Sir, I read the article by Tickle et al. (BDJ 2006; 201: 769–773) on dental screening in schools with great interest. It was particularly noteworthy that the concept of negative consent was acceptable to all groups interviewed, but not to the Department of Health. The Department's decision was based on the entirely erroneous assumption that physical contact between the screening dentist inevitably takes place during screening. In my lengthy career I estimate that I have screened over 50,000 children but have made contact with less than 0.1% of these. I suspect that others have achieved less contact. The Department's decision is based on ignorance of what can be done and indeed what is usually done.

The lack of health benefit from screening found by the same authors in a previous article supports the belief of many dentists who undertake screening – that it is an ineffective use of resources. For screening to be stopped if it is ineffective seems to be a sensible evidence-based decision. For it to be stopped or rendered even more inefficient due to an uninformed assumption is nonsensical. The authors give evidence that dental health can reasonably be considered to ultimately be a parental responsibility. It is time to investigate the use of measures that can help those parents who find it difficult to meet this responsibility rather than encouraging reliance on an outdated and ineffective public health measure.