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Implants The EditorThe News Bulletin Australian Dental Association Dear Sir, I uphold Prof Branemark’s concept of the team approach to the various stages of implant treatment yet I merely question the concept of specialists operating a limited practice.
My observation over the years of a dentists skill and inclination is that there are red or white dentists or a special hybrid, the red/white dentist . The red dentist loves the challenge of extracting apices from over the IDN whilst the white dentist abhors even the sign of hemoglobin on a retraction cord. The red practitioner remains in general practice which is the first portal for wisdom teeth and difficult extractions, whilst the white dentist will often specialize and proudly evangelically boast that "we do not extract teeth" hoping to hide the fact that not only does he not like extracting teeth, but that he is not that good at it! - usually an insightful resolve following some bad experiences in the first few months following graduation. A third group, the red/white dentist loves the diversity of general practice and is multi-skilled in all aspects. It is noble that each group precipitates about their point of interest and skill, but the possibility that white specialists will abandon their traditionally limited practices and re-enter the abandoned red areas begs consideration about their level of skill and their motives, for a team approach can only work if the first portal is the general dentist and the more expensive specialist is only accessible through a referral. That’s how medicine protects the public interest and purse. The second tier of the dental health system needs to be accessible only by referral and the time honored limited practice concept is valid and should be upheld. A specialist Endodontist, Peridontist or Prosthodontist should not dabble in fillings, extractions or other red techniques because they are not experienced in those activities and the public deserves to know that they are "new chums". I would not want Christian Barnard removing my gall bladder. Some gall! Do the State dental boards have the metal and resolve to address this matter or will it be left to the insurers’ and federal government’s interference on behalf of the "customer"? Julian P. O'Brien |
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For
periodontists and endodontists who traditionally never extracted teeth but referred the
patient to an oral surgeon to be now purchasing a range of forceps and elevators so to
place implants immediately after they extract a tooth, not only challenges the concept of
limited practice but raises the possibility of limited experience. Heaven help the public
if prosthodontists start doing their own red dentistry and start buying forceps, needle
holders and sutures and bone screws.