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The DDS-DMD issue
If we let C D S blatantly disregard th e A D A guidelines, which were ob viously intended to protect the prac tice of general dentistry, w hat kind of treatm ent can we expect from private insurers? L O U IS M A R A V IG L IA , D D S SAN FR A N C ISC O
■ E d ito r’s note: T he 1973 H ouse of D elegates referred for study and re p o rt back in 1974 the question of delet ing, retaining, or modifying th e exist ing Standard X X II, on w hich D r. M araviglia com m ents. T he Council on D ental Care Program s has been in touch with a broad range of interested dental groups in the process of form u lating a recom m endation to be sent, through the Board of T rustees, to the 1974 H ouse for its judgm ent. A lthough the Council’s files do not show any correspondence with D r. M araviglia, the Council will respond to him directly on this matter.
The D D S -D M D issue a I w ould like to com m ent on the let te r from D avid Griggs (April j a d a , page 691) concerning the use of the D D S degree versus the D M D degree. If the dentist sees his professional duties as strictly treating the hard structures of the m outh, then either of these degrees should be sufficient since both of them refer specifically to the teeth. If the dentist sees his pro fessional duty as the m echanistic re pair of dental dam age, he always will rem ain in the back row of the health professionals. T he dentist probably is the only medical practitioner who does no routine diagnostic tests to de term ine the etiology of the diseases he treats, other than to merely establish their presence or absence. It is unusual to find a dentist who perform s b lood, urine, or other tests to aid in diagnosing system ic influences on oral disease. M any diseases have oral sym ptom s as part of their syn drom e or “ cluster” effect. Leukem ia, purpura, diabetes, hypoglycemia, syphilis, and avitam inoses are only a few of the system ic pathoses that are reflected in the mouth. It would seem to me that our pro
fessional organizations such as the A D A would strongly advise all den tists to routinely prescribe and inter p ret medical screening tests as part of their ordinary diagnostic procedures. T his would be an educational process for the dentist as well as a legal asset. It would seem that any dentist per forming oral procedures w ithout hav ing medical screening tests as back ground is leaving himself open to legal liability. If the dentist becomes aw are of his true responsibilities in the health field and perform s diagnosis and therapeu tics in a thorough and scientific fash ion, then the logical degree would be D O M — D o cto r of Oral M edicine.
specialization in oralogy. H ow ever, such a proposal would cut across many existing political and organ izational lines. A lthough such a proposal would be preferable, it is questionable how feasible it would be. A m ore feasible idea would be for the A D A to bestow a D O M (D o cto r of Oral M edicine) degree on all current and future prac titioners. R O B E R T S. R IC H M A N CLASS O F 1974 SU N Y A T ST O N Y BROOK D E N T A L SC H O O L
E n joys Q & A section
ROY E . S T A N F O R D , J R ., D D S Me L E A N , VA
■ I also share the concern o f D avid Griggs. H ow ever, I believe his letter only scratches the surface of the “ de gree dilem m a.” I believe that the only way to clear up the current confusion is to view it from an historical perspective. T he term s “ den tist,” “ d en tal,” and “ den tistry ” all stem from the Latin word “ d e n s,” which means tooth. T he main reason why the dental profession de veloped an identity separate from the medical profession is because the sole responsibility of the form er was once restricted to the repair and extraction of teeth. As it once existed, dentistry was considered purely a mechanical skill, requiring no knowledge of the human body. T he D D S degree is a direct re sult of this type of dental practice and, as such, is an anachronism . It is my opinion that the D M D degree is not much more valid because the term “ dental” still implies that the d en tist’s only concern is the teeth. H ow ever, the dental profession— as it exists today—does not ju st con cern itself with the teeth but with the entire oral cavity. Because of this, the practitioner more properly should be called an ‘‘oralist’’ and the field named “ oralogy.” Logistically, it shouldn’t even be a separate field, but rather ju st another medical specialty like ophthalmology or derm atology. T he degree should be one with an M D designation, with
m Regarding your question posed in the April j a d a (page 185) concerning the usefulness of the “ Q uestions and A n sw ers” departm ent, my response would have to be an em phatic “ yes!” I consider the reading of this section of t h e j o u r n a l a requirem ent; the topics covered always are relevant and interesting. M any tim es the infor mation is of th e sort that is not easily located in oth er reference sources, w hether textbooks or the periodical literature. By all means continue the depart m ent. Perhaps your point of refer ence might be to deal with questions that are on the periphery o f dentistry — controversial and unconservative subjects and treatm en ts, or questions of interest to laymen (your recent item on w ater hardness is a good example). Y ou might expand the departm ent to serve as a reference source on all as pects of dentistry to all of the profes sion. FRED s ie m o n D A L Y C IT Y , C A L IF
Im portan ce o f flu o rid e
■ W ater is m an’s m ost essential food. It contains essential food com pon ents, elem ents taken from the earth it contacts. F o r millions of years, m an’s w ater supply was that of running stream s, lakes, rivers, wells, and cisterns. All o f these forms w ere soil leaching, en riched with the m inerals from the soil
LETTER S TO THE EDITOR / JADA, V o l. 88, J u n e 1974 ■ 1241
■ E d ito r’s note: T he 1973 H ouse of D elegates referred for study and re p o rt back in 1974 the question of delet ing, retaining, or modifying th e exist ing Standard X X II, on w hich D r. M araviglia com m ents. T he Council on D ental Care Program s has been in touch with a broad range of interested dental groups in the process of form u lating a recom m endation to be sent, through the Board of T rustees, to the 1974 H ouse for its judgm ent. A lthough the Council’s files do not show any correspondence with D r. M araviglia, the Council will respond to him directly on this matter.
