I read with great interest the very diplomatic response from Dr. Bruce Small (Letters to the Editor, November JADA) about Dr. Jeffcoat’s off-the-cuff comment regarding gold foil restorations in her June editorial, "Ah, That New Car Smell."
I, too, place gold foil restorations. In fact, the first restoration I ever placed for a patient was a Class V gold foil when I was a student entering the clinic at Temple University. I’ll wager it is still functioning, unless some bondodontist with a proclivity for tooth-colored everything has replaced it with a direct composite.
Having been blessed to practice dentistry in Sun City, Ariz., for the past 15 years, I have made the following observations:
Nothing lasts like well-done gold restorations. The demographics of my practice are such that the average patient age is 75 years. Since Sun City is a retirement community, I have had the privilege of seeing dentistry not only from every part of this country, but from many foreign countries as well. When I see a 50- or 60-year-old Class III foil that looks like it was placed yesterday, I can’t keep from wondering how many times that restoration would have been replaced, even if it had been done with today’s state-of-the-art composites. And also of importance, how much would it have grown?
Some patients absolutely demand tooth-colored restorations, and I will not deny them that option. But even with these restorations having improved so markedly over the past several years, my first recommendation is usually for a gold restoration. I guess my point is that you should not discard a wonderful restoration option for the mere sake of expediency. (When the only tool you have is a hammer, everything starts taking on the curious appearance of a nail.)
Having been a member of the R.V. Tucker Cast Gold Academy since 1990, I do have some prejudice toward gold restorations, and hate to see them abandoned for what I feel in most cases will have a shorter life span. The prevailing climate in dental schools regarding gold restorations is moving toward their removal from the curriculum. Comments such as Dr. Jeffcoat’s do not help in this matter and, as Dr. Small pointed out, the discipline necessary to successfully complete a gold restoration is an asset in virtually all dental techniques.
