Sir, earlier this year Lord Saatchi launched his Medical Innovation Bill with the aim of changing the current culture within the profession that makes practitioners fearful of the new and untested. Under the heading 'The fear of being sued is ruining modern medicine' Dr Max Pemberton, in The Telegraph (10 December 2012) wrote that 'Evidence-based research, whilst noble in theory, in reality is not always realistic given the complex nature of some medical problems'.

Within the dental profession a similar dilemma exists particularly in the field of chronic head and neck pain related to dental occlusion and TMJ problems. Where mainstream treatments, such as rest, reassurance, night guards, analgesics and counselling have failed, the practitioner wishing to best serve his patients may wish to try methods which are not supported by evidence-based research.

'Frightened of litigation many practitioners do not push the boundaries of medical knowledge and opt instead for the “safe” standard procedures. This attitude is not good for patients who are denied the chance of cutting edge techniques when they have little or nothing to lose. It is not good for practitioners who are constantly questioning what they do or don't do – not on behalf of the patient, but because they fear having to justify what they are doing in front of cross examination.'

Practitioners are bound by professional guidance and their duty of care to their patients still remains. Where the evidence is shaky or wanting or not clear, then practitioners should be free to innovate, and this is what Lord Saatchi's Bill suggests. Let us hope for the sake of our long suffering chronic pain patients that more useful treatments will be accepted, rather than just 'learning to live with pain'.

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