Anthony E. Badalamenti, DDS
West Islip, N.Y.
Your amalgam vs. composite debate was very well-presented, and each side did a good job of stating opinions. I must note that while both sides were thorough, Dr. Dickerson`s statements left me with some unanswered questions.
I cannot help but wonder what is at the root of his passionate feelings against placing amalgam restorations. Why would he never (and he means never) place an amalgam restoration in a family member`s mouth? Since Dr. Dickerson took such great umbrage at the thought that his motivation was money, surely there must be some other reason. I would love to hear it.
I have had numerous patients tell me that their mother`s, brother`s, or friend`s dentist told them he would not place an amalgam restoration. While they rarely ask the next question, I know that they are thinking: "If Dr. X doesn`t use it, why do you?" I advise them that while it is most certainly each dentist`s prerogative to render treatment as he or she sees fit, the dentist does owe some explanation as to the reasons behind this approach. This especially is true when one considers that the alternative usually costs more. Much like the presentation by Dr. Dickerson, answers to questions of this type are hard, if not impossible, to find.
As Dr. Dickerson points out with the commonly used cardealer reference, consumers make different choices. Some drive a Yugo and others drive a Lexus. While this is a given, as a Yugo dealer, I would find it patently unfair if the Lexus dealer stated or implied something negative about my product without some valid reason for doing so. Many dental consumers rely solely on the advice of their dentists in making treatment decisions.
There is no consumer guide to the 1999 dental-treatment options. If the dentist`s advice is based upon some personal preference, that should be clearly elucidated. If Dr. Cardealer tells his patients a Lexus is their only choice, and all other options are bad, and offers no sound support for this viewpoint, he or she is not truly offering them all possible choices. As an idealist, I`m sure most practitioners offer their patients all the choices and present the facts based upon sound science, not some passionate, unsubstantiated feelings. Yet, as an observer of reality, I know this is not the case.
If the Dr. Dickersons of the world want to avoid amalgam, that is great. My concern is that, in doing so, they present all the facts and don`t cloud the picture to support only their passionate views. The fact that I elect to place all types of restorations in my practice has no impact on the anti-amalgam crusader. I would appreciate it if the opposite also remained true.