Dental decay is the leading reason for hospital admission in children 6–10 years old despite being largely preventable.1 Treatment of oral conditions costs the National Health Service (NHS) £3.4 billion annually, and impacts the emotional, psychological and physical well-being of the child and family.1 Dental pain is linked to failure to thrive due to impact on diet and sleep, with over 60,000 days missed from school annually for tooth extractions thus impacting adult productivity.1 2

Dental decay adversely affects those from socially deprived and minority ethnic backgrounds.2 Eligibility for free school meals is associated with poorer dental health outcomes and oral health behaviours including toothbrushing and sugary diet.2 In the 2013 Child Dental Health Survey, those eligible for free school meals were more likely to report toothache, bleeding gums and broken teeth.2 Between 2018 and 2019, the rate of dental extraction for the most deprived Index of Multiple Deprivation quintile was three times that of the least deprived quintile.2

Vulnerable children, including children looked after (CLA), asylum seekers and refugees (ASRs) and children with disabilities experience extreme oral health inequalities.3 A population linkage study in Scotland found CLA were more likely to need dental treatment, including urgent care, and require dental extractions under general …