Maximising paediatricians' roles in improving children's oral health: lessons from Leicester.

AIMS: To provide an overview of steps taken to improve oral health in one UK city and to review factors relevant to maximising the contribution that paediatricians (and potentially other health professionals) can make to improving oral health. METHODS: The article provides information on the strategic approach taken in Leicester, one of the most ethnically diverse cities in England, and also one of the most deprived. Over a third of children aged 3 years, and half of those aged 5 years, have experience of obvious dental decay. The collaborative strategic approach taken includes implementing a comprehensive evidence-based early intervention programme from birth (Healthy Teeth, Happy Smiles!) and a focus on professional education and engagement. In order to ensure sustainability and further improvement, wider engagement with paediatricians and other primary care providers is essential and is increasingly recognised by professional bodies.Literature relevant to the factors which inhibit engagement with paediatricians and others is reviewed and highlights issues of knowledge and competency, policies and guidelines, time and capacity and referral and access. CONCLUSION: Children's oral health in England has improved over the last 30 years, but inequalities persist, with those living in areas of higher deprivation experiencing a substantially higher burden of dental disease. The article highlights several potential barriers which can be reduced. Collaboration is encouraged between medical and dental professionals as well as commissioners and providers at both the national and local level in order for oral health to be fully integrated within general health. Such collaboration requires appropriate leadership in order to develop policies that support curriculum changes, drive the implementation of associated guidelines, design integrated healthcare service provision and develop the partnership relationships to support this work.

Oral Healthcare Implications of Mass Migration.

Population movements, whether voluntary or forced, are an integral part of an increasingly globalized society and, while the health needs of migrant populations cannot be generalized, some migrants can have worse oral health outcomes compared with their host-country counterparts, with their first dental contact typically being for emergency care. Failure to provide immediately necessary treatment may be unlawful under the Human Rights Act 1998. CPD/Clinical Relevance: NHS dental services need to evolve and address the challenges inherent in caring for vulnerable migrants. Education and appropriate training needs to be developed for the dental profession in order to enable new ways of promoting intersectoral care and community engagement.