Sir.—While we generally agree with the comments in Dr Gardner's article that appeared in the December issue of the Journal (129:1445-1448, 1975), we feel he has understated the case for considering dental anomalies to be a constant feature of the Morquio syndrome. We would like to emphasize that dental anomalies are consistently found in the Morquio syndrome, and are a necessary component of the clinical diagnosis.
In March 1975, an article by us was published that described the oral findings in 12 unrelated patients with the Morquio syndrome.1 These 12 patients were diagnosed on biochemical, roentgenographic, and clinical grounds. Dental examinations were performed after the diagnoses had been established. Therefore, no ascertainment bias influenced the results of our study. Each of the 12 patients had dental anomalies similar to those described in Dr Gardner's article. In April 1975, the oral findings of two siblings with Morquio syndrome were