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The Buckley-Price Debate
The Journal of the American Dental Association 58 E ast W ashin gton Street, Chicago, Illinois. P le a s e sen d in p ro m p tly n o tice o f ch a n ge o f ad d ress, g iv in g b o t h o ld a n d n ew . Im porta n t in fo r m a tio n reg a r d in g s u b s c r ip tio n p r ic e , e tc ., w ill b e fo u n d in th e a d v e rtis in g p ages.
Editorial THE BUCKLEY-PRICE DEBATE As will be noted in another department, we are publishing in the present issue the Buckley-Price debate. While it is not cus tomary to make editorial comment on matter appearing else where in T h e J o u r n a l , the transcendent importance of this question of pulpless teeth and its prominence in the professional and public mind at this time makes it imperative that the widest consideration be given it from every possible source. First, we would pay a tribute to the masterly way in which each debater presented his subject. It was, as President Goslee said, a momentous occasion, with an estimated audience of fifteen hundred listening tensely to the arguments pro and con ; and the evident seriousness with which each speaker approached his subject showed how important the issue appeared to him. It would be futile at this time to attempt to refer in any detail to the various points raised by the debaters, but out of the haze of the entire discussion— and there was much haze connected with it— there is one concrete consideration which has a practical bear ing on the general question of pulpless teeth, which it would seem appropriate to emphasize. It was the pivotal point made repeatedly by Dr. Price to the effect that a pulpless tooth cannot be sterilized in the mouth. In this connection, he said: “ It is practically a physical impossibility, if not completely so, to sterilize infected cementum by treating through the dentin. It is like trying to sterilize infection in the label of a bottle by putting disinfectants in the bottle.” 1540
Editorial Department
1541
His argument is based upon the assumption that no disinfectant can ever pass the barrier of the dentinocemental junction, that the line where these two structures join is impenetrable. This he emphasizes in the strongest possible terms, and there is no mis understanding his position. He even goes so far as to prove this by a study of the laying down of these tissues in the development of the tooth. He says: aThe two formative organs, building toward each other, throw down at first a common continuous wall, which is in effect like a bottle or flask, the opening to which is at the root apex.” He further states: “ Silver nitrate, for ex ample, placed in the interior of a tooth stains the dentin, but does not stain the cementum. Similarly, silver nitrate placed on the exterior of a tooth stains the cementum, but does not stain the dentin.” Nothing can be more positive than this, and yet, in making these assertions, Dr. Price has unconsciously been “hoist on his own petard.” It is a poor rule that will not work both ways, and if it is impossible for the agents of disinfection to pass this bar rier, it is equally impossible for the agents of infection to pass. Consequently, the only thing necessary to make every pulpless tooth perfectly safe to the host is to seal the apical foramen. There is no escaping this contention— if Dr. Price is right. Mayhap, Dr. Price is right, and mayhap that accounts for the well-known clinical fact that there are countless thousands of pulpless teeth being retained in the mouths of people today to their great comfort and advantage, and with not the slightest injury to their physical well-being. There is no intent, at this time, to take sides in the recent debate, but merely to refer to this point, which was so strongly emphasized by Dr. Price, and to call attention to its practical application. The consideration of the subject of pulpless teeth is not ended. It is to be followed up by other organizations, notably by the Chicago Dental Society at its December meeting, and also at its midwinter clinic in January, 1926. We are also creditably in formed that it is to be one of the topics for discussion at the meeting of the Dental Society of the State of New York next
1542
The Journal of the American Dental Association
May, and doubtless it will be taken up by various other organiza tions. All of this is well. Out of much deliberation there must come a clearer idea on this mooted question— a question which today is leading to greater confusion and more uncertainty than any other before the dental profession. And be it said, in this connection, that much of the confusion is caused by clouding the issue with too many irrelevant statistics which have no practical bearing on the main issue, and which take no account of the actual happen ings in the mouths of actual people. The farther we get away from concrete clinical experience, and the more we browse in the herbage— or verbiage— of speculative and spectacular deduc tions, the more we are likely to confuse the profession and the people, and the farther we shall wander from common sense and the truth. Let us above all things keep our feet firmly on the ground, and study this question calmly and judiciously instead of employing so much sensationalism and extravagance in its dis cussion. We may thereby be less impressive, but we shall be nearer the truth, and in the end we shall do more good. OUR GENERAL SECRETARY At various times in the past, there have appeared in the pages of T h e J o u r n a l o f t h e A m e r i c a n D e n t a l A s s o c i a t i o n the portraits of officers of the organization, but the picture of one man has been omitted except where it appeared in a group. In this issue, we are presenting as our frontispiece and without his knowledge, the picture of our General Secretary. We feel sure that our readers in all parts of the world will be glad to see a por trait of the man who has been so intimately associated with the development of the Association for many years. D r . King is probably more familiar with the various activities of our organi zation than any other man living. He has been so close to every movement which has been made for its advancement, and has watched its growth with so vital an interest that it has become the very warp and woof of his professional life. Each succeed-
