Jayne Dowle : A very painful extraction from my pocket in the dentist's chair

I'll never forget that root canal work. It was done on the NHS, on the very day that Margaret Thatcher was ousted from Number 10, which is

more relevant than it sounds. After the 1992 General Election, the generous but expensive dental contract Mrs Thatcher had introduced was overturned by a government desperate to reduce public spending. Dentists were faced with a seven per cent cut in their fees for NHS work, so they responded with a mass stampede into private practice.

Finding a NHS dentist became a big political issue. In 1999, I also remember Tony Blair standing up at the Labour Party Conference and announcing that every citizen in Britain would have access to a NHS dentist within two years. You don't need me to tell you that this hasn't happened.

Interesting how, under the party that gave us the NHS in the first place, access to free dental care has got worse. A lot worse.

Reforms have made it more of a bureaucratic, target-driven profession than ever. It is ironic that while television makeover programmes tell us that a perfect smile – and several thousand pounds worth of cosmetic dentistry – will knock 10 years off our age, and chemists' shelves heave with miracle toothpastes, so many of us can't even get a dentist to look inside our mouths without it costing an arm and a leg.

Anyway, this cyst needs removing. So the dentist sent me off to our local hospital to see an orthodontist, who advised an operation. But before that, I must have the original filling removed and replaced. Simple, you might think. Well, simple if I had 600 to spare. This is how much it is going to cost to have one new root canal filling done, privately.

When my dentist rang to tell me, I stamped my foot. Why should I have to pay, when I look after my teeth obsessively, floss twice a day, and visit him and the hygienist every six months, handing over at least 1,000 these past few years for the pleasure of check-ups, the odd routine filling and a new crown? Why should I have to pay, when the

only times I have personally bothered the NHS recently is to have my

two babies, and other people seem to have no trouble getting it to fund their gastric band operations etc, etc?

You can imagine the rant I was on.

But fundamentally, the operation would be on the NHS, so why couldn't the filling be, too? My dentist tried to persuade the dental hospital at Sheffield to do it, but they refused. So he is negotiating with a colleague who might use me as a case study for his students. If I refuse to hand over the 600, I am worried that he might drop me from his excellent practice for refusing to co-operate with his professional advice. All this for a cyst that isn't even causing me any pain. So we are in limbo.

I guess cyst removal is "preventative dentistry", one of the key areas which the Conservatives promise to pour resources into should they get into power. So I suppose I could always wait and see. If they win the General Election, perhaps they might send me a cheque for 600.

Somehow, I doubt it. When thousands of people can't even get access to a NHS dentist, or don't have the money to pay for a basic check-up privately, situations like mine are going to come way down the priority list. At least we live in a town, and I could move to another dentist if I had to.

For many people, especially in rural areas, any dentist at all is a luxury. Age Concern recently published a report which told the heartbreaking tale of a pensioner forced to pull two of her own teeth out because she couldn't find a NHS dentist and couldn't afford to go private. It sounds like something from the 1930s; never mind a decent smile knocking 10 years off your age, this is turning the clock back on a frightening scale.

So it does make me wonder what the NHS is actually for. When people in my situation do need it, its lack of joined-up thinking means it obviously fails to meet our needs.

What if the cyst suddenly became infected and I was in agony and needed urgent attention? Would the hospital do the whole job there and then for free, or present me with a bill afterwards? I hope that I don't have to find out.

Meanwhile, I'll carry on stamping my foot. Whatever the outcome, I have no doubt that it will end up being expensive and painful. Just like solving the problem of what exactly the NHS is supposed to deliver.