the buccal and labial surfaces of the teeth. Once the patient has been helped to discover the cause and to eliminate it, then topical agents such as strontium chloride or fluoride will assist in occluding the tubules. . . . O ne reason some of the treatments seem to provide relief is that they taste so bad the patient reduces the mechan­ ical factors. . . . BILLY J. POWELL, DMD AUSTELL, GA

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ures to cure, or, at the very least, de­ crease oral disease in all humans. W hat other medical discipline can make the same claim? Should we dis­ continue or severely cut down on the push for prevention simply because a large percentage of people is unreceptive? This would be the easy way out. I like to think we have more integrity and concern for the health of our fel­ lows than that. .. . We all realize what we are up against, but we will not quit trying when we have the answers to oral disease. We will push prevention as long as we are a profession dedi­ cated to the health of mankind. Until people can rinse with a miracle drug to abolish decay, we must advo­ cate present measures of prevention. I wish those outside the profession would quit being backseat drivers and, instead, strive to help our cause.

m The majority of dentists in this country are not in favor of advertising, as it seems product- rather than service-oriented. However, it appears that advertising is going to be a fact of life for the professions. Since this is so, it seems unfair to both the public and the dentist that although fees can be advertised, extra training cannot. The dentist who is . . . continually upgrading his services in quality and scope cannot inform the public of this achievement. Are the consumer protection or­ ganizations and the FT C really inter­ ested in the total concept of the deliv­ ery of health care? The manner in which advertising has been thrust on us shows that little thought has gone into any of its ramifications. Realistic guidelines must be set up immediately to ensure that the best possible treat­ ment be rendered, not necessarily the cheapest.

■ An article by Chambers in the D e­ cember 1977 issue of The Journal (p 1159) said that the goal of preventive oral health education programs is to ‘‘develop in patients a self-maintaining habit of daily mechanical disruption of plaque.” The mass appeal of dental floss de­ pends on its simplicity of use. Most people do not floss. M ost of those who floss do not floss daily because it is inconvenient and awkward. . . . U n­ doubtedly, when a truly convenient and safe system of flossing is avail­ able, the public will adapt, and the dental flossing IQ will increase. . . .




the patient’s subacute bacterial en­ docarditis was the direct result of bac­ teremia produced by the irrigating de­ vice, but that they were impressed by the close relationship between the onset of the disease and the use of the device. MANUEL I. WEISMAN, DDS AUGUSTA, GA

■ Dr. Weisman has called attention to a letter to the editor of The Lancet which Dr. Ray Anderson and I pre­ pared after the American H eart Asso­ ciation committee recommendations were in press (these recommendations were published originally in Circula­ tion and then reported in The Journal). The concern about bacteremia fol­ lowing the use of oral irrigation de­ vices was the reason that D r. Ander­ son and I reported the temporal asso­ ciation of infective endocarditis and the use of an oral irrigating device. One month later, another report of two additional suspected cases appeared in Annals o f Internal Medicine (87:455, 1977). The time between the purchase of the instrument and the onset of en­ docarditis was longer for these two pa­ tients, and, therefore, the relationship may be more open to question, but again the point is emphasized that in­ fective endocarditis may be associated with use of these devices. EDWARD L. KAPLAN, MD CHAIRMAN, COMMITTEE ON PREVENTION OF RHEUMATIC FEVER AND BACTERIAL ENDOCARDITIS AMERICAN HEART ASSOCIATION

Dental magicians Give up on prevention? m Dr. Chambers (The Journal, D e­ cember 1977) has spent time and en­ ergy discovering what every dentist al­ ready knows about the frustrations of prevention motivation. . . . H e re­ minds us half a dozen times that those who are good dental patients are the ones who need our help the least. . . . We need more help in this area, not constant reminders of our biggest pro­ fessional struggle! We have at our disposal the meas­

Magic can be a great adjunct for spicing up dental health presentations. I know how much fun and interest magic provokes because I not only use it within my office but also in presenta­ tions to service groups, parent-teacher organizations, churches, and schools. Dentists who might be interested in a small group of colleagues who are magic-buffs are invited to get in touch with me at 34 Shirley Ave, Revere, Mass 02151. m

Endocarditis and the irrigating device m The new guidelines for antibiotic coverage of patients who might be susceptible to subacute bacterial en­ docarditis (The Journal, September 1977) say that there have been no re­ ported cases resulting from the use of oral irrigating devices. However, a case has subsequently been reported in The Lancet (Sept 17, 1977). The authors say it cannot be proved that

190 ■ LETTERS TO THE JOURNAL / JADA, Vol. 96, February 1978


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