LETTERS TO THE JOURNAL
THE JOURNAL devotes this section to com m ent by readers on to p ics of current interest to dentistry. The m anaging ed itor reserves the righ t to edit all com m unications to fit available space and requires that all letters be signed. Printed com m unications do no t necessarily reflect the op in io n o r o ffic ia l po licy of the Association. Your pa rticipatio n in this section is invited.
Let the user beware m American Endodontic Society’s Newsletter (Fall 1977) asserts that “ The A D A Council on Dental Mate rials and Devices has released its re port including N2 as a routine of endodontics.” This claim is completely contrary to the stated position of the Council. In the Guide to Dental Materials and Devices, 8tli Edition, N2 is men tioned, but is neither endorsed by the Council nor considered as a routine of endodontics. The AES statement ig nores the Council’s warning of “ the severe postoperative complications that not infrequently accompany those (N2) types of materials, particularly when inadvertently extruded through a tooth apex.” 1 The Association should set the rec ord straight when other publications brandish its imprimatur without au thorization. When an untoward result occurs, either Association approval or general acceptance of a drug by pru dent practitioners may constitute a de fense to a suit for professional negli gence. On the other hand, customary usage of a drug that is not consonant with due care is not legally sufficient
proof that a dentist met the standard of care.2 The AES article concedes that N2 remains unapproved by the FDA. N onetheless, the article concludes that “ It can be prescribed and sold by pharmacists without question.” This bold assertion ignores the California Department of Health and the FDA which have both, in the past and cur rently, taken the position that distribu tion of N2 and its various progenies is illegal. Accordingly, cease and desist letters have been sent to various drug manufacturers, as well as dispensing pharmacies. Drug promoters, whether dentists or lay persons, who deceitfully prop agandize a drug’s safety or mislead practitioners regarding drug agency approval risk personal liability.3 Un less AES corrects this error, it is con ceivable that the ADA NEWS may one day report litigation alleging fraudulent misrepresentation on the part of these drug promoters serving in their corporate executive capacity. ED W IN J. Z IN M A N , D DS, JD SAN F R A N C ISC O , C A L IF 1. Guide to Dental Materials and Devices, 8th ed. Chicago, American Dental Association, 1976, p 187.
2. Helling vs Carey, 519 P. 2d (1974). 3. Toole vs Richardson-Merrill, Inc., 251 Cal. App. 2d 689, 60 Cal Rptr. 398.
You can change the patient ■ “ Patient susceptibility limits to the effectiveness of preventive oral health education” (The Journal, December 1977) was a disservice to den tistry ... . Basically the author viewed people as “ susceptible” or “ not susceptible,” as though they were fixed and incapa ble of further growth. . . . This is characteristic of the negative ap proach. A positive approach is to see what can be done to change the patient’s susceptibility. . . . A humanistic pre ventive dentist helps people get in touch with their strengths and values and grow out of their problems. . . . We help patients by leading them from what is probable to what is possible. N ext, we help them develop a percep tion of what future is preferable. A vision of what they want to have hap pen makes them better learn ers.. . . It sometimes takes people three or four years to come around to jumping from belief to commitment. Consequently, prevention can be a long-range grow JADA, Vol. 96, March 1978 ■ 381
ing process. People’s basic goal is to be compe tent in life. If you can help them in the area of health, they almost always re spond positively, regardless of socio economic background. When I worked in a pedodontic welfare trailer, I often found that the parents had a greater interest in their children’s oral health than did people from a higher socio-economic group. . . . Dr. Chambers should study ways in which the susceptibility of people can be altered. I would be happy to have him observe how we built a preventive practice with people who had not gone to the dentist regularly. . . . It is re warding to see people grow and be come competent at being healthy. EDWIN C. CARLSON, DDS ST. PETERSBURG, FLA
