h y g r e n is t , a n d d e n t a l a s s is ta n t i n t h e
o f e n d e m ic f lu o r o s is , b u t l e t ’ s k e e p
p ro v e
U n ite d
t h e f ig u r e s w i t h i n r e a s o n .
d e c is io n s m a d e w i l l h a v e a f i r m f o u n
S t a t e s s h o u ld b e c e r t i f i e d
in
b a s ic c a r d i a c l i f e s u p p o r t ( c a r d i o p u l
RICHARD C. ABRAHAM SON, DDS
m o n a r y r e s u s c it a t io n ) b y t h e A m e r i
UNIVERSITY OF NAIROBI
c a n H e a r t A s s o c ia tio n o r th e A m e r i can
R ed
C ro s s .
B e s id e s
.
b e n e fit
to
a ls o
t h e ir
be
of
hom es,
began
h e a lth ,
m any
th e
y e a rs
p re
M y p o in t is t h a t a l l t h e “ i r r e l e v a n t ” r e c e iv e d
in
th e
p r e c lin ic a l
y e a r s p a v e s t h e w a y t o a n in t e l l e c t u a l V ie w s o n b a s i c s c ie n c e s
c o m p r e h e n s io n o f t h e b o d y t h a t w i l l b e c o m e v e r y r e le v a n t in p a tie n t m a n
p o t e n t ia l n e ig h b o r
th a t
p a tie n t’ s
v io u s l y .
m a te r ia l
d l e s u c h l i f e - t h r e a t e n i n g e m e r g e n c ie s , w o u ld
d a tio n
KENYA
in c r e a s in g
t h e c a p a b ili t ie s o f t h e i r o f f i c e s t o h a n
d o c to rs
h is /h e r
m In
r e p ly t o y o u r é d ito r ia l o n p a g e I
a g e m e n t.
h o o d s , a n d c o m m u n it i e s . O f f i c e p e r
7 9 5 o f th e M a y J A D A ,
th in k y o u
I a g re e w i t h th e a u th o r in th a t m u c h
sonnel
m o r e e m p h a s is s h o u ld b e p l a c e d o n
CPR
m ig h t
even
h a v e m is s e d t h e p o i n t e n t i r e l y r e g a r d
s a v e t h e ir d o c to r ’ s life
(it has
hap
in g t h e i m p o r t a n c e o f t h e b a s ic s c ie n c e
o r g a n s y s te m s . I f e e l v e r y p r iv ile g e d
c u r r ic u lu m in a d e n ta l u n d e rg ra d u a te
t o b e a t t e n d in g t h e U n i v e r s i t y o f C o n
tr a in e d
in
p e n e d s e v e r a l t im e s ) . T r a in in g life
c o u rs e s
in
b a s ic
c a rd ia c
e d u c a t io n . Y
s u p p o r t a r e a v a i la b le a t n o c o s t
(o th e r
th a n
e ig h t
h o u rs
of
tim e )
n e c t ic u t w h e r e it s b a s ic s c ie n c e p r o
o u r m a in o b je c tio n to a n e x te n s iv e
b a s ic s c ie n c e p r o g r a m
seem ed to b e
g r a m is t a u g h t w i t h t h e o r g a n s y s t e m a p p r o a c h . W e a ls o a t t e n d 8 5 % o f o u r
th r o u g h a n y lo c a l A H A o r A R C c h a p
th a t m u c h o f th e in fo r m a tio n ta u g h t
c la s s e s f o r t h e f i r s t t w o
t e r , as w e ll a s th r o u g h m a n y f ir e d e
w a s n o t d ir e c tly r e le v a n t to m a k in g a
m e d ic a l
“ g o o d c l i n ic a l d e n t i s t . ”
t h e r e w e r e t im e s w h e n w e a s k e d , “ I s
p a rtm e n ts , re s c u e
squads, and hos
T h i s , in m y
s tu d e n ts .
p ita ls . F u r t h e r m o r e , m a n y la r g e r m il
o p i n i o n , is a d a n g e r o u s a s s u m p t io n .
