Sir, the humanitarian crisis in Syria has left a high impact on the Syrian people's general health1,2 including dire consequences to their oral health status and care,3 and has negatively impacted what was once labelled as the best dental care system in the Arab world. In response to the ongoing crisis and as an alternative to conventional dental clinics, several refugee dental clinics have been established in border regions to provide the Syrian refugees with much needed dental care. These clinics provide the bare essentials with limited resources and are the dental equivalents of field hospitals.3

In light of the obviously challenging circumstances faced by ourselves and other dentists when working in the dental clinics for refugees established in the regions bordering Syria, it is evident there is a need for clinical guidelines with standardised protocols for use in areas of conflict. We would like to propose several areas of focus for immediate attention. Foremost, importance should be given to addressing each patient's chief complaint(s) and to prioritising treatment of infection and acute pain. Thereafter, a simple medical screening tool could help categorise patients in terms of suitability for dental work. For instance, one category could include patients who have immediate medical concerns needing attention before receiving any dental work, another may encompass patients having serious but controlled medical conditions who are fit for dental work, and a third category may be reserved for healthy patients with no or non-significant medical issues who are suitable for dental work.

Apart from prioritisation schemes, guidance should be provided for creating:

  1. 1

    Better protocols for management of war-related maxillofacial traumatic injuries using a step-by-step approach

  2. 2

    Circumstance-specific infection control strategies (eg sterilisation and disinfection techniques) with substitutes in cases of material unavailability

  3. 3

    Treatment alternatives in the absence of dental equipment and radiographic X-ray

  4. 4

    Mechanisms for charting which are simple yet comprehensive enough to assure adequate patient information

  5. 5

    Decision tools for medication use including contingencies in circumstances where adequate medications are unavailable.

Lastly, we call for more efforts and attention to the continued suffering of Syrian refugees, and for more humanitarian aid efforts from the dental community to help in relieving the medical and dental consequences of this tragedy.