LETTERS
325
TO THE EDITOR
having undergone intravenous sedation for outpatient oral surgery. I believe this article is misplaced in our iournal, as it has very little to offer to members of our society. Perhaps it fills the need for increasing the thickness of our journal. However, to report on incidents of hypoxemia in the postoperative anesthetic area and not to supply supplementai oxygen during surgery does not lend any credibility to this study or to the reasons for performing the study. If we are truly concerned about hypoxemia and the associated arrhythmias developed from hypercapnia and the associated hypoxemia, then certainly it requires that all of our patients who are undergoing intravenous sedation-general anesthesia receive supplemental oxygen, and that strong consideration also be given to its use for people undergoing local anesthetia. I fail to see the relevance of this article for our colleagues and I submit that better screening of publications should be accomplished. EWARD L.C. SMITH, DDS Santa Cruz, California LESSONS FROM THE PAST To the Editor:-Congratulations
on the publication of Erik K. Curtis’s article on ‘*Extraction with String;” a totally refreshing and informative article on exodontia and its “roots.” We are faced with so many complexities in professional life that we can lose sight of the pleasures of historical readings. Please continue to remind us of the origins of dentistry in this pleasant, lighthearted fashion. JOHNA. NESPECA,DDS College Park, Maryland INFORMATION ABOUT LITIGATION? To the Editor:-We recently noted an article in the Newsletter of the American College of Oral and Maxillofacial Surgeons that alleged that there are scores of
lawsuits involving oral and maxillofacial surgeons, Vitek, and other corporations in respect to problems with the use of Proplast TMJ implants. We are not sending you this letter to debate TMJ surgery, but to vigorously question why such important facts involving our members and regarding this treatment modality are not being reported to the membership. Why do we have to find out such important information in another Society’s newsletter? Why hasn’t our own Association reacted and issued an alert about this prosthesis? Why is Vitek reportedly bankrupt, yet you keep advertising its products? Our office is composed of three board-certified oral and maxillofacial surgeons who have a cumulative total of 70 man-years of private practice, in addition to associations with different oral surgery teaching programs. Why is it that we haven’t seen all these TMJ surgical cases reflected in the Journal. Brooklyn, New York, has over two million people, but yet, the number of surgical TMJ cases done at our hospitals is practically nil. Can all the oral and maxillofacial surgeons in our area be missing all these pathologic joints? For the responsibility and respectability of our profession, I hope our association will investigate these allegations. MICHAELSOLE, DDS SHELDONM. JACOBSON,DDS ROBERTEDWAB, DDS, Brooklyn, New York
EQUAL OPPORTUNITIESFOR ALL To the Editor:-As I sat in the recent forum on the dual degree in New Orleans and tried to collect my thoughts to say something profound, nothing flowed. Much rhetoric was espoused and passionate pleas were made, but we never got down to the basic issue. As director of a program of 5 years simultaneously leading to a medical degree, the reasons I had for adding 1 more year and one more degree fit into all of the categories that were discussed at the meeting. However, the signal that we must strongly send to everyone is that the programs that are not adding time and another degree should still be able to assure their graduates that the scope of oral and maxillofacial surgery is not based on degrees, but rather on the degree of training. This signal should also be sent strongly to prospective residents. We did not disallow orthognathic surgery training to oral surgeons on the basis of degree. Cosmetic surgery training, with its comparative simplicity. should certainly be no less attainable. The leadership and the constituency of this Association must not let restrictions based on degree happen, and certainly not let outside agencies interfere or dictate. In my training program there is one mandated track, but there are also 4-year trainees in the program. These 4-year residents are no less oral and maxillofacial surgeons than those with a dual-degree. They are just as skillful and intelligent, and must not be denied training or privileges based on a single degree. I have told my residents who are simultaneously enrolled in medical school that there is no innate surgical birthright provided by obtaining the medical degree: this must be obtained by good oral and maxillofacial surgery training. If we are to expand into new vistas, these must be taught in the residency programs. For those programs or persons lacking experience in cosmetic surgery. for instance, fellowships must be established. If other disciplines will not allow oral surgeons without a medical degree to seek such training, then we must establish our own programs for them. The Chair at the meeting kept making a plea for ideas, but only wonderful reminiscences and platitudinal pleas came forth. Let me offer some concrete suggestions:
Additional degrees (MD, DO, PhD, MSD, MS) should not make a difference in scope, which is a factor of training. There should never be two tiers of oral and maxillofacial surgeons. Dual-degree oral and maxillofacial surgeons should insure that single-degree oral and maxillofacial surgeons have the same access to training. Fellowships should be established for all interested oral and maxillofacial surgeons. We owe it to those that come after us to inherit a strong association, united and welded as boilerplate for the many battles to be fought and won. Let’s not allow the present discussions to sap our strength, but rather, let us use our energy to tell the world what oral and maxillofacial surgeons are and what we can do.
