JCDA - Canadian Dental Association

Letters
Editor’s Comment
The Journal welcomes letters from
readers about topics that are relevant
to the dental profession. The views
expressed are those of the author and do
not necessarily reflect the opinions or
official policies of the Canadian Dental
Association. Letters should ideally be no
longer than 300 words. If what you
want to say can’t fit into 300 words,
please consider writing a piece for our
Debate section.
Bridging Implants
Implant manufacturers have
reported successful osseointegration, in
excess of 95%. However, many of
today’s successfully integrated implants
are failures waiting to happen. The
preponderance of failures will occur
not due to peri-implantitis but to
trauma and excessive occlusal load on
the supporting scaffold. Inadequate
numbers of implants, inadequate
implant length and diameter, excessive
occlusal forces and premature loading
are a few of the more common causes
that lead to implant failure over time.
In Can implants be bridged to
natural teeth? (Point of Care, JCDA,
July-August 2003), Dr. Dennis
Nimchuk recommends rigidly joining
an implant to a natural tooth in the
construction of a 3-unit bridge.
Although he carefully lists the conditions
that encourage this approach,
most dentists may well ignore them
and initiate treatment that has a high
failure rate when inappropriately
applied.
As well, the clamour by many
impatient clinicians and the aggressive
marketing by implant manufacturers
to promote immediate loading of
implants, is certain to yield higher
rates of failure and, with time,
discredit the valuable service that
dental implants can provide. In jest, it
was recently suggested that we will
soon see claims of an implant system
Journal of the Canadian Dental Association
that can be loaded 2 days before insertion
of the implant.
Faster and easier are not necessarily
better! Doing things properly is
certainly better!
To be of optimum benefit to
our patients, treatment should be
evidence-based, respecting underlying
physical and basic science principles.
Modifications of the ideal need not be
abandoned, but should be recognized
for what they are — convenient and
expedient compromises, which too
often fall short of long-term successes.
Dr. Frederick I. Muroff
Montreal, Quebec
CDA Resources
The Town of Tecumseh (Ontario)
had problems with fluoride equipment
and has not been adding
fluoride to the municipal water supply
for over a year. In view of this problem
and the expense involved, the town
council considered the possibility of
not adding the fluoride at all. The
health unit I work for and the Essex
County Dental Society spoke to the
Tecumseh town council on 2 occasions.
On May 13, the council voted to
replace the equipment and to again
add fluoride to the water supply to
bring it up to recommended levels.
Much of the material we required
for our presentations to town council
came from CDA’s Resource Centre.
Dr. John O’Keefe also provided me
with a copy of the May 2003 JCDA,
so that we had the excellent article by
Dr. Steven M. Levy (“An Update on
Fluorides and Fluorosis”) to refer to.
Some of the anti-fluoride delegation
accused us of not being up-to-date.
The material from the Resource Centre
and JCDA proved to town council that
we were in fact up-to-date. I believe
that this contributed significantly to
the outcome of the vote.
In my 40 years of dentistry, I have
used the Resource Centre many times.
The staff there has always helped me
in my research, my clinical practice
and my efforts to locate current and
past literature. I believe the Resource
Centre alone makes my membership
in CDA worthwhile.
Dr. Arnold Abramson
Windsor, Ontario
Five Decades —
Where Have They Gone?
Not all your readers are aware of
Dr. Wesley J. Dunn’s contribution to
dentistry over these past 50 years, and
the impact he has had on the profession
as a result of his involvement in
dental organizations, including the
Royal College of Dental Surgeons of
Ontario (RCDSO). I have always
admired him.
In his editorial in the July-August
JCDA, Dr. Dunn mentions an
example of unacceptable progress —
namely, advertising by dentists, which
he describes as demeaning to the
profession. Many dentists would like
to see restrictions on advertisements
similar to those that existed before the
Supreme Court decision. The rules of
the land dictate otherwise and, as he
noted, the governing bodies cannot be
faulted.
As a staff person at RCDSO for
over 10 years, with direct involvement
in advertising issues that come to the
College’s attention, I disagree with
one of Dr. Dunn’s comments —
specifically, that “we are not commercial
competitors.” Over the last decade,
we have witnessed a tremendous
growth in demand for elective dental
procedures, especially with respect to
cosmetic dentistry. That aspect of our
profession, which is the most heavily
advertised in all media, has indeed led
to commercial competition.
I agree that some advertisements by
dentists may be considered professionally
demeaning. My remarks to you are
just meant to bring the practical reality
November 2003, Vol. 69, No. 10 633