Sir, in the light of a society that may seem to some increasingly focused on superficiality and appearance than on substance and principles, I was personally impressed to read the editorial HPV vaccine for boys (BDJ 2014; 216: 1) that in my view so clearly demonstrated the leadership needed in terms of endeavouring to promote general as well as oral health, and oral healthcare, and to promote the latter (dentistry) as a healthcare profession. Such leadership may require some frank discussion stepping outside conventions into areas rarely discussed openly previously, as was noted in this editorial which mentioned oral sexual practices.1

For example, there have been clinicians who for years recognised and termed some temporomandibular pain dysfunction colloquially as 'snoggers jaw', though totally unsupported by evidence, for example from a MEDLINE search on 'temporomandibular pain dysfunction and kissing'. Many authors, including us, have ventured into the area from time to time not only in relation to recognised sexually shared infections,2 where there are multiple publications on the oral manifestations and management, but we have also reported on the possible sexual undertones of the then novel fashion of body art,3 a minority of mouth/throat cancer associated with HPV,4 and even some unexplained burning mouth sensations;5 always at the risk of those who might perceive this approach as salacious.

Fortunately, with the recognition of such practices, more open discussion and the breaking of taboos, the causes of some hitherto unexplained oral symptoms and signs may now become more evident to all, the recognised aetiological agents will be taken even more seriously, and there could be positive moves to obviate the potential damage that may follow – such as minimising trauma, immunising against implicated agents, or avoiding infection transmission in other ways.