Sir, after the last Children's Dental Health in the United Kingdom Survey we have been somewhat self congratulatory (especially the Government – who may even have been a little smug) on the fact that 12-year-olds in the UK had the best dental health in Europe. Sometimes this is a little difficult to equate with what some of us witness on a regular basis. Colleagues may be interested to know the results of a school dental screening of an infant school in the suburbs of Leicester last month. This is in a moderately deprived area and has primarily Caucasian children in attendance. Of the 119 children examined: 45.4% required referral for further investigation; 12.6% had one or more abscesses; 22.7% had three or more teeth decayed; with the highest number of teeth affected with active decay in one child being 13.

Although it is accepted that there are outliers in all walks of life, it is plainly unacceptable that by the year 2006 children attending a primary school in England should harbour such poor dental health. On an epidemiological basis, little has changed locally dental health wise for this age group over the last 15 years, but services have. The Community Dental Service was instructed by government to direct all routine patients to GDS colleagues, and is now a referral service primarily for those same colleagues. With the new contract imminent and some local colleagues in the GDS informed by the PCT that they already have too many patients, and need to shed some, where should the children requiring referral seek dental care? Perhaps we should not be asking where has all the caries gone, but where have all the services gone and just who is going to provide treatment for children in need with high rates of dental decay? Access, I see no access.