Sir, I read with interest the opinion piece in the BDJ entitled Craniofacial dystrophy. A possible syndrome? by M. Mew (216: 555-558).

I have two main issues with this piece which I think are worth mentioning.

Firstly, concluding with the statement, 'Attempts to constructively critique or falsify this hypothesis with quality evidence and sound logic are welcomed', is somewhat misleading. It would suggest that this article has presented a valid, evidence based argument for the existence of the potential syndrome 'Craniofacial dystrophy'.

What you have is the author's opinion on how malocclusion compares to a referenced ideal occlusion/posture described by his father (J. Mew) over 30 years ago, also in this Journal. The article is full of interesting claims regarding 'signs' and 'symptoms' that are almost wholly unsubstantiated by scientific reference. One would hope that given the author belongs to a worldwide elite number of 'master level' orthotropic practitioners1 practising facial growth guidance, that a substantially higher level of evidence for this syndrome could be provided.

As such, inviting readers to falsify the presented hypothesis seems to eschew the scientific process of initially testing whether or not the hypothesis is valid.

Secondly, when there are opinions given in the BDJ regarding potentially controversial patient related issues, it would help if this was done in point/counter-point fashion, similar to the recent pieces on short-term orthodontics.

I fully respect the opinion of M. Mew and his right to voice those opinions. However, I am concerned when patients on public Internet forums are directed to these opinion pieces by the author2 and then this published work finishes by linking to a website where you can 'learn more' about a potentially serious and common 'syndrome' and its treatment. As it turns out, M. Mew and J. Mew are the sole orthotropists between London and the Ukraine registered with this website.1

I feel strongly that where an opinion piece with all the scientific rigour of a Facebook posting is published without an accompanying retort, it may result in damage to the reputation of the BDJ as a scientific journal.