Doctor, ic is another unique service of your Ticonium Laboratory. A magazine you can read with interest, with pleasure, and with profit. •

A MAGAZINE FOR , DENTAL ASSISTANTS, AND DENTAL HYGIENISTS INDEX TO 1972 TIC Ie Published monthly by CIRCA 1973: A International Gallery of Postal Dental Art, An ~ . ~~ ~ ~.~ ~ ~.~ September TlCONIUM COMPANY Angles and Impressions ~ ~ ...... July-December M. W . Martin Division of CMP Industries, Inc. Maurice J. Teitelbaum, D.D.S. K Albany, New York Award-Winning Patients! . December Division of Dental Health, NIH Key ta Happy Endodontics, The ~ ~ ~ .. . ~ .... ~ .. . . December Editor Joseph Strack leon A. leonard, D.D .S. Contributing Arthur H, Levine, D,D.S. C Bruce H. Rice, D.D.S. Editors Maurice J. Teitelbaum, D.D.S. An American Know How Others Judge You .. ~~ ~ October Carver, William Frank ~ ..... ~ ...... ~ .. June Cover Artist Edward Kasper lily-B Rozar M Case of the Reluctant , The ...... May liIy-B Rozar Malpractice Problems and lawsuits ~ ~ . August J. leon Schwartz, D.D.S. ~ MEMBER PUBLICATION I IAMERICAN ASSOCIATION OF DENTAL EDITORS Caution-Patient Disputes I .. . ~ . Nov.ember ::Dental practice Ernest W. Fair Method of Securing the Curve of Spee Cold light-for You ...... May for Complete Dentures, A ~ ~ ~~ ~ ~ .~ ~ ~ . ~ ~ ~~ ~. ~ ~ .. ~ ~ March January 1973 Vol. XXXII No.1 Arthur S. Freese, D.D.S. Harold S. Janes, D.D.S. Community Obligations .. · January Modernization and Replacement Made Easier September CONTENTS Donald B. Giddon, D.M.D C. V. Ashe by Dudley lynch Coping with Freeloaders .. ~ ...... ~ ...... ~ · October Motivation of Employees in the Dental Office . October AN AMERICAN DENTAL PRACTICE Raymond l. Hilgert, D.B .A. A report on a young den­ o N ti s t' s preventive- Dr. R. Paul Fultz, chairman of the preventive dentistry depart­ Dental Practice Asepsis . July Johnson & Johnson National Dental Association , Inc . .. April practice ment at Baylor College of Dentistry in Dallas, is talking. He has Never Treat a Stranger June Dentist and His Silent Partners, The ... July been asked why it has taken so long for most dental practitioners to Maurice J. Teitelbaum, D.D.S. RH YTHM, BACKGROUND MUSIC, AND C. V. Ashe offer their patients training in techniques like the Bass Method of Nitrous Oxide Analgesia ... April 1 Dentist in Modern Fiction, The October 20/ 20 HEARING Ralph H. Desmarais Warren W. Hunt, D.D.S. A knowledgeable reporter plaque control and similar daily home-care preventive measures. Dentist Should Be a Dentist, A .... ~ ...... ~ .~ ~ ... October o of the dental scene evalu­ "I think," says Dr. Fultz, "one of the problems has been that den­ Eugene F. Eidern, D.D.S. Office Noise ~ ~ ~ April ates t hat "b a c k g r 0 u n d tists have been oriented toward associating fees with concrete serv­ Dentistry and the Aging ...... ~. October Arthur H. levine, D.D.S. leo Rosenhouse stuff" 5 ices. For years physicians have charged fees for office consultations. Dentists, Awake! . .. ~ ... · January p But dentists have traditionally charged fees for taking out a tooth or Maurice J. Teitelbaum, D.D.S. THE DENTIST WHO MADE A MILLION! Doctor, Check Your Bank Statement I Practice Management Blind Spot ~~ ~~ ~ November making a denture or something like this. And when they performed .. ... July Harold J. Ashe Beginning a fascinating Joseph Arkin, C.P.A. two-part profile of the fab­ a preventive-dentistry consultation for a patient they didn't feel like Dr. Vole, Esq . .... Protect Your Recordsl ~ ~~ May January Joseph Arkin, C.P.A. making a suitable charge for it." Harry Cimring, D.D.S. ulous Dr. Robert M. Hall _ ~ 7 Raffetto, Edward C., Rear Admiral, U.S. Navy Dental Corps .. March Don't Invite a Tough Tax Audit . ... February That's no longer the case, he added. A small cadre of dentists Joseph Arkin, C.P.A. Rediscovery of Prevention-or from Materia Alba to Plaque ~ ~ April ANGLES AND IMPRESSIONS Maurice J. Teitelbaum, D.D.S. with understandings of dental economics and patient motivations­ Da You Follow Through on Ideas? .. December Dentistry's own columnist, a group that includes men like Dr. Robert Barkley of Macom, Ill., Harald J. Ashe with worthwhile comment, S Dr. Orner Reed of Phoenix, Arizona, and Dr. Charles Amenta of news, and original perspec- F Selling Your Program to Groups March Chicago - have helped to break down the psychological barrier for Erne" W. Fair tives 11 Familiarity Breeds Carelessness .. ... ~ ...... ~ ... March E. E. Craven Sign of the Dentist, The ~ ~ ~ ~ .. ... ~ . ~ ~ April both dentists and patients by showing that preventive dental "con­ Federation Dentaire Internationale . .. ~ .. ~~ ...... October Arthur S. Freese, D.D.S . DEVELOP YOUR PROFESSIONAL sultation" can be an accepted, paying affair. Feed Your Practice New Ideas . May Smith, Edwin H., Jr., Major General, U.S. Army Dental Corps ~~ June POTENTIAL "If you want to see it work, and work well," Dr. Fultz said, "go Forensic Odontology .. . September Smith, Robert l., President, National Dental Association, Inc. ~ ~ April A program for 1973 for Paul G. Stimson, D.D.S. Sobkowski, Frank J., D.D.S ., Dean, Southern Illinois visit Dr. Mike Rodgers." So I did. every dentist _ .~ ______.. .. 13 University School of Dentistry ~ ~ ~~ _ ' _" ~ ~ "_ ~ " ~~'~_ ~ '" _ ~ .. ~ .. ~ August If a visitor isn't suspicious that he is about to encounter a dentist G Southern Illinois University School of Dentistry . ~~ . ~ ~ .. ~ ~ ~ _ ~ .. . ~~ August Stop the Time· Wasters I ~ ~ ~ .~~ ... ~ .. ~ .. ~ ~~ . December THE THEORY AND RATIONALE at home in the "under 30" crowd when he walks through the door Get the Name and Title Right ...... ~ ...... July E. E. Craven Ernest W. Fair BEHIND ULTRASONIC SCALING of Dr. Charles M. (Mike) Rodgers' office in the Dallas suburb of Gingivectomy: Use and Abuse ... February So You Think It's Tough to Practice Dentistry in 19721 .. ~ .~ .. _ ~~_ June A definitive analysis that is Richardson, Texas, all doubts are removed when the young dentist Allen A. Young, D.D.S. Paul J. Kalis, D.M.D. must reading 14 appears. Rodgers is 28 and wears his hair accordingly. He dresses T H ANNUAL INDEX 16 in knit trousers and open-collared shirts that are exceeded in their TIC Begins 31 st Year ~ ~ ~ ~ ~ ~ ~ .. ~ _ ~ .. ~ .. ~ .. August Hillenbrand, Harold, D.D.S., President, Tissue Glues-for Youl .. ~ ~~. ~ .. ~ _ ~ ~ _ January Copyright, 1973 variegated colors only by his office decor. "Contemporary," he sug­ Federation Dentaire Internationale . . ~ .. . ~ .... October Arthur S. Freese, D.D.S. gested, when asked to describe the theme for his tomato red, sun­ How Are Your Public Relations? . ~ ... ~ . August To Fit One Face Only ~ . ~ ~ ~ .. ~ ~~ ~ ~. _.. ~ .. ~ ~ .~ ~~ _~ .. ~ .... ~ ~ .. ~ .. February TICONIUM COMPANY, Harold J. Ashe E. E. Craven Division of CMP Industries, Inc. shine yellow, and black-an-white walls. It obviously is the working How Is Your Office Etiquette? ~ September 413 North Pearl St., Albany, New York t 220 1 quarters for a young man who is willing to buck conventions - and U leo Rosenhouse from the start Dr. Rodgers intended his new practice to "be differ­ How the Better Business Bureau Helps the Dentist _ ...... January Upgrading Dentistry with C.D.T.'s _~ .. ~_ .. _. May leo Rosenhouse U.S. Army Dental Corps Today .. ~ .. ~ .. _ ~ _ June Send all editorial contributions to ent" in several ways, the most important perhaps in the use of pre­ How Well Do You Manage Your Practice? . ... February U.S. Naval Dental Corps ~ .... ~ ...... ~ _~ .. March Joseph Strack. P.O. Box 407 ventive-dentistry training. Harold J. Ashe North Chatham, New York t213 2 w After graduating from the University of Texas Dental Branch at We're Dentists, Not Motivators November Houston, Rodgers had two years as an Army dentist to think about Opinions expressed by contributors 10 Importance of Interpersonal Skills in Dental Practice November Maurice J. Teitelbaum, D.D.S. what he wanted in a private dental practice. One desire that was Rex Witherspoon, D.D.S. Will Dentistry Be "Monitored"? . February TIC do not necessarily reflect the views of the publishers. Improve Your Concentration ...... ~ .. ~ ...... ~ .. ~~ .. ~. ~. ~ .. . May Maurice J. Teitelbaum, D.D.S. never in doubt: his intention to offer his patients intensive training Ernest W . Fair Will They Steal Your Car Next? _~ . ~ .. ~ ~_ ~~ ~ ...... _.. . ~ ~. ~ .. ~ ...... ~ ~ .. March Printed in U.S.A . by in home , with emphasis on plaque control. Index to 1971 TIC .... ~ .. ~ .. ~ ~ .. . ~. ~ ~ January leo Rosenhouse Jersey Printing Co., Inc., Bayonne, N.J. It's not surprising that he has a strong interest in the preventive Insure Your Ability to Earn ~ . ~ . ~ ~~_ ~ .. ~~ .. March Wire Whimsies _ ~ . ~~ ~~ . ~~ .. ~ . ~ ~ ...... ~ . ~ ~ .. _ ~ .... ~ .... ~ . ~ ~ .. ~~ .~ ~_ ~ .... _ November Joseph Arkin, C.P.A. Mary Nell Naughton Annual Subscription, $5.00 aspects of dentistry. After all, the UT Dental Branch has been the

