Sir, Professor Richards is to be congratulated on his editorial In search of quality (BDJ 2009; 207: 109). He distils from a complex mixture of ingredients the fact that the basic professional product we provide is oral health and this should be used as a quality benchmark linked to an internationally recognised ISO standard. Nobody would disagree with this but a potholed road will impede the speed of our quality journey in the absence of a fairly major revolution in the organisation of our profession and the administrative structures of BSI/ISO.

It is well known that cheap dentistry is probably the most expensive product that money can buy and it is a betrayal of the best interests of our patients to continue to ignore this fact.

But in the one area of product standards that something could be done, and done quickly, our regulatory body the GDC seems to have acquired a scotoma. Now I am not talking here about toothbrushes and tubes of toothpaste but about the products manufactured in dental laboratories and prescribed by dental surgeons on a daily basis. Where is the product standard that ensures every denture, crown, bridge or other fixed or moveable dental prosthesis is fit for purpose? Indeed where is the basic definition of 'clinical fit' recorded to validate the claims that 'all my caps fit and patients wear them'!

But now of course we have access to technology that measures in microns and displays on computer screens graphic pictures of the truly awful quality of far two many impressions of equally awful clinical preparations. And so at the very outset the chances of a dental technologist being able to craft a properly fitting prosthesis are often reduced to zero.

A major trade supplier has recently claimed in sales literature supporting the use of their intra-oral scanner that nearly 60% of dental impressions are unsatisfactory .

I myself have carried out a random survey of more than 6,000 dental impressions and of the 100 cases that I subjected to audit can confirm this supplier's figure is very close to mine at 52%. This is a shocking indictment.

At the time of writing, my letter and a reminder to the President of the GDC requesting the introduction of quality based product standards remain unanswered and the 6,000 word paper I wrote in response to the GDC's invitation to comment on their 'Standards on Commissioning and Manufacturing Dental Appliances' has been ignored. Sadly Professor Richards I feel that whilst the patient may be hungry for better quality our professional representatives seem unwilling to create the recipe.