Denturists―Heaven Forbid!
The Kellogg report [ click here ] lists conventional dental providers in the United States as dentists, hygienists and assistants. Missing is one component of the dental work force that is all but invisible: denturists. There are about 300 licensed denturists nationwide in six states: Arizona, Idaho, Maine, Oregon, Montana and Washington. But there are also uncounted dental technicians who, like many abortionists, work undercover. Many American denturists are trained in Canada, which has 2,000 recognized denturists. Legalized denturists function in other countries throughout the world including Australia, Demark, Switzerland, New Zealand, the Netherlands and the United Kingdom. Surely, if dental therapists can advance American dentists, denturists should also be considered to help us along, just as orthopedic technicians support orthopedists.
For an excellent review of denturist issues and concerns on limiting their scope of practice, see Maine’s 2005 Sunrise report at: http://www.docstoc.com/docs/20037692/Denturists-Sunrise-reportdoc,
Is Consensus “Evidence-based”?
Rather than endorse APHA’s policy, “Opposition to Prophylactic Removal of Third Molars (Wisdom Teeth),” the Association of State and Territorial Dental Directors’ Policy Committee “determined that it is premature…to adopt a policy statement at this time since there is not a consensus on the issue. We support the recommendation to convene an expert panel to consider the evidence base and generate a consensus statement.” [Personal communication to yours truly, Jan. 28, 2010.]
I replied that I do not believe another consensus panel would serve any useful purpose. “This issue is not about consensus. It is about ‘evidence-based’ practice. Any consensus panel would include representatives of the American Association of Oral and Maxillofacial Surgeons, which would preclude consensus. This, after all, was the outcome of the 1979 NIH Consensus Development Conference on Removal of third molars. AAOMS is too heavily invested in prophylactic third molar extractions to come to any other conclusion. Further, with the exception of AAOMS, there already is a consensus as reflected in the APHA policy.
“In opposing the APHA policy, the American Dental Association stated it is 'prepared to host a systematic evidence-based review on the topic in 2009….' Do we need yet another review to recognize that there is no evidence to support prophylactic third molar extractions? To be sure, some of the previous reviews have equivocated in their conclusion, but that should not be interpreted as approving prophylactic extractions. Quite the opposite: where there is no scientific evidence that the benefit of the procedure outweighs the known risk of harm, there is no evidence-basis for the procedure.”
Jay W. Friedman