Apparently, Dr. Brackett misunderstood the entire intent of the article. My purpose in writing the editorial was to motivate dentists to differentiate between dentistry that needed to be accomplished and dentistry that was for esthetic or other elective reasons.
This differentiation clarifies the treatment for patients and may actually reduce the amount of dentistry performed by dentists. I feel it is the professional responsibility of our profession to offer patients the opportunity to upgrade their appearance if they desire to do so. Failure to educate patients about dentistry’s elective services reduces the influence our great profession has on the overall psychological health of patients.
As all of us remember, failing to divide potential treatment into mandatory and elective categories caused the profession considerable distress and criticism in a Reader’s Digest article a few years ago (
Ecenbarger W. How honest are dentists? Reader’s Digest Feb. 1997;150: 50–6
). It is very easy for a dentist or a dental staffperson to observe when a crown or other restorative therapy is needed or when overt periodontitis is present. I assume that Dr. Brackett would concur that these conditions should be treated.
However, there are many times (I approximate about 50 percent of the time) when worn-out restorations or esthetically impaired tooth-supportive tissues could be improved, thereby causing a significant upgrade in patient appearance and self-esteem. If dentists divide therapy into items that must be accomplished for the better physiologic health of the patient, and those that can be accomplished if patients desire to improve their appearance and psychological well-being, there should not be patient misunderstanding as to what is needed.
This concept seems to be a logical and rational one. It certainly has proven acceptance among patients. Perhaps Dr. Brackett has some further information that would elaborate on his rather unclear allegations.
I contend, using Dr. Brackett’s terminology, a true "professional" has the obligation to educate patients and that professionals need not "sell" anything. Education changes behavior, and patients must make their own decisions about elective dentistry. It is the absence of education that leaves dental patients confused and upset about dentists and dentistry.
