« PreviousContinue »
clinical history of those cases, and does not recognize the differences in the anatomical positions of the teeth in the various shaped dental arches. I think the more successful way would be for each practitioner to do his own radiography. We do find conditions to be very bad occasionally under crowns and bridges, but I do not feel that the dentists are so much to blame because they have not had knowledge in the past that has been gained in the last few months or years.
It would be splendid if some one could devise a perfect root canal filling which would meet the requirements of the profession, in which there could be incorporated an insoluble salt that would be impervious to the ray. It would then be possible to diagnose whether a hair line on very minute canal was filled to the apex with filling material or with "hot air." It would enable us to depend more completely on the radiograph.
I believe the matter of the root canal filling is very important, and is something that should be taken up by a committee of men qualified to pass upon this question to the satisfaction of the dental profession. In fact this is one of the first questions to be worked out by the research committee of the National Dental Association. (Applause).
DR. M. N. FEDERSPIEL, Milwaukee, Wis.
I would like to have some one tell me how it is possible to differentiate a root granaloma from a dental cyst-personally I believe that it is impossible to do so with the X-ray.
DR. H. J. KAUFFER, of New York City. Too often we are satisfied with a clinical diagnosis, and when the film agrees with that clinical diagnosis, an operation is performed in that particular part, whereas there are obscure conditions that may be found upon the plate. I have in mind the case of an apical abscess of the lateral tooth, of which a
plate was taken, and disclosed an apical abscess of the second molar, which was draining into the antrum. That abscess would be entirely lost from general dental observation, and it was really more essential to be taken care of and eradicated than the abscess. The film of course is well as a secondary precaution, after we have made a diagnosis, to get a more definite radiograph of a circumscribed area.
DR. R. OTTOLENGUI: I do not want the essayist to think I was attacking the usefulness of the full plate radiograph. I was only combating the argument for the exclusive use of the full plate radiograph. I once acted as consultant in an orthodontic case in a distant city, and I recommended a certain orthodontist in that city. The mother occasionally visited New York, and she would bring the child to see me. In the course of the procedure it became necessary to determine the presence or absence of a left lower second bicuspid. At the completion of the case the mother came in with this peculiar story, she said that the first radiograph showed that the tooth was present, and a space was opened in the arch for this tooth. They waited for it to erupt, and at the end of a year another radiograph was taken to see the progress of the eruption, and lo the tooth was not there. Now the solution of that was simple. We needed a full plate picture to show where that tooth had drifted. The first picture definitely showed that a bicuspid was present in that bone; the second picture only showed that there was no bicuspid in the field covered by the film, and it was a wrong reading to say that the tooth was absent because it did not show on a small film. Not having seen either of these pictures, I was convinced that these two films were records of different areas, and hence, as a year had passed, that there might have been some migration. I did not know whether I would find it at the
surface or up at the top of the skull (Laughter). We obtained a full plate and it was lying under the first molar. It was lying horizontally, and there is no doubt in my mind that it moved distally as it developed, and that is why it showed in the first picture and not in the second.
I precipitate myself into this discussion to say that I do appreciate the value of the big plate, and also to tell why I am opposed to its primary use in connection with dental work. It has been said here today, and very truly, that the radiographers have done wonders. They have brought home to us our disgraceful root canal technique, and, then preach thru one of our lines of literature that the physician must consider the mouth in making his diagnosis. must not be surprised if he goes to his medical radiographer, and if he finds a lot of these little shadows, indicating blind abscesses, he has a right to say the dental work is at fault. There is but one remedy. We must reconstruct our technique, so that when these cases come to these medical men, they will not find those defects, and we cannot do that without the constant use of the radiograph to check up our root technique. We cannot apply that in general practise unless we can bring the cost of it within the reach of the multitude. Here is the advantage of the small film and of the dentist doing his own work. In the first place, if that is all the dentist wants to know, that his root work is right, he can install a very inexpensive apparatus.
