Latest figures show 141,000 fewer Midland people have gone to an NHS dentist since the controversial new dental contract shook up the system three years ago.

The surprise drop in numbers and a surge in extractions have raised concerns that the region will return to a pre-war era when most people had dentures.

Department of Health statistics show that in the 18 months following the introduction of the contract in April 2006, Birmingham NHS dentists saw 66,000 fewer people, there was a 19,000 reduction in Worcestershire and Solihull dentists’ numbers were 13,000 down.

Numbers of patients dropped by 11,000 in Warwickshire, 9,000 in Dudley, 6,000 in Sandwell, 10,000 in Wolverhampton and there were 7,000 less in Walsall.

Coun Deirdre Alden, chair of Birmingham’s Health Scrutiny Committee, said: “This sounds like we are stocking up problems for the future. Our parents’ generation had dentures and greater care has been taken over teeth since then but we will see a return to those old days.”

Eddie Crouch, secretary of Birmingham Local Dental Committee, said numbers of complex treatments by dentists to save teeth, such as crowns and root fillings, had dropped in recent years, but tooth extractions had risen.

He added that queues at Birmingham Dental Hospital, where treatment is free, were also at their worst.

Mr Crouch believes the new price brackets for all treatments made it expensive for more detailed treatment and were acting as a deterrent to have teeth checked. A patient has to pay £45.60 for a tooth to be taken out but £198 for crowns, bridges or dentures, while a checkup and polish costs at least £16.

Some private practices are now offering more competitive prices although there are fears many people are avoiding going to see a dentist at all.

“This contract has taken us back a generation,” said Mr Crouch. “Dental Hospital bookings are the worst they have ever been. This contract has too many simplifications. There are 400 types of treatment which are now in four price bands.”

Mr Crouch said ten per cent of Birmingham dentists, or 40 practitioners, had left the NHS when the new contract came into force, with more following.

Dentists were in uproar over the contract which changed the way dentists were paid, with critics saying it was more profitable for a dentist to take out a tooth than try to save it with complex, lengthy procedures.

A Commons health select committee has heard that since the contract was introduced, extractions have increased by 18 per cent nationally in two years while numbers of complex treatments have fallen by 57 per cent during the same period.

Figures show that there has been a 30,000 drop in numbers going to see an NHS dentist within the Heart of Birmingham Primary Care Trust area of inner-city Birmingham. There were 11,000 fewer people seen across north and east Birmingham and a 25,000 reduction across the south of the city.

Ros Hamburger, consultant in dental public health for the region, has said there are still a lot of NHS dentists taking on new patients in Birmingham and that some dentists were returning to the NHS due to the credit crunch.