Sir, we applaud the British Dental Health Foundation's National Smile Month (13 May – 12 June 2007) oral health campaign but have some serious concerns associated with the sponsorship of this initiative.

Much of the promotional material available to purchase from the BDHF constitutes nothing less than blatant advertising for Golden Vale's Cheestrings. For example, the promotional sticker makes no mention of National Smile Month. Taken away from the dental environment, it has no overt connection with the BDHF's campaign.

Furthermore, there is a link to the Cheestrings website from the National Smile Month web page. This website constitutes a sophisticated advertisement directly aimed at children, with a strap line 'Gotta get some 100% real cheese'.

We believe that Cheestrings is an inappropriate sponsor for the National Smile Month initiative. This is a processed food and constitutes a very expensive way of obtaining the nutrients and oral health benefits that could be obtained from traditional cheeses such as Cheddar, Edam or Red Leicester as well as a huge range of other foods.

The promotional material states that 'eating Cheestrings as a snack can help reduce tooth decay' which we would argue is a misleading statement because it infers it can repair caries. Furthermore, promotional material does not refer to moderate consumption of Cheestrings. We acknowledge that dairy products are an important part of the nation's diet and have a role in oral health. However, from a holistic public health perspective, we are also mindful of the fact that cheese should be eaten in moderation because it tends to be high in both saturated fat and salt.

With a childhood obesity epidemic looming, the dental profession does not need to be accused of making matters worse by sanctioning high fat processed foods like Cheestrings. Their promotion is in direct conflict with the strenuous efforts that are being made to encourage a multi-disciplinary wider determinants approach to tackling inequalities in oral and general health.

Dr Nigel Carter, Chief Executive of the British Dental Health Foundation, responds: We welcome the opportunity to respond to Mrs Morgan et al.'s letter.

None of the resources available for purchase from the Foundation for National Smile Month contain any commercial sponsorship of any kind. The material to which Mrs Morgan refers formed part of a pack of material distributed free of charge by Cheestrings with every National Smile Month order. As such it could be used by practitioners, or not, as they pleased. Many workers in the field of oral health promotion have little or no budget and welcomed any free promotional material.

Golden Vale, the manufacturers of Cheestrings, were one of many corporate sponsors of the campaign this year whose generous support helped us to extend our oral health promotion activities and the reach of this event. Others included Procter and Gamble, Boots, Tesco, Dental Design and HSA. Cheestrings has been accredited by the Foundation's independent accreditation panel who considered a robust submission with supporting peer reviewed papers before approval. Cheestrings is not a processed food but 100% cheese. The dental benefits of eating a small portion of cheese after a meal, to help neutralise plaque acid, have been well researched and there are many publications on the subject. Cheestrings has the advantage of being individually wrapped and thus portion controlled at 21 g promoting the moderate intake that Mrs Morgan et al. suggest as a healthy snack.

It should be noted that the Schools Food Trust packed lunch advice recommends cheese as a component of three out of five examples of healthy lunch boxes. The preparation of lunch boxes and snacks for children generates a demand for conveniently packaged, attractively presented nutritious food items. Where convenience takes priority children will very often be presented with several sugar containing snack items and it may be helpful that cheese can be presented as a novelty item.

The Cheestrings literature and website refer to eating a healthy balanced diet and specifically encourage parents to check food packaging for salt and fat content, as well as promoting five portions of fruit and vegetables a day. We accept, however, that this message could be more prominent and we will be taking this up with Golden Vale.

We entirely support the view that dairy products should form part of a balanced diet and constantly promote this position in our media activity. Indeed last year's National Smile Month Campaign theme 'Feed Your Smile' was heavily based on promotion of a healthy balanced diet.

We welcome all feedback on a major campaign such as National Smile Month and take it into account when planning future campaigns to ensure that the health messages the Foundation presents are holistic in approach.