Chief Dental Officer for England, Barry Cockroft, is discussing with PCTs how to stop dentists 'playing the system', recalling healthy patients for checks too frequently and dividing courses of treatment to trigger extra payments.

A Department of Health official quoted in The Independent on October 13 said: 'There is gaming (playing the system) going on and we have got to deal with it. If we don't we are losing too many appointments. The overriding public concern over dentistry is about access, not quality of service. We can't improve that when gaming is going on. If we can deal with it, it will go a long way to meeting access targets.'

'These dentists are seeing the same healthy patients a lot. Instead of recalling them every year or two they are coming back every three or four months. They are also splitting courses of treatment. It is worst in areas which have not got strong NHS provision already,' the spokesperson added.

Ending the practice of healthy patients being recalled too frequently could release an estimated 800,000 appointments, according to The Independent report. Gaming was more prevalent in the South of the country, where access to NHS dentistry was worse than in the North, but all areas were affected, it said.

In a statement the Department of Health said: 'NICE guidance says that adults with healthy teeth do not need to go to their dentist as frequently as six months if there's no clinical need. Many patients have been seeing their dentist at six month intervals for years but there is no evidence to support this as clinically necessary. The recommended NICE check-up period is every two years.'

The statement adds: 'It is a contractual requirement for dentists to apply the NICE guidance. However it is now clear from new data available to PCTs that many patients are being seen every six months or so. This effectively prevents new patients from getting access to NHS dentistry.'

In answer to a written question on dental charges from the Prime Minister's office on October 6, health minister Ann Keen said a single charge covered all the interventions identified within an NHS treatment plan.

'This applies whatever the gaps between appointments within that course of treatment,' she said. 'Additionally, if within two months of the course of treatment ending the patient requires further treatment which falls within the same or a lower charging band as the previous treatment, no charge may be made in respect of that further treatment.'

Peter Ward, chief executive of the BDA, said: 'The BDA does not have the necessary data to comment on these suggestions. The interval between patients being recalled by their NHS dentist is, according to NICE guidelines published in 2005, a matter for the practitioner's clinical judgement in consultation with the patient. The BDA supports this guideline.'

Dr Cockcroft is due to speak to the National Association of Dental Advisers conference in York on November 13.