Large numbers of dentists are still disputing the controversial NHS dental contracts which came into force in April, according to Midland lawyers.
Although Government figures revealed 95 per cent of contracts in the West Midlands had been signed by the April 1 deadline, solicitors Young & Lee claim many of these remain "in dispute".
Solicitor Clare Emery, who is working for the Birmingham Local Dental Committee and up to 40 dentists, has discovered 177 of 400 dental practises are still challenging the new contracts.
Shortly after the new financial regime came into effect, regional health bosses said 356 of 372 contracts had been signed.
But Ms Emery said a number of these were signed "because they could not afford to become private practises".
Under the new contracts dentists have their spending capped, based upon the amount of work they did over a 12-month period in 2005/2006.
Ms Emery said: "This takes no account of any special circumstances and leaves many d entists, especially in deprived areas, facing a major crisis and even bankruptcy.
"We are working against the clock to help dentists negotiate their contracts with the primary care trusts that fund NHS dentistry and to take their disputes through the NHS litigation authority."
Sandwell, one of the most deprived wards in the West Midlands, is the worst hit area where only three out of 50 NHS practices have agreed their contract, while 95 per cent of dentists are contesting them. But the situation is no better in areas like Solihull, where three out of every four NHS dentists are in dispute over their contracts. More than half of dentists in the Heart of Birmingham and East Birmingham Primary Care Trusts also remain in dispute.
"The implications of the contract are that dentists are only funded to do a set amount of work and this means that patients will suffer and more dentists will be forced out of the NHS," added Ms Emery.
"It also means that some dentists who have invested heavily in practices often in the most deprived parts of the region are facing serious financial difficulties.
"These contracts run to 150 p ages and represent a bureaucratic nightmare. Managers within the NHS are out of their depth in dealing with contracts that were clearly not properly thought through."
Despite fears that a mass exodus of dentists to the private sector would leave a skeletal NHS dental service, Birmingham's Local Dental Committee remained adamant this was not a case of "dentists being greedy".
Eddie Crouch, secretary of the committee, said: "This is a point of principle that we're given the necessary funding to enable us to treat local patients properly.
"I have 270 children in braces at my Acocks Green practise and the £52,000 I've got for my contract is only just enough to treat them all.
"I certainly can't take on any more patients, and some colleagues are having to 'ration' treatment to ensure their budgets last all year."
He added: "While practises in affluent areas like Solihull can afford to opt to go private, I have colleagues in inner-city surgeries who are struggling to pay their staff, let alone treat patients, as a result of these new contracts. Unfortunately it is the areas which really need access to NHS services that are being hardest hit, as those communities cannot afford to go private so they're being forced to wait."