■ Susceptibility is not, fortunately, an all-or-none concept. It can vary in each individual from moment to mo ment. . . . F or example, people with poor self-images, or highly anxious or depressed people, would be poor can didates for plaque control if com pliance were the primary goal. How ever . . . an individual can significantly alter his self-image, or become less anxious or depressed. In a long-term interpersonal relationship we can an ticipate such behavioral change in many patients who would be consid ered “ unsusceptible” by Dr. Cham bers. . . . Patient “ susceptibility” to preventive oral health education, as it pertains to compliance in home care procedures, is only one determinant of success for a plaque control program. The validity of having a plaque con trol program in my practice is based on its success in accomplishing these ob jectives: —Patients’ awareness of the mean ing of dental health is increased . . . and they learn that they have a continuing responsibility to maintain their own health. —Patients become accustomed to our office; they are more comfortable and less threatened in a space they know and with people who appreciate them and care. Decreased patient anx iety also means decreased dentist anx iety. —The process of working with
rather than on someone is rewarding for all involved. I cannot conceive of practicing den tistry without the advantages of having a plaque control program, as well as other preventive modalities that are available today. An unbiased article on increasing “ susceptibility” to home care procedures would be of value to any dentist for whom preven tion has become the core of his prac tice. Work with us, A D A , not on us! MARVIN MANSKY, DDS NEW YORK, NY
Weight reduction fo r JADA m The Journal is fairly heavy now. I would like to suggest a step to lighten it. Why is it necessary to print so many pictures of individual members during Annual Sessions? Page after page of nonessential pictures! I tear out many of these personal and corporate snap shots so I can get to the Scientific Sec tion. CHARLES L. R. MYERS, DDS CHESTER, PA
N ote: Recent issues of JA D A have contained fewer “ personal and corpo rate snapshots” and a larger scientific section. JBG
Yellow pages blues m In August 1977, when I was prepar ing to open practice here in O ctober, I called the telephone company to re serve my phone number so that I could appear in the Yellow Pages to be pub lished in November. In September, the telephone company verified the in formation with me and said I would be included in the Yellow Page section and also in bold print in the white pages. When the new book came out in November, my name was not in the Yellow Pages at all. It was in the white pages, but not in bold print. These er rors will undoubtedly cost me a lot of business. I wonder if other dentists have had similar experiences and whether they
382 ■ LETTERS TO THE JOURNAL / JADA, Vol. 96, March 1978
have found solutions. I have consid ered litigation. If any dentists have suggestions or proof of how valuable the Yellow Pages are to their prac tices, I would appreciate hearing from them. JEFFREY BASSMAN, DDS DAVENPORT, IOWA
Compliance with advertising policy m The advertisement on page 33 of The Journal for January does not comply with the A D A advertising policies which, ironically, appear on page 34 of the same issue. Paragraph 4 under “ Advertising and Exhibiting Standards” specifies that advertisements shall not state that a dentist is in any way connected with a product or service e x c ep t' for textbooks. The mention of Sargenti by name in the ad clearly violates this standard. Paragraph 5 prohibits advertise ments publicizing techniques or prod ucts that have been ‘ ‘the subject of an unfavorable or cautionary report by an agency of the American Dental Asso ciation.” Both the technique and the product promoted by the advertise ment have been the subjects of unfa vorable and cautionary reports by such agencies.1'4 Paragraph 6 says that advertise ments of products or services that are “ dangerous” are unacceptable. Num erous reports of the dangers of the techniques and products advo cated by the American Endodontic Society advertisement appear in the literature and even in the same issue of The Journal.5 Interestingly enough, the adver tisement does not violate paragraphs 7 and 10 which prohibit superlative words and disparagement of competi tive products. In other words, the AES did not, in this ad, claim their technique is the best, or even that it is better than that taught in US dental schools. Paragraph 8 prohibits ads with di rect quotes, and paragraph 9 bans those with testimonials by a profes sional person. The statement, “ One of our members in the American En dodontic Society reported to us that it is ‘thegrand opera of his operations,’ ”
THE JOURNAL devotes this section to com m ent by readers on to p ics of current interest to dentistry. The m anaging ed itor reserves the righ t to edit all com m unications to fit available space and requires that all letters be signed. Printed com m unications do no t necessarily reflect the op in io n o r o ffic ia l po licy of the Association. Your pa rticipatio n in this section is invited.
