Dentists may be deliberately misleading their patients about their NHS entitlements to prompt them to pay for private care, a watchdog has said.
Half a million patients a year may have unnecessarily paid to receive private dental treatment after receiving inaccurate information from their dentist about health service entitlements, an Office of Fair Trading (OFT) study found.
Patients are given insufficient information to make informed decisions about their choice of dentists and the treatments they receive, and the dental industry is not always working in their best interest, the report said.
The OFT, which enforces consumer protection law and competition law, has called for major changes to the dentistry market in the UK after the study also raised concerns about restrictions preventing patients from directly accessing dental care professionals, such as hygienists, without a referral from a dentist.
These restrictions are unjustified and likely to reduce patient choice and dampen competition, the OFT said.
John Fingleton, chief executive of the OFT, said: "Our study has raised significant concerns about the UK dentistry market which need to be tackled quickly in the interest of patients.
"All too often patients lack access to the information they need, for example when choosing a dentist or when getting dental treatment.
"We also unearthed evidence that some patients may be receiving deliberately inaccurate information about their entitlement to NHS dental treatment, and we expect to see robust action taken against such potential misconduct by dentists."
"This study has also highlighted that the current NHS dental contract in England may well not be working in the best interests of patients, and that regulations unjustifiably restrict patients from getting direct access to dental care professionals like hygienists.
"Reform in both these areas is needed without delay."
It is difficult for new dental practices to be established and successful practices offering a high quality of service to NHS patients are prevented from expanding because of the structure of NHS dental contracts in England, the report said.
The majority of contracts are not time-limited, and only a small volume of new contracts are put out to tender each year, the OFT said.
The watchdog also expressed concern about the complexity of the complaints process for patients and instances of dentists pressuring patients to buy dental payment plans.
The British Dental Association has since agreed to develop a robust and effective code of practice covering the sale of such plans.
The OFT said it is calling on NHS commissioning bodies, the General Dental Council and the Care Quality Commission to enforce existing rules requiring dentists and dental practices to provide timely, clear and accurate information to patients about prices and available dental treatments.
It called for the General Dental Council to remove restrictions preventing patients from making appointments to see dental hygienists, dental therapists and clinical dental technicians directly as soon as possible.
It also urged the Department of Health to redesign the NHS dental contract so new dental practices could enter the market and successful practices could expand, saying it was not convinced indefinite contracts to supply NHS dentistry are in the best interests of patients.
The complaints system should be made simpler and less time-consuming for patients and dentists to resolve grievances, the report added.
Health Minister Lord Howe said: "We welcome this study which has found that the vast majority of patients are happy with their dental treatment, and that the vast majority of dentists behave ethically.
"However, denying patients care on the basis of misinformation is a very serious matter. Any dentist that does this risks breaching their contract and we would expect the local NHS to take action.
"Since May 2010 an extra one million people are now seeing an NHS dentist, and we are strongly committed to increasing the skill mix, making sure patients can see the right dental professional at the right time.
"This is why we support the study's finding that patients should be able to have direct access to the appropriate dental care professional.
"We are currently piloting elements needed to design a new dental contract. These pilots will help establish a better basis for a system where patients can see the right dental professional when they need to."
Dr Susie Sanderson, chair of the BDA's executive board, said: "Research by bodies including the regulator of dentistry, the General Dental Council, confirms that the vast majority of patients are happy with the care they receive. The Office of Fair Trading's own research also confirms this to be the case.
"Where patients do have concerns about their care, it is clearly important that they have an effective complaints process. This is helpful for dentists and patients alike and dentists support the goal of making the process as simple as possible.
"The delivery of effective dental care is all about good communication between dentists and patients. That communication will not be enhanced by the OFT's headline-grabbing approach to publicising this report. That it has chosen to ignore what it knows about patient satisfaction and instead focus on a very small number of cases where it believes it has identified problems is disappointing.
"This report treats dentistry purely as a market, and dental care as a commodity. In doing so, it has taken a simplistic view of dental care that fails to take into account the huge sums of money dentists invest in surgeries and ignores the unique role in screening and diagnosis that dentists are trained to perform.
"Dentistry is not a commodity; it's the delivery of healthcare to real patients. Failing to understand that serves neither dentists nor patients well.
"Also crucial is the development of a new dental contract which is already under way in England. In piloting and designing those new arrangements Government must ensure that it provides clarity about what the NHS offers and properly supports practitioners in providing the kind of modern, preventive care that our patients deserve."