You did, however, admit that licens­ ing someone to practice dentistry is “ no guarantee that he will continue to be professionally competent.” True professionalism does entail self-improvement, but as long as some —you say 1% or 2%—of the nation’s dentists are negligent in keeping up with new knowledge and technique, or simply refreshing themselves with the old knowledge, some kind of manda­ tory self-improvement seems justi­ fied. If your idea of “ professionalism” permits the incompetent to remain incompetent, or the stagnant to con­ tinue to stagnate, then it is hard for me to see how it (your profession­ alism) truly serves the public, or how it can be ethically defended. The real reason for my support of mandatory continuing dental educa­ tion is not to keep my office in busi­ ness, but rather the following: (1) we need a mechanism to at least main­ tain, and hopefully improve, the skills and knowledge of the 1% or 2% of indifferent and/or negligent profes­ sionals; (2) to bring within hearing and seeing range of the participants a de­ velopment explosion of new materials and techniques; (3) public interest and demand; (4) since you don’t have to worry about the 98% or 99%—I think your percentage is off—they will take the necessary courses anyway, man­ datory or not. But what about the 1% or 2%? Wouldn’t it be “ profes­ sional” to bring them along?; and (5) for lack of a better mechanism, it is my opinion that mandatory continu­ ing dental education is philosophical­ ly, professionally, ethically, morally, and legally right.

or broaden their professional position. I would assume that the biggest op­ position to continuing education, be it mandatory or elective, would be a lack of time, for what other reason could any professional offer for not desiring to broaden his scope of the knowl­ edge of dentistry. If this be the case, then I question the priorities of that dentist. What kind of a professional is he or she? Is he offering the latest concepts to his patients and is his technique on par with the most recent research? Continuing education is not, in my opinion, “forced feeding” to raise the level of incompetent dentists (al­ though I would question your con­ servative estimate of 1% to 2% of the nation’s dentists needing remedial training), nor is it intended as an “ in­ carceration” or punishment for all the good dentists who, by far, make up the overwhelming majority. It is merely one way of keeping the dental popu­ lation abreast of new concepts and the latest research. We can never know it all and, when we feel totally satisfied with our level of knowledge, that is when we will begin to stagnate. That fraction which is most rigidly opposed to mandatory continuing edu­ cation is probably the group that would benefit most from its inception. P A U L A . G O L D S T E IN , D D S L O U IS IA N A ST A T E U N IV E R S IT Y M E D IC A L C E N T E R N E W O R LEA N S

Motivation is key ■ I have enjoyed reading your Sept 8

H A N S S. S JO R E N , D D S

ADA News editorial, “ Can dentistry

D IR E C T O R , C O N T IN U IN G D E N T A L

be appreciated by outsiders?” I cer­ tainly agree with you that our den­ tistry is the best, but conveying this image to the public is a big problem. Preventive methods, fine restora­ tive materials, modern equipment and postgraduate training are all very im­ portant, but the sad fact remains— 40% of the American population doesn’t go for dental treatment. I feel we have to overcome what I call the great American dental myths: —people are supposed to lose their teeth as they get older (in other words —dental disease is normal).

E D U C A T IO N L O M A L IN D A U N IV E R S IT Y

■ I was very disappointed with your editorial in the August j a d a on man­ datory continuing education. Professionalism is characterized by requiring long-term, intensive, spe­ cialized training, and the knowledge obtained from that training. There­ fore, mandatory continuing education does not conflict with professional­ ism, but on the contrary, it forces practitioners to “ find time” to expand

930 ■ LETTERS TO THE EDITOR / JADA, Vol. 91, November 1975

—dental treatment is the most pain­ ful and fearful of health services. Until we get professional public re­ lations experts to further the image of dentistry, each dentist should remind his patients of the positive benefits of his services and try to have them motivate their family and friends to seek these benefits. Patients do not appreciate good dentistry and tell others about it if they do not know what has been done, why it was done, how it was done, and what it means to them to have it done. S H E R W IN D . L A F F , D D S C H IC A G O , IL L

More prepayment data m The article in the September j a d a , p 493, from Delta Dental Plans en­ titled “ The participating dentist agreement: an explanation,” was very informative for dentists in states where Delta Plans do not exist. Hav­ ing been a member of California Den­ tal Service for 15 years, I have come to learn about the Plan from actual experience and want to point out facts that were not mentioned in your article: —CDS is in violation of the ADA Standards for Prepayment Programs, namely, #3, #11, and #12. —CDS resorts to coercive methods to enforce membership by: (a) non-participating dentists are paid at the 51st percentile level rather than the 90th percentile level, and (b) non-participating members are not paid directly, but the payment is sent to the patient. —CDS members may only attend board of directors’ meetings by writ­ ten request and, after addressing the board, they must leave. —Review committees which often settle disputes between the dentist and CDS do not always reach an equitable solution. They may base their conclusions on subjective rather than objective determinations. Also, some of the committee members may not be able to divorce themselves from their own personal prejudices. L O U IS M A R A V IG L IA , D D S SA N F R A N C IS C O , C A L IF