Sir, Thank you for raising the worrying shortage of specialists in paediatric dentistry in your article 'Where are all the Specialists.'1

The shortage has been endemic in our specialty for many years. A freedom of information request to the General Dental Council by one of our members confirmed your analysis and revealed that the numbers of paediatric specialists has been static since 2001 while the numbers of oral surgeons and orthodontists has trebled.

Regrettably, there is no obvious quick solution to the shortage of paediatric specialists. Years of chronic shortages can only be turned around with robust management based on local need. Each Deanery should be supporting the training of dentists in specialties where there is a shortfall.

Normally, the route forward is through oral health needs assessments completed by Specialists in Dental Public Health. However, this is not infallible. As chair of the Managed Clinical Network in paediatric dentistry in Greater Manchester, I asked one of our Consultants in Dental Public Health to complete an oral health needs assessment. This confirmed that more specialists in paediatric dentistry should be trained. Unfortunately, the shortage of consultants in paediatric dentistry has meant that that we do not have enough trainers and so cannot increase our training numbers, a classic vicious circle. We urgently need more consultants who can support both clinical leadership and training roles.

It takes time to nurture a specialist, a minimum of three years. If your area needs more of any kind of specialist, my advice is to encourage the Chair of the relevant MCN to get an OH needs assessment carried out to get things moving. Unless we start somewhere, our patients are not going to get the care they need and deserve.