16 TI C, JANUARY 1973 TIC, JANUARY 1973 I home since 1947 for Dr. Sumter Smith Arnim, one of through home-preventive care was important With slow, even, regular strokes passing over the tuning the instrument by arriving at the greatest level "grand old men" of preventive dentistry. By the time enough to do at all, it was important enough to risk root surfaces of extracted teeth, root surfaces are rub­ of "hissing" Rodgers graduated in 1968, Arnim's relentless cam­ offending a patient to get him involved, Rodgers de­ bed gently. Fragmentation and dislodgement of calcu­ 6. "Bursting" of the strong fluid jet at the very tip paign to sell American dentistry on plaque control was cided. His commitment to the potential for relief of lus takes place, leaving the surface visibly debrided of of the insert when properly tuned having its effect on the UT Dental Branch curriculum , mental anxiety, and patient expense inherent surface accretions. Comparison of the root or cemen­ 7. "Brushing" the tip over the accretions until they and Rodgers and his class came away exposed, if not in the cause of preventive dentistry would permit him tal surfaces of these teeth reveals a series of fine dislodge from the tooth surface always "sold," on the technique's value. to do no less, he now says. scratches and lines following hand scaling and an ap­ 8. Directing the tip of the instrument perpendicular Rodgers was one '68 graduate who was sold, parent absence of markings following ultrasonic scal­ to the long axis of the tooth is not advised, as this will The Preventive Program 3 though he didn't exactly know how he was going to im­ ing. groove or notch and dentin plement his intentions. "What I learned mostly in den­ Yet he had no intention of building a "sales" tech­ 9. "Wetting" the front surface of the mirror with school," he says, "was the theory behind preven­ nique based on fear or any motivation that might re­ Microscopic tal a surface tension reductant (ex. clear dip) and/or tive dentistry - that it could work and that you should motely suggest flimflam. He wanted to guide the pa­ A study of the wound produced by ultrasonic coag­ water available at the insert tip in order to provide an take the time to sit down and tell your patients how to tient in a manner that would allow him to do his diag­ ulation in soft tissue curettage has been conducted by adequate reflective surface and visibility during indi­ floss and brush. But I wasn't sure that the patients nosing as much as possible. Ewen in animals and humans to observe the immedi­ rect vision would accept it." ate and subsequent effects at the clinical and micro­ 10. Depressing the foot-control for long periods of He picked up a few ideas in the Army-which was scopic levels. 4 establishing its own preventive dentistry training pro­ time, since sporadic on-and-off motion is wasted With ultrasonic curettage crevicular epithelium was time and motion, noisy and irritable, as well as damag­ grams - but having trouble motivating its new re­ removed and white strips of tissue emerged. ing to the equipment cruits, who found it difficult to get excited about den­ was minimal and / or less noticeable due to the pres­ tal hygiene in the midst of all the distractions of basic ence of water irrigation, and surface injury to the free 11. Depending upon the severity of the present, the time interval should occupy between 20 training. Once his duty tour was over, Rodgers and marginal gingivae negligible. minutes and 45 minutes for a full complement of teeth his wife, Gina, who is serving now as his plaque-con­ The crevicular epithelium was either coagulated, trol assistant, began to explore the available tech­ shredded, or missing. The underlying corium showed 12. Sterilizing the tip by first wiping with 70 per niques for offering preventive dentistry to dental pa­ typical fusion of collagenous connective tissue bun­ cent alcohol and placing in cold sterilization; then, tients. They soon realized there was one indispensable dles. The coagulated surface stained darkly, similar prior to its next use, actuating the tip in the cold steri­ requirement: a sense of conviction on the dental staff's to necrotic or burned (electro-) tissue. Colla­ lizer for 10 seconds to assure microbial death via ul­ part. gen bundles were forced apart, condensed in appear­ trasound