t h is
r e a lly
ita r y
A
is n ’ t
a lw a y s
m e d ic a l
and
d e n ta l
f a c i lit i e s
A H A /A R C -c e r tifie d
in s tr u c
good
c lin i c a l
d e n tis t
s u re th a t w e
had
a
can
be
e x c e l l e n t b a s ic
p l a c in g
a m a lg a m s , r e m o v a b le
c o n d u c t in g c la s s e s f o r a n y in t e r e s t e d
a n c e s , a n d f u l l d e n t u r e s , b u t h e a ls o
ta ilo r -m a d e f o r us as d e n ta l s tu d e n ts ,
g r o u p s . M a n y p r o f e s s i o n a l m e e t in g s
m u s t b e c a p a b le o f e v a l u a t in g t h e p a
o u r m e d ic a l e d u c a t io n w a s n ’ t s h o r t
a r e a ls o o f f e r i n g c o u r s e s in C P R .
t ie n t as a w h o le , n o t m e r e ly a m o u th .
changed.
u r g e a l l d e n t is t s
to
a v a il
t h e m s e l v e s o f th is v a l u a b le li f e - s a v in g t e c h n iq u e a n d b e c o m e c e r t i f i e d , a n d
One
cannot
r e c e iv e
an
in
answ er
you
t o r s w h o a r e w i l l i n g a n d c a p a b le o f
w o u ld
e x p e rt
The
but
w ith
p ro c e s s ,
be
I
and
r e le v a n t? ” c le a r ,
y e a rs
t h is
s h o u ld
have
p r o fic ie n t
c e r ta in ly
In
a p p l i
s c ie n c e
p ro g ra m .
W h ile
it
w asn ’t
e ffe c tiv e
As
e d u c a t io n i f o n l y t h e c l i n i c a l l y r e l e
t is tr y
v a n t m a t e r i a l is p r e s e n t e d . W i t h o u t a
m o r e a s a m e d ic a l s p e c ia lt y — w h i c h i t
th e is
p r o fe s s io n b e in g
m a tu re s ,
p e r c e iv e d
den
m o re
and
fu n d a m e n ta l u n d e rs ta n d in g o f h o w th e
t r u l y is . I t h i n k t h e p r o b l e m o f t im e
f o l l o w . Y o u w i l l n e v e r f i n d a n y t h in g
h u m a n b o d y fu n c tio n s , w h a t e ffe c ts
f o r c lin ic a l d e n t a l c o u r s e s c o u l d b e s t
m o r e v a l u a b le f o r f r e e . A n d t h e li f e
d ru g s h a v e o n it , a n d so f o r t h , a d e n
be
s a v e d m ig h t b e y o u r s !
t is t w i l l h a v e a h a r d e r t i m e le a r n in g
fiv e -y e a r
n e w c lin ic a lly r e le v a n t fa c ts . O n s e v
o n e -y e a r in te rn s h ip s .
th e n see th a t a ll th e o ffic e p e rs o n n e l
R. E. ALEXAND ER, DDS SAN DIEGO
e ra l
o c c a s io n s ,
I
have
c lin i c a l d e n t is t s t a l k
C o r r e c tio n o n f lu o r id e c o n te n t
h e a rd
s o lv e d
by
th e
e s t a b l is h m e n t
p ro g ra m s
or
by
of
r e q u ir in g
good
T h e d e n ta l e d u c a to rs in th is c o u n
a b o u t s y s t e m ic
t r y m u s t d e c id e w h a t a g o o d d e n t i s t
c o n d it io n s ( i e , d ia b e t e s m e l l i t u s ) a n d
s h o u ld b e — a n e x p e r t t e c h n ic ia n o r a
h o w th e y a ff e c t p a tie n t m a n a g e m e n t
d e n ta l p r a c titio n e r c o m p e te n t in e v a l
— o n ly to h e a r th e m m a k e c o m m e n ts
u a t in g h i s / h e r p a t i e n t a s w h o l e b e in g .
