Sir, the search for truth is behind all legitimate human endeavour. In our profession, the practitioner has to forever make clinical decisions based on a balance between acquired knowledge and the best evidence from research.

It was, therefore, enlightening to find these principles expressed in the letter from A. Toy (BDJ 2009; 207: 345–346). 'We have to understand that no research finding can be applied directly to the problem in front of us... We have to exercise the skill of professional artistry to balance the heart and head.' Both these concepts are contrary to current practice guidelines.

Interestingly, in the same issue, F. B. Naini writes (BDJ 2009; 207: 345) on the negative terminology of 'deaf and dumb' and states: 'The one true deafness, the incurable deafness, is that of the mind'. Perhaps we could serve our patients better if instead of blindly following the 'clinical correctness' of evidence-based dentistry, we employ in addition our clinical judgement based on the years of accumulated knowledge and experience.

We need to recognise the immense complexity of the stomatognathic system and its intimate relationship with the rest of the body. In particular, the dental occlusion and its relationship to head/neck posture and the healthy functioning of the rest of the body. Respiration, deglutition and jaw relationships must be considered when diagnosing and treating malocclusion. The research of early pioneers like Arnold Nove, who wrote on cervico-facial orthopaedia1 along with many others, has been largely ignored by mainstream orthodontists in favour of a more rigid reductionist viewpoint. The treatment of malocclusion should be based on a more comprehensive understanding of its cause. Simply rearranging the teeth, minus a few premolars, to provide an aesthetic dental improvement does not fulfil our responsibility as physicians of the stomatognathic system. The demands of evidence-based research means that anecdotal reports are not considered when formulating treatment principles. Simple classifications of malocclusion into dental and jaw relationships ignore the often subtle complexity of individual variations.

The inevitable compensations involving head posture, the effects on the cervical vertebrae, spinal column and pelvic alignment require the cooperation and interdisciplinary work of physical therapists (eg osteopaths) if a comprehensive and stable result is to be achieved.

As a profession, we need to look beyond the teeth and jaws and recognise our full responsibility and the enormous contribution we can make to the general health and functioning of the entire body.