Dentists could be paid a salary, under government proposals aimed at improving NHS services.

Many patients have problems finding NHS care because dentists are doing more and more private work, and the government is looking at ways to retain them in the health service.

There are also plans to simplify the way patients are charged for dental treatment, ending any perceived incentive to dentists to "drill and fill".

Dentists are currently paid for each item of treatment they give.

Paying them a salary instead is one of several initiatives proposed in a report published on Tuesday.

Dentists are frustrated by working within a clapped out and under-funded service

Dr John Renshaw, British Dental Association

It also suggests payment by contract or a system based on the number of patients registered.

It proposes oral health assessments for patients when they visit an NHS dentist and advice on how to prevent disease.

But some critics of the report are concerned that measures, such as the extended oral health check, could lead to increased charges for patients.

The report also suggests dental care should be commissioned and funded locally, rather than nationally.

'NHS Dentistry: Options for Change' was written by a working party headed by Chief Dental Officer Dame Margaret Seward.

The proposals will be piloted at 10 sites across England over the next two years.

The British Dental Association (BDA) estimates the number of dentists earning most of their salary from the NHS has fallen from 75% in 1993 to 60% last year.

'Under threat'

Launching the report on Tuesday, health minister David Lammy said: "I am keen that we continue to keep the momentum on reform, working in partnership with the dental profession.

"NHS dentists do a valuable job and they need to be part of the wider process of NHS modernisation, including pay reform, improved working lives, lifelong skills improvement and clinical governance."

Dr John Renshaw, of the British Dental Association, said the current payment system for dentists was "well past its sell-by date".

He added: "Despite the access problems in parts of the country, dentistry remains one of the NHS's best used services which serves huge proportions of the population on a regular basis.

"But it is under threat because dentists are frustrated by working within a clapped out and under-funded service in which they struggle to give the quality of care patients deserve."

Dr Renshaw welcomed the government proposals.

"These new ideas have the potential to ensure that in the future everyone who wants NHS dental care can get it.

"By focusing more on prevention, this is also an opportunity to tackle the growing health inequalities which exist, particularly among children."

Free care call

Dr. Liam Fox, Shadow Health Secretary, said the report was an attempt by the government to divert attention away a failure to meet a pledge that everyone would be able to see an NHS dentist within two years, made three years ago.

He said: "Less than half of the population is registered with an NHS dentist, so it is farcical to talk of 'improving the patient's experience of NHS dentistry' and offering 'greater transparency for patients'."

Liberal Democrat health spokesman Dr Evan Harris said: "Nothing in these proposals will allow any new patients to register with an NHS dentist in those areas where many practices have gone private.

He added: "This plan doesn't scrap charges for dental checks.

"If the government is serious about prevention then persuading people to go to the dentist is critical and it ought to be free."