Patients needing complex dental work might have to wait longer under new NHS targets, dentists warn.
The British Dental Association fears NHS England will impose penalties on practices that fail to reach 45% of their normal activity level, after negotiations broke down.
And practices may have to prioritise routine check-ups over more time-consuming treatments.
A check-up lasts 20 minutes – but an urgent filling takes about an hour.
An NHS official said: “The NHS and the government are working to determine a safe and reasonable contractual arrangement with dentists, which recognises the constraints on practices and the need to maximise access for patients to see their dentist.”
The waiting list for NHS dentistry could reach eight million by New Year’s Eve, according to the Association of Dental Groups.
In October, practices were at a third of normal levels, to stay Covid secure.
And NHS England data seen by BBC News shows, with a 45% target, 57% of practices would have to hand back some of the money given to them by the NHS .
In Wales, there is no target.
In Scotland, it is just 20%.
Laura Floyd, from Berkshire, was part-way through her treatment when it was cancelled because of the lockdown in March.
“As we went from April to May, I had an abscess develop on the tooth which was still awaiting treatment,” she said.
“I did receive care over the phone and a course of antibiotics, which helped ease some of the pain and swelling.
“But this never fully went away.
“I just lived with it as cautiously as I could.”
Sam Shah, who runs a number of NHS practices serving deprived communities in London’s King’s Cross and Hounslow, said: “We’ve looked at the numbers – and these targets leave the future of our smaller NHS practices in doubt.”
“It’s a simple choice between shutting up shop or upping private work.
“The patients who need us most are likely to lose out.”
Dave Cottam, who chairs the BDA’s General Dental Practice Committee, said: “This move will actively undermine patient care.
“Ministers are instructing dentists to churn through routine appointments against the clock, rather than deal with a huge backlog of urgent cases.
“Dentists wanting to do the right thing by their patients will now be punished for it.
“To stay financially viable we are being made to choose the worried well over people in pain.”
All Party Parliamentary Group for Dentistry vice-chair and Bradford South Labour MP Judith Cummins said: “I have had numerous constituents contact me in recent months completely unable to get the dental treatment they require.
“The government’s decision will make this considerably worse and threatens the viability of many local dental practices.”