Let the user beware m American Endodontic Society’s Newsletter (Fall 1977) asserts that “ The A D A Council on Dental Mate rials and Devices has released its re port including N2 as a routine of endodontics.” This claim is completely contrary to the stated position of the Council. In the Guide to Dental Materials and Devices, 8tli Edition, N2 is men tioned, but is neither endorsed by the Council nor considered as a routine of endodontics. The AES statement ig nores the Council’s warning of “ the severe postoperative complications that not infrequently accompany those (N2) types of materials, particularly when inadvertently extruded through a tooth apex.” 1 The Association should set the rec ord straight when other publications brandish its imprimatur without au thorization. When an untoward result occurs, either Association approval or general acceptance of a drug by pru dent practitioners may constitute a de fense to a suit for professional negli gence. On the other hand, customary usage of a drug that is not consonant with due care is not legally sufficient
proof that a dentist met the standard of care.2 The AES article concedes that N2 remains unapproved by the FDA. N onetheless, the article concludes that “ It can be prescribed and sold by pharmacists without question.” This bold assertion ignores the California Department of Health and the FDA which have both, in the past and cur rently, taken the position that distribu tion of N2 and its various progenies is illegal. Accordingly, cease and desist letters have been sent to various drug manufacturers, as well as dispensing pharmacies. Drug promoters, whether dentists or lay persons, who deceitfully prop agandize a drug’s safety or mislead practitioners regarding drug agency approval risk personal liability.3 Un less AES corrects this error, it is con ceivable that the ADA NEWS may one day report litigation alleging fraudulent misrepresentation on the part of these drug promoters serving in their corporate executive capacity. ED W IN J. Z IN M A N , D DS, JD SAN F R A N C ISC O , C A L IF 1. Guide to Dental Materials and Devices, 8th ed. Chicago, American Dental Association, 1976, p 187.
2. Helling vs Carey, 519 P. 2d (1974). 3. Toole vs Richardson-Merrill, Inc., 251 Cal. App. 2d 689, 60 Cal Rptr. 398.
You can change the patient ■ “ Patient susceptibility limits to the effectiveness of preventive oral health education” (The Journal, December 1977) was a disservice to den tistry ... . Basically the author viewed people as “ susceptible” or “ not susceptible,” as though they were fixed and incapa ble of further growth. . . . This is characteristic of the negative ap proach. A positive approach is to see what can be done to change the patient’s susceptibility. . . . A humanistic pre ventive dentist helps people get in touch with their strengths and values and grow out of their problems. . . . We help patients by leading them from what is probable to what is possible. N ext, we help them develop a percep tion of what future is preferable. A vision of what they want to have hap pen makes them better learn ers.. . . It sometimes takes people three or four years to come around to jumping from belief to commitment. Consequently, prevention can be a long-range grow JADA, Vol. 96, March 1978 ■ 381
ing process. People’s basic goal is to be compe tent in life. If you can help them in the area of health, they almost always re spond positively, regardless of socio economic background. When I worked in a pedodontic welfare trailer, I often found that the parents had a greater interest in their children’s oral health than did people from a higher socio-economic group. . . . Dr. Chambers should study ways in which the susceptibility of people can be altered. I would be happy to have him observe how we built a preventive practice with people who had not gone to the dentist regularly. . . . It is re warding to see people grow and be come competent at being healthy. EDWIN C. CARLSON, DDS ST. PETERSBURG, FLA
