Sir, we have seen the recent publication of the commissioning guides for specialist dentistry (Introductory guide and specialist pathways for orthodontics, oral surgery & oral medicine and special care dentistry). The guides are now live on NHS England's website at www.england.nhs.uk/commissioning/primary-care-comm/dental/dental-specialities/

These guides provide aspirational commissioning standard setting for the provision of specialist dental care across all healthcare settings. However, a note of caution, the commissioning based upon these guides will only be successful with local intelligent implementation and with sufficient workforce to deliver this level of care of specialist services.

I remain very concerned, with an inadequate existing workforce in many specialties, about those patients coming to harm whilst a suitable fit-for-purpose workforce to deliver this standard of care is identified and trained.

1. London