The letters from Drs. Robert Brackett and Gordon Christensen in January JADA regarding "elective" vs. "necessary" dentistry reminded me when, as freshmen in dental school, we were greeted on our arrival by the dean.
In his first meeting with our class, the dean told us that our biggest problem in dental practice would be to convert patient "needs" into "wants" (his words). How true! That was 50 years ago.
Patients have frequently asked, "Is such-and-such necessary?" My response frequently is both "yes" and "no." If by "necessary" do we mean you will die from this condition if we don’t do the procedure, then I guess the answer is no. If, on the other hand, do we mean that you will be much better off in later years if we do it, the answer is yes. It all depends on one’s definition of the word "necessary."
I have in my mouth as large a collection of crowns, inlays, endodontically treated molars and so on, as does anyone. But I also have in my mouth 28 natural teeth in good occlusion. I eat my food comfortably. It is a tribute to my parents, my childhood dentist (who put countless amalgams in my teeth without benefit of local anesthesia, I might add), my orthodontist and a few other excellent practitioners that I am in this condition at my age.
Is proper dental care "necessary"? By my standards it sure is! Unfortunately, however, not everyone defines the word "necessary" in the same way.
