Dr. McCrummen has raised questions concerning the validity of the published images. First, I should emphasize that no part of the research depended on the images, and they were included only to illustrate the maximum responses seen.
In the manner of how the images were taken, I’m sure Dr. McCrummen is familiar with the old dental school trick of taking the pretherapy images on Kodachrome to emphasize the reds and the posttherapy images on Ektachrome to emphasize the blues. I am sure that Dr. McCrummen is also familiar with the difficulty in controlling wet chemistry variables. With this knowledge, we have tried to provide information that is as unbiased as possible.
As this is a serious scientific study, the images have been produced by what are accepted by the Food and Drug Administration and other regulatory agencies as the current scientific norm for image recording: unretouched digital images. The images were taken using a Nikon 990 Coolpix (Nikon, Melville, N.Y.) using the dental light for illumination from the closest nonmacro distance for autofocus. As such, images taken may not conform to familiar norms of either Kodachrome or Ektachrome films but they are uniformly exposed under identical conditions and free from processing variables.
Dr. McCrummen points out an interesting observation that I had missed—the change in gingival color. In his critique, comment is made that gingival color is different in the after photos; to quote Dr. McCrummen, "both ‘after’ photos show a more normal pink appearance to the gingiva."
Actually, that is exactly what was reported in our data evaluation. The article clearly states that there was a significant reduction in Gingival Index (decreased redness) relative to baseline in all groups. I had not thought to verify this by considering the digital images. I would like to thank Dr. McCrummen for sharing this observation that seems to support our conclusions.
