Sir, further to your correspondents Shirsat et al. in BDJ 227 issue 6 p. 436 (Self-repaired dentistry), I spent much of the 1980s working as a peripatetic dentist in several areas of the Canadian arctic and sub-arctic.

In a part of what then was the North West Territories (and since 1999 is called Nunavut - the Eastern Arctic), I recall two particular patients with prosthetic problems. Many of the Inuit patients could speak little or no English so I always engaged a local resident to act as interpreter during my visits.

One elderly gentleman presented with a slightly loose full upper acrylic denture, the looseness brought on by the denture's age and his resorbing palatal bone ridge.

What made it interesting was that the denture had obviously sustained a previous midline fracture and had been repaired.

The repair had been undertaken by drilling about two dozen tiny holes along each side of the fracture and both halves were then held together with what the interpreter told me was seal gut. The very fine thread 'stitching' was both across opposite holes and diagonally to adjacent ones, right along the length of the fracture. It transpired that the repair had been done some 20 years previously.

The denture itself was solid but on inspecting his palate, there was a concomitant set of thread impression indentations which to a degree appeared to have assisted the denture's lateral stability. They showed no sign of local inflammation and both denture fit surface and palatal tissues were clean and healthy. I was told that he cleaned both when possible with snow…

I effected a chairside reline for him over the reduced ridge but avoided covering the manageable midline repair, at his request.

The second patient was an elderly lady who presented with a full upper acrylic denture. The fit was fine but her complaint when interpreted was that one of the upper front teeth was discoloured. It had been getting steadily darker in shade.

On inspection, indeed it was: the tooth was perfect in anatomy: shape and surface polish, but darker than all the other teeth. I was at a loss to explain how or why until the interpreter told me that 15 years previously, this front tooth had been lost and that this lady had then repaired it herself. It transpired that the dark tooth was made of walrus ivory and I was assured that initially, it was a perfect colour match.

Given the distance from her summer and winter hunting grounds to any dental care, this was a truly ingenious accomplishment.

To my eternal chagrin, I didn't at that time (pre-digital) take any clinical photographs. Bulky film was then for people, wildlife and the truly stunning landscapes for which and in which I was privileged to work.