The True Believer ance, or fused into diffuse masses. The nuclei of the Conclusion "You have to convince yourself that prevention fibroblastic cells were pyknotic or irregularly con­ In conclusion, one should value the possible limita­ really works," Rodgers says. "You have to commit "First of all," Rodgers says, "we have them in for densed, and hence hyperchromatic. tions of this modality, especially in regard to the pene­ yourself one way or the other - and do it totally. Or an examination. During that examination, you are Within three to five weeks complete healing took tration potential of ultrasonic waves. you don't do it at all." poking around with instruments, of course, so I just place and no difference could be detected microscopic­ Since the ultrasonic instruments are contraindicated The Rodgerses acted on their convictions. Among pick up a little piece of floss and run it between their ally between gingival tissue treated with hand curet­ for clinical use on young, growing tissues, treatment the instructions they gave to the architect who de­ teeth and try to work it out with a big hunk of plaque tage and that treated with ultrasonic curettage. of children should be avoided. signed their quarters in Richardson's trendy Prome­ on it. Usually, I try to take this plaque from an area While the removal of epithelium cannot be ex­ Osseous tissue should be kept at a respectable dis­ nade Shopping Center was a request for a "control with some kind of pathology caused by the plaque. If plained entirely on the basis of coagulation by heat, tance in areas under treatment; one should avoid un­ lab"-meaning plaque control. It was installed, and their gums bleed a little then I draw this plaque from separation may be due to the accumulation of energy derlying in order to prevent local osteitis and se­ Dr. and Mrs. Rodgers began to make use of it from the that area-trying not to flip it off the floss. Then I at the interface of the basement membrane and under­ questration. moment the doors opened in April, 1971. stick it up under my nose and make an ugly face. lying corium. Another possibility is the shearing ef­ With the aforementioned material to serve as a During those first few months, he hesitated to come Wheww! 'Smell of that,' I tell the patient. 'What do fect from a change in the direction of the sound waves guide, this modality may be added to the office arma­ on strongly about preventive training, still worrying you think of that?' at the interface (the plane or depth at which the sound mentarium under the realization that it be used with that patients would look on his urgings to enroll in a "Of course, it has a terrible odor. I ask, 'Do you waves disperse). discretion and respect. course on "toothbrushing" as an insult to their intel­ know what that is?' Some say, 'Food?' And I ask if Only calculus recognition, skillful removal on a reg­ ligence. "They think they know how to brush, and food smells like that when they eat it. 'Well, no.' I Preparatory Steps ular basis, and allocation of sufficient working time they do, to a certain extent," Rodgers says. The route explain, 'This isn't food, it's plaque, that are The chair-side technique involves: will improve the patient's health and retain the natural that he chose initially was an indirect one. He thor­ on your teeth.' We show them some pictures of what 1. Draping the patient and placement of an ab­ dentition for a longer time. oughly demonstrated the use of plaque-staining dis­ it's like, or if you have a microscope in your office you sorbent towel 366 Forsyth Medical Park Winston-Salem, North Carolina 27103 closing tablets and hygiene techniques when patients can take a scraping and let them see it. We don't 2. Positioning the mandibular arch horizontally so came in for their regular six-month cleanings. have a microscope because of the expense, but we plan as to assure evacuation of water flow REFERENCES "Then we let them go and assumed that they knew to get one. Then I tell the patient that this is what is 3. Placing the saliva ejector-this is adequate to 1. Meinig, D. A.: Calculus and scaling. J.A.D.A. 64:822 how to do it," Rodgers says. "But when they came causing his problems - 'It's bacteria that is causing June 1962. back the next time, we came to find out that they did your gums to hurt and bleed and it's causing cavities.' remove any amount of fluid collection 2. Rush, Ken: Personal communication. School of Engi­ not know how. Very few of them had maintained their "Then I ask, 'Would you like to know how to get 4. Applying 2 per cent topical lidocaine to achieve neering, University of Tennessee and Goddard Space Center, flossing and brushing techniques and very few of them, this off your teeth?' Most will say yes. At this point superficial soft tissue anesthesia Greenbelt, Maryland. 