318
Journal of Public Health Dentistry
The Associate Editor’s Corner “Well Now, It May Not Taste Very Nice, But It’s Going To Do You a Lot of Good” A common belief many people held in the past which may persist among some people today, is that: if a medicine or product has a bad taste or is unpleasant to take, it must cure or prevent disease, or at least, be good for you. The sales of many patent medicines and nostrums thrived on this trust. The advertising for Listerine Antiseptic still capitalizes on the confidence that many people have in products that taste bad. In the late 1960’s and early 19703, “Operation Brush-in,” a regimen purported to prevent dental caries became popular in this country. Several states in the midwest and elsewhere heavily promoted this program of the self-application by school children of a stanyos fluoride-zirconium silicate prophylaxis paste. In Indiana, in at least one year, virtually every child who attended school on a specified day took part in one of the Brush-ins, many, one presumes somewhat reluctantly, because the highly astringent, concentrate stannus fluoride in the paste certainly did not have a pleasant taste. Although some studies of the regimen in which the children applied the paste annually demonstrated a marked reduction in the incidence of dental caries, others failed to corroborate these findings. A few studies produced “negative results.” At best, the collective findings of annual “Brush-ins” may be described as equivocal. Perhaps some of the proselytizers of this method believed that the agent and the regimen must be good for the children since it tasted so bad. There has been greatly reduced interest in this method of caries prevention in the last several years, perhaps, in part, because the early promises for it (fewer cavities, toothbrushing instruction, community professional involvement) could not be demonstrated or sustained. Its demise was undoubtedly hastened by the decision of the largest manufacturer of this product to stop selling it, largely because FDA approval was denied unless additional studies showed definitive proof of effectiveness. Another reason for the decline of “Operation Brush-in” has been the rapid adoption of school-based programs of weekly mouthrinsing with solutions of sodium fluoride or, where indicated, the daily ingestion in school of dietary fluoride supplements or combinations of these regimens. Best estimates indicate that eight to nine million schoolchildren in this country are regularly taking part in one of these programs. Abundant, consistent data attest to the effectiveness of these regimens in reducing the incidence of dental decay. Moreover, they taste pretty good too. This piece has gotten rather out of hand because when begun it was not meant to indict “Operation Brush-in.” Rather, it was just a way to introduce the tollowing letter concerning “Operation Brush-in” that was sent in 1972 by the director of a large county dental program in western United States. He had received the letter from a nurse who worked for a school district in the same state. At the time, the letter gave me one of the best work-related chuckles I had had in a long time. On rereading the letter recently (on its way to the circular file), I enjoyed it as much as the first time. With the Editor’s indulgence, I a m sharing it with our readers. To extract the greatest pleasure, the letter must be read aloud with the proper inflection. Names have been eliminated to protect the innocent (and me). -Herschel S. Horowitz Associate Editor
Vol. 39, No. 4-Fall,
319
1979
June 23, 1972 Dear Dr. You have asked me to relate my experiences and reactions to the “brush-in” program, in which I have participated as a school nurse for the last two years. My general feeling is that the program is very good, because it does something for the children who so badly need dental care. Anything that can be done t o help the children with their dental needs is worthwhile. I have participated in the program this and last year, working in conjunction with a dentist each time. There were about 250-350 children participating in the program at each of the schools in which I was involved. There was a considerable reduction in the incidence of nausea a n d / o r vomiting in comparison t o last year. This reduction was felt to be a result of the following: (1) a strong emphasis upon the positive beneficial aspects of the program, (2) encouragement of frequent spitting out of the paste during the actual procedure and (3) afirrn approach in allcases where psychologicalfactors were suspecred. The over-all district wide impression was that there were no more cases of nausea and vomiting on “brush-in’’ day than on any normal school day. The numbers who actually vomited varied from school to school, ranging from 0 to 3-5. As you are aware, there was a n experience a t one of our schools this year in which, on the day of the brush-in, two children who participated were quite ill (both running temperatures to 105”); a third child was also ill. However, all three of these children were from one family, which would seem to suggest that the vomiting, diarrhea, and high fevers originated from some other cause. As you know, the Health Department’s Acute Communicable Disease Division is conducting a n investigation in this matter. As I indicated above, it is my general feeling that preventive dental programs are most desirable, but I would hope that a material can be developed which is more pleasant tasting. I have noticed a significant diminution in numbers of children participating in the program this year. At one school there were approximately 1 5 Q k w e rchildren participating this year. In my opinion this drop-off was largely due to the number of children reporting to others that they would vomit if they participated. When I mentioned “brush-in’’ there were a few unhappy faces among the children who apparently remembered the unpleasant taste. 1 had to approach the matter from the point of view of “well now, it may not taste very nice, but it’s going to d o you a lot of good.” I hope that my reactions as a participant in the program will be of some value in future planning. Yours truly,
