- Email: [email protected]
REPORT QUESTIONED
V I E W S
1. Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science 1999;284 (5418):1318-22.
REPORT QUESTIONED
Dr. James Hamilton and colleagues present a well-planned clinical evaluation of caries and possible treatment (“Early Treatment of Incipient Carious Lesions,” December JADA). I find a number of issues with the article, but prefer to address one. JADA has again allowed an article championing nontreatment that was underwritten by an insurance company (Delta Dental). There is a saying that applies well to this situation: “Make a fool of me once, shame on you. Make a fool of me twice, shame on me.” Brian Gray, D.D.S. Washington Editor’s note: The fact that Dr. Gray, and all our readers, know where the funding for a particular study originated is a clear indication that we are doing our jobs properly. Materials published in JADA are judged on their merits through a well-established peerreview process that requires full disclosure of sponsoring organizations and author affiliations. Armed with this information, readers are free to draw their own conclusions about the information provided. In this case, our peer reviewers were sufficiently satisfied that the information provided and conclusion drawn were valid and worthy of The Journal. BIOTERRORISM RESPONSE
The ADA’s response to the threat of bioterrorism has made
276
me very proud to be a member. Normally, organizations like the ADA move slowly and deliberately when addressing a difficult new issue that might involve its constituency. But that has not been true in the ADA’s response to the bioterrorist threat, and I applaud the ADA’s courage. The conference on this topic sponsored by the Association in June 2002, its rapid publication in JADA in September 20021 and the plan to co-sponsor a major meeting on the role of the profession in bioterrorism preparedness in collaboration with the U.S. Public Health Service in March 2003 have underscored the commitment of the ADA to mobilizing dentists to serve the nation in these troublesome times. Dr. Jeffcoat’s December JADA editorial (“Are We Ready? Thinking About the Unthinkable”) continues the leadership role that the ADA has assumed in providing a pathway for dentists to become involved in making the country stronger to future bioterrorist events. Dr. Jeffcoat outlines the important skills and facilities offered by dentists; but she also singles out a key weakness in our responsiveness to date. That is, almost 18 months after Sept. 11, 2001, we do not have a solid communications system in place where committed professionals can turn for help. Dr. Jeffcoat calls for a hotline in the 911 mode that we can turn to for help. I agree with her assessment and would call for additional modes of communication. Public health officials at the local, state and federal levels should be able to reach health professionals by zip code
through a well-ordered system of e-mail, phone and fax; but, to the best of my knowledge, they cannot. With such a system, private practicing health practitioners in an affected area can be educated and mobilized. Although some hospitals have set up such contact networks, the broader public health system has not. Thus, as in the anthrax attacks, professionals will be forced to listen to the same information available to the general public via the mass media. There will be no opportunity to explain appropriate treatment regimens to health professionals, and the response to the threat will be less robust. There are several other weaknesses unfolding as the nation struggles to get prepared. For example, while investing in the national pharmaceutical stockpile is a critical need, we do not yet have effective plans in place to distribute these medical supplies at the local level. One group that will be ready, based on the ADA’s leadership, is the nation’s dentists, who will play a far more important role in preparedness and response than anyone ever imagined in the dark days of September 2001. Michael C. Alfano, D.M.D., Ph.D. Dean, College of Dentistry New York University New York 1. Guay AH. Dentistry’s response to bioterrorism: a report of a consensus workshop. JADA 2002;133(9):1181-7.
JADA, Vol. 134, March 2003 Copyright ©2003 American Dental Association. All rights reserved.
1. Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science 1999;284 (5418):1318-22.
REPORT QUESTIONED
Dr. James Hamilton and colleagues present a well-planned clinical evaluation of caries and possible treatment (“Early Treatment of Incipient Carious Lesions,” December JADA). I find a number of issues with the article, but prefer to address one. JADA has again allowed an article championing nontreatment that was underwritten by an insurance company (Delta Dental). There is a saying that applies well to this situation: “Make a fool of me once, shame on you. Make a fool of me twice, shame on me.” Brian Gray, D.D.S. Washington Editor’s note: The fact that Dr. Gray, and all our readers, know where the funding for a particular study originated is a clear indication that we are doing our jobs properly. Materials published in JADA are judged on their merits through a well-established peerreview process that requires full disclosure of sponsoring organizations and author affiliations. Armed with this information, readers are free to draw their own conclusions about the information provided. In this case, our peer reviewers were sufficiently satisfied that the information provided and conclusion drawn were valid and worthy of The Journal. BIOTERRORISM RESPONSE
The ADA’s response to the threat of bioterrorism has made
276
me very proud to be a member. Normally, organizations like the ADA move slowly and deliberately when addressing a difficult new issue that might involve its constituency. But that has not been true in the ADA’s response to the bioterrorist threat, and I applaud the ADA’s courage. The conference on this topic sponsored by the Association in June 2002, its rapid publication in JADA in September 20021 and the plan to co-sponsor a major meeting on the role of the profession in bioterrorism preparedness in collaboration with the U.S. Public Health Service in March 2003 have underscored the commitment of the ADA to mobilizing dentists to serve the nation in these troublesome times. Dr. Jeffcoat’s December JADA editorial (“Are We Ready? Thinking About the Unthinkable”) continues the leadership role that the ADA has assumed in providing a pathway for dentists to become involved in making the country stronger to future bioterrorist events. Dr. Jeffcoat outlines the important skills and facilities offered by dentists; but she also singles out a key weakness in our responsiveness to date. That is, almost 18 months after Sept. 11, 2001, we do not have a solid communications system in place where committed professionals can turn for help. Dr. Jeffcoat calls for a hotline in the 911 mode that we can turn to for help. I agree with her assessment and would call for additional modes of communication. Public health officials at the local, state and federal levels should be able to reach health professionals by zip code
through a well-ordered system of e-mail, phone and fax; but, to the best of my knowledge, they cannot. With such a system, private practicing health practitioners in an affected area can be educated and mobilized. Although some hospitals have set up such contact networks, the broader public health system has not. Thus, as in the anthrax attacks, professionals will be forced to listen to the same information available to the general public via the mass media. There will be no opportunity to explain appropriate treatment regimens to health professionals, and the response to the threat will be less robust. There are several other weaknesses unfolding as the nation struggles to get prepared. For example, while investing in the national pharmaceutical stockpile is a critical need, we do not yet have effective plans in place to distribute these medical supplies at the local level. One group that will be ready, based on the ADA’s leadership, is the nation’s dentists, who will play a far more important role in preparedness and response than anyone ever imagined in the dark days of September 2001. Michael C. Alfano, D.M.D., Ph.D. Dean, College of Dentistry New York University New York 1. Guay AH. Dentistry’s response to bioterrorism: a report of a consensus workshop. JADA 2002;133(9):1181-7.
JADA, Vol. 134, March 2003 Copyright ©2003 American Dental Association. All rights reserved.