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Passages
NEWS Message
From Our President
Passages As my presidential year comes to a close, a myriad of impressions flood my mind concerning our Association and the specialty of endodontics. A seemingly endless number of flights across the country, meetings with endodontic study clubs and state endodontic associations, telephone calls, and conference calls, Executive Committee and Board of Directors meetings, and working with a superlative group of volunteer endodontists will long be remembered. Culling from all this just two or three of my most salient impressions seems almost impossible, yet doing so is a good way to force the identification of issues I see as most important to us now and in the year immediately ahead. The paramount issue we face is the realization that "retreatodontics," and all it represents, is with us forever. No longer will North American endodontists treat large volumes of simple endodontic cases. The huge number of teeth requiring endodontic treatment that characterized American dentistry in the 1950s and 1960s will never recur again. The postfluoridation era has begun. Fewer teeth need root canal treatment, fewer teeth are lost to extraction, and fewer fixed bridges are being constructed. Our general dentist colleagues, by all reports, are less "busy." They keep busy with greater emphasis on prevention, aesthetic dentistry, TMJ diagnosis and treatment, and treating the easiest of the cases previously referred to dental specialists of all types. This is natural; it will not go away. The natural consequence of all this for endodontists is that we will be busy in the decades ahead, but we will be treating, for the most part, the difficult cases, the youngest and the oldest patients, the calcified and tortuous canals, and cases in which an initial attempt at endodontic treatment has been unsuccessful. Then will the endodontic specialists be called in to salvage the case, to find the canal, to bypass the ledge, the calcification, the paste, the broken instrument, to seal the perforation, to hemisect the root, to reverse seal the apex, to do the magic to save the case. If it sounds like your practice this week, you are notalone. But after the culture shock, cheer up; you are training for the future, and there is going to be an immense need for us in the years ahead. Our Public Awareness Program is working successfully to slow this trend and in some cases to reverse it. Yet other powerful forces tell us that eventually, our work will be more difficult, hopefully more interesting, certainly more fatiguing. The Public Awareness Program is essential in order to maintain the best balance possible for our patients no less than for ourselves. Another major issue was touched upon in this column slightly more than a year ago. When Steve Schwartz was AAE president, he wrote a piece entitled "Leave it to your own devices." I regret that the problem he alluded to has become worse since that time. A profitless proliferation of endodontic gadgets floods the marketplace. The market will deal with this flotsam and jetsam as it has in the past. But we may need to define again our endodontic practices, who we are, and what we purport to teach. We will surely have to redefine as well our primary concern for patient care as opposed to personal convenience and self-interest after the debris is cleared away. Don't misunderstand me. I'm all for experimentation and innovation, and I really do appreciate the market's role in technology advancement. I'm speaking here only of the most flagrant and am fearful that it become, even temporarily, the commonplace. I.'m speaking of bankrupt ideas and bankrupt factories, of textbooks promoting products rejected by the market before the ink is dry on the page and of vacation paradises used to lure the uninitiated to courses featuring the latest device that moves, makes noise, or lights up in root canals. The real problem, of course, is the lag between the time we endodontic specialists evaluate and reject a notion or gadget and the rejection of the concept or machine by the general dentists who look to us for guidance. It is a free market. I'm calling only for collective wisdom, caution and restraint. Hundreds of our members have expressed their anxiety to me in this regard. I look forward to seeing many of you in Boston at our annual meeting and to talking to you about your concerns. This is a time of change, a time of transition. Fortunately, we are ready for the task. The Association is strong. Our membership is large, better informed and better educated than ever. Irma Kudo, our Executive Director, heads a truly outstanding staff in our Chicago office. I leave office with confidence and admiration for the intelligence, resourcefulness, and experience of our incoming president, Mike Heuer. It has been a privilege to serve as your president. My time is over, but the work goes on. Come join in that work. Herbert Schilder, DDS President