3. Ewen, Sol J.: A photomicrographic study of root plan­ if th·ey were still doing it, were doing it correctly." it's a good idea to use a film strip. This will save you 5. Setting the amount of power on medium and de­ ing. Periodontics 4:273 September-October 1966. So much for the indirect approach, Rodgers de­ the talking-and I tend to talk too much a lot of times pressing the foot-control in order to fill the handpiece 4. Ewen, Sol, J. : Personal communication. New York cided. If trying to induce a patient to save his teeth and about the pathology of . You need to with water; inserting the specific scaler inserts and University.

2 TIC, JANUARY 1973 TIC, JANUARY 1973 15 preview your films well, make sure that they agree see that she can do it." The Theory and with the theories you have about brushing and floss­ Rodgers has long since ceased to refer to the plaque­ Rationale ing. There are many films out and some are good and control training in those terms. He calls it a "treat­ others aren't. If it's a good film, your patient will see ment." There is no subterfuge intended. It is simply Behind Ultrasonic Scaling that brushing gets approximately 60 percent of a tooth an attempt-and an effective one, he has learned-to clean. They'll see that periodontal problems and a help override the psychological conditioning that pa­ by Frank R. Pfau, D.D.S. lot of cavities begin between the teeth, where they are tients have received against paying for any services at not brushing at all." a dentist's office other than treatment of existing di­ Rodgers knows better than to expect a 100 percent sease. "They want you to 'treat' them when they come t is possible to debride tooth surfaces and encourage I operation of ultrasonic instruments after analyzing the conversion rate among his patients, but he has found in," Rodgers says. "So it's easier to involve them in a healing of periodontal lesions by producing clean, microscopic observations to be elucidated below. that the success ratio has grown in proportion to his 'treatment' than an education." He may phrase the smooth, and even surfaces through the use of ultra­ When a coil of copper wire is wound around a ease in presenting the preventive program to a patient. idea of plaque-control training to a patient in these sonic vibrations applied to appropriate instruments. plastic cylinder and alternating current flows through "We are now averaging a little higher than 50 percent terms: "Look, you have some gum , and we Thus, ultrasonic vibrations can scale, plane, rub, and the coil from an oscillating electric current supplied by of those who need control," he says. Yet he still en­ need to have you back in for a series of treatments. abrade teeth to free them of calculus, plaque, food a generator, a magnetic field is created. counters failure with individuals who clearly need to You can see where the gums are bleeding. So lets debris, stain, and affected cementum. Ultrasonic scal­ In the application of ultrasonic energy to periodon­ practice plaque control or face immediate and irre­ get you involved in these treatments to correct the ing is a particularly useful technique in the treatment tal instrumentation a magnetostrictive transducer pro­ parable damage, and these instances disturb him. problem." of the following: ducing about 25 ,000 vibrations per second is em­ "I had a woman, an older woman, to whom I pre­ The dentist's manner is crucial in enrolling patients (a) Marginal --calculus and plaque re­ ployed. The magnetostrictive transducer or insert, sented the program yesterday," he says. "I stained her in the plaque-control program; then it becomes a moval lying within the cylinder and bathed in flowing water, teeth and showed her where proper brushing and floss­ function of the dental hygienist'S or plaque control (b) Pre- and post-surgical scaling contracts in step with the current vibrations. When ing would help her. I told her that her resistance to nurse's skills as to whether the patient will be moti­ (c) Acute necrotizing