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Letters: Dr. Cole letter to the editor

July 08, 2019

Here is a quote from the June 18 ADA News: “The American Dental Association and dentists across the country are dedicated to the health and safety of the patients they serve.” That was the message ADA President Jeffrey M. Cole emphasized in a June 16 letter to the editor of The Atlantic, in response to the magazine’s May article, “The Trouble With Dentistry.” Dr. Cole also strongly disagreed with the author’s implication that dentists are motivated by profit to pay down their student loans. “[This implication] is not borne out by the facts,” Dr. Cole said. “For instance, dentists have for decades advocated for fluoridation of community water supplies to prevent tooth decay. Why does the profession advocate for something that results in less need for treatment? Because dentists are doctors of oral health, and tooth decay is a disease that we want to prevent for the good of the public,” he concluded. I am recently retired from 39 years as a clinical dentist. My experience is that there is truth to The Atlantic article. I too often had patients come see me for second opinions because of their doubts about the unexpectedly large amount of problems diagnosed by another dentist, and more often than not, the diagnosed problems were exaggerated beyond what was actually there. No one can say for sure that the previous doctor’s motivation was to pay off burdensome student loans. Actual motivation aside, the fact remains that there is actually overdiagnosing and unnecessary treatment occurring. How widespread is it? I could not say, but I do know that it has been increasing in the past five to 10 years, and any level of that is unacceptable. I always wondered when someone would realize that there was an actual problem here, and it is obvious that the author of The Atlantic article has discovered this problem and has started pointing it out. For the ADA president to flatly deny it is disingenuous. Obviously, the problem is not caused by a majority of dentists, and is not an epidemic, but the problem must be admitted and dealt with. People are finally starting to notice.

John P. Walker, D.M.D.
Clearwater, Florida


Editor’s note: The Atlantic shortened Dr. Cole’s original letter he submitted to the publication. His original letter also stated, “Dentists hold a special position of trust and as such are obligated to adhere to the highest ethical standards with the primary goal being the benefit of patients and the public. A dentist’s ethical obligation is to meet the needs, desires and values of the patient within the bounds of accepted treatment, as described in the ADA Principles of Ethics and Code of Professional Conduct. The ethical responsibility of dentists and the rights of dental patients are paramount to experiencing and receiving optimal dental care and dentists across the country encourage their patients to take an active role in their dental health. That includes being selective in finding a dentist with whom they can openly communicate in order to receive personalized care and asking questions they may have about a diagnosis or procedure before any treatment is performed.

We want our patients to know that they always have the option to discuss alternative treatment plans, decline care or seek another opinion.
The overwhelming majority of dentists are ethical practitioners, and that’s why dentists are consistently ranked among the most honest and ethical professionals, according to Gallup public opinion polls. Every profession unfortunately has some individuals with questionable ethics.

This is as true in journalism as it is in dentistry. It is unfair to paint an entire profession with such a broad and negative brush.”