Crippled Epistomology

Op-ed piece from an online discussion forum……..worth a read….everything is grist for the mill……….there is method and madness in the concept of a dental knowledge network in Canada. There is no question that anonymity will lead to some incendiary commentary, but have you been reading the newspaper these days?  It’s a part of life, the human condition. Regardless, we are in a pivotal time in dentistry….technologic change in the midst of a global recession and a disparity in those who can afford to seek care….we as a profession need to be sure we are providing care that is needed, not market driven……and so we begin…please realize, that this is endo related, it’s the area I can access easiest…commentary as it pertains to all areas of the dental discipline are not only welcome, they are essential to give this blog relevance. The writer is a brilliant clinician, however, nothing will be served by offering his name……..

“No tool or material is by nature evil (Sargenti paste, Peeso burs, Silver points,  pins, posts, AK47’s, incendiary bomb devices, and nuclear weapons).  The elemental problem is the “opportunity” these tools and materials provide based upon their design and promotion to do evil.  When I find a good use for anything including Thermafilth I’ll be happy to incorporate it to my armamentarium.   The big problem is the horrific message which is attached to the promotion and sales of these materials. We can all argue the extent to which we’ve legitimately found an important use for an abused technology/material. 

  1. Wave one- “fast, one file, don’t need to be an expert and can still do expert work” –
  2. Thermafil – “allows you to treat curves and get a cool radiographic look”
  3. General Rotary file promotion – “makes treatment faster and easier on your neck and hands, a few separated files now and then are ok”
  4. Resilon –  “flows great, creates super radiopaque final radiographs which emulate true density and sealing,  never mind the research by Pashley”
  5. Isolite –  “works as well as a rubber dam and is much easier and less complicated to place”
  6. Lasers – “space age and you can jack up your fee and promote your practice as high tech”
  7. cbCT – ” same as a laser except it actually has some valuable utility”
  8. Microscope – ditto CBCT

It is very clear that the clinical/science community needs to be guiding the product developers/distributors and that the product developers and their paid advocates should not be guiding the education of the clinical/science community. My fear has been realized.  I’m getting about 2-3 CBCT disks a week from dentists who bought a CBCT and are now “CBCT Scamming” every single patient who walks in the door.  They simply have their assistant take the scan, charge the patient $200-$300, make a copy and mail it to me to spend the time to interpret it for them expecting me to charge no additional fee since they’ve already “pre-scammed” the patient.  The patient pays for the tool not the expertise nor the time involved with knowing how to use it. You can go on and on, but until our health care culture realizes that the most important “tool/material” is the education, common sense, and ethics of the clinician willing to spend time with the patient to critically examine, plan, communicate, and then finally execute treatment,  the soul of the health care community is lost.  All those who say that this message is just singing to the choir are living in oblivion.  All we constantly hear is “what file did you use? what filling material did you use?, what bur did you use? yada, yada, yada, with no emphasis whatsoever on the most important phase of treatment which was the complex critical thinking and decision making, WHICH MIGHT HAPPEN TO BE INADVERTENTLY ENHANCED BY A TOOL OR MATERIAL.  No tool or material allows you to think more clearly (except for maybe a little caffeine or 5 hour energy drink). Tools are simply like misleading statistics, a microscope, and the CBCT.  Tools used without expert clinical diagnosis, clinical experience and clinical understanding are simply nuclear weapons of ethical destruction.  Double clickez-vous on the images……