■ Susceptibility is not, fortunately, an all-or-none concept. It can vary in each individual from moment to mo ment. . . . F or example, people with poor self-images, or highly anxious or depressed people, would be poor can didates for plaque control if com pliance were the primary goal. How ever . . . an individual can significantly alter his self-image, or become less anxious or depressed. In a long-term interpersonal relationship we can an ticipate such behavioral change in many patients who would be consid ered “ unsusceptible” by Dr. Cham bers. . . . Patient “ susceptibility” to preventive oral health education, as it pertains to compliance in home care procedures, is only one determinant of success for a plaque control program. The validity of having a plaque con trol program in my practice is based on its success in accomplishing these ob jectives: —Patients’ awareness of the mean ing of dental health is increased . . . and they learn that they have a continuing responsibility to maintain their own health. —Patients become accustomed to our office; they are more comfortable and less threatened in a space they know and with people who appreciate them and care. Decreased patient anx iety also means decreased dentist anx iety. —The process of working with
rather than on someone is rewarding for all involved. I cannot conceive of practicing den tistry without the advantages of having a plaque control program, as well as other preventive modalities that are available today. An unbiased article on increasing “ susceptibility” to home care procedures would be of value to any dentist for whom preven tion has become the core of his prac tice. Work with us, A D A , not on us! MARVIN MANSKY, DDS NEW YORK, NY
Weight reduction fo r JADA m The Journal is fairly heavy now. I would like to suggest a step to lighten it. Why is it necessary to print so many pictures of individual members during Annual Sessions? Page after page of nonessential pictures! I tear out many of these personal and corporate snap shots so I can get to the Scientific Sec tion. CHARLES L. R. MYERS, DDS CHESTER, PA
N ote: Recent issues of JA D A have contained fewer “ personal and corpo rate snapshots” and a larger scientific section. JBG
Yellow pages blues m In August 1977, when I was prepar ing to open practice here in O ctober, I called the telephone company to re serve my phone number so that I could appear in the Yellow Pages to be pub lished in November. In September, the telephone company verified the in formation with me and said I would be included in the Yellow Page section and also in bold print in the white pages. When the new book came out in November, my name was not in the Yellow Pages at all. It was in the white pages, but not in bold print. These er rors will undoubtedly cost me a lot of business. I wonder if other dentists have had similar experiences and whether they
382 ■ LETTERS TO THE JOURNAL / JADA, Vol. 96, March 1978
have found solutions. I have consid ered litigation. If any dentists have suggestions or proof of how valuable the Yellow Pages are to their prac tices, I would appreciate hearing from them. JEFFREY BASSMAN, DDS DAVENPORT, IOWA
Compliance with advertising policy m The advertisement on page 33 of The Journal for January does not comply with the A D A advertising policies which, ironically, appear on page 34 of the same issue. Paragraph 4 under “ Advertising and Exhibiting Standards” specifies that advertisements shall not state that a dentist is in any way connected with a product or service e x c ep t' for textbooks. The mention of Sargenti by name in the ad clearly violates this standard. Paragraph 5 prohibits advertise ments publicizing techniques or prod ucts that have been ‘ ‘the subject of an unfavorable or cautionary report by an agency of the American Dental Asso ciation.” Both the technique and the product promoted by the advertise ment have been the subjects of unfa vorable and cautionary reports by such agencies.1'4 Paragraph 6 says that advertise ments of products or services that are “ dangerous” are unacceptable. Num erous reports of the dangers of the techniques and products advo cated by the American Endodontic Society advertisement appear in the literature and even in the same issue of The Journal.5 Interestingly enough, the adver tisement does not violate paragraphs 7 and 10 which prohibit superlative words and disparagement of competi tive products. In other words, the AES did not, in this ad, claim their technique is the best, or even that it is better than that taught in US dental schools. Paragraph 8 prohibits ads with di rect quotes, and paragraph 9 bans those with testimonials by a profes sional person. The statement, “ One of our members in the American En dodontic Society reported to us that it is ‘thegrand opera of his operations,’ ”
