February 1, 2011
by Oral Health
Re: The Ethics of Cosmetic Dentistry: Beneficence, Beauty or Bucks? October, 2010
I applaud the work of Karen Faith and the important message she brings in her discussion paper on ethics and jurisprudence.
I do however, have a concern that for many of those who choose only to scan the title and don’t actually read the article, in its entirety, may get the impression that Ms Faith is suggesting that all dentists who perform cosmetic dental procedures, and the organizations that represent them, are financially motivated.
All dentists are sensitive to the fact that dentistry is often targeted as being something unpleasant to avoid, rather than focusing on the modern painless techniques and the health benefits we provide. The propagation of those sentiments are not in the public interest. The propagation of the myth that cosmetic dentistry is limited in scope, or that cosmetic dentistry is performed for financial motivation is equally as absurd and not in the public interest.
The concern that you infer in your article about the organizations that represent dentists who have a special interest in cosmetic dentistry are suggesting or promoting unethical behaviour is a dangerous and erroneous misrepresentation. As a member of several organizations that promote education in cosmetic dentistry, all of them promote the concept of “ethical comprehensive treatment” and “patient health”.
It is about time we stop the propagation of “dental myths” just for the sport of it and the attention that brings.
Ron Goodlin, DDS
Vice-President, American Academy of Cosmetic Dentistry, Aurora, ON
Re: Editorial, Dental Care – A Basic Human Right?
DPM, Winter 2010 (oralhealthjournal.com)
es, certainly dentistry for relief of pain and suffering should be on Medicare. In fact, dentistry is covered on the Oregon health Plan.
This is a highly successful public plan that works and has worked for more than 20 years.
The basic formula of cost sharing was correct, unfortunately, the Federal Government has lowered its share of the cost sharing arrangement and imposed an inflexible set of rules called the Canada Health Act. This piece of legislation has been an unmitigated disaster. The irony is that it has created exactly what it was designed (or rather mis-designed) to prevent – Private Medicine.
And who is the main driver of private medicine? GOVERNMENT. Physicians and nurses and other healthcare providers are being employed by private concerns to provide medical services to the public– the RCMP, Cambie Surgicenter, and Ultima Medical to name just a few.
Until Canadians wake up and smell the coffee and realize their system was misconceived and is ineffective, get ready for more out of control costs and yes, private medicine.
PC Bradley, DDS
graduated from U of T Dental School in 1977. From that time until the end of ’79, I was one of four full-time dentists in the Yukon. I was in a private practice, with the government subsiding us to travel to communities outside of Whitehorse. The experience had a profound impact on the way I practice dentistry to this day.
While there, we could not drill, fill or pull fast enough. Once a week on average, I would go into the hospital and remove what remained of a person’s teeth and insert dentures. The average age was probably in the 30s. The youngest was a 14-year-old native girl from a small community. Interestingly she was not in pain (dentists who have seen these situations, understand why), but because she had no smile, she wanted teeth like the other kids she met since starting high school in the city.
I also had the pleasure of treating a cohort of people in their 80s and 90s. I didn’t need to help them often because of the few problems they had despite having most of their teeth. These people were born in the late 1800s (!) often in the “bush”.
Both groups displayed poor or, more often, complete lack of oral hygiene. The difference was diet. The younger group grew up with store bought food and the older group with what they gathered from the land.
This nutrition problem started to become quite obvious in the north starting in the ’70s – read: diabetes, cardiovascular disease, tooth decay, etc. The government, working with community groups and local retailers, tried various approaches such as colour coding food labels to indicate good and bad foods. Unfortunately, like trying to eradicate alcohol, drugs, smoking, bad food and sedentary lifestyle, the government(s) have had little success.
Excellent dental health comes as a result of eating well and properly using inexpensive tools (about $20/yr) on a regular basis. The government’s involvement can be as basic as imparting knowledge, some sealants and cleaning. If we are going to provide complete dental care for those who neglect their health, then we must consider manditory fluoridation (when was the last time you saw someone with a goiter because of lack of iodine since it was added to salt?), mandatory twice a year instruction/cleaning, and elimination of various “foods” from our diet (stores) such as “pop” and other junk.
After returning to Ontario and running a solo practice for 23 years, I did loccums for five years and am now providing dental services in a federal medium security institution. At the jail, I see some of the poorest dental health and I have also seen the cleanest mouth in my career. Having seen people from so many parts of Canada and the world over the past 33 years, I have made two observations: people who grew up in fluoridated areas had less decay and dentists and hygienists don’t show flossing and brushing in the patient’s mouths. This second point is particularly troubling and embarrassing to the profession. After all these years of demonstrating proper cleaning technique, the response has been the same, “you are the first person who has shown me”. Despite the rule of thirds in respect to patient compliance, for there to be any positive result, people need to feel how it is done. Should I ask the obvious question? Has someone actually put a toothbrush and floss in your mouth? Why do you think the Sensodyne makers are making so much money? People clean the way they think they are supposed to, with poor results, despite their socioeconomic background.
Catherine, our healthcare system costs are out of control now. We have a poor health epidemic in this country because we have chosen to embrace poor lifestyle. It should be an easy choice between prevention and treatment but the political costs seem to be too high.
Steve Burrows, DDS
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