Sir, an article/letter is always a pleasure to read as it will have been written from both the heart and the head.

M. Kelleher (Abuse of dental practice; BDJ 2011; 211: 347) speaks of the 'elective destructive dentistry' which we all see coming into our practices from elsewhere, frequently under that dentist's pretence of 'I'm only doing what my patient asked/told me to do'. The criminal defence of 'just following orders' did not work in the Nuremburg Trials and our colleagues should not use it to justify their abuse of the patient's trust in their professional ethics.

Anyone providing a service to another has the option to state that the request will not be to that person's long-term benefit and that alternatives should be explored. If the potential recipient persists in their demand then the provider always has the option to decline to provide such treatment, and yet this option seems to be unknown to those providing 'elective destructive dentistry'.