th a t s h o w th e y d o n ’ t u n d e rs ta n d th e
CRAIG M . L EF F IN G W E L L
d is e a s e p r o c e s s a t a ll. I c a n n o t a c c e p t
CLASS O F 1979
t h e b e l i e f t h a t a g o o d c lin ic a l d e n t i s t
UNIVERSITY O F CO N N EC TICU T,
im p r e s s io n s g i v e n i n t h e l e t t e r t o t h e
s h o u ld n o t h a v e a f i r m f o u n d a t i o n o n
SCHOOL OF DENTAL M ED IC IN E
e d i t o r b y D r . B r u c e L . D o u g la s p u b
w h i c h t o b a s e h is s t a t e m e n t s o r o p in
li s h e d in t h e A p r i l is s u e o f T h e J o u r n
io n s o t h e r t h a n h i s / h e r c l i n ic a l e x p e r
a l.
ie n c e .
m I w o u ld lik e to c o r r e c t s o m e o f th e
H e s ta te s t h a t t h e c i t y o f N a k u r u ,
■
I t is p r o b a b l y t r u e t h a t n o d e n t i s t
Y o u r n e g a t iv e v i e w o f b a s ic s c ie n c e
te a c h in g
in
s u r you
flu o r id e . T h e
a t a m u s c l e ’ s r e a c t i o n t o v a r i o u s s t im
s h o u ld p r o v i d e e q u a l e x p o s u r e t o t h e
b o d y o f L a k e N a k u r u , a la k e w ith o u t
u li,
o p p o s it e
e x i t w h i c h o n l y lo s e s w a t e r t h r o u g h
u s e d in m e d ic a l s c h o o ls — d o g i v e t h e
who
e v a p o r a tio n , h a s flu o r id e c o n te n t o f
s t u d e n t a n a p p r e c ia t io n f o r a n d u n
t in u e t r a i n in g i n b a s ic s c ie n c e s i n a
2 , 8 0 0 p p m , b u t t h e b e in g s t h a t d r i n k
d e r s t a n d in g o f t h e l i f e p r o c e s s a n d its
b a la n c e d ,
r e a c t io n t o d r u g s , e le c t r i c a l c u r r e n t s ,
tio n a l p r o g ra m .
w a te r w ith
2 ,8 0 0 p p m
i t a r e its w o r l d - f a m o u s f lo c k s o f f l a m in g o s a n d o t h e r w i l d l i f e . T h e p e o p le o f t h e t o w n o f N a k u r u
but
fro g
la b s — a ls o
a n d s o f o r t h . S h o u ld o n e b e li e v e t h a t th e
p r a c t i c in g
h a v e a c o m m u n a l w a t e r s u p p ly w i t h
ru ra l
a flu o r id e c o n te n t o f 0 .9 p p m .
p h y s io lo g y ?
T h e p e o p le o f K e n y a d o h a v e a lo t
p h y s io lo g y
to w n
is
p h y s ic ia n
in
c o n c e rn e d
P r o b a b ly
n o t.
a
w ith
In
w as
p r is in g
o f 4 7 ,8 0 0 ,
m e.
a ll f a ir n e s s ,
h a s e v e r p i t h e d a p a t i e n t a n d lo o k e d
a p o p u la tio n
to
d e n t a l s c h o o ls
d r in k s
w ith
v ie w p o in t
r e a l iz e s
th e
d e n ta l
fro m
som eone
n e c e s s it y
d o c to r a l,
to
con
educa
I w o u l d l i k e t o e m p h a s iz e t h a t d e n
s m a ll
t a l s c h o o ls a r e t r a i n in g d o c t o r s w h o
fro g
m a y b e c o m e s p e c ia lis t s o r t e a c h e r s ,
B u t you
c a n b e s u r e t h a t in a n a t t e m p t t o i m
a s w e l l a s d e n t a l p r a c t i t i o n e r s . I t is i m p o s s ib le f o r e d u c a t o r s
to
p r e d i c t in
LETTERS TO THE EDITOR / JADA, Vol. 95, A ugu st 1977 ■ 185 /
o f e n d e m ic f lu o r o s is , b u t l e t ’ s k e e p
p ro v e
U n ite d
t h e f ig u r e s w i t h i n r e a s o n .