W. ROBERTHIATT, DDS Kansas City, Missouri
325
TO THE EDITOR
having undergone intravenous sedation for outpatient oral surgery. I believe this article is misplaced in our iournal, as it has very little to offer to members of our society. Perhaps it fills the need for increasing the thickness of our journal. However, to report on incidents of hypoxemia in the postoperative anesthetic area and not to supply supplementai oxygen during surgery does not lend any credibility to this study or to the reasons for performing the study. If we are truly concerned about hypoxemia and the associated arrhythmias developed from hypercapnia and the associated hypoxemia, then certainly it requires that all of our patients who are undergoing intravenous sedation-general anesthesia receive supplemental oxygen, and that strong consideration also be given to its use for people undergoing local anesthetia. I fail to see the relevance of this article for our colleagues and I submit that better screening of publications should be accomplished. EWARD L.C. SMITH, DDS Santa Cruz, California LESSONS FROM THE PAST To the Editor:-Congratulations
on the publication of Erik K. Curtis’s article on ‘*Extraction with String;” a totally refreshing and informative article on exodontia and its “roots.” We are faced with so many complexities in professional life that we can lose sight of the pleasures of historical readings. Please continue to remind us of the origins of dentistry in this pleasant, lighthearted fashion. JOHNA. NESPECA,DDS College Park, Maryland INFORMATION ABOUT LITIGATION? To the Editor:-We recently noted an article in the Newsletter of the American College of Oral and Maxillofacial Surgeons that alleged that there are scores of
lawsuits involving oral and maxillofacial surgeons, Vitek, and other corporations in respect to problems with the use of Proplast TMJ implants. We are not sending you this letter to debate TMJ surgery, but to vigorously question why such important facts involving our members and regarding this treatment modality are not being reported to the membership. Why do we have to find out such important information in another Society’s newsletter? Why hasn’t our own Association reacted and issued an alert about this prosthesis? Why is Vitek reportedly bankrupt, yet you keep advertising its products? Our office is composed of three board-certified oral and maxillofacial surgeons who have a cumulative total of 70 man-years of private practice, in addition to associations with different oral surgery teaching programs. Why is it that we haven’t seen all these TMJ surgical cases reflected in the Journal. Brooklyn, New York, has over two million people, but yet, the number of surgical TMJ cases done at our hospitals is practically nil. Can all the oral and maxillofacial surgeons in our area be missing all these pathologic joints? For the responsibility and respectability of our profession, I hope our association will investigate these allegations. MICHAELSOLE, DDS SHELDONM. JACOBSON,DDS ROBERTEDWAB, DDS, Brooklyn, New York
EQUAL OPPORTUNITIESFOR ALL To the Editor:-As I sat in the recent forum on the dual degree in New Orleans and tried to collect my thoughts to say something profound, nothing flowed. Much rhetoric was espoused and passionate pleas were made, but we never got down to the basic issue. As director of a program of 5 years simultaneously leading to a medical degree, the reasons I had for adding 1 more year and one more degree fit into all of the categories that were discussed at the meeting. However, the signal that we must strongly send to everyone is that the programs that are not adding time and another degree should still be able to assure their graduates that the scope of oral and maxillofacial surgery is not based on degrees, but rather on the degree of training. This signal should also be sent strongly to prospective residents. We did not disallow orthognathic surgery training to oral surgeons on the basis of degree. Cosmetic surgery training, with its comparative simplicity. should certainly be no less attainable. The leadership and the constituency of this Association must not let restrictions based on degree happen, and certainly not let outside agencies interfere or dictate. In my training program there is one mandated track, but there are also 4-year trainees in the program. These 4-year residents are no less oral and maxillofacial surgeons than those with a dual-degree. They are just as skillful and intelligent, and must not be denied training or privileges based on a single degree. I have told my residents who are simultaneously enrolled in medical school that there is no innate surgical birthright provided by obtaining the medical degree: this must be obtained by good oral and maxillofacial surgery training. If we are to expand into new vistas, these must be taught in the residency programs. For those programs or persons lacking experience in cosmetic surgery. for instance, fellowships must be established. If other disciplines will not allow oral surgeons without a medical degree to seek such training, then we must establish our own programs for them. The Chair at the meeting kept making a plea for ideas, but only wonderful reminiscences and platitudinal pleas came forth. Let me offer some concrete suggestions:
Additional degrees (MD, DO, PhD, MSD, MS) should not make a difference in scope, which is a factor of training. There should never be two tiers of oral and maxillofacial surgeons. Dual-degree oral and maxillofacial surgeons should insure that single-degree oral and maxillofacial surgeons have the same access to training. Fellowships should be established for all interested oral and maxillofacial surgeons. We owe it to those that come after us to inherit a strong association, united and welded as boilerplate for the many battles to be fought and won. Let’s not allow the present discussions to sap our strength, but rather, let us use our energy to tell the world what oral and maxillofacial surgeons are and what we can do.
W. ROBERTHIATT, DDS Kansas City, Missouri
