Sir, as a specialist registrar in training in special care dentistry I have been working in an urgent dental care (UDC) hub providing care for shielded, vulnerable and COVID positive patients in a rural county.

We have had a considerable number of patients referred to the UDC with significant complex medical conditions and medication regimes. Referrals have included pre-transplant patients, oncology patients undergoing active treatment, complex liver and kidney disease, an array of rare diseases and numerous rheumatology patients taking a range of disease modifying medications.

Many patients have required additional blood tests, investigations and medication reviews prior to undertaking dental treatment inevitably requiring communication with multiple medical specialities. A great majority would have benefited greatly from a dental examination prior to starting treatments such as bisphosphonates, chemotherapy or radiotherapy. Many are now in a compromised position where risks of conditions such as medication-related osteonecrosis of the jaw is high. The patients themselves have often had little knowledge about the importance of optimising their dental health as part of their medical condition and some have not accessed dental care for many years.

This experience has highlighted that dentistry plays an important role within the integrated care system but is currently often overlooked. As we look to the future, and the restoration of dental services, the profession needs to work with stakeholders to ensure that the importance of oral health as part of holistic healthcare is fully understood and high on the public health agenda.