Sir, it's that time of year again when we seem to attract an eclectic bunch of patients. Last year we had a high-needs patient whose underlying problem turned out to be burning mouth syndrome (Fig. 1). We had a further patient for whom, despite extensive investigation, we were unable to resolve his atypical facial pain (Fig. 2).

Figure 1
figure 1

High-needs patient with burning mouth syndrome

Full size image
Figure 2
figure 2

Patient with unresolved atypical facial pain

Full size image

Do other colleagues have this problem at the end of October?

Editor's note: After further enquiry, Dr Mallon revealed that the pumpkins illustrating this letter were actually carved as part of an annual dental practice 'carve off' competition: 'The burning mouth syndrome patient was carved using a peeler to break the surface then a wax knife to create form, then finished with a Mitchell's trimmer and Molt #9 periosteal elevator. It was actually designed with 15 different dental issues for a DF1 training day on Pain Management – including roots, over eruption, pericoronitis, cracked teeth, lost fillings and OAF. This became a bit of a nightmare as the family dog got to it the morning it was due to be used! The atypical facial pain patient was carved in a similar fashion with the addition of a courgette.'