Dental Amalgam

Dental Amalgam

symposium was overwhelming; 500 practitioners from 40 states, Puerto Rico and Canada attended. More th an 20 leading oral health scientists presented ...

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symposium was overwhelming; 500 practitioners from 40 states, Puerto Rico and Canada attended. More th an 20 leading oral health scientists presented the latest research results and their im m ediate and potential use in the field of dentistry. The talks covered everything from neurobiology and pain control to genetic engineering and transgenic mice. The scientists discussed m olecular features of the cleft lip and palate syndromes, the benefits and safety of fluoride, alternatives to amalgam fillings, antiplaque agents in use and in developm ent and m any other issues offering a tantalizing glimpse into the future of dentistry. The symposium differed from other continuing education activities in th at it did not prom ise any new procedures th at could be used in the office the following Monday. By design, the symposium sought to familiarize practitioners w ith the current research agenda and w ith the scientific th ru st of the time, pointing to inevitabilities, opportunities, and prospects. W hether we like it or not, dentistry finds itself at a crossroads. In a way, we always have. But this time it is different; it is not m erely a case of adapting to high-speed dental engines or the advent of new m aterials or procedures. This tim e it is the realization th at within the very n ear future, as caries prevalence continues to decline, restorative dentistry will no longer be the m ainstay of dental practice. As adults keep their natural teeth longer, traditional prosthetic appliances will become obsolete; as vaccines against oral bacterial and viral infections become available, oral diseases will be prevented. Subdisciplines will 10

JADA, Vol. 122, July 1991

disappear, be rearranged or both. This scenario is not unreasonable. Both in a historical context and based on a fair assessm ent of contem porary trends, these are some of the changes th at will occur within the next two or three decades. The symposium held at the NIDR this spring, and sim ilar ones planned for the future, are aimed at providing practitioners with a vision of the scope and content of dental practice that is consistent with the intellectual and technological dem ands of the next generation of patients. Dr. Loe is director, National Institute of D ental Research.

LETTERS JADA devotes this section to comment by readers on topics of current interest in dentistry and reserves the right to edit all communications. JADA requires that all letters be typed, double­ spaced and signed. No more than 10 references should be included with each letter. The views expressed are those of the letter writer and do not necessarily reflect the opinion of the Association. Your J Ê ttË participation in this section is invited. jjr DENTAL AMALGAM

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I was very disappointed when I read the commentary ^ by Gordon Christensen in “Are There Alternatives to Dental Amalgam?” (March). I am a big fan of Dr. Christensen, but this particular piece reminded me of Dr. Robert Barkley’s famous comment, “Dentists have a slum mentality.”

People in general have the money for what they want. We do not compete with each other nor with the local supermarkets. We compete with the travel agents, VCR salespeople, and car and boat dealers. The only block to being able to sell fine dentistry is our own “slum mentality” and the thought that maybe we can’t do it because we’re not good enough. These thoughts came up over and over in Dr. Christensen’s piece. Dr. Christensen said, “If the patient has financial difficulties and challenges, as do most of the people in the world, you have no alternatives” to the use of dental amalgam. So I guess amalgam is “good enough.” For whom? I’m sure glad Dr. Christensen doesn’t sell heart valves! Don Quixote said, “A tooth is as valuable as a diamond.” Let’s let our clients know what is best, and what we would want in our mouths, and then let them make the decision as to what they w ant in their mouths. Thomas E. Baldwin, D.D.S. Towson, Md. Author’s response: I appreciate and respect Dr. Thomas Baldwin’s views. In fact, I find that most of my own patients choose some alternative restoration, instead of dental amalgam, after they have been educated by my auxiliaries or '— me.

Perhaps Dr. Baldwin misinterpreted my comments. ' W After lecturing in most of the countries of the world for more than 30 years, I find that our small microcosm of affluence, the United States, offers its citizens financial choices enjoyed only by the people of a few other countries