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President’s Message: Value in Retaining Natural Teeth

AAE President Dr. Alan H. Gluskin

The public will value saving their natural teeth and seek endodontists — the specialists in saving teeth — for their care.

I am writing this President’s Message having just completed 18 radio interviews around the country for “Save Your Tooth Month”, which will already have been concluded as you read this column. It was a very affirming experience for me to project the value of saving the natural dentition to an audience I could not see and which was only represented by numerous radio hosts who were cordial and for the most part, acted enthusiastic and interested. That was their job. They needed to act engaged, at least for the 10 to 15 minutes we were occupied. The thing that weighed heaviest in my own mind was… Was I convincing enough? Am I doing my job? Does our message as endodontists grab the casual listener and focus their attention? Would the untold thousands, multiplied to millions of people, listening to a live broadcast, tape or podcast feel that I was saying something that made sense to them or might influence them? Would some listeners possibly understand differently the importance of saving their natural dentition? And understanding that, if a listener were going to commit to that process because of pain or swelling, would you believe the message that you should consider an expert to solve your problem. An expert with two to three years of additional training beyond dental school; who utilizes advanced technology such as an operating microscope and three dimensional radiographs to make your investment in your health one that is worthy of the expense and actually has the best chance to allow your tooth  to last your lifetime. To make the argument that going to a specialist is the most cost-efficient treatment, with the best chance for success because of the endodontist’s skill, is a solid argument. Nonetheless, it is also a sales pitch, pure and simple. But a sales pitch that is meant to benefit the health of the intended listener and create the most convincing message for our specialty.

First I needed to get past the understanding that very few people, in the general public, know what an endodontist does. For years I strongly believed our Association should be called the American Association of Root Canal Specialists, because everybody knows what a root canal is. Realizing, that that idea was going to go nowhere, it became important for me to emphasize on radio that the prefix “endo” means “within” or “inside” the tooth and why in this era of COVID-19, 85 percent of endodontists were open to see emergencies and pain issues related to inflammations and infections within their teeth. The public needed to know why we were prepared and capable to help and take care of them in an expert fashion should a toothache or dental swelling require a proficient and knowledgeable specialist  who could resolve their emergency expediently and effectively and save their tooth at the same time.

The argument beyond all of the things we promote in this our Strategic Priority 1, should be, that, in this our new COVID environment, an endodontist knows how to safeguard you and solve your problem. An endodontist knows how to protect you from aerosols and utilizes infection control measures with shields and rubber dams, and special evacuation measures that are not common and highly important to protect you the patient, as well as the doctor. Our infection control practices are our badge to safe and effective best practice.

But also, as a consequence of our current COVID environment, imagine you are an American who has lost their job as have more than 36 million people as I write this message. You turn on the television and hear medical experts and academics explain that we must open our economy cautiously because public health is important. Yet all these experts that are making this case have jobs; have maintained their standards of living and in fact are now in greater demand. They feel as though they are doing important work, and they are. But if your patient in pain on the other hand, has lost his/her job, they may feel a sense of worthlessness and saving their natural tooth takes on less importance to them when having enough groceries means survival. It is not so hard to understand why people in this position might be skeptical of an expert.

So we all have a very big job ahead of us. We are healers and caregivers. We must all recognize that we need to hear many voices as we make decisions for ourselves and our patients, and that we, who are making decisions need to have empathy for all Americans — those whose lives have not been severely impacted by this virus, but also those whose lives have been turned upside down by this horrible disease and need our help as well.

To help within our own offices, we currently have a special committee working on endodontic-specific best practices to protect against COVID-19 issues in the operatory. This special committee has the intended purpose of producing a position paper regarding specific ways to stay safe and practice maximum infection control for viral protection issues in an endodontist’s office. The special committee will focus on targeted recommendations for using the microscope; dealing with ultrasonics and aerosols; handpiece guidelines and other exclusive issues involving the chairside practice of endodontics in a specialty office.

In this way, we can not only promote best practices to our membership and dentists in general, but as is equally important, we can promote the fact that endodontics, performed and practiced by endodontists, is safer and more well regulated than your average dental environment.

These guidelines can be promoted in a new White Paper, a position paper or a Colleagues for Excellence manuscript and that will be determined by the Special Committee and our Board of Directors…. but the basic message from  the AAE and your now President will never lessen in passion and intensity…. The public will value saving their natural teeth and seek endodontists — the specialists in saving teeth — for their care.