Primary care trusts successful at commissioning dental services should be able to take over from those that are failing, says the Patients Association.
The organisation claimed a survey of PCTs revealed a postcode lottery for NHS dental care and "a lack of creativity in commissioning".
It called for new best practice guidance and said there should be more scope to intervene where commissioning was "poor or weak".
Association vice chair Michael Summers said it showed NHS dentistry was in crisis. "If some PCTs have been so ineffective in commissioning dentistry, you have to think, could someone else do it better?" he said.