New dentist era 'has not emerged'

Contract reforms were designed to improve NHS dentistry

The shift from "drill and fill" dentistry to a more preventative approach has failed to materialise, the head of an inquiry into dentistry says.

The new contract in 2006 was meant to give dentists in England more time with patients to promote oral health.

But Professor Chris Drinkwater, who is carrying out a review for the British Dental Association, said in many areas that was not happening.

The government said preventative dental health was improving however.

The 2006 deal, which has subsequently been implemented in Wales, promised dentists the same income for doing 95% of the work they had traditionally done as well as simplifying the NHS fees system for patients.

We need to look at what we are doing and whether it could be improved Professor Chris Drinkwater, head of the review

Ministers said this would allow dentists more time to talk to patients about good dental health practices.

But Professor Drinkwater, who is president of the NHS Alliance, an influential group which represents NHS staff working in the community, said: "It seems reasonably clear that the contract is not allowing a more proactive approach to preventative dental health.

"In some areas it could be because of the way the contract is being implemented and there may also be an issue with funding.

"Clinician engagement is also problematic. It is something that needs addressing."

The review he is leading was set up last month as an independent commission into NHS dentistry. It is expected to produce a final report in September this year.

Pilot

Professor Drinkwater said he would be talking to a range of experts, including local health bosses working for primary care trusts and dentists, about how the NHS could get more out of the contract.

"We need to look at what we are doing and whether it could be improved."

The setting up of the commission comes after the publication of a critical report by the House of Commons' Health Committee last year.

The cross-party group of MPs said access to dentistry had not improved and the 2006 changes should have been piloted better.

Even when it was introduced it was not popular among the profession, prompting 1,000 dentists to either retire or move totally to private practice - although the numbers have since been replaced.

But the government, which is also carrying out its own review, said preventative health care had "increased substantially".

Chief Dental Officer Barry Cockcroft added: "Prescription of high concentration fluoride toothpaste rose by 133% in 2006-7 and sales of topical fluoride varnishes have increased dramatically."