Sir, I believe dentistry could be at the centre of a health revolution. There is the very real possibility that simple public health measures could minimise and even eliminate malocclusion, TMJ and sleep apnoea, thereby improving the lives of countless individuals and saving the NHS huge sums of money. I don't have all the answers, but I am asking the right questions. I want the truth, backed by scientific evidence, so our patients can benefit.

For a decade, I have raised concerns that our profession treats a modern disease, malocclusion, as a genetic inevitability. The evidence for an environmental origin is unambiguous. Less than 1,000 years ago, the vast majority of people gained and maintained all of their teeth in reasonable occlusions and alignment from birth to death.

Today, more than a third of 12-year-old children in the UK have an index of treatment need score of 3.8 or above and permanent retention is routine.

We should work together to change this by finding definitive answers to questions such as:

  • Why has there been such a rapid rise in malocclusion?

  • Why do teeth become crooked in the first place?

  • How is TMD related to malocclusion?

  • Will root resorption affect root canal therapy?

  • Why are we extracting so many wisdom teeth and premolars?

  • Does permanently holding teeth out of their balance zone eventually compromise perio-support?

If there is an environmental influence, then there must be discernable pathological process. I proposed a hypothesis 'craniofacial dystrophy',1 which suggests that environmental factors cause a downswing in facial form.

This, in turn, leads to malocclusion, by reducing the cross-sectional area to accommodate the adult teeth. It also increases the likelihood of developing sleep apnoea by moving the tongue closer to the airway. This suggests contemporary orthodontics, when retractive, may exacerbate sleep apnoea.

I am not the only professional to believe that changes in masticatory effort, swallowing patterns and oral posture are influencing facial growth. If we are right, malocclusion and its associated health problems are preventable lifestyle problems.

This has profound consequences for how and when we treat them because the best medicine identifies the cause and prevents the problem. Unfortunately, few within our profession are keen or willing to follow this realisation to its natural conclusion. My suspicion is that some fear upsetting the status quo or lucrative business models.

There is justification for fearing the consequences of speaking out. The BOS has reported me to the GDC for attempting to raise awareness and educate the general public through our YouTube channel orthotropics.

The BOS exists to serve its beneficiaries – the public – not its own profession. It is scandalous that the BOS should try to control public access to intellectual debate and curb the freedom of speech of members.

The genie is out of the bottle. Around the world, professionals and patients asking these questions are finding one another and forming online communities demanding change. I have decided to respond by sponsoring a parliamentary petition to discuss this issue. To find out more please visit https://preventcrookedteeth.com. It is supported by academics and medical professionals from five continents. My objective is to work together to find answers through the application of science and to transform people's lives for the better.