I have been a JADA reader for the last 18 years. Aside from the standard prosthodontic journals to which I subscribe, JADA has proven to be consistently pertinent. Dr. Gordon Christensen’s monthly editorial is especially important, as he always seems to have his finger on the pulse of our profession and presents his information in a very warm and tutorial fashion.
In January JADA, Dr. Christensen’s discussion involved a shift toward over-preparation of teeth ("Has Tooth Structure Been Replaced?"). He spoke briefly of a colleague who overprepared teeth for porcelain laminates and then experienced debonding of the majority of the restorations placed.
Dr. Christensen hinted that the dentist was using research from a manufacturer as his guide in tooth preparation, and further used the manufacturer’s research and documentation on dentinal bond strengths as a defense in potential litigation.
I truly believe that the problem that Dr. Christensen lightly touched on—how information affecting the way we practice is filtered down to the profession—is a crisis facing our profession. Trade journals that pass themselves off as educational tools are a major source of the problem. Many articles in these journals are written by uncredentialed practitioners who claim expert or specialty status. Some of these authors are representatives of the manufacturers whose materials and techniques they tout.
The biggest problems seem to occur with the "cosmetic" articles. Many of these are written and presented as cookbook approaches to dentistry. The entire concept of evidence-based dentistry is trashed, as these magazines offer no editorial review process. These journals create a dilemma for the majority of practitioners: "Whom to believe?" "What research is valid?" "Is a bench test a true representation of clinical situations?"
Dental journals that require review by an editorial board and dental society–endorsed continuing education are the answer. The paradigm shift has been toward overpreparation of tooth structure. It has been a slow process, yet if one were to listen to anecdotal lectures by "cosmeticdontists" over the last 15 years, it would be evident.
I urge the ADA membership, especially the general dental community, to seek their continuing education on a postgraduate level. University programs run by specialists, as well as the yearly meetings run by the given specialties, should be the standard for what information and techniques are implemented in our practices.
Trade journals are about selling products and advertising. This does not make them a source of continuing education and technique.
Dr. Christensen is, without a doubt, the most respected and listened-to leader in our profession. I do hope he continues his articles in an attempt to quell the tide of misinformation and poorly performed research protocol and data that threaten our profession.
