95% of dentists practising in the UK were trained by the NHS an yet as soon as they qualify they are not obliged in any way to put anything back. It is fair to say that NHS pricing doesn't allow dentists to do the best for their patients but the real issue here is that the dentists just can't earn enough on NHS. It would be hard for anyone to convince me and I suspect most of the population, that people become dentists for anything but the money. If a private Dentists is earning less than £100K pa then in my view they are either incompetent or liars. Do some research on Dentists earnings both on NHS and Private practice. I know which I would rather have.
Gary Waylett, Bournemouth UK
At present it is not possible to register with a dentist as an NHS patient in the whole of Dumfries and Galloway. I understand that this is recognised by the local PCT, who are trying to address this problem. Why should one have to pay to go private after many years payment of National Health Insurance?
John Frew, Kirkcudbright, Scotland
My partner and I are both young (21 & 23) hardworking individuals on fairly low incomes. My partner has had toothache for about six months now and the only option we have is an emergency clinic at a hospital 15 miles away where you still have to wait over a month to get an appointment. We can't afford any treatment due to the government's unfairness towards anyone under the age of 25 and he has to have a permanent ache until we can raise the money for treatment
Sarah Chappell, Cullompton, Devon
I have been suffering toothache for the last couple of weeks and I tried to book an appointment on Monday and unless I could go in the day I was looking at July before I could be seen. I have ended up having to use my brother's appointment next week in order to get seen, and he has had to re-book, but it is still a week and a half after I wanted to be seen.
Helen, Leeds, England
It's totally unacceptable for the Health Minister to claim 'things are being done to improve the situation'. We are not seeing any improvements where they are needed. This is just more spin.
AMcR, Stirling, UK
170 extra dentists a year when the is a shortage of 3000 dentists!- no worries then, it will be all right in about 21 years. Come on Tony - get your act together.
Peter, Preston UK
Will the plans outlined by Rosie Winterton include measures to persuade the new influx of dentists to work for the NHS? Or will they too prefer to opt for the more lucrative private practice market?
Steve Pauline, Warrington, UK
Is it significant that many dentists only work a 4 day week? They are making such good money working in private practice that they can afford to do this. The average dentist appears to regard the mouth as an open cash drawer.
John Plank, Crawley Down, England
The public wants results from the Health Minister NOW. Blair has had 6 years to sort it so it should have been sorted out by now. Or is it a case that they just don't care about their voters who elected them? Next general election the voters may literally be toothless voters!
Gary Hook, Whittlesey
It's an appalling situation, and dentists aren't helping. My family was NHS registered, then we got a letter informing us that they were turning private only, but would continue treating our son on NHS as long as my wife and I signed up as private patients, which I find an ugly way to do business. Either the practice takes NHS or not, not just limiting to kids of private patients. I'm fed up with the whole lot of 'em, government and greedy dentists. Now we can't find any dentist in the area that has NHS places and have been told the nearest is 40miles away.
Wayne, Milton Keynes
I contacted 12 dentists in my local area and not one of them could take me as an NHS patient. I since have had to pay over £1m200 for treatment of 2 teeth for canal root treatment. I would be glad to see more NHS dentists in all areas.
Jane Addison, Beckenham Kent
I have three local dentists which will not take me - even if I could begin to afford them NHS or privately. We paid to train them - and yet we are denied access. They have new Porsches and Audis and have several very long holidays abroad each year. Something is horribly wrong here - this government has failed us dramatically.
Andy Coombes, Glos
As far as I understand it, newly qualified dentists are only required to work as NHS dentists for a short time. Maybe this time should be increased as their education is subsidised by the government/taxpayer?
Grant, Newcastle, Staffs
My dentist is going private in August and he will give preference to patients who sign up for a dental plan. Being a pensioner this is bad news, but who cares about pensioners anyway? It is a very selfish world we live in today.
Where I live there isn't an NHS dentist accepting patients for dozens of miles in every direction. Even those providing private treatment have waiting lists for people just to be registered. I recently required treatment and had to go privately, in London. It ended up costing me thousands of pounds otherwise I would have lost several teeth. The NHS dentistry provision in my county, and the country as whole, is an absolute disgrace.
Tony White, Downham Market, Norfolk, UK
At the time of writing, I have toothache. On the 27th December 2004, I was seen by an NHS dentist, who informed me I had a wisdom tooth that needed extraction, and that he would refer me to the hospital. In April I was seen by a dentist in the hospital who confirmed what my dentist had said, and promised I would get an appointment within the next few months. It's now May 19th, I have had toothache for over 5 months! Just how difficult/expensive/ time consuming, is it to pull a tooth?
Paul O'Connor, Manchester
This is absolutely pathetic! I am an overseas dentist, fully registered after undergoing strict re-qualification exams in the UK. I also have a Ph.D. I paid for all my exams and did not receive any sort of support in order to get re-qualified. Despite all this I have been unable to find a job as a dentist due to the absurd requirements imposed during the selection processes for NHS jobs. In the meantime some so-called authorites within the NHS, obviously interested in promoting themselves, go to India and recruit newly qualified dentists who have not been tested in the UK and give them all the support denied to those, who like me, are legal residents and taxpayers.
Whilst at university in York I tried to register with an NHS dentist. The nearest ones I could reach without a car were in Leeds. This meant I was without a dentist for the 4 years of my course. This is unacceptable and I expect the government to put more money into NHS dentistry to entice dentists back.
Nancy Smith, London, England