PROPOSED reforms of NHS dentistry carry significant risks and could even reduce access for patients, a report from the National Audit Office (NAO) warns today.

The NAO's study to Parliament cites uncertainty among dentists about how the new system will work when it comes into force next October.

It also says there are concerns over the lack of experience of primary care trusts in dentistry.

Worryingly, given the shortage of dentists in the £3.8bn industry, the NAO says: "Given the scepticism of some dentists compounded by a lack of detail on how the new system will operate, there is a risk that dentists will reduce their NHS commitments."

Amid Government claims that the plans would see two million NHS places created, the British Dental Association agreed with the NAO it was "make or break" time for state provision.

It also said it had been telling the Government for some time that NHS dentistry was at crisis point and botched changes may well push it over the edge.

The crisis in NHS dentistry in some parts of the country has seen long queues forming outside new practices.

In February, hundreds of people queued in Scarborough, North Yorkshire, to register with a new NHS dentist.

The NAO report also reveals that only 45 per cent people in the North find it easy to make an appointment with an NHS dentist, the lowest proportion in the country.

An earlier review by the Department of Health found there would be a shortage of 1,850 dentists by last year and the Government produced a raft of plans to combat the shortfall.

These included increasing the number of training places, recruitment to fill 1,000 new posts, and opening 47 new NHS dental access centres in areas where people experienced difficulty.

By next October, new three-year contracts - rather than the current payment-per-treatment system - will come into force for dentists who want to offer care on the state.

But the NAO points to a risk of under-treatment in the new system, rather than the over-treatment which can occur in the current system.

Patient lists tend to be longer in the North, making it difficult for them to get more individual treatment on the health service, according to the NAO.

Dentists working in County Durham and the Tees Valley have an average of 1,369 patients - the largest lists in England.

Bridget Read, spokeswoman for Scarborough, Whitby and Ryedale Primary Care Trust, North Yorkshire, said an action plan introduced earlier this year had been effective.

"In total, an extra 1,200 patients have been allocated to dentists in the Scarborough area," she said.

A recently-recruited Polish dentist is due to treat about 2,000 patients and she will soon be joined by a Lithuanian colleague.

By October next year, an extra 11,000 patients should be registered, said Mrs Read.