Sir, in the last ten years, over 2 million Romanians have migrated to work in EU member states.1It is likely that recent migrants will be seen increasingly by UK primary care services. These patients may present with unusual, delayed, and complex needs. In the light of our exit from the EU, many UK dentists may lose the incentive to understand the way dental services are provided and accessed across Europe. Primary care dentists could therefore find themselves ill-equipped to detect and manage dental complexities as they arise.

In Romania, 95% of dental care is delivered privately, and unsurprisingly the primary barrier to access has been identified as cost of treatment.1There are limited public resources allocated for preventive dental care and the funds allocated to the oral healthcare of young people rarely covers the cost of treatment. This became evident to us recently when treating an 18-year-old Romanian male recent migrant to the UK who presented complaining of oral pain and poor dental appearance, speaking limited English and requiring an interpreter. Examination and radiographic assessment revealed a fully erupted permanent dentition with the additional presence of erupted bilateral supplemental maxillary incisors, coupled with dental disease and extensively compromised oral health. He had no previous experience in any dental setting but responded well to intense preventive care, followed by restorative and surgical care to manage the crowded anterior maxillary segment.

The late presentation of the anomaly described highlights the importance of access to routine dental care for the purposes of early detection and intervention, and gives pause for thought with regards to how treatment planning may be challenging when patients have experienced differing levels of access prior to presenting at UK primary care services.