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Air-Abrasive Technology
m aterial supplied by the BBC and R euters, this process cannot even begin. B ut th e m edia, feeding on the unquenchable public th irs t for inform ation th a t allegedly will enhance well-being, have their own ethic, and it doesn’t include scientific verification. Nor does th e press consider th a t a single research report m ay not accurately reflect the “real” tru th . D espite this study’s prelim i nary n a tu re , the profession and its scientists should look forw ard to its tim ely publica tion. As th e first U.S. investi gation linking elevated m ercury levels to subclinical behavioral differences in dentists, it deserves special attention. To those who will exam ine the data, th e ADA scientist who co authored th e research offers a series of caveats. F irst, he cautions, the study was able to find only 19 dentists w ith m ercury levels averaging 36 pgs/liter in urine. This num ber represents less th a n 3 percent of all dentists who
LETTERS ADA welcomes letters from readers on topics of current in terest in dentistry. JADA reserves the right to edit all communications and requires th a t all letters be typed, double spaced and signed. The views expressed are those of the letter w riter and do not necessarily reflect th e opinion or official policy of the Association. Brevity is appreciated. 1164
JADA, Vol. 125, September 1994
participated in the screening, allowing a few dentists to have a large im pact on the results. Second, the researcher notes th a t the “u rinary m ercury levels were not significantly associated w ith any of the individual cognitive or motor functions.” He concludes th a t it was only th e sum of ranked score m easurem ents th a t suggested any mercury-induced effects. Third, he cautions th a t the m ercury levels reported for the sam ple dentists were seven to 10 tim es higher th an the norm al m ercury levels noted in national surveys of dentists— and 15 tim es higher th an m ercury levels found in the general public. The BBC and R euters failed to point th is out, apparently content to infer th a t w h at was noted in a few dentists would also be noted in all those w ith silver fillings in th e ir m ouths. These restrictions notw ith standing, certain elem ents of th is investigation require im m ediate professional
attention. For example, the excessively high urine m ercury levels noted in the dentists studied should alert all of us to the hazards of poor m ercury hygiene. Are th ere dentists who still use squeeze cloths? Are some still not using pre-encapsulated am algam ? Or not w earing gloves w hen preparing am algam ? Are m ercury spills more frequent th an reported? These are p ertinent questions if you recall the recent research describing reduced fertility in those dental assista n ts whose m ercury handling processes were inconsistent w ith ADAadvocated guidelines. U rinary m ercury concentrations in dental practitioners participating in the ADA h ealth screening program have decreased more th a n fivefold in th e last decade. W ith p resent technology there is no excuse for dentists to continue practices th a t m ay be harm ful to them selves or th eir dental team members. ■
AIR-AB RASIVE TECHNOLOGY
dental school, is not to restore teeth w ith these signs. Were the authors sim ply looking to dem onstrate an expensive new piece of dental equipm ent, or is th ere other pertin en t diagnostic inform ation dem onstrating caries th e authors failed to in clude? If not, perhaps it would have been more prudent to put the “air-abrasive cavity prep aration system ” away and seal the tooth or do nothing! C h risto p h er A. H ooper, D.D.S. V irg in ia B each , Va.
This letter concerns the May 1994 cover story on “AirAbrasive Technology: Its New Role in Restorative D entistry” by Drs. Ronald E. Goldstein and Frederick M. Parkins. I call your attention specifically to Figure 1. I am quite taken aback by the authors’ decision to restore, by th eir own account, a “lower prem olar with m inimal staining, to which the explorer does not stick and is unable to penetrate.” The standard of care in Virginia, th e state where I practice and instruct a t the Medical College of Virginia
A u th o rs’ resp on se: Dr. Hooper expresses concern with
LETTERS ADA welcomes letters from readers on topics of current in terest in dentistry. JADA reserves the right to edit all communications and requires th a t all letters be typed, double spaced and signed. The views expressed are those of the letter w riter and do not necessarily reflect th e opinion or official policy of the Association. Brevity is appreciated. 1164
JADA, Vol. 125, September 1994
participated in the screening, allowing a few dentists to have a large im pact on the results. Second, the researcher notes th a t the “u rinary m ercury levels were not significantly associated w ith any of the individual cognitive or motor functions.” He concludes th a t it was only th e sum of ranked score m easurem ents th a t suggested any mercury-induced effects. Third, he cautions th a t the m ercury levels reported for the sam ple dentists were seven to 10 tim es higher th an the norm al m ercury levels noted in national surveys of dentists— and 15 tim es higher th an m ercury levels found in the general public. The BBC and R euters failed to point th is out, apparently content to infer th a t w h at was noted in a few dentists would also be noted in all those w ith silver fillings in th e ir m ouths. These restrictions notw ith standing, certain elem ents of th is investigation require im m ediate professional
attention. For example, the excessively high urine m ercury levels noted in the dentists studied should alert all of us to the hazards of poor m ercury hygiene. Are th ere dentists who still use squeeze cloths? Are some still not using pre-encapsulated am algam ? Or not w earing gloves w hen preparing am algam ? Are m ercury spills more frequent th an reported? These are p ertinent questions if you recall the recent research describing reduced fertility in those dental assista n ts whose m ercury handling processes were inconsistent w ith ADAadvocated guidelines. U rinary m ercury concentrations in dental practitioners participating in the ADA h ealth screening program have decreased more th a n fivefold in th e last decade. W ith p resent technology there is no excuse for dentists to continue practices th a t m ay be harm ful to them selves or th eir dental team members. ■
AIR-AB RASIVE TECHNOLOGY
dental school, is not to restore teeth w ith these signs. Were the authors sim ply looking to dem onstrate an expensive new piece of dental equipm ent, or is th ere other pertin en t diagnostic inform ation dem onstrating caries th e authors failed to in clude? If not, perhaps it would have been more prudent to put the “air-abrasive cavity prep aration system ” away and seal the tooth or do nothing! C h risto p h er A. H ooper, D.D.S. V irg in ia B each , Va.
This letter concerns the May 1994 cover story on “AirAbrasive Technology: Its New Role in Restorative D entistry” by Drs. Ronald E. Goldstein and Frederick M. Parkins. I call your attention specifically to Figure 1. I am quite taken aback by the authors’ decision to restore, by th eir own account, a “lower prem olar with m inimal staining, to which the explorer does not stick and is unable to penetrate.” The standard of care in Virginia, th e state where I practice and instruct a t the Medical College of Virginia
A u th o rs’ resp on se: Dr. Hooper expresses concern with