177
Notes From Here and There The Chicago Dental Society held its 121st Midwinter Meeting, entitled " N e w Horizons," February 16-19 at the Chicago Hilton and Towers. Several AAE members participated in the meeting including Dr. Bernard J. Grothaus, Secretary of the CDS; Dr. Michael J. K o w a l i k , Program Chairman; Drs. Leo J. Miserendino, Amy B. Dukoff and Peter A. Guagliano w h o presented endodontic table clinics; Dr. F r a n k l i n S. Weine in a presentation on "Endodont i c s - - B a c k to the basics;" Drs. James L. Gutmann, Joseph D. Maggio, and Atsumu Miyahara in an all-day participation course on " A d v a n c e d princ i p l e s of r o o t c a n a l t r e a t m e n t : ultrasonic preparation and thermoplastic condensation;" Drs. Donald Arens,
Gary Taylor, Taisa L. SzeremetaBrowar, Thomas J. Rysz, and Robert L. T r o p p in L i m i t e d A t t e n d a n c e Seminars, and Drs. Richard Burns, Donald Arens, Michael Gaynor, James Gutmann, and Joseph Maggio leading Breakfast Conferences. In addition to the above clinicians, m a n y other AAE members contributed to the meeting as planners or m o d e r a t o r s . . . Dr. Manuel I. W e i s m a n presented an all-day course on February 8 in Fort Lauderdale, Florida, for the South Florida Institute for Post Graduate Health Education. The course was entitled "Conquering p a i n - - t h e e s s e n c e of e n d o d o n t i c c a r e . " Dr. Weisman also helped to present a three-day continuing education course, January 3 1 - F e b r u a r y 2, at the Medical College of Georgia on "Surgical intervention in e n d o d o n t i c s - - i t s place in today's p r a c t i c e . " The course, designed to provide the endodontist with hands-on experience in surgical approaches to endodontic care, consisted of lectures, demonstrations on patients using television monitors, and actual participation with the patients. The participants had an opportunity to see their cases recorded on slides for the purpose of discussion and evaluation. At the conclusion of the course, the slides w e r e presented to participants. Because of the success of this specialized continuing education course, the (cont. next page)
From Our President
Passages As my presidential year comes to a close, a myriad of impressions flood my mind concerning our Association and the specialty of endodontics. A seemingly endless number of flights across the country, meetings with endodontic study clubs and state endodontic associations, telephone calls, and conference calls, Executive Committee and Board of Directors meetings, and working with a superlative group of volunteer endodontists will long be remembered. Culling from all this just two or three of my most salient impressions seems almost impossible, yet doing so is a good way to force the identification of issues I see as most important to us now and in the year immediately ahead. The paramount issue we face is the realization that "retreatodontics," and all it represents, is with us forever. No longer will North American endodontists treat large volumes of simple endodontic cases. The huge number of teeth requiring endodontic treatment that characterized American dentistry in the 1950s and 1960s will never recur again. The postfluoridation era has begun. Fewer teeth need root canal treatment, fewer teeth are lost to extraction, and fewer fixed bridges are being constructed. Our general dentist colleagues, by all reports, are less "busy." They keep busy with greater emphasis on prevention, aesthetic dentistry, TMJ diagnosis and treatment, and treating the easiest of the cases previously referred to dental specialists of all types. This is natural; it will not go away. The natural consequence of all this for endodontists is that we will be busy in the decades ahead, but we will be treating, for the most part, the difficult cases, the youngest and the oldest patients, the calcified and tortuous canals, and cases in which an initial attempt at endodontic treatment has been unsuccessful. Then will the endodontic specialists be called in to salvage the case, to find the canal, to bypass the ledge, the calcification, the paste, the broken instrument, to seal the perforation, to hemisect the root, to reverse seal the apex, to do the magic to save the case. If it sounds like your practice this week, you are notalone. But after the culture shock, cheer up; you are training for the future, and there is going to be an immense need for us in the years ahead. Our Public Awareness Program is working