Sir, the refugee crisis is a pressing global challenge. Refugees often take treacherous journeys towards safety, encountering grave dangers and fraught challenges. Increasing numbers of refugees are stuck in protracted physical, sexual and emotional oppression, and endure traumatic events and a complete lack of autonomy in their host countries.

In addition, they often struggle to find their feet in often hostile environments with foreign languages and cultures. The significance of language cannot be over-emphasised as there is a long history of using pejorative language to dehumanise and stigmatise new arrivals. Their experiences of physical and psychological distress can be literally so unspeakable that they become deeply embedded within them.

The stigma of mental health issues is often compounded by cultural and language barriers between health personnel and refugees which often create obstacles for them thereby risking not getting the urgent care they desperately need.

Given the stigma surrounding refugees, they might also become haunted not only by past violent events but by feeling hesitant to come forward and seek either general or oral healthcare treatment.

Institutional accommodation, gender disparities and the restriction or prohibition of refugees in host countries to access labour markets also have significant harmful impacts on health outcomes, as well as a possible correlation between the typology of refugees, refugee settlement and refugee trauma.1

This diverse and complex array of factors often also contribute to poor oral health and manifest in untreated decay, periodontal diseases, malocclusion, fractured and missing teeth, and orofacial trauma.2

There should also be an emphasis on services' provider sensitivity to the political, religious, social and historical contexts associated with each refugee. Developing multilevel interventions requires consideration of factors that go far beyond these factors in each refugee's country of origin. It necessitates the understanding, respect, acceptance and awareness of service providers to their clients' beliefs, religions, values, experiences and cultures.

This integrated model emphasises the importance of understanding the full backgrounds of refugees that influenced them to leave their homeland, their pre- and post-migration experiences, difficulties with host government refugee policies, and the physiological and psychological factors contributing to their mental distress and subsequently their poor oral health status.

The broader the knowledge of service providers about the values and beliefs that underlie refugees' experiences, the better and more efficient their services will be tailored to meet their needs. In a nutshell, policy- and decision-makers need to inextricably integrate and bind physical, mental and oral healthcare issues in their future service provision and philosophies for refugees.