Inside Dentistry
March 2006
Volume 2, Issue 2

Letters to the Editor

Dental CE Buyer Beware!
Congratulations on your flagship issue of Inside Dentistry (October 2005). I commend you on the quality, relevance, and content of your publication and I look forward to future issues.

As an experienced and accomplished educator in dental continuing education, I note that there are many courses, opportunities, and options available from which dental professionals can choose. Dental professionals have an obligation to continue their education and the quality of the CE decided on should be an important selection consideration. Dental CE varies with respect to subject matter, methods of presentation, levels of complexity and intensity, and clinical relevance. Noteworthy is the variability of the quality of the CE provided.

Of concern is the fact that some dental CE presentations are nothing more than advertisement, promotion, and commercialization of specific products, materials, methods, and devices. This advocacy is often based on the anecdotal experience of the presenter. Product advocates should divulge any financial interests with specific manufacturers and they should compare and contrast other therapeutic options that are available. Dental providers must discern the accuracy and the validity of claims and endorsements made by product advocates, who may have an unbalanced and biased opinion. This is especially true regarding claims made for newly introduced materials, methods, devices, and technologies. The alert CE participant should consider whether the conclusions made in the presentation are evidence-based, scientifically valid, and do not represent a conflict of interest.

The goal of the dental profession is the acquisition and maintenance of the optimum oral health of our patients. The means, methods, materials and strategies used to achieve this goal must be effective, efficient, and economically feasible, and they should be consistent with the health, safety, and wellbeing of the patient. Questionable claims regarding product efficacy and therapeutic value should be challenged. Do these new products and technologies serve in the best interest of the dental patient, the general public, and the dental profession? As discriminating perpetual students, dental CE participants should be vigilant regarding the quality of what is being presented and they should be judicious in the selection of their CE courses.

Paul J. Vankevich, DMD
Assistant Professor
Department of General Dentistry
Tufts University School of Dental Medicine
Boston, Massachusetts

Prepare Students for the Real World

I read the premier edition of Inside Dentistry and enjoyed the articles. One article in particular was very provocative and is an issue that I have thought about for quite some time. I am referring to the article “At the Head of the Class,” by Allison M. DiMatteo.

The article makes a number of excellent points as to the both the causes and solutions to the dental education crisis. I indeed agree with the sentiment that there is a crisis in dental education, and I contend there has been one in existence for decades. I am astounded when I reflect at the innumerable changes in our profession since my graduation in 1982. When I graduated, bonding and veneers were in their infancy, implants were limited to television shows like “That’s Incredible,” silver points were still a standard in endodontics, and bleaching was an archaic method of lightening endodontically treated teeth.

Fortunately, I have had the benefit of having over 23 years to adapt and obtain more education through residencies and continuing education; today’s students have no such luxury, and that is unfortunate. The simple fact of the matter is that dental education is still primarily a 4-year event with some students obtaining residencies or specializing. I would contend that no dental student is capable of practicing full time immediately after graduation from dental school. These students and their instructors may delude themselves into believing that they are capable clinically and can contend with the myriad of business issues involved in a dental practice, but I can assure you they are not.

What is needed is at least a 2-year residency program following graduation to provide these students with a suitable foundation for private practice. What we need is to have a residency program mirroring that of medicine where students vie for positions and are then “matched” so that students can have a variety of experiences and instructors from which to learn. I believe that this can be best accomplished by incorporating a separate, private-practice environment attached to the dental school. In this manner, instructors would benefit from being able to earn extra income from the practice, and students would have the opportunity to practice under supervision and learn. The current system is fine for learning the basics, but private practice is another matter altogether.

In the article, there were some suggestions as to having private-practice clinicians teach on a part-time basis; I whole heartedly endorse this concept. The problem is that most dental schools rely on either full-time academic faculty or recruit from the retired military ranks. From my perspective and that of many of my colleagues, private-practice dentists are shunned from the dental school unless they are nationally or internationally known. There is still too much of the “good ole boy” network that exists in dental schools, and that is why the faculty numbers are dwindling. I have seen too many schools hire recent graduates who have no business teaching something that they either cannot do or do well, and yet that is exactly what happens. So the message sent to us in the private sector is that you are not wanted or welcome. I know because I have offered to teach and was not even given the courtesy of a rejection letter. I had even offered to teach without pay, only asking for payment for my parking, but was told “there was no money for that.”

When my friends and colleagues and I get together and reminisce about our dental school experiences, they are, for the most part, the reliving of a nightmare. As I recall, most of the instructors were belligerent and difficult and often abusive. Many seemed to literally relish being insulting and demeaning to the student, and from my many discussions with my colleagues, their experiences are notably similar. For most us, graduation was about survival and liberation from the horrors of our purported educators. Why then would any of us consider returning to that environment we so loathed? Why would we think that we would be made to feel welcome and treated as a colleague? Why would we consider becoming the “enemy”? From what I hear from more recent graduates, current dental school experiences are far less onerous, but still the educators have many of the traits I noted when I went dental school. In addition, the lack of private-practice experience by the instructors does not permit the real world to enter. There is no discussion of real-life economics of dentistry, dental insurance with its alphabet soup of PPOs, DMOs, etc.

The message we in private practice hear loud and clear is that we are not wanted and valued except as revenue for continuing education courses. There is certainly a crisis in dental school education, but unless there is the desire and the will to change the programs and attitudes, then nothing will change. For those of us in private practice who are willing to “give back,” there must be the equivalent force of reception to our giving and that, sadly, largely does not exist in most dental schools today.

Thank you for permitting me to express my views, and it is my fervent hope that this discussion will lead to changes in education, but I am less than optimistic.

Richard J. Reinitz, DDS, MBA, FAGD

Tearing Up the Premier Issue

Congratulations! What a great issue! After 35 years in practice I rarely even crack open a journal or professional magazine, and when I do it is to tear out one article of interest. If I had been smarter, I would have torn out what I was not interested in. With nine tear outs you have set a new record and high water mark for relevancy and quality of content.

Greg Vigoren, DDS

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