Sir, it is somewhat of a relief to peruse your periodontal issue. Not least welcome are the comments on implants, given that our profession, and especially periodontists, are surely mainly concerned with preserving the natural teeth whenever possible.1 Also welcome is the re-use of the term 'focal infection revisited' although it is, perhaps, best accompanied by the concept in the original of the dentist as physician.2,3 While one periodontal disease does, indeed, occupy most activity, we really must stop using the term periodontal disease as if there were only one.4 And it is well past the time when patients need to appreciate that we are physicians as well as surgeons3 and that periodontal medicine5 is here to stay. Focal infection, too, has come of age, with ever increasing evidence of the relationships between periodontal and systemic diseases.6,7

Not that we should ever forget the roots (no pun intended) of our common chronic inflammatory periodontal disease group, although assessment in ancient populations is undoubtedly best done when one uses, for example, Miles' method of ageing and Darling and Levers' methods of assessing eruption and bone height, which provided the evidence for the widespread nature of both caries and the chronic inflammatory periodontal diseases.8