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I was at first hesitant to respond to Mr Costa since it seems clear from his letter that he has a gun, however, hopefully he is no more accurate with this than in his interpretation of the abundant research into Cognitive Dissonance.1,2,3 As noted in my original letter, messengers of dissonant facts (‘flossing doesn’t work'), have historically been denounced, dismissed and even martyred for challenging dogma with evidence. Please don't shoot the messenger!
More scary than his gun is his clairvoyance; my hair is white; spectacles varifocal; cricket and rugby ensured more than a couple of metal/ceramic restorations. I am also unarmed and certainly in the last third of life if his aim is true! Perhaps NICE could investigate the use of tea leaves in treatment planning?
Seriously, I too am baffled by some of the workings of NICE. In their most recent reports on management of Type 14 and Type 25 diabetes, running to over 200 pages, they make no mention on the significant improvements in blood sugar levels provided by proper periodontal care, with a potential enormous long-term health and financial benefit. Indeed, the panel of over 30 experts included Physicians; Endocrinologists; Nurses; Opthalmologists; Dieticians; Podiatrists; Lay People…. but NO DENTISTS. Fortunately? my fellow Scots do not have NICE just NICOLA.
While timing of children's flossing to the 100th of a second perhaps indicates OCD and is more suited to Olympic finals than oral hygiene practices, he should rest assured, particularly in this post Halloween (and Brexit) period, where comfort food is clearly in use, that the one area where flossing was shown to be effective was in high caries risk children when flossed daily by a dental professional.6
His expectation that scientists will ‘get it right’, if we give them another chance, smacks of the Liberal Democrats' approach to Brexit. I note the post-Trump riots have been explained as ‘This is what happens when you give children a trophy for losing’. And, of course, I cannot accept, and must strongly challenge the result of the England – Scotland World Cup game, and none of we liberal urban elite can accept that Australia really beat Scotland by one point again!
Finally, with regards to parachutes Mr Costa should recall that they, like minds, work better when they are open!
The Editorial Director now considers this correspondence closed.