Sir, I feel I must strongly support Professor Thomson's view (BDJ 2006; 200: 242) on the need for specialist referral and biopsy and find the reply of Professors Scully and Felix alarming if not slightly arrogant. I work in hospital practice as an oral surgeon and occasionally in 'High Street' specialist practice also. If someone presents to me in the latter I organise an immediate referral to my local oral surgery colleagues and I do not mess around with biopsy in this setting. I also feel that charging a patient either on a GDS basis or a private basis for this is inappropriate. Do Professors Scully and Felix have to cope with the surgical problems that such a delay could potentially cause?