While it is difficult for a dentist to disagree with the central thrust of your editorial ("Time to take more of the fizz out of the family diet", The Herald, October 25), it missed the key issue as did the article ("Fizzy drinks are linked to increased teen violence", October 25) and indeed the original study which led to it.

In a recent study we found that teenagers in Scotland from deprived areas have a seven-times-greater risk of alcohol-related facial injuries than those from more affluent neighbourhoods.

This over-riding determinant of social and economic circumstances at the individual, family, and area level and the associated inequalities, was not even considered in the US research on fizzy drinks and violence.

A major problem with this kind of study is the concern that the finding is “confounded” – that is, fizzy drinks are associated both with the real determinant (social factors) and outcome (violence) but not necessarily in the pathway.

Nevertheless, fizzy drinks are highly consumed in Scotland and are associated with our substantial obesity, dental decay and other ill-health levels.

In the same way the Scottish Government is pursuing more active policies and levers to address the alcohol problem (via minimum pricing), further serious consideration needs to be given to taxing fizzy drinks (as proposed by Richard Simpson in a recent motion in the Scottish Parliament, entitle Vive la France, which highlighted similar action on fizzy drinks in France ). However, tackling our health problems will only ever be achieved when we tackle our shameful social and economic inequalities, which are the real determinants – the causes of the causes –of our poor health record.

David Conway,

Clinical Senior Lecturer in Dental Public Health,

University of Glasgow Dental School

378 Sauchiehall Street,

Glasgow.