dentists from the surrounding tow ns signed up for the program —even though to som e o f them Stephen had been only a professional acquain tance. T he receptionists in Stephen’s of fice w ere kept busy contacting pa tients and explaining to them that all appointm ents w ould be filled. N o t only w ere the dentists great in donating their tim e and skill but the patients w ere equally special, too. T h ey w ere m ost understanding. F ew appointm ents w ere cancelled and many m ore w ere m ade for m onths ahead for the new dentist who would take S tephen’s practice. T h e team w ork am ong these three groups of people was adm irable. The dentists w orked under difficulty be cause o f unfam iliar surroundings. The patients and the receptionists were u nder a strain, too, because each day th ey w ere w orking w ith a different dentist. H ow ever, w ith the splendid team w ork of dentists, patients, and receptionists, S tephen’s office was kept in operation fo r the intended two m onths. T he donation of these dedicated m en’s tim e and skill w as given to me and my children to help us financially. But it has m eant much m ore to us than that. We feel it to be a splendid tribute to Stephen and to us an am eliorator to a very tragic loss. This is indeed an act of which the dental profession and th e people of A cadianna can be ju stly proud, and w e w ant to thank the m any dentists, especially those from N ew Iberia, Je an erette, and Loreauville, who de voted their tim e and skill so willingly and unselfishly to us. C O N N IE B ER N A R D N E W IB E R IA , LA
W ife c o m m e n ts on in su ra n ce m I am writing as the wife of a prac ticing dentist, concerning the increas ing problem s with dental insurance program s. I fail to see the reason for the den tists’ plight. Y ou are all universityeducated m en, with as much time, m oney, and skill invested in your p ro fession as any physician and certainly
any P hD in this country, and yet you have allow ed yourselves to becom e chattels o f the insurance com panies of A m erica. It is incredible to me that you m ust first seek their authorization to perform your professional ser vices, and then be forced to do their paper w ork, at y o u r expense, before you can receive paym ent for services you’ve already com pleted! It seems to me that you fail to rec ognize the fact that united you are the m ost pow erful single dental group in this country. N o t even the m ost skilled surgeon in these U nited States can replace you at the dental chair! W hy ca n ’t you merely treat your patients w ithout seeking “ preauthor ization” and advise them to submit their own resum e of w ork com pleted, in laym an’s term s, along with their cancelled check or your receipt, and collect directly from their own insur ance com panies? A N N E M . W IR T Z BAY V IL L A G E , O H IO
L ik e d e n d o h isto ry article
tions to the dental profession. M A N U E L I. W E IS M A N , D D S A U G U S T A , GA
B itew in g s a lso n e e d e d m I w ould like to refer to the 1976 re p ort o f the Council on D ental M ater ials and D evices on “ Pit and fissure sealan ts” as it appeared in the July JA D A .
C oncerning the precautions listed, I w as am azed th at am ong them the use o f the bitewing radiograph was not m entioned. It has been my exper ience that careful clinical evaluation o f pit and fissures, especially on mo lars, is not always adequate to d eter mine the p resence of caries. T he use of the bitew ing X ray allows one to determ ine the presence of radiolucency in the occlusal portion o f the dentin. If such radiolucency is p res en t, you can rest assured th at caries is present and the tooth requires a dental restoration not a sealant, notw ith standing th at this sam e to o th , when clinically exam ined, gives no indica tio n of caries ingress.
E d ito r ’s n o te : T h e original copy of
A L A N D A V IT T , D M D
this letter was sent to D r. Louis G rossm an and refers to his article, “ Endodontics 1776-1976: a bicen tennial history against the background of general d en tistry ” (July j a d a , page 78).
N E W B U R Y P O R T , M ASS
■ Again, a m arvelous historical w ork on endodontics in the July j a d a . C on gratulations. I hope this will be re quired reading by all our undergrad uates and graduate students. By the w ay, I realize that the article is prim arily on A m erican dentistry from a historical note, but I would like to bring to your attention chapter X of F au ch ard ’s S u rg e o n D e n tis t — 1746. H e describes how a pulp is re m oved with an annealed needle. But he em phasizes that the thread should be attached, lest the patient swallow it! Perhaps som e of our early A m er ican dentists who could read F rench or heard about F au ch a rd ’s w ork from visitors from E urope used his text. Again let me congratulate your great efforts and w onderful contribu
518 ■ LETTERS TO THE EDITOR / JADA, Vol. 93, September 1976
B ro n c h o sp a s m a n d d ea th m Regarding D r. L loyd L. W ruble’s Ju n e j a d a com m ent on my statem ent from the April j a d a (page 720) that “ bronchospasm (is an) em ergency m ore citical than cardiac a rre st,” D r. W ruble fails to see how broncho spasm can “ p resen t more o f an em er gency than death its e lf ’; this is an exam ple of literal interpretation of an interview which did not pretend to be a docum ented scientific paper. I w el com e the opportunity to clarify my com m ent. M y statem ent referred to broncho spasm occurring as a result of aspira tion of stom ach contents under gen eral anesthesia, a grave em ergency w hich accounts for up to 26% of pri m ary anesthetic deaths. If the pH of aspirated m aterial is less th an 1.2, recovery, even with prom pt and her oic treatm en t, is doubtful, the patient