Birmingham doesn't have a problem with the total number of NHS dentists available, only with the locations of services.

'Some people have never accessed NHS dentistry, 'says Ros Hamburger, consultant in dental and public health with Birmingham health authority.

In March, the HA decided to tackle the problem by merging its former community dental service and its emergency dental service, run from the dental hospital, to form a personal dental service scheme. This offers treatment to disadvantaged children and their families, and has taken on the equivalent of two new dentists in salaried posts.

The problems were on housing estates such as those in King's Norton. 'It was less attractive for dentists to set up in those areas, 'says Ms Hamburger.

After initial treatment, families are referred to an NHS dentist who has agreed to accept new patients.

'We have asked for dentists to volunteer to do this, 'she says. 'The dentists have been extremely helpful. '

It is too early to judge the results, but Birmingham is also working out, with NHS Direct, how it will monitor the level of NHS dental services available in the area. This will include:

regular feedback on callers unable to access a dentist after calling NHS Direct;

surveys to record the proportion of NHS work that dentists are carrying out;

random checks on dentists working in areas where it is known to be difficult to get NHS treatment, including the borders with Warwickshire, Solihull and Worcestershire.