Most people in Wales do not have a dentist and dentists are wasting millions of pounds on giving the wrong services, a report has found.

The Audit Commission publication paints a damning picture of dental care in Wales, where just 45% of adults are registered.

It is critical of regulations paying dentists for each treatment, which leads to too-frequent check-up and other appointments, costing �8m each year.

Dental Facts

UK dentists paid per treatment Encourages needless visits �8m wasted in Wales on needless treatment �3.5m wasted on cosmetic appointments 55% of adults have no dentist Dentists' salary called for to solve problem

Wales already has the worst child tooth decay record in the UK. Many people are worried about dental costs.

The report from the commission criticises the "treadmill" system in which the NHS pays UK dentists �1.6bn annually, on a treatment-by-treatment basis - a "perverse incentive" ripe for exploitation.

"Many dentists feel under pressure to work increasingly hard and quickly, possibly compromising quality, in order to keep their businesses afloat," it said.

It means polishing and other cosmetic work, which has little health benefit, accounts for 11% of dentists' time and �3.5m.

That system was developed in the 1940s, when dental health was worse.

The Audit Commission suggests paying dentists proper salaries and ensuring appointments are no more regular than two or three years for adults, instead of six months, would correct the problem.

Care access problem

But the report also warns about access to any dental services at all.

"This pressure on dentists means that some leave the NHS for private practice," the report says.

Privatisation leaves some areas without dentists

"A small town can be left without NHS dental care if the main practitioner goes private."

And the commission calls for a review of dental charges so that low-income families are not deterred from seeking legitimate treatment.

Audit Commission controller Sir Andrew Foster said: "Since the creation of the NHS, we have seen a great improvement in people's dental health.

"But today's system does not provide the right incentives to ensure that the remaining pockets of poor health are tackled, or to provide equitable access.

"It needs to be changed, to become more flexible, and more focused on the needs of individual people."

The Welsh Assembly's own dental strategy will be published in the coming months.

The British Medical Association watchdog wants the body to put fluoride in water supplies to stop tooth decay.