Sir, Hedger and colleagues (BDJ 2006; 199: 754) are looking for a scientific enquiry to establish the truth about functional appliances. There is extensive literature about functional appliances and perhaps the most significant studies are those of Tulloch1 and O'Brien.1

As a member of the BOS and of the Establishment I should like to refute the suggestion that we do not use functional appliances. I have been using them for 40 years and have recently carried out a prospective trial, of twin blocks and activators. The preliminary results which have been analysed by my colleague are disappointing – of the 60 patients included in the trial only 27 achieved satisfactory resolution of their malocclusion with functional appliances alone. Fifteen achieved partial overjet reduction and required completion of treatment with fixed appliances and in nearly half of the cases (28) functional appliances failed to achieve any satisfactory reduction of overjet. This poor success rate may partially explain why they represent only 3% of NHS treatment.

I am sure that the British Orthodontic Society Foundation would be delighted to receive financial contributions as these funds are used to support worthwhile orthodontic research projects.