A recent report claimed more Midlanders resort to performing their own tooth surgery than anywhere else in the country, so scarce are NHS places.

But at Cox's Dental Health Care, in Daventry Street, Warwickshire patients appear to be taking such provision for granted.

Liz Cox spoke out on Tuesday after scanning a waiting room full of apples, balloons, stickers and comics - but not people.

She claimed attendance at the surgery's annual event, during which all private work is deferred to make time for children on the NHS, has slowly declined in the last five years.

Despite ringing parents ahead to confirm times, arranging the week to coincide with holidays and contacting every school to make them aware of the opportunity, the practice could only book out two-thirds of the time. Then only one patient in three arrived.

At the same time - and not lost on Mrs Cox - came renewed criticism last week for dentists who choose private work over providing public health care.

A frustrated Mrs Cox said: "It's forever in the press how dentists are failing to provide places for NHS patients - yet when we bend over backwards to say 'come and see us' this happens. This is the other side of the coin.

"We've put all our other work to one side and paid for all our staff to be in. Today I had 48 booked and 16 did not arrive. Because the NHS does not allow us to charge for missed appointments we have lost money.

"I am very angry with the current system - and on top of this week I am being charged about £300 a month for failing to meet my NHS quota. I am trying to run a business here."

A report in January based on government estimates found 2 million people across the country had no access to an NHS dentist, partly caused by flaws in the government's new contract of April 2006 which led to health authorities running out of money to pay for treatment.

The 'average dentist' now splits their private and NHS work about half and half - with contracts for health service work based upon historical numbers of patients.

Warwickshire has not yet seen the problems experienced in other parts of the country, Local Dental Committee chairman David Pulsford said recently.

He attributed that to wealth and the ability to go private, flurodisation, good oral health and a comparatively large number of surgeries.