d e c is io n s m a d e w i l l h a v e a f i r m f o u n
S t a t e s s h o u ld b e c e r t i f i e d
in
b a s ic c a r d i a c l i f e s u p p o r t ( c a r d i o p u l
RICHARD C. ABRAHAM SON, DDS
m o n a r y r e s u s c it a t io n ) b y t h e A m e r i
UNIVERSITY OF NAIROBI
c a n H e a r t A s s o c ia tio n o r th e A m e r i can
R ed
C ro s s .
B e s id e s
.
b e n e fit
to
a ls o
t h e ir
be
of
hom es,
began
h e a lth ,
m any
th e
y e a rs
p re
M y p o in t is t h a t a l l t h e “ i r r e l e v a n t ” r e c e iv e d
in
th e
p r e c lin ic a l
y e a r s p a v e s t h e w a y t o a n in t e l l e c t u a l V ie w s o n b a s i c s c ie n c e s
c o m p r e h e n s io n o f t h e b o d y t h a t w i l l b e c o m e v e r y r e le v a n t in p a tie n t m a n
p o t e n t ia l n e ig h b o r
th a t
p a tie n t’ s
v io u s l y .
m a te r ia l
d l e s u c h l i f e - t h r e a t e n i n g e m e r g e n c ie s , w o u ld
d a tio n
KENYA
in c r e a s in g
t h e c a p a b ili t ie s o f t h e i r o f f i c e s t o h a n
d o c to rs
h is /h e r
m In
r e p ly t o y o u r é d ito r ia l o n p a g e I
a g e m e n t.
h o o d s , a n d c o m m u n it i e s . O f f i c e p e r
7 9 5 o f th e M a y J A D A ,
th in k y o u
I a g re e w i t h th e a u th o r in th a t m u c h
sonnel
m o r e e m p h a s is s h o u ld b e p l a c e d o n
CPR
m ig h t
even
h a v e m is s e d t h e p o i n t e n t i r e l y r e g a r d
s a v e t h e ir d o c to r ’ s life
(it has
hap
in g t h e i m p o r t a n c e o f t h e b a s ic s c ie n c e
o r g a n s y s te m s . I f e e l v e r y p r iv ile g e d
c u r r ic u lu m in a d e n ta l u n d e rg ra d u a te
t o b e a t t e n d in g t h e U n i v e r s i t y o f C o n
tr a in e d
in
p e n e d s e v e r a l t im e s ) . T r a in in g life
c o u rs e s
in
b a s ic
c a rd ia c
e d u c a t io n . Y
s u p p o r t a r e a v a i la b le a t n o c o s t
(o th e r
th a n
e ig h t
h o u rs
of
tim e )
n e c t ic u t w h e r e it s b a s ic s c ie n c e p r o
o u r m a in o b je c tio n to a n e x te n s iv e
b a s ic s c ie n c e p r o g r a m
seem ed to b e
g r a m is t a u g h t w i t h t h e o r g a n s y s t e m a p p r o a c h . W e a ls o a t t e n d 8 5 % o f o u r
th r o u g h a n y lo c a l A H A o r A R C c h a p
th a t m u c h o f th e in fo r m a tio n ta u g h t
c la s s e s f o r t h e f i r s t t w o
t e r , as w e ll a s th r o u g h m a n y f ir e d e
w a s n o t d ir e c tly r e le v a n t to m a k in g a
m e d ic a l
“ g o o d c l i n ic a l d e n t i s t . ”
t h e r e w e r e t im e s w h e n w e a s k e d , “ I s
p a rtm e n ts , re s c u e
squads, and hos
T h i s , in m y
s tu d e n ts .
p ita ls . F u r t h e r m o r e , m a n y la r g e r m il
o p i n i o n , is a d a n g e r o u s a s s u m p t io n .