Editorial THE BUCKLEY-PRICE DEBATE As will be noted in another department, we are publishing in the present issue the Buckley-Price debate. While it is not cus tomary to make editorial comment on matter appearing else where in T h e J o u r n a l , the transcendent importance of this question of pulpless teeth and its prominence in the professional and public mind at this time makes it imperative that the widest consideration be given it from every possible source. First, we would pay a tribute to the masterly way in which each debater presented his subject. It was, as President Goslee said, a momentous occasion, with an estimated audience of fifteen hundred listening tensely to the arguments pro and con ; and the evident seriousness with which each speaker approached his subject showed how important the issue appeared to him. It would be futile at this time to attempt to refer in any detail to the various points raised by the debaters, but out of the haze of the entire discussion— and there was much haze connected with it— there is one concrete consideration which has a practical bear ing on the general question of pulpless teeth, which it would seem appropriate to emphasize. It was the pivotal point made repeatedly by Dr. Price to the effect that a pulpless tooth cannot be sterilized in the mouth. In this connection, he said: “ It is practically a physical impossibility, if not completely so, to sterilize infected cementum by treating through the dentin. It is like trying to sterilize infection in the label of a bottle by putting disinfectants in the bottle.” 1540
Editorial Department
1541
His argument is based upon the assumption that no disinfectant can ever pass the barrier of the dentinocemental junction, that the line where these two structures join is impenetrable. This he emphasizes in the strongest possible terms, and there is no mis understanding his position. He even goes so far as to prove this by a study of the laying down of these tissues in the development of the tooth. He says: aThe two formative organs, building toward each other, throw down at first a common continuous wall, which is in effect like a bottle or flask, the opening to which is at the root apex.” He further states: “ Silver nitrate, for ex ample, placed in the interior of a tooth stains the dentin, but does not stain the cementum. Similarly, silver nitrate placed on the exterior of a tooth stains the cementum, but does not stain the dentin.” Nothing can be more positive than this, and yet, in making these assertions, Dr. Price has unconsciously been “hoist on his own petard.” It is a poor rule that will not work both ways, and if it is impossible for the agents of disinfection to pass this bar rier, it is equally impossible for the agents of infection to pass. Consequently, the only thing necessary to make every pulpless tooth perfectly safe to the host is to seal the apical foramen. There is no escaping this contention— if Dr. Price is right. Mayhap, Dr. Price is right, and mayhap that accounts for the well-known clinical fact that there are countless thousands of pulpless teeth being retained in the mouths of people today to their great comfort and advantage, and with not the slightest injury to their physical well-being. There is no intent, at this time, to take sides in the recent debate, but merely to refer to this point, which was so strongly emphasized by Dr. Price, and to call attention to its practical application. The consideration of the subject of pulpless teeth is not ended. It is to be followed up by other organizations, notably by the Chicago Dental Society at its December meeting, and also at its midwinter clinic in January, 1926. We are also creditably in formed that it is to be one of the topics for discussion at the meeting of the Dental Society of the State of New York next
1542
The Journal of the American Dental Association
May, and doubtless it will be taken up by various other organiza tions. All of this is well. Out of much deliberation there must come a clearer idea on this mooted question— a question which today is leading to greater confusion and more uncertainty than any other before the dental profession. And be it said, in this connection, that much of the confusion is caused by clouding the issue with too many irrelevant statistics which have no practical bearing on the main issue, and which take no account of the actual happen ings in the mouths of actual people. The farther we get away from concrete clinical experience, and the more we browse in the herbage— or verbiage— of speculative and spectacular deduc tions, the more we are likely to confuse the profession and the people, and the farther we shall wander from common sense and the truth. Let us above all things keep our feet firmly on the ground, and study this question calmly and judiciously instead of employing so much sensationalism and extravagance in its dis cussion. We may thereby be less impressive, but we shall be nearer the truth, and in the end we shall do more good. OUR GENERAL SECRETARY At various times in the past, there have appeared in the pages of T h e J o u r n a l o f t h e A m e r i c a n D e n t a l A s s o c i a t i o n the portraits of officers of the organization, but the picture of one man has been omitted except where it appeared in a group. In this issue, we are presenting as our frontispiece and without his knowledge, the picture of our General Secretary. We feel sure that our readers in all parts of the world will be glad to see a por trait of the man who has been so intimately associated with the development of the Association for many years. D r . King is probably more familiar with the various activities of our organi zation than any other man living. He has been so close to every movement which has been made for its advancement, and has watched its growth with so vital an interest that it has become the very warp and woof of his professional life. Each succeed-