Sir, for oral health to be included as a key indicator in the Royal College of Paediatrics and Child Health report1 published in February is welcome progress. At last the mouth is considered to be integral to well-being. A number of factors seem to have brought us to this point including a Chief Dental Officer whose rallying cry is that the mouth needs to be put back into the body. Other factors are the growing awareness that the state of children's oral health is unacceptable in a first world country and an acceptance that children's teeth are not simply the responsibility of parents or dentists. As a society, we all have a part to play whether it's a willingness to embrace a sugar tax, to support tooth-brushing in nurseries or to adopt fluoridation where it's warranted.

BSPD welcomes the movement towards greater collaboration among all those working with children. This was one of the key aims from the stakeholders meeting we held last year. We are grateful that the Child Oral Health Improvement Programme Board is driving that collaboration.

It's now understood that in these straitened times we are spending millions of pounds carrying out extractions under general anaesthetic in hospital. By working together we can dramatically reduce the burden on the public purse and the impact on children and their families, suffering from a disease which, let's remember, is almost always preventable.