t h is
r e a lly
ita r y
A
is n ’ t
a lw a y s
m e d ic a l
and
d e n ta l
f a c i lit i e s
A H A /A R C -c e r tifie d
in s tr u c
good
c lin i c a l
d e n tis t
s u re th a t w e
had
a
can
be
e x c e l l e n t b a s ic
p l a c in g
a m a lg a m s , r e m o v a b le
c o n d u c t in g c la s s e s f o r a n y in t e r e s t e d
a n c e s , a n d f u l l d e n t u r e s , b u t h e a ls o
ta ilo r -m a d e f o r us as d e n ta l s tu d e n ts ,
g r o u p s . M a n y p r o f e s s i o n a l m e e t in g s
m u s t b e c a p a b le o f e v a l u a t in g t h e p a
o u r m e d ic a l e d u c a t io n w a s n ’ t s h o r t
a r e a ls o o f f e r i n g c o u r s e s in C P R .
t ie n t as a w h o le , n o t m e r e ly a m o u th .
changed.
u r g e a l l d e n t is t s
to
a v a il
t h e m s e l v e s o f th is v a l u a b le li f e - s a v in g t e c h n iq u e a n d b e c o m e c e r t i f i e d , a n d
One
cannot
r e c e iv e
an
in
answ er
you
t o r s w h o a r e w i l l i n g a n d c a p a b le o f
w o u ld
e x p e rt
The
but
w ith
p ro c e s s ,
be
I
and
r e le v a n t? ” c le a r ,
y e a rs
t h is
s h o u ld
have
p r o fic ie n t
c e r ta in ly
In
a p p l i
s c ie n c e
p ro g ra m .
W h ile
it
w asn ’t
e ffe c tiv e
As
e d u c a t io n i f o n l y t h e c l i n i c a l l y r e l e
t is tr y
v a n t m a t e r i a l is p r e s e n t e d . W i t h o u t a
m o r e a s a m e d ic a l s p e c ia lt y — w h i c h i t
th e is
p r o fe s s io n b e in g
m a tu re s ,
p e r c e iv e d
den
m o re
and
fu n d a m e n ta l u n d e rs ta n d in g o f h o w th e
t r u l y is . I t h i n k t h e p r o b l e m o f t im e
f o l l o w . Y o u w i l l n e v e r f i n d a n y t h in g
h u m a n b o d y fu n c tio n s , w h a t e ffe c ts
f o r c lin ic a l d e n t a l c o u r s e s c o u l d b e s t
m o r e v a l u a b le f o r f r e e . A n d t h e li f e
d ru g s h a v e o n it , a n d so f o r t h , a d e n
be
s a v e d m ig h t b e y o u r s !
t is t w i l l h a v e a h a r d e r t i m e le a r n in g
fiv e -y e a r
n e w c lin ic a lly r e le v a n t fa c ts . O n s e v
o n e -y e a r in te rn s h ip s .
th e n see th a t a ll th e o ffic e p e rs o n n e l
R. E. ALEXAND ER, DDS SAN DIEGO
e ra l
o c c a s io n s ,
I
have
c lin i c a l d e n t is t s t a l k
C o r r e c tio n o n f lu o r id e c o n te n t
h e a rd
s o lv e d
by
th e
e s t a b l is h m e n t
p ro g ra m s
or
by
of
r e q u ir in g
good
T h e d e n ta l e d u c a to rs in th is c o u n
a b o u t s y s t e m ic
t r y m u s t d e c id e w h a t a g o o d d e n t i s t
c o n d it io n s ( i e , d ia b e t e s m e l l i t u s ) a n d
s h o u ld b e — a n e x p e r t t e c h n ic ia n o r a
h o w th e y a ff e c t p a tie n t m a n a g e m e n t
d e n ta l p r a c titio n e r c o m p e te n t in e v a l
— o n ly to h e a r th e m m a k e c o m m e n ts
u a t in g h i s / h e r p a t i e n t a s w h o l e b e in g .
