Fining patients for missing dental appointments is one of the proposals published by the Conservative Party, which has outlined its reforms to NHS dentistry. The party claims its proposals would cut down on wasted appointments and increase access to dental care.

The proposals include reforming dentists' contracts to provide incentives to provide preventive care, and plans to spend £17 million to allow all five-year-old schoolchildren an oral health check-up. They would also remove barriers to setting up and selling new practices by looking at long-term deals to help dental professionals to buy into NHS dentistry, and introduce five-year tie-ins to the NHS for taxpayer-trained dentists, so that those who take public bursaries for dental training would have to do at least five years' work for the NHS in return.

The Tories would also open up commissioning to allow a wider range of professionals, such as hygienists and oral health educators, to be used to support improvements in NHS dentistry. Each NHS dentist would have a list of patients for whom they are responsible under plans to have people register with a practice, and the number of patients on the list would form the means by which dentists would be paid, replacing the current fixed treatment quotas.

John Milne, Chair of the BDA's General Dental Practice Committee, said that the dental contract had created significant problems for dentists and patients alike. 'In seeking to address those problems it will be important to afford access to dentists to all and ensure that dentists can provide modern, preventive care. Also vital is engagement with the profession in developing the detail of these proposals and properly testing new arrangements before they are implemented. The BDA looks forward to seeing those details and discussing them further.'

However, the British Dental Health Foundation called into question the proposal for free check-ups in primary schools, saying that the money would be better spent on effective preventative measures.

Foundation chief executive Dr Nigel Carter said, 'Compulsory school screenings are simply a waste of money when there are far more effective measures available. The evidence is overwhelming that school dental check-ups are not effective. Indeed, far from improving pupils' oral health they have been shown to increase existing disparities.' The Foundation believes the budget would be best spent on water fluoridation and programmes in schools for the application of fluoride varnishes and supervised brushing.