From: russ@wpg.com (Russell Lawrence)
Subject: Re: Mercury in dental fillings?
Organization: WP Group
Date: Sat, 15 Aug 1992 11:01:09 GMT


In article <BswGn5.CJL@wpg.com> russ@wpg.com (Russell Lawrence) writes:
rl> Of the 100,000 (plus/minus) dentists in north america, I'll bet that
rl> 99% of them had prayed (literally or figuratively) at one time or
rl> another that amalgams really were toxic;  yet the scientific research
rl> demonstrated that this simply wasn't the case.  Both the ADA and 
rl> the AGD took a lot of flak after exposing the prevalence 
rl> and nature of this particular bit of quackery, and several 
rl> employees very nearly lost their jobs because they stood up for 
rl> the truth, rather than economic self-interest. 

Gordon Banks writes:
gb> Listen, this is really going too far, Russ.  

From article <jb7mnrc@dixie.com>, by jgd@dixie.com (John De Armond):
jda> Amen.  Any dentist worth his salt is way overworked.  

Is this true?  Thanks to capitation grants in the 70's and the impact
of better nutrition, fluoridation, and dental hygiene, most 
dentists I know are not overworked; they're greatly underworked.
If you really want to debate this particular point, I'll stop by 
the dental library over the next few days or so and innundate you 
with several dozen citations from _Dental Economics_.  :-) 

jda> The last thing he needs or wants is to be forced to use some new 
jda> restorative material that will not last and thus has to be 
jda> replaced more often.  None of the substitutes come anywhere near 
jda> lasting as long as amalgam.  

No and yes.  Acrylic composites have a high coefficient of expansion,
poor durability, biocompatibility problems, leakage problems, etc.  
Amalgam is stable, lasts for years and years, has few 
biocompatibility problems, rarely leaks once the material begins 
to corrode around the edges (a GoodThing), and carves well.  
Unfortunately, an unscrupulous dentist may be able to get as much 
as $300 for a large acrylic composite restoration that will last
a few years whereas a large amalgam may cost just $40 bucks.  And 
therein, we can see why the theory was so tempting.

jda> Disregarding the humanity side for a moment, mercury substitutes 
jda> are a logistical nightmare.  Regarding the humanity side, any 
jda> dentist who does something that makes his patients come back and 
jda> go under the needle and drill more often is going to lose those 
jda> patients to dentists who don't.  The only dentists whom I've 
jda> heard about using substitutes generally don't fit well with my 
jda> first full sentence.  

I agree with you in terms of scientific and ethical principles.  
I don't agree with the notion that quackery may be unprofitable.  
In reference to the amalgam scam, one highly respected dentist 
was quoted by JADA as saying that Gresham's Law applies, not only 
to money, but to dentists as well: 

     "Bad dentists drive out good dentists".  
	  
A guy who's making $500,000 a year replacing "toxic amalgams" can 
buy a lot of glitzy office space and impress a lot of naive 
patients with deceptive glitter.  Meanwhile, a guy who's doing 
honest restorations may have a tough time making ends meet.  I wish
it weren't so, but most dental patients don't know enough to tell
the difference between good work and poor work.

jda> Disclaimer: I'm not a dentist and don't even play one on TV.  But 
jda> I come from a long line of 'em.  When yer sitting around the 
jda> dinner table full of dentists and doctors, it's damn hard to keep 
jda> the conversation steered toward computers and cars, my two 
jda> interests.  

My dad's got a dental degree from University of Louisville.  I've
personally interviewed well over a hundred dentists, dental
educators, and public health officials on this particular topic.

-- 
Russell Lawrence, WP Group, New Orleans (504) 443-5000
russ@wpg.com   uunet!wpg!russ