In response to the letter A no-win situation in the spring issue of Vital magazine (page 4) regarding my article Let your hygienist shine (Vital autumn 2011 pages 24-26), I think the author of this letter missed the point of the article slightly. Her [or his] response is somewhat indicative if the current state of affairs in our profession. To say that her patients cannot find value in perio treatment scares me somewhat, and saying that only the affluent can afford perio treatment is unfair and untrue. I have several patients that are not ‘affluent’ and have had to save up for treatment, but they would rather do that than visit an NHS practice or indeed another private practice in my local area. If my patients could not see any ‘worth’ in my treatment they wouldn't a) complete treatment and b) recommend their friends and family members to our practice. I'm sure if my patient in the article were questioned he would tell you it was worth all of the £586 he paid for treatment.