The D D S -D M D issue a I w ould like to com m ent on the let te r from D avid Griggs (April j a d a , page 691) concerning the use of the D D S degree versus the D M D degree. If the dentist sees his professional duties as strictly treating the hard structures of the m outh, then either of these degrees should be sufficient since both of them refer specifically to the teeth. If the dentist sees his pro fessional duty as the m echanistic re pair of dental dam age, he always will rem ain in the back row of the health professionals. T he dentist probably is the only medical practitioner who does no routine diagnostic tests to de term ine the etiology of the diseases he treats, other than to merely establish their presence or absence. It is unusual to find a dentist who perform s b lood, urine, or other tests to aid in diagnosing system ic influences on oral disease. M any diseases have oral sym ptom s as part of their syn drom e or “ cluster” effect. Leukem ia, purpura, diabetes, hypoglycemia, syphilis, and avitam inoses are only a few of the system ic pathoses that are reflected in the mouth. It would seem to me that our pro
fessional organizations such as the A D A would strongly advise all den tists to routinely prescribe and inter p ret medical screening tests as part of their ordinary diagnostic procedures. T his would be an educational process for the dentist as well as a legal asset. It would seem that any dentist per forming oral procedures w ithout hav ing medical screening tests as back ground is leaving himself open to legal liability. If the dentist becomes aw are of his true responsibilities in the health field and perform s diagnosis and therapeu tics in a thorough and scientific fash ion, then the logical degree would be D O M — D o cto r of Oral M edicine.
specialization in oralogy. H ow ever, such a proposal would cut across many existing political and organ izational lines. A lthough such a proposal would be preferable, it is questionable how feasible it would be. A m ore feasible idea would be for the A D A to bestow a D O M (D o cto r of Oral M edicine) degree on all current and future prac titioners. R O B E R T S. R IC H M A N CLASS O F 1974 SU N Y A T ST O N Y BROOK D E N T A L SC H O O L
E n joys Q & A section
ROY E . S T A N F O R D , J R ., D D S Me L E A N , VA
■ I also share the concern o f D avid Griggs. H ow ever, I believe his letter only scratches the surface of the “ de gree dilem m a.” I believe that the only way to clear up the current confusion is to view it from an historical perspective. T he term s “ den tist,” “ d en tal,” and “ den tistry ” all stem from the Latin word “ d e n s,” which means tooth. T he main reason why the dental profession de veloped an identity separate from the medical profession is because the sole responsibility of the form er was once restricted to the repair and extraction of teeth. As it once existed, dentistry was considered purely a mechanical skill, requiring no knowledge of the human body. T he D D S degree is a direct re sult of this type of dental practice and, as such, is an anachronism . It is my opinion that the D M D degree is not much more valid because the term “ dental” still implies that the d en tist’s only concern is the teeth. H ow ever, the dental profession— as it exists today—does not ju st con cern itself with the teeth but with the entire oral cavity. Because of this, the practitioner more properly should be called an ‘‘oralist’’ and the field named “ oralogy.” Logistically, it shouldn’t even be a separate field, but rather ju st another medical specialty like ophthalmology or derm atology. T he degree should be one with an M D designation, with
m Regarding your question posed in the April j a d a (page 185) concerning the usefulness of the “ Q uestions and A n sw ers” departm ent, my response would have to be an em phatic “ yes!” I consider the reading of this section of t h e j o u r n a l a requirem ent; the topics covered always are relevant and interesting. M any tim es the infor mation is of th e sort that is not easily located in oth er reference sources, w hether textbooks or the periodical literature. By all means continue the depart m ent. Perhaps your point of refer ence might be to deal with questions that are on the periphery o f dentistry — controversial and unconservative subjects and treatm en ts, or questions of interest to laymen (your recent item on w ater hardness is a good example). Y ou might expand the departm ent to serve as a reference source on all as pects of dentistry to all of the profes sion. FRED s ie m o n D A L Y C IT Y , C A L IF
Im portan ce o f flu o rid e
■ W ater is m an’s m ost essential food. It contains essential food com pon ents, elem ents taken from the earth it contacts. F o r millions of years, m an’s w ater supply was that of running stream s, lakes, rivers, wells, and cisterns. All o f these forms w ere soil leaching, en riched with the m inerals from the soil
LETTER S TO THE EDITOR / JADA, V o l. 88, J u n e 1974 ■ 1241