I hope every dentist will read with a discerning eye the letter to the editor in January JADA by Dr. Maureen Murphy, president of the North Carolina Academy of Family Physicians. She is describing an untenable situation in her state, and in many others I suspect, where there is grossly inadequate access to proper preventive and restorative dentistry for young children.
Why are physicians applying fluoride varnish to their young patients? Because dentists are not doing so. Nature abhors a vacuum.
When there is an unmet need, some group, qualified or not, often will step in to fill that need. Instead of bemoaning the fact that physicians are applying fluoride varnish, the dental profession should fulfill its responsibility by seeing to it that all children, rich or poor, have their dental health needs met by members of our profession. Turf wars benefit no one.
Although organized dentistry bears the primary responsibility for their situation, other groups are at fault as well. Legislators often do not provide adequate reimbursement for procedures provided by skilled practitioners. Too many parents do not place the proper value on the dental health of the children for whom they are responsible.
What can the dental profession do?
- Push the U.S. Food and Drug Administration to determine whether fluoride varnish is a safe and effective preventive measure.
- Educate parents and legislators as to the fact that people are not in good health if their oral health is poor.
- Make greater use of dental hygienists and auxiliary personnel in educational and preventive programs.
- Provide more predoctoral and postdoctoral training in the care of very young children and perhaps increase the number of pediatric dentists.
In my opinion, the issue is not really fluoride varnish and who applies it, but why the dental profession has not taken more vigorous steps to provide adequate care to all citizens, regardless of income.
What can individual dentists do? A not-so-old adage will suffice: If you are not part of the solution, you are part of the problem.
