HEALTH leaders have been left baffled as to why so few people are registering with state dentists in Stoke-on-Trent, even though there are now more practices taking patients than for 10 years.

The no-shows means the city's NHS is paying for slots which are not being taken up.

They are still happening despite a string of initiatives through the summer to tell the public how easy it has become to sign up at a surgery.

Now, the Primary Care Trust (PCT) is investigating which groups and areas are staying away the most so more can be done to tempt them to come forward.

And NHS contracts at all the city's 26 practices are to be reviewed to see which are under-performing.

Those with the worst records will be visited by PCT officials to help them make progress, while the best performers are being rewarded with extra money to bring even more patients through the door.

At present, 10 surgeries are taking in new NHS patients, yet only about a third of the city's 250,000 population is registered and Potteries people still suffer from among the most decayed teeth in the West Midlands.

Kate Taylor-Weetman, North Staffordshire's dental public heath consultant, said: "There is now more access to dentistry in the city than for 10 years, but still patients are not taking it up.

"I have some concerns that we have procured more activity from dentists than is being used.

"A fundamental issue is that the public have to pay towards NHS treatment ,but there is misunderstanding among them of how much that is, what the price structure is and exactly what they are entitled to.

"Without doubt, we are missing certain groups of the population and we need to look at how we can do more to get the clear message out to them about this good access.

"However, we do not know exactly which groups are staying away."

The PCT spends about £10 million a year on dentistry and has recently contracted for thousands of extra NHS places in Shelton, Smallthorne and Tunstall.

It is planning to set up new practices in the Hartshill and Penkhull and Stoke and Trent Vale council wards to create a further 20,000 slots.

Publicity initiatives over the past few months have included posters on buses, cards placed in public places containing the dental advice line (01782 425846) and new signs making it clear which practices are open to new patients.

But Alby Walker, chairman of the city council health scrutiny committee, said: "The trust is still not communicating and engaging effectively with the right people.

"When people start to have toothache they will have a vague recollection they have seen something that can help, but won't remember where.

"The PCT has shown good intent here but the practices it is opening may be in the wrong place to attract high numbers.

"The public are also confused about how much they will have to pay and that also puts them off."

Dentists have to return any money not spent on extra patients to the PCT.