Sir, I write in response to Nigel Harradine's comments on a previous letter of mine (BDJ 2010; 209: 439). While I am grateful for his comments, with all due respect I disagree with the content: the speciality of orthodontics is treating malocclusion as if it were a genetic disease. If, as he states, orthodontics has 'found very little good evidence to identify the environmental factors', then treatments provided must be genetically based or guesses.

The cumulated efforts of the British Orthodontic Society's (and its predecessor's) 'research, publications and presentations at meetings and conferences' over the course of 100 years have failed to elucidate the aetiology, pathology or cure of malocclusion. When common sense and the weight of published scientific evidence could so obviously prove an environmental cause, the fact that it has not suggests a strong resistance to opening this Pandora's Box. Calling for more research or review articles asks for an unethical delay, for material that could also be ignored. I believe that only a forum of active participation will deliver the truth.

We have been granted a legal monopoly over dental care on the condition that we act professionally and in the best interests of our patients. I feel that we are falling short of this. If repeating the GDC's debate of 1936 is not acceptable, would an independent review be?

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