ulcerative gingivitis-bac­ the current goes from maximum to zero at the end of dental disease was ebbing-that she had done well vated to continue to practice the skills and techniques terial and necrotic tissue removal an alternation, the insert (transducer) returns to its thus far but was starting to have some serious perio­ that he learns. (d) Dilantin hyperplasia-circumferential calcu­ original size. 2 These changes in shape provoke an dontal problems. She said she would think about the lus removal amplitude of vibration which expresses itself as re­ program. She called back this morning and said she Dramatize and Project All instruments have some effect on tooth surfaces, ciprocal motion, the fundamental element in ultrasonic didn't think she could learn the flossing technique. The Rodgerses agree about the most essential qual­ but the general opinion is that curettes leave the tooth instrumentation. The amplitude represents the travel­ So I failed somewhere. But we'll have her back in for ity for a control nurse: enthusiasm. "You need some­ surface smoother than any other type of instrument. ing distance of the "working end" of the periodontal a cleaning and we'll go over it again and perhaps she'll body who has been through your control program per- It has been pointed out by Meinig that dentists do not tool which approximates .0015 cm. take sufficient time to handscale the teeth properly.l Ultrasonic waves traveling any distance and reach­ The routine and thorough removal of calculus is to ing an interface or junctional surface are dissipated in keep the irritation at a level that the tissues can tolerate. the form of heat. This is reduced by running water There is a great value to be realized by hand scaling which is expelled at the working end through a metal when the necessary sense of touch and ability to per­ tube. In a liquid medium these waves agitate its mole­ form a thorough and complete scaling have been de­ cules, thereby drawing out of solution gases which veloped by the practitioner. have been previously dissolved or entrapped. The re­ An evaluation of ultrasonic versus hand instrumen­ leased bubbles burst open with tremendous local pres­ tation deserves a separate cover. It is highly desirable sure; this bubbling action or cavitation enhances the to perfect "hand" technique, as this will best serve to cleansing action in the gingival crevice. aid in manipulation of the ultrasonic device. The vibrations of ultrasound tend to remove the tactile Finally, the motion of a tip depends upon its design: sensation of the operator, thus making the operator pure reciprocal motion produces knocking and ham­ dependent upon positioning the instrument tip by mering; elliptical motion produces scraping and cut­ means of visualization (direct or indirect) and a pro­ ting. Sonic energy, then, is made up of waves that me­ prioceptive sense (spatial orientation). Conversely, chanically hammer, knock, scrape or cut, and that it is true that utilization of the ultrasonic instrument produce cavitation (bubbling action) and generate will not enhance performance in hand scaling. There­ heat through absorption. The heat generated in the fore, it becomes germane to first develop an under­ magnetostrictive transducer is relatively high; this standing of the instrument to complement the scaling loss of energy in the form of heat is termed "hysteresis armamentarium and therapeutic approach toward loss. " resolution of gingival . Ultrasonic instruments are reciprocal action devices The various unit models marketed by manufac­ which move in a push and pull. Since the vibrations turers represent a sudden transition from manual in­ are sufficient to dislodge deposits, it is preferable that strumentation. It is hoped that one can justify the for gross scaling they remain dull to avoid inadvertent planing of root surfaces. Root planing is accom­ The author is in private practice of periodontia in Wins­ plished by using the convex or rounded surfaces of vi­ ton-Salem, N .C. (Photo by Richard Pruitt) Tic is grateful to the Journal of the North Carolina Dental brating ultrasonic tools lightly and quickly over the Dr. Mike Rodgers and his wife, Gino, who serves as his plaque-control assistant, use castings like the one Society for permission to reproduce this interesting article. areas to be polished. shown to educate their preventive-dentistry patients on the dangers of dental pathology.

