Sir, how I agree with L. Kennedy (Hygienist appointments: Pain vs non pain, BDJ 2017;223: 67). The only time that I recall this issue being raised during my undergraduate education many moons ago was in relation to the use of elevators, where we were advised to use only a fingertip grip to minimise the risk of bone fracture due to the application of excessive force.

I learned much later in practising life, almost by chance, that several young patients had been brought by their parents to me from other colleagues, far more qualified than I, for orthodontic treatment. I was told it was entirely on account of their previous 'rough' treatment. Until then I had not realised that apparently I had developed a 'gentle touch'. I was never taught this; I am not sure how it developed in me; but it could and should have been taught. From that time on, I made the point at every opportunity.

I have certainly experienced the sort of hygienist described by L. Kennedy but never more than once!

1. London