You may not get films good enough for reproduction on the screen but they will tell him how far the root canal filling has gone, at moderate cost, without any
such elaborate apparatus as we have seen, and without the necessity of sending the patient out. The cost of sending the patient to the specialist in radiography prohibits his getting the picture after the work is done. These men have no records of the results after treatment. With the outfit installed in your office, you can take pictures, whether you need them or not, and you can get a number of pictures, which you cannot get if you send the patient out.
DR. RHEIN: The main point in the essayist's very valuable production, is the discriminating detail of the different tissue for diagnostic purposes. A picture of the entire head or mouth may be a very pretty adjunct to have, but it's value as compared with the well focused film is not very great. When it is desirable to discriminate between healthy and unhealthy tissue in any particular field, more so when it is important to intelligently read the nature of the abnormal condition, the glass plate has very little value along side of a well focussed film. In modern scientific root canal therapy, it is imperative that every step of the treatment be checked by a correct Roentgenogram, even to a picture when the operation is finally concluded. The inordinate benefit obtained in this way is appreciated by every operator who has utilized the X-ray in this way. The glass plate will never satisfy the operator who has once used the film for this purpose.
DR. E. J. EISEN: I won't say anything further than to thank you, ladies and gentlemen, and those of you who have so kindly discust the paper. (Applause.)
THE RESPONSIBILITIES OF THE STATE
By Homer C. Brown, D. D. S., Columbus, Ohio.
(Read before the State Society Officers' Section, National Dental Association, Rochester, N. Y., July 8th, 1914.)
T WAS only at the urgent solicitation of the officers of this section that I consented to present a paper on this occasion. This could more appropriately have been contributed by another, but it was argued that my varied official experience would qualify me to present some points worthy of consideration to those interested in this section. In this way my consent was secured, as it was generally understood that I would have no other particular duties to perform at this meeting.
The subject was selected with a view of stimulating, if that be necessary, the officers of the various state dental societies to recognize and assume their full responsibilities. This is especially emphasized at this particular time, when it is so very important to have every such society, with its full membership, affiliated with the National Dental Association as a constituent.
It has always been more or less discouraging to note the lethargetic tendency of so many members of our profession in doing some service that does not render, at any particular time, some positive financial remuneration. Unfortunately this has been a distinct handicap in our progress and it also has been somewhat discouraging when attempting to transact official business with the officers of some of our state societies. In view of this, if I can say anything that will tend to develop a more efficient
corps of officers for these societies I will feel that my efforts have been worth while. Under our present plan of organization the need of this increased efficiency is especially desirable.
We are confident that under favorable conditions the reorganized National Dental Association is going to prove a far greater success than even its most loyal supporters anticipated, but it must be distinctly understood that the individual member is the primary unit of its strength. Where component or district societies make up the state organization they become the next step, while in other instances the state society becomes the second step. Be that as it may, the future of the National will depend upon the co-operation of its constituents, the state dental societies, and the success of these, in this new relation, will very largely depend upon the officers who serve their respective societies during the next few years.
For that reason, we earnestly appeal to those who have been or will be thus honored, to assume and discharge their official duties with the same interest and devotion that prompts them to safeguard their personal affairs. To do other than this will not be just to themselves or prove them worthy of the confidence placed in them by their associates. We are further confident that if the state society officers become sufficiently interested in this new relation, it will result
in a harmonious co-operation, as well as an increased membership in the state and component societies. This will be true just as soon as this relationship is fully understood and especially when our National Dental Journal is published. Then membership in these organizations will mean more than heretofore and will be proportionately sought and appreciated.
In some states the profession is better organized than in others and this is largely due to the officers and committees of such societies. Under ordinary circumstances what is possible in one section of the country can, in a modified way, be accomplished in another. Oklahoma and North Dakota have in a very brief time organized very effective societies and have secured the co-operation of a large per cent of the legal pratitioners in their respective states. This has been accomplished under unfavorable transportation facilities and it would seem that some of the more populous states could afford to investigate their methods. I was particularly interested in the efforts of the officers of the North Dakota Society in stimulating an interest in their last meeting. Their secretary was kind enough to send me a copy of their program, one of their circular letters and a unique but dignified post card which I here with incorporate:
North Dentist Should Decline Attending
Grand Forks, Friday and Saturday
This was in two colors, the N. D. S. D. A. and the date of meeting in red, the other in black.
