Occlusal equilibration

prevent bleeding. The reason for this phenomenon is not in the clotting mechanism, but rather the contraction o f the m uscles in the artery and cap­ illary system s. The use o f hypnosis during dental surgery for the cessation of bleeding is described by Dr. Hartland in M edical a nd D ental H ypnosis (London, Balliere, Tindall, & Cassell, 1966, 329). I understand that there is research in this area regarding the hemophiliac at the present time. H ow ­ ever, because of the serious problems that the hemophiliac patient can pre­ sent to the dentist, the use of hypno­ sis should be considered. The reader also is referred to my case report concerning a chronic bleeder in the October 1971 Journal o f Clinical H ypnosis. Subsequently, the daughter of the patient in ques­ tion was found to have a bleeding problem and referred to a hematolo­ gist, who reported that she had a fac­ tor V III problem. The daughter, as well as the mother, has been success­ fully treated by me via hypnosis— with no occurrence of bleeding. M ILTON N E W M A N , DDS PEEKSKILL, NY

O cclusal equilibration In the N ovem ber j a d a article, “ Nonrigid connectors for fixed par­ tial dentures,” by Drs. Shillingburg and Fisher, the patient could have been spared the expense of a preci­ sion attachment by an adequate occlu­ sal equilibration. If prematurities alone were eliminated, the schematic fulcrum drawn by the authors would be invalid. The responsibility of the dentist to equilibrate the case both prior to and after the insertion of the prosthesis would give the patient a better result at a lower cost. m

PETER CHIA RAVALLI, DDS VIRG IN IA BEACH, VA

A u th o r’s reply: Dr. Chiaravalli very rightly makes a strong case for occlu­ sal equilibration. The importance of its judicious use in mouths requiring extensive restorations cannot be over­ emphasized. We would not suggest

that the need for occlusal equilibration is obviated by the use of nonrigid con­ nectors in fixed partial dentures. That is not the rationale for their use. The utilization of nonrigid connec­ tors is advocated to minimize the destructive effects of physiologic tooth movement under a fixed pros­ thesis when that appliance is sub­ jected to normal occlusal forces. It would be foolish indeed to use this restoration design to circumvent needed equilibration. HERBERT T. SHILLIN B U RG , JR, DDS

Sim ple claim fo rm ■ Eli Lilly and Co. should be com­ mended for its recently announced dental plan w hose single requirement for payment is the submission by an em ployee of a bill showing the den­ tist’s name, date, nature o f procedure, and itemized charges. N o claim form need be filed by the dentist. Until all other dental insurance plans are able to provide the dentist with the same freedom from extra bookwork, we could improve our own lot a great deal by revising our cur­ rent ADA-approved Uniform Claim Form. This form, while excellent in concept, leaves a great deal to be de­ sired in actual practice, as it is more detailed and time-consuming to com­ plete than 90% o f the insurance forms which are furnished by the carriers. The first 12 entries on the A D A Uniform Claim Form are personal to the patient, and could best be filled in by the patient himself with a con­ siderable saving in secretarial time for the dental office staff. The Blue Shield Participating D octor’s Statement of Services form has a similar section which is color-coded and identified by the legend, “ subscriber com pletes.” If it works for so large an organization with its diversified clientele, it should work for dentistry, also. The examination and treatment rec­ ord on the Uniform Claim Form re­ sembles a photo-billing ledger card. It easily could be rearranged on the form so that the dentist could either staple a photocopy of his ledger card over it or make his entries directly on it, as must be done now. This would

effect an enormous saving in time for the many dentists who use photocopy billing, and would in no way incon­ venience those who do not. Entries 13 through 16 would be fur­ nished by the bill’s heading and by a rubber stamp. With these two changes, when a patient requested a claim form, the dentist would merely have to check off the answers to items 17 to 20, staple a photocopy of his bill to the claim form, stamp it, sign it, and send it off in a mat­ ter o f a few seconds. What a convenience to the patient, compared to the present situation when the patient requests a claim form and the dental assistant— with perhaps a slight droop in her smile— promises that she will provide one just as soon as she can do the’considerable typing involved, “ maybe in a week or tw o.” JAMES T . O ’CONNOR, DDS GOSHEN, NY

A D A ’s yo ung a n d old ■ The phrase, “ where have all the young men g on e,” refers to the lyrics from a recently popular song, but could just as well refer tb the situation in organized dentistry. There is proportionately a smaller number of young men involved in all levels o f activity at all levels of the A D A . One only has to look at pictures of the A ssociation’s boards and coun­ cils to note the lack of young faces, and thus begin to understand why the young practitioner feels that the or­ ganization frequently fails to represent his viewpoint. Since I have been active in the or­ ganization— not sure whether I’m considered young or old— I have found that the Association is more concerned about young dentists than those young dentists think it is. H ow ­ ever, the frustration young men feel about organized dentistry is based on their view that it is ultraconservative, nonresponsive, and nonaggressive. The lack of interest that these young dentists show for the American D en­ tal A ssociation is extremely impor­ tant, even if their basis for disinterest is wrong, because they are essential in our battles of the present and in those to com e. Our future strength is found­

LE TTE R S TO TH E E D ITO R / JAD A, V o l. 88, F e b ru a ry 1974 ■ 275