Dear editor

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.