successfully to slow this trend and in some cases to reverse it. Yet other powerful forces tell us that eventually, our work will be more difficult, hopefully more interesting, certainly more fatiguing. The Public Awareness Program is essential in order to maintain the best balance possible for our patients no less than for ourselves. Another major issue was touched upon in this column slightly more than a year ago. When Steve Schwartz was AAE president, he wrote a piece entitled "Leave it to your own devices." I regret that the problem he alluded to has become worse since that time. A profitless proliferation of endodontic gadgets floods the marketplace. The market will deal with this flotsam and jetsam as it has in the past. But we may need to define again our endodontic practices, who we are, and what we purport to teach. We will surely have to redefine as well our primary concern for patient care as opposed to personal convenience and self-interest after the debris is cleared away. Don't misunderstand me. I'm all for experimentation and innovation, and I really do appreciate the market's role in technology advancement. I'm speaking here only of the most flagrant and am fearful that it become, even temporarily, the commonplace. I.'m speaking of bankrupt ideas and bankrupt factories, of textbooks promoting products rejected by the market before the ink is dry on the page and of vacation paradises used to lure the uninitiated to courses featuring the latest device that moves, makes noise, or lights up in root canals. The real problem, of course, is the lag between the time we endodontic specialists evaluate and reject a notion or gadget and the rejection of the concept or machine by the general dentists who look to us for guidance. It is a free market. I'm calling only for collective wisdom, caution and restraint. Hundreds of our members have expressed their anxiety to me in this regard. I look forward to seeing many of you in Boston at our annual meeting and to talking to you about your concerns. This is a time of change, a time of transition. Fortunately, we are ready for the task. The Association is strong. Our membership is large, better informed and better educated than ever. Irma Kudo, our Executive Director, heads a truly outstanding staff in our Chicago office. I leave office with confidence and admiration for the intelligence, resourcefulness, and experience of our incoming president, Mike Heuer. It has been a privilege to serve as your president. My time is over, but the work goes on. Come join in that work. Herbert Schilder, DDS President
177
Notes From Here and There The Chicago Dental Society held its 121st Midwinter Meeting, entitled " N e w Horizons," February 16-19 at the Chicago Hilton and Towers. Several AAE members participated in the meeting including Dr. Bernard J. Grothaus, Secretary of the CDS; Dr. Michael J. K o w a l i k , Program Chairman; Drs. Leo J. Miserendino, Amy B. Dukoff and Peter A. Guagliano w h o presented endodontic table clinics; Dr. F r a n k l i n S. Weine in a presentation on "Endodont i c s - - B a c k to the basics;" Drs. James L. Gutmann, Joseph D. Maggio, and Atsumu Miyahara in an all-day participation course on " A d v a n c e d princ i p l e s of r o o t c a n a l t r e a t m e n t : ultrasonic preparation and thermoplastic condensation;" Drs. Donald Arens,
Gary Taylor, Taisa L. SzeremetaBrowar, Thomas J. Rysz, and Robert L. T r o p p in L i m i t e d A t t e n d a n c e Seminars, and Drs. Richard Burns, Donald Arens, Michael Gaynor, James Gutmann, and Joseph Maggio leading Breakfast Conferences. In addition to the above clinicians, m a n y other AAE members contributed to the meeting as planners or m o d e r a t o r s . . . Dr. Manuel I. W e i s m a n presented an all-day course on February 8 in Fort Lauderdale, Florida, for the South Florida Institute for Post Graduate Health Education. The course was entitled "Conquering p a i n - - t h e e s s e n c e of e n d o d o n t i c c a r e . " Dr. Weisman also helped to present a three-day continuing education course, January 3 1 - F e b r u a r y 2, at the Medical College of Georgia on "Surgical intervention in e n d o d o n t i c s - - i t s place in today's p r a c t i c e . " The course, designed to provide the endodontist with hands-on experience in surgical approaches to endodontic care, consisted of lectures, demonstrations on patients using television monitors, and actual participation with the patients. The participants had an opportunity to see their cases recorded on slides for the purpose of discussion and evaluation. At the conclusion of the course, the slides w e r e presented to participants. Because of the success of this specialized continuing education course, the (cont. next page)