For years NHS patients have been used to going back to the dentists every six months for a check-up.

That is likely to change after April 1 when the new NHS contract comes into force.

The great majority of dentists in the region will continue to operate as part of the NHS, but how they are paid and the priorities they have will change.

The Government is keen to see NHS funds being spent on improving access to the portion of the population -approximately half -who are not registered with a dentist.

To do this, the Government will encourage dentists to delay routine checks for the "worried well", those who have good dental health and have looked after their teeth.

This means people who rarely have fillings may not be recalled for a year or even longer.

The Government hopes that this will free up more time so that NHS dentists will be able to see patients with dental pain, who currently find it difficult to find a dentist.

Another change that will surprise many NHS patients is the introduction of three bands of charges, setting maximum prices for different levels of treatment.

For most people who pay for NHS treatment, this will mean a check-up, which could include scaling and polishing, would cost £15.50.

The second band of pricing would mean basic treatment, such as fillings or extractions, costing £42.40.

To sweeten the pill, the maximum charge for a complex course of treatment will fall from £384 to £189.

While a small but significant number of previously loyal NHS dentists are going private after April 1 - more so in parts of North Yorkshire than County Durham and Teesside - local primary care trusts (PCTs) will now be able to hang on to NHS fees which would have gone to those dentists who have left the health service.

David Landes, dental advisor to County Durham and Darlington PCT, explains.

He said: "We will be able to recycle this money to provide more services in the areas where they are most needed.

"This could range from paying for an extra part-time dentist at an existing NHS practice, to signing a contract with a private provider who could come in and build and staff a new dental surgery."

Under a pilot system which gives a taste of things to come, a new practice has been established in Coundon Health Centre.

Coundon, near Bishop Auckland, is a relatively deprived part of County Durham where local people have struggled to find NHS dental care.

After signing up to the new way of working - which replaces a complex system of piecework payments with a regular monthly payment - the Burgess Hyder Dental Group opened a new practice in Coundon.

Dr Az Hyder, who jointly owns the practice with colleague Dr Martin Burgess, said: "The new system allows us to inwardly invest and attract dentists to this area. It has allowed us to grow and expand our service."

Dr Hyder said the patients were "over the moon" to have an NHS dentist on their doorstep.

But some North-East dentists are less impressed.

Robin Turbitt, chairman for the Durham Local Dental Committee, admitted that most of his members had signed the new contract but said most regarded themselves as "in dispute" with the NHS.

Apart from regarding the new banding system of charges as unfair, he thinks the changes will not be in the interests of most of his regular patients.

"There is no continuing care any more once patients sign off from treatment. You are not registered with a dentist," he said.

The Darlington dentist predicted that the new way of working would soon run into trouble.

"I personally think there are so many flaws in the new system that it will be unworkable."