The success of any commercial enterprise very largely depends upon the active officers responsible for its management and this is true with organizations such as ours. In a commercial organization, the officers actively interested are usually paid salaries commensurate with their positions and abilities and there
fore they are expected to give the interests of their concern first consideration. A dental society can in no sense be considered as having been organized for financial profit and it seldom occurs that any attempt is made to compensate any of its officers. For that reason those actively in charge, such as the officers and committees, must necessarily make many sacrifices in order to develop their society so that best results may be accomplished.
As a general rule, only those who have rendered efficient service in minor positions should be elected or appointed to the more responsible positions. The fact that a dentist may be recognized by his conferers as prominent in his profession, in his city, section or state, should not necessarily qualify him for active official duties of a responsible nature. He may not have any particular qualification or liking for organization work, may not possess any iniative and may not be willing to make the necessary sacrifices.
Therefore, I frankly say that no member should be elected to a responsible office in the state society, and this applies alike to all others, unless he possesses some degree of qualification for the position. This should be supplemented with a deep interest in the affairs of the particular society, as well as what applies to the progress of the profession generally. Further, he should also be willing to make the necessary sacrifice of time, energy and money in order to make his official term a successful one.
No officer or committeeman, elected or appointed, should assume autocratic power or more responsibility than rightfully belongs to his position. I do not mean by this that a person in a responsible position should always wait to be told just what to do or neglect matters for lack of some definite instruction. Acts of omission are equally if not more censurable than acts of commission.
That is, inactivity or lack or effort is open to as much or more criticism than an honest effort to do what the official thinks to be for the best interests of the organization he represents. Either may result in mistakes, but the official who makes a mistake trying to do something should be less criticised than one who makes no effort to accomplish anything. The person who never makes a mistake or never makes an enemy probably will never do much that can be considered of any special value.
It is always advisable to be considerate of the interests of others and this is especially true in our dental organizations. Officers and committeemen, serving in responsible positions, should consult freely with those having an equal interest in the success of the society, as well as take into consideration the wishes of those in the ranks who made it possible for them to hold official positions.
Many of our members are perfectly willing to permit others to do all the work and receive all the credit, when success crowns their efforts. When the reverse is true they are equally willing that the workers should receive all the criticism. My contention is that in success there is ample credit for all and it is especially desirable that this should be generously distributed, since it is hardly possible to conduct a successful meeting without the loyal co-operation of many assistants. To be liberal and to encourage others, we should go back far enough to take in every member of the organization, since without them little could have been accomplished.
The offices of the president and secretary are the two most important in a state dental society. The continued success of a society depends even more upon the secretary than the president, as it is more or less customary to re-elect a good secretary from time to time and in this manner he becomes quite famil
iar with the affairs of the organization and is naturally the bureau of information for the members and others.
Most societies have a Board of Trustees, or executive council, or some similar business body which very largely regulates the business affairs. Their terms of office expire at irregular periods and this is a very desirable feature, as it tends to maintain the continuation of established policies instead of having too frequent and too drastic changes. It is not usually a good policy for these boards of control to waive too many of their prescribed duties in favor of newly elected officers, altho it is only natural that a new president should have some individual ideas as to how to best make his administration a success and due deference, within reasonable limits, should be shown him. This frequently produces enough change from year to year to safeguard against too much of a sameness and makes possible the development of individual features that become attractive.
One instance might be cited in way of illustration. The Ohio State Dental Society at its meeting last December, set aside one evening for what was termed a "Health and Science Conference." diversified program was presented on this occasion, which proved very interesting and instructive. This is herewith incorporated in order to show the features presented:
HEALTH AND SCIENCE CONFER-
6:00 P. M. Reception to guests. (Informal.)
7:00 P. M. Dinner.
President, Dr. Weston A. Price, presiding.
Greetings from the National Dental Association, President, Dr. Homer C. Brown.
The State and Dental Science, How