Sir, a review of dentistry in Russia since the 1970s has been published recently;1 this letter is a brief update. The motto of Soviet healthcare was the priority of prophylaxis, realised by mass examinations (so-called dispensarisations), a programme which is currently revitalised.2 Initial and questionable carious lesions were treated by dry cutting, sometimes with dull rotary instruments, which led to excessive removal of hard tissues. At schools, dental dispensarisations were recommended to be performed twice yearly although consent for treatment was not always sought, especially from children and adolescents or their parents. The checkups and treatments were performed under time pressure.

An early start of the restoration cycle and suboptimal quality of filling materials caused progressive enlargement of cavities: the restorations failed, the cavities were further enlarged. This led to fractures and extractions at a relatively young age. Radiographs reveal that the quality of root canal treatment was often insufficient. The procedural quality was additionally impaired by the limited availability of effective anaesthesia. With regard to orthodontics, domestic postgraduate programmes have been organised, which do not meet the requirements for postgraduate education by the World Federation of Orthodontists.3

The large-scale privatisation of Russian dentistry in the 1990s created new problems. Some practitioners avoid conservative treatment of advanced lesions and manipulate patients towards extractions and prosthetics, often choosing treatment plans based on commercial considerations rather than clinical indications. With tooth extraction, some dentists at state polyclinics offer a choice: 'Do you want a paid or free injection?' Anaesthesia after a free injection is incomplete. Formally, the obligatory insurance in Russia covers basic dental treatments, but some personnel at polyclinics accept payments. The level of care has been limited by a shortage of resources.4

Admittedly, a general improvement tendency is noticeable. The growing economy had allowed for the acquisition of modern equipment and consumables.

In conclusion, dental treatment at polyclinics, providing free care to patients with obligatory medical insurance, must be performed on a state-of-the-art level. Economic change in dental practices is needed, to guide preventive and minimally-invasive methods. Finally, in a recent experience the author of this letter received free dental treatment from the NHS in the UK. Thereafter, I went together with a visiting British citizen to a state dental policlinic in Moscow, where the latter was refused free treatment.

The Editor-in-Chief notes: In a vote on 26 May 2022 delegates at the World Health Assembly agreed a resolution on the 'Health emergency in Ukraine and refugee receiving and hosting countries, stemming from the Russian Federation's aggression.'

Among other issues, the resolution brings attention to the direct and indirect health impacts in Ukraine, in the region and beyond; condemns attacks on health care, as documented by WHO's Surveillance System for Attacks on Health Care; and urges the Russian Federation to immediately cease any attacks on hospitals and other healthcare facilities.