Journal of Public Health Dentistry
The Associate Editor’s Corner “Well Now, It May Not Taste Very Nice, But It’s Going To Do You a Lot of Good” A common belief many people held in the past which may persist among some people today, is that: if a medicine or product has a bad taste or is unpleasant to take, it must cure or prevent disease, or at least, be good for you. The sales of many patent medicines and nostrums thrived on this trust. The advertising for Listerine Antiseptic still capitalizes on the confidence that many people have in products that taste bad. In the late 1960’s and early 19703, “Operation Brush-in,” a regimen purported to prevent dental caries became popular in this country. Several states in the midwest and elsewhere heavily promoted this program of the self-application by school children of a stanyos fluoride-zirconium silicate prophylaxis paste. In Indiana, in at least one year, virtually every child who attended school on a specified day took part in one of the Brush-ins, many, one presumes somewhat reluctantly, because the highly astringent, concentrate stannus fluoride in the paste certainly did not have a pleasant taste. Although some studies of the regimen in which the children applied the paste annually demonstrated a marked reduction in the incidence of dental caries, others failed to corroborate these findings. A few studies produced “negative results.” At best, the collective findings of annual “Brush-ins” may be described as equivocal. Perhaps some of the proselytizers of this method believed that the agent and the regimen must be good for the children since it tasted so bad. There has been greatly reduced interest in this method of caries prevention in the last several years, perhaps, in part, because the early promises for it (fewer cavities, toothbrushing instruction, community professional involvement) could not be demonstrated or sustained. Its demise was undoubtedly hastened by the decision of the largest manufacturer of this product to stop selling it, largely because FDA approval was denied unless additional studies showed definitive proof of effectiveness. Another reason for the decline of “Operation Brush-in” has been the rapid adoption of school-based programs of weekly mouthrinsing with solutions of sodium fluoride or, where indicated, the daily ingestion in school of dietary fluoride supplements or combinations of these regimens. Best estimates indicate that eight to nine million schoolchildren in this country are regularly taking part in one of these programs. Abundant, consistent data attest to the effectiveness of these regimens in reducing the incidence of dental decay. Moreover, they taste pretty good too. This piece has gotten rather out of hand because when begun it was not meant to indict “Operation Brush-in.” Rather, it was just a way to introduce the tollowing letter concerning “Operation Brush-in” that was sent in 1972 by the director of a large county dental program in western United States. He had received the letter from a nurse who worked for a school district in the same state. At the time, the letter gave me one of the best work-related chuckles I had had in a long time. On rereading the letter recently (on its way to the circular file), I enjoyed it as much as the first time. With the Editor’s indulgence, I a m sharing it with our readers. To extract the greatest pleasure, the letter must be read aloud with the proper inflection. Names have been eliminated to protect the innocent (and me). -Herschel S. Horowitz Associate Editor
Vol. 39, No. 4-Fall,
319
1979
June 23, 1972 Dear Dr. You have asked me to relate my experiences and reactions to the “brush-in” program, in which I have participated as a school nurse for the last two years. My general feeling is that the program is very good, because it does something for the children who so badly need dental care. Anything that can be done t o help the children with their dental needs is worthwhile. I have participated in the program this and last year, working in conjunction with a dentist each time. There were about 250-350 children participating in the program at each of the schools in which I was involved. There was a considerable reduction in the incidence of nausea a n d / o r vomiting in comparison t o last year. This reduction was felt to be a result of the following: (1) a strong emphasis upon the positive beneficial aspects of the program, (2) encouragement of frequent spitting out of the paste during the actual procedure and (3) afirrn approach in allcases where psychologicalfactors were suspecred. The over-all district wide impression was that there were no more cases of nausea and vomiting on “brush-in’’ day than on any normal school day. The numbers who actually vomited varied from school to school, ranging from 0 to 3-5. As you are aware, there was a n experience a t one of our schools this year in which, on the day of the brush-in, two children who participated were quite ill (both running temperatures to 105”); a third child was also ill. However, all three of these children were from one family, which would seem to suggest that the vomiting, diarrhea, and high fevers originated from some other cause. As you know, the Health Department’s Acute Communicable Disease Division is conducting a n investigation in this matter. As I indicated above, it is my general feeling that preventive dental programs are most desirable, but I would hope that a material can be developed which is more pleasant tasting. I have noticed a significant diminution in numbers of children participating in the program this year. At one school there were approximately 1 5 Q k w e rchildren participating this year. In my opinion this drop-off was largely due to the number of children reporting to others that they would vomit if they participated. When I mentioned “brush-in’’ there were a few unhappy faces among the children who apparently remembered the unpleasant taste. 1 had to approach the matter from the point of view of “well now, it may not taste very nice, but it’s going to d o you a lot of good.” I hope that my reactions as a participant in the program will be of some value in future planning. Yours truly,
