LETTERS of the medications are relatively low (15 mg phentermine resin and one 20 mg tablet of dl-fenfluramine). Based on the data available, Dr. Devereux in his editorial in the New England Journal of Medicine (339:11, 1998) concluded that evidence linking the use of fenfluramine or dexfenfluramine to heart-value regurgitation reaffirms the wisdom of the FDA’s decision to withdraw them from the market. In addition, the incidence of clinically overt valvular disease after the use of fen-phen for three or fewer months or for four or more months was low. Finally, though the absolute levels of risk differed, the study by Khan et al demonstrated that the use of high dose of fenfluramine (120 mg per day) may have contributed to the high rate of clinically significant aortic regurgitation, and thus confers a high risk of cardiac-valve abnormalities. The Association appreciates the gravity of the issue involving the safety of dental patients and will continue to work closely with CDC and other regulatory agencies to keep members informed of any change in guidelines and recommendations relating to this issue in a timely manner. This Editor’s Note was prepared with assistance from Chet Siew, Ph.D., director of Toxicology Research in the ADA’s Division of Science. DENTAL PRACTICE VALUE
Your editorial in March JADA relating to future value of dental practices (“Ready or Not”) was very misleading and could cause a great deal of unneces-
sary consternation among your colleagues. As founder of the oldest and largest dental practice brokerage in the United States, it is our experience that dental practices usually sell for 70 percent to 80 percent of annual gross revenues, not the 60 percent you quoted from an unnamed practice broker. A dental practice with an annual gross of $500,000 would sell for an average price of $375,000, not the $300,000 stated in your editorial. If this dentist was given appropriate advice on when and how to sell this practice, then 100 percent of these sales proceeds could be invested in the doctor’s pension plan and there would be no taxes needed to be paid on this sale. That means there would be $337,500 available for investment in a retirement plan, which is quite a difference from the $190,000 quoted in your editorial. I feel sorry for all the dentists who have followed the advice of this broker if this is typical of the advice they have received from him or her. If the doctor sold this practice early enough in his or her career (say 15 years before retiring), then this money would grow to four times its present value, or $1.35 million at the time of retirement. Add this to their present savings and it should prove to be more than adequate to allow all your colleagues to enjoy their retirement years instead of having to work until they die. Your editorial implies that practice value plays little or no role in a doctor’s retirement plans, but it should. All dentists could retire at age 591⁄2 if they would capitalize on their
practice value early enough and then use those proceeds to fund their retirement plans. I feel that your editorial will cause many of them to give up hope and that is a shame. I hope you will allow this letter to be printed in your next issue to set the record straight. Your colleagues deserve it. Alan F. Thornberg President, AFTCO Associates Roswell, Ga. Editor’s note: Our data came from American Dental Sales Inc., a private concern that tracks dental practice sale transactions. Between 1986 and 1999, the firm tracked the sales of 1,360 dental practices. On average, these practices sold for 60.8 percent of annual gross revenues. CARING ENOUGH TO CHANGE
For many years, there has been considerable debate and discussion over the regulation of dental licenses in the United States. The premise for these debates has been a collection of very interesting and academic points concerning the real need for regulation of dental licenses between different states. But the inability for us to handle this question as a profession has touched me personally. States historically felt an honest obligation to protect their citizens from subpar schools graduating inadequately trained dentists. But the reality of the profession today is that schools across the country offer an excellent dental education and graduate well-trained dental professionals. Dental schools successfully graduate dentists with knowledge and a
JADA, Vol. 131, July 2000 Copyright ©1998-2001 American Dental Association. All rights reserved.
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