Sir, I am writing to you in response to the article Obesity and dentistry: a growing problem (BDJ 2009; 207: 171–175). I would like to add a few points.

It would be pertinent to mention about the use of hoists. When I attended the induction programme for my first job as a community dentist, I was introduced to the use of hoists for lifting bariatric patients. These hoists are available in different makes and sizes and each has a recommended maximum load it can lift. In surgery I have used the hoist a few times to transfer patients from wheelchair to dental chair.

We also have a very wide wheelchair designed for bariatric patients and we use a wheelchair tipper which again is indispensable for such patients.

These patients are also a high risk category for treatment under general anaesthesia. One of my bariatric patients went into cardiac arrest on the operation table when she had to undergo full clearance under GA. She had to undergo a defibrillator to start her heart again and the operation had to be abandoned.