In my column, “That’s The Way I See It,” January Edition 2010, I discussed my thoughts on what some in the dental profession refer to as “Coronectomy.” Dr. Barron’s reactive comments were published in the March issue of Spectrum dialogue. I am now pleased to have the opportunity to reply to Dr. Barron’s coloumn as this is “true” professional dialogue.

In Dr. Barron’s research to verify the terminology of the word “Coronectomy,” he quotes “Wikipedia” as his main source. For those of us who are familiar with Wikipedia, there is a disclaimer that states that Wikipedia can’t guarantee the validity of the information found on its site. The disclaimer goes on to say that the contents of any article or information may recently have been changed, vandalized or altered by someone whose opinion does not correspond with the state of knowledge in the relevant field. If you need specific medical advice, it states, please seek a professional who is licensed or knowledgeable in this area.

I read with great interest Dr. Gaum’s recent article regarding his criticism of the coronectomy procedure. In the article, he criticized several procedures for lack of scientific based implementation in clinical practice. I would particularly like to address his claim that intentionally leaving tooth fragments such as third molar fragments in the mandible to prevent possible paresthesia caused by their removal is a poor treatment decision. He further claims this procedure would open an avenue for complaints by licensing bodies which would be indefensible.

Recently, I read of a case in England where a female patient suffered a very serious accident in which her trachea was severely damaged. She underwent surgery to repair the damage but was never satisfied with the results. She constantly complained of pain and discomfort in her neck, being unable to swallow properly and eventually became very depressed. She could not function normally on a daily basis.

Several years ago, I was invited to present an oral surgery seminar to a group of colleagues in Halifax, Nova Scotia. This was indeed an honour and a pleasure as Nova Scotia is my native home. I was born and raised in this beautiful part of Canada and still miss it even today.

Nova Scotians or bluenosers as they are affectionately called are good people and the salt of the earth; tough people that survived for centuries by their wits and street smarts.

I was going back home and was really looking forward to meeting my maritime colleagues.

At this time of year, as the summer draws to a close and the cooler weather moves in to give us some relief from the blistering heat, I begin to reflect on the years that have passed me by. I think fondly of my parents and how their love and devotion to me and my brothers sustained and comforted us as we grew from children to manhood. I recall how they provided for us spiritually as well as physically and mentally. They were both religious people and had an unwavering belief in God, the supreme being, and always kept a religious house and presence for us at all times.

My wife and I visited a nice restaurant the other day. Nothing fancy but certainly a little higher on the rung than Wimpey’s.

As we sat down a young waitress approached us, handed us menus and gave us the following greeting.

“How are we doin you guys?

I answered, “I don’t know how we guys are doin. Do you know?”

The waitress smiled a rather silly grin and didn’t answer, but asked, “ Anything to drink guys?”

I was immediately turned off even before I tasted a mere morsel of their fare.

For those of us who are independent and have their own practices, businesses, labs, and companies, look in a mirror and say to the image you see smiling back at you, “AM I LUCKY!!” Yes, lucky for many reasons. Lucky that you don’t have to answer to anyone but yourself, except maybe to your college or your licensing body and that is understandable and to be expected. We all have to be governed by rules and regulations. Also lucky because everything we generate financially we keep. Yes, I know we have expenses such as staff salaries, overhead and taxes. And yes I know we have a partner in Ottawa, a Mr. Revenue, that says two for me and if you’re lucky, one for you. But the bottom line is everything that remains is ours to spend, bank, invest or give away. As well, we don’t have to answer to any one higher than ourselves, because as self employed individuals, there is no one higher.

The majority of dental offices in Canada have excellent equipment for sterilizing their instruments. Many have state of the art autoclaves that they utilize religiously following the cleaning of their hand instruments. Some even have equipment that is designed specifically for sterilizing hand pieces and all of their parts and pieces.

There are times when I honestly believe that as Canadians, we sometimes are on the cutting edge of dental and medical technology. Unfortunately I usually discover that I’m wrong and very far from the truth. Most of the time we tend to be copycats of our neighbors to the south and eventually, after much time has elapsed, we adopt procedures and techniques that have been utilized by our American cousins for several years. I will hasten to add however that in some cases, expatriate Canadians working and living in the United States of America are the ones mostly responsible for the discovery of these advancements. Canadians have the brain power but we lack the desire and ambition our American relatives display on a daily basis.

When I was a resident and teaching fellow at the University Of Pittsburgh, I had the distinct pleasure and duty of supervising 3rd year dental students administering their first injections of local anesthetic.

Lots of fun and games ensued from patients hollering and crying and even some dental students throwing up on the floor. It was a real learning session not just for the students, but for me as well. I did my best and tried to teach them not only proper techniques but the proper chairside manner in which to approach and talk to the patients. One clinic in particular was extremely stressful not only for the students but for me as well. One student just stood in front of his patient holding the syringe, muttering to no one in particular, “I can’t do it, I can’t do it.”

We all reach a stage in our lives when we begin to think back and review the years that have passed us by. There is an old Amish saying that goes as follows: “Ve get too soon old, und too late schmart.” How true that really is. When we were young, our parents did the best for us and in the majority of cases we didn’t really have to worry about money or room and board. With my generation, parents would sacrifice their own wants and desires to give to their children. We wore nice clothing and never thought about what they cost or how our parents skimped or saved to purchase them for us.