- Email: [email protected]
STANDING UP FOR DENTISTRY
L E T T E R S
LETTERS ADA welcomes letters from readers on topics of current interest in dentistry. The Journal reserves the right to edit all communications and requires that all letters be signed. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of the Association. Brevity is appreciated.
J
STANDING UP FOR DENTISTRY
Great editorial (“Health Care or Beauty Treatment,” September JADA). Dr. Jeffcoat pointed out the most important thing we do as dentists—diagnosis and treatment planning—and that we have a tendency to make it the least important part of the trip to the dentist. We also don’t charge enough for this service, but that is another point. Dr. Jeffcoat further points out that those who regulate us (each state’s legislature) can change who does what in the dental field if we, the profession of dentistry, don’t become active in letting our patients and our legislators know just what we really do for the public. I have served on a Special Legislative Study Council Committee on Dental Access in Wisconsin, and the public and legislative members more than once stated that “they only see the dentist for a minute or two when they go to the dentist for their cleanings, and that it is the hygienist and staff who take care of them.” This is how, as Dr. Jeffcoat pointed out, others easily can 1604
get the legal grounds to be doing what dentists and the dental team should be taking care of. In times of tight budgets on all levels, dentistry has to stand up tall and tell its story loud and clear. Take our light out from under the basket and let it shine through each one of us by informing our patients of what really happens during their visit to the dentist. We also need to get involved with “Give Kids a Smile” day next February [Feb. 21, 2003]. We are the only ones who can tell our story, so please start spreading the news so that everyone knows who to go to when dental problems or dental needs need to be addressed. Thomas J. Hughes, D.D.S. Cassville, Wis. Past President Wisconsin Dental Association CHRONIC FACIAL PAIN
The September JADA article by Dr. Cynthia Myers and colleagues, “A Review of Complementary and Alternative Medicine Use for Treating Chronic Facial Pain,” was very interesting. Unfortunately, the conclusions do not follow from the data. The authors stated that “across studies, results indicated acupuncture was at least comparable to other conservative dental treatment (for example, intraoral appliance and self-care instruction) and warranted further study.” But acupuncture is not conservative. It has potentially far greater risks than the other treatments. I think a more appropriate conclusion would be that acupuncture has not been
shown to be an effective alternative to conventional, noninvasive temporomandibular disorder pain therapies. The results for biofeedback and relaxation therapies were equally equivocal. I believe the proper conclusion for these treatments is the need for costbenefit analysis. As the authors state, the popularity of complementary and alternative medicine, or CAM, should not blind us to the fact that very little is known about the safety and efficacy of these techniques. John E. Dodes, D.D.S. Forest Hills, N.Y. Authors’ response: We thank Dr. Dodes for his commentary on our review of CAM use for treating chronic facial pain, and Dr. Jeffcoat for this opportunity to respond. It appears that Dr. Dodes disagrees with two aspects of our conclusion that “acupuncture was at least comparable to other conservative dental treatment (for example, intraoral appliance and self-care instruction) and warranted further study.” First, he disputes the implication that acupuncture is conservative treatment, on the basis of its “potentially far greater risks.” While needle acupuncture is more invasive than intraoral appliance or selfcare instruction, with regard to potential risks and benefits of acupuncture, we refer the reader to the 1997 statement1 from the Acupuncture NIH Consensus Development Conference: “One of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions. As an exam-
JADA, Vol. 133, December 2002 Copyright ©2002 American Dental Association. All rights reserved.
LETTERS ADA welcomes letters from readers on topics of current interest in dentistry. The Journal reserves the right to edit all communications and requires that all letters be signed. The views expressed are those of the letter writer and do not necessarily reflect the opinion or official policy of the Association. Brevity is appreciated.
J
STANDING UP FOR DENTISTRY
Great editorial (“Health Care or Beauty Treatment,” September JADA). Dr. Jeffcoat pointed out the most important thing we do as dentists—diagnosis and treatment planning—and that we have a tendency to make it the least important part of the trip to the dentist. We also don’t charge enough for this service, but that is another point. Dr. Jeffcoat further points out that those who regulate us (each state’s legislature) can change who does what in the dental field if we, the profession of dentistry, don’t become active in letting our patients and our legislators know just what we really do for the public. I have served on a Special Legislative Study Council Committee on Dental Access in Wisconsin, and the public and legislative members more than once stated that “they only see the dentist for a minute or two when they go to the dentist for their cleanings, and that it is the hygienist and staff who take care of them.” This is how, as Dr. Jeffcoat pointed out, others easily can 1604
get the legal grounds to be doing what dentists and the dental team should be taking care of. In times of tight budgets on all levels, dentistry has to stand up tall and tell its story loud and clear. Take our light out from under the basket and let it shine through each one of us by informing our patients of what really happens during their visit to the dentist. We also need to get involved with “Give Kids a Smile” day next February [Feb. 21, 2003]. We are the only ones who can tell our story, so please start spreading the news so that everyone knows who to go to when dental problems or dental needs need to be addressed. Thomas J. Hughes, D.D.S. Cassville, Wis. Past President Wisconsin Dental Association CHRONIC FACIAL PAIN
The September JADA article by Dr. Cynthia Myers and colleagues, “A Review of Complementary and Alternative Medicine Use for Treating Chronic Facial Pain,” was very interesting. Unfortunately, the conclusions do not follow from the data. The authors stated that “across studies, results indicated acupuncture was at least comparable to other conservative dental treatment (for example, intraoral appliance and self-care instruction) and warranted further study.” But acupuncture is not conservative. It has potentially far greater risks than the other treatments. I think a more appropriate conclusion would be that acupuncture has not been
shown to be an effective alternative to conventional, noninvasive temporomandibular disorder pain therapies. The results for biofeedback and relaxation therapies were equally equivocal. I believe the proper conclusion for these treatments is the need for costbenefit analysis. As the authors state, the popularity of complementary and alternative medicine, or CAM, should not blind us to the fact that very little is known about the safety and efficacy of these techniques. John E. Dodes, D.D.S. Forest Hills, N.Y. Authors’ response: We thank Dr. Dodes for his commentary on our review of CAM use for treating chronic facial pain, and Dr. Jeffcoat for this opportunity to respond. It appears that Dr. Dodes disagrees with two aspects of our conclusion that “acupuncture was at least comparable to other conservative dental treatment (for example, intraoral appliance and self-care instruction) and warranted further study.” First, he disputes the implication that acupuncture is conservative treatment, on the basis of its “potentially far greater risks.” While needle acupuncture is more invasive than intraoral appliance or selfcare instruction, with regard to potential risks and benefits of acupuncture, we refer the reader to the 1997 statement1 from the Acupuncture NIH Consensus Development Conference: “One of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions. As an exam-
JADA, Vol. 133, December 2002 Copyright ©2002 American Dental Association. All rights reserved.