th a t s h o w th e y d o n ’ t u n d e rs ta n d th e
CRAIG M . L EF F IN G W E L L
d is e a s e p r o c e s s a t a ll. I c a n n o t a c c e p t
CLASS O F 1979
t h e b e l i e f t h a t a g o o d c lin ic a l d e n t i s t
UNIVERSITY O F CO N N EC TICU T,
im p r e s s io n s g i v e n i n t h e l e t t e r t o t h e
s h o u ld n o t h a v e a f i r m f o u n d a t i o n o n
SCHOOL OF DENTAL M ED IC IN E
e d i t o r b y D r . B r u c e L . D o u g la s p u b
w h i c h t o b a s e h is s t a t e m e n t s o r o p in
li s h e d in t h e A p r i l is s u e o f T h e J o u r n
io n s o t h e r t h a n h i s / h e r c l i n ic a l e x p e r
a l.
ie n c e .
m I w o u ld lik e to c o r r e c t s o m e o f th e
H e s ta te s t h a t t h e c i t y o f N a k u r u ,
■
I t is p r o b a b l y t r u e t h a t n o d e n t i s t
Y o u r n e g a t iv e v i e w o f b a s ic s c ie n c e
te a c h in g
in
s u r you
flu o r id e . T h e
a t a m u s c l e ’ s r e a c t i o n t o v a r i o u s s t im
s h o u ld p r o v i d e e q u a l e x p o s u r e t o t h e
b o d y o f L a k e N a k u r u , a la k e w ith o u t
u li,
o p p o s it e
e x i t w h i c h o n l y lo s e s w a t e r t h r o u g h
u s e d in m e d ic a l s c h o o ls — d o g i v e t h e
who
e v a p o r a tio n , h a s flu o r id e c o n te n t o f
s t u d e n t a n a p p r e c ia t io n f o r a n d u n
t in u e t r a i n in g i n b a s ic s c ie n c e s i n a
2 , 8 0 0 p p m , b u t t h e b e in g s t h a t d r i n k
d e r s t a n d in g o f t h e l i f e p r o c e s s a n d its
b a la n c e d ,
r e a c t io n t o d r u g s , e le c t r i c a l c u r r e n t s ,
tio n a l p r o g ra m .
w a te r w ith
2 ,8 0 0 p p m
i t a r e its w o r l d - f a m o u s f lo c k s o f f l a m in g o s a n d o t h e r w i l d l i f e . T h e p e o p le o f t h e t o w n o f N a k u r u
but
fro g
la b s — a ls o
a n d s o f o r t h . S h o u ld o n e b e li e v e t h a t th e
p r a c t i c in g
h a v e a c o m m u n a l w a t e r s u p p ly w i t h
ru ra l
a flu o r id e c o n te n t o f 0 .9 p p m .
p h y s io lo g y ?
T h e p e o p le o f K e n y a d o h a v e a lo t
p h y s io lo g y
to w n
is
p h y s ic ia n
in
c o n c e rn e d
P r o b a b ly
n o t.
a
w ith
In
w as
p r is in g
o f 4 7 ,8 0 0 ,
m e.
a ll f a ir n e s s ,
h a s e v e r p i t h e d a p a t i e n t a n d lo o k e d
a p o p u la tio n
to
d e n t a l s c h o o ls
d r in k s
w ith
v ie w p o in t
r e a l iz e s
th e
d e n ta l
fro m
som eone
n e c e s s it y
d o c to r a l,
to
con
educa
I w o u l d l i k e t o e m p h a s iz e t h a t d e n
s m a ll
t a l s c h o o ls a r e t r a i n in g d o c t o r s w h o
fro g
m a y b e c o m e s p e c ia lis t s o r t e a c h e r s ,
B u t you
c a n b e s u r e t h a t in a n a t t e m p t t o i m
a s w e l l a s d e n t a l p r a c t i t i o n e r s . I t is i m p o s s ib le f o r e d u c a t o r s
to
p r e d i c t in
LETTERS TO THE EDITOR / JADA, Vol. 95, A ugu st 1977 ■ 185 /
