Sir, although there is implied criticism of the denture technician in the recent paper on an undiagnosed case of malignancy (BDJ 2005; 198: 341) the authors also make it clear that dental practitioners are sometimes culpable. Indeed, the dental profession should consider why general medical practitioners have been shown to be better at diagnosis and prompt referral than their dental colleagues – surely an embarrassing finding at the very least!

I remember a similar case being referred to me a few years ago by a suitably embarrassed general dental practitioner who admitted that he had completely missed a palatal malignancy in a similar clinical situation when the patient presented with ill-fitting dentures. It was left to the astute technician on this occasion to return the plaster model with the comment that the 'blow hole' looked a little too large to fill in, and that in his opinion it could even be a tumour! Stones and glass houses come to mind!