NHS dentistry faces its biggest shake-up in years from April 1, when a new dental contract is introduced.

Wales' Local Health Boards will take responsibility for agreeing NHS provision with their areas' dental practices.

The laudable main aims are to improve patient care and access to NHS dentistry. Gwent's Local Health Boards (LHBs) are upbeat but some dentists predict worsening oral health and eventual shrinking of NHS provision.

Despite the well-publicised privatisation of two practices in Chepstow, leaving around 17,000 patients without NHS cover, Gwent LHBs are confident of securing sufficient NHS places and in some cases, increasing provision.

When major organisational change arrives, the hope is that patients benefit, or at least notice no change.

Gwent patients have largely been spared the problems of parts of mid and west Wales, where NHS provision remains scarce, new capacity generating hundreds deep queues of hopeful patients.

Even in Chepstow, with Boscobel House and Fairlight practices going private, Monmouthshire LHB is confident of attracting new practices to fill the gap. Countywide, contract negotiations could deliver around 7,500 extra NHS places.

Elsewhere, LHBs are cautiously optimistic. Newport LHB predicts a five per cent increase in NHS places while Caerphilly county borough has 24 practices, with the LHB estimating the creation of around 6,000 new places.

No problems have been highlighted in Blaenau Gwent, while Torfaen LHB is confident the area's 15 practices will sign contracts, with new places a possibility.

Across Gwent, 29 Personal Dental Services (PDS) contracts have been approved by the Assembly, allowing practices to move early to new working arrangements.

Positive predictions, but a key fact must be borne in mind - the final details of the new dental contract and the finance to support them is not issued until mid-March.

If dentists do not like what they see, more withdrawals of NHS cover might follow.