I would like to comment on the Soapbox column by Dr. Matt Bynum in your October 2004 issue (Dental Economics, page 88). There is an old saying, "Never judge a man until you walk a mile in his shoes." Dr. Bynum tends to generalize in stating that every city has a group of dentists who are primarily older, known as "good ol' boys" who never took the chance to be better, are jealous, blinded, upset, and feel a loss of control. The quality of dentists' care is not determined by how high-tech they are or their ages. It is based on a commitment to excellence and a caring attitude toward their patients. As a middle-aged dentist who has been in practice 24 years, I see good and bad dentists in all age groups. I recently bought and absorbed the practice of a dentist who retired at the age of 72. While he did not do much "cosmetic" dentistry, the quality of his treatment was impeccable. His patients were loyal to him and were well-cared for.
Some of my mentors were "older" dentists, such as Drs. Earl Estep, Peter Dawson, and even Gordon Christensen (sorry Gordon). I learned volumes from these and other experienced dentists.
Sometimes dentists tend to become more conservative over time because we have been burned so many times by new materials, techniques, or the latest and greatest piece of equipment that we just "gotta have." After a while, you stick with what you know will work. As a dentist who has intraoral cameras, digital X-ray, air abrasion, electric handpieces, cosmetic imaging, and computerized treatment rooms, I can say that I am less likely to jump into something new without seeing a track record of success.
Maybe the older dentists do long for a day when there wasn't HIPAA, OSHA, lawsuits, insurance intrusion, costly advertising, and when most dentists didn't "bad mouth" other dentists. I would long for the same thing.
If there is an issue, let's help revitalize dentists who have become burned out and help them discover the exciting developments in dentistry today, but not create divisions based on a generalization of age as related to attitude.
Craig C. Callen, DDS
Fear of dentistry is not irrational
I'm glad that Dr. Davis took the time to respond to my letter about fearful patients (Dental Economics, September, page 22). My first reaction is to say that he missed the whole point of my letter. On further reflection though, I realized that he "got" just what I was saying. His point that the main cause of patients' dental problems is due to their own neglect is absolutely correct. My point is that they neglect their teeth primarily because of bad experiences in dental chairs. His question, "Is it rational thinking on a patient's part to let a disease (caries or periodontal) progress to the point of severe acute pain before seeking treatment?" is easily answered. The answer is: Of course it's not rational. However, my point is this - Is it rational to avoid going to someone who you are convinced is going to hurt you? The answer to this one also is easy: This behavior is totally rational.
One of the statements made by Dr. Davis is very revealing and shows the defensive posture many of us take when we're faced with this fact - The majority of fearful patients are created by rough or insensitive dentists and hygienists. He states, "... I have definitely seen my share of 'childish' adults when it comes to injections!" His exclamation mark for emphasis shows just how far from reality some of us are in understanding our patients. Just imagine: there are adults out there who are nervous about us sticking a needle into their mouths. What bizarre behavior on their part!
Come on folks, wake up. These people are neither irrational nor childish. Our attitude toward these people says more about us than it does about them. I don't blame people at all who are very nervous about having dental work done. If you do, then you really don't have the empathy you need to help them.
Jeff Wilcox, DDS
Encouraging implantology for general dentists
I do not know Dr. Meltzer, but can only speculate he is a specialist (Dental Economics, November, page 22). His comment, "Implants never fail to provide surprises that require confidence gleaned from repetition and a great deal of experience" is simply a statement of "turf protection." How does a general dentist or specialist develop experience? Which comes first, the chicken or the egg? I believe Dr. Christensen is correct. With proper training and case selection to build confidence and develop skill, it is not dangerous for a general dentist to become involved in implant dentistry. I am a general practitioner with 15 years of implant experience. I am more experienced today than 10 years ago, but I was not dangerous at any time. I strongly advise all general practitioners with surgical interest to pursue with passion the field of implant dentistry.
Emil Verban, DDS