14 TIC, JANUARY 1973 TIC, JANUARY 1973 3 haps and has become very enthusiastic about it," Rod­ kind of dentistry we can do for them. I'm not talking sures exist, they invariably exert a dampening effect gers says. "They don't have to be attractive (though about the best 'esthetic-wise' but 'function-wise.' Once Develop Your upon the capability of the individual involved. The Mrs. Rodgers decidedly is) or beautiful or anything they are caught up in the attitude of prevention, they opportunity to plan and develop his practice seldom like this, but they do have to be someone who is sold want restorative work that is going to last a lifetime." Professional Potential arises, since all of his thinking time is taken up with on the idea of preventive dentistry. Really gung ho! Dr. Rodgers is currently working to reduce the by Ernest W. Fair combatting his financial problems. So that the program doesn't become routine, some­ dropout rate among graduates of his prevention pro­ • Keep your family involved in your professional one who will build and change things around to keep gram. "Any failures that we encounter I tend to blame life to a small extent at least. Where such involvement Perhaps you feel, every now and then, that you are the ennui out of it." on myself or my office for not motivating the patient is lacking, your family's disinterest in what you can do not getting as far ahead in the profession as you The doctor's description fits Mrs. Rodgers to a "T." properly," he says. One method they have installed will always slow down or stifle your own drive for bet­ She has become accustomed to being asked by patients is the periodic mailing-free of charge-of reprints on should. Many dentists feel that way, no matter where ter potential. There are substitutes for this, naturally; they stand on the dental-practice ladder. There are if she majored in drama in college (actually, her de­ pyorrhea, control programs, the fallacy of the tooth­ j. but none have as much value as the contribution a gree from the University of Houston is in business ad­ brush, and other topics to patients who have taken the boosts you can generate on your own which may lift doctor's interested family can supply, you up a number of rungs higher in a short time. ministration). She makes a production out of each plaque-control training. • Accept nothing in your working life as being set Here are some of them. training session, keeping the patient alert with a suc­ "It is expensive," Rodgers admits, "but if a patient and perfect. If that attitude exists, good avenues to cession of well-planned demonstrations, explanations, likes what you are doing and is sold on you, think of • Find one new approach in your practice this year advancement are almost automatically closed. It also and fully and carefully develop it. Concentration on and jokingly delivered observations. She draws her all the other people that he is going to send your way. leads to a sense of personal satisfaction that precludes own posters and placards, changing them every few How much does 3-M or Coca Cola spend on adver­ this one approach, made after careful selection, as­ realization of one's potential; there are no additional days. Sample: a photo of a toothless oldtimer, with tising as a percentage of the profits that they make? sures a good chance of its being realized. fields to conquer, so expending any more effort in the caption "If you've got 'em, floss 'em." Or "Take Quite a bit. Dentists aren't able to advertise in very We all tend to become satisfied with the drives we whatever direction would be a waste of time. it All off (plaque, that is)!" And there is always her many ways, and this is probably one of the best legiti­ have exercised in the past, and this often results in our being held back without our ever realizing it. • Know what is going on in dentistry all of the time. own healthy smile to emphasize the attractiveness of mate methods that we have." Keep out all of your lines of contact and have them a clean, wholesome mouth. • Try to avoid copying what the other fellow is do­ Colleagues Are Interested open so that you can fully utilize them every day of In a new practice like that of Dr. Rodgers', money ing. Neither his objective nor his "style" may suit your working life. you. However, study what he accomplishes; it may is always an issue. He has not been able to equip his The enthusiasm, planning, and execution of their Much of the potential any doctor will achieve, and plaque-control lab as fully as he hoped because of a preventive dentistry approach has not only attracted help you develop ideas of your own. when he will achieve it, will come from his knowledge a growing number of patients, the Rodgerses have lack of funds. But he is convinced that his preventive­ • You are never too old to learn about the newest of what is happening in his field and as it happens. found, but more and more dentists are contacting training program, in addition to its other important developments in dentistry-and to use them to advan­ Stay up-to-date in the techniques, equipment, meth­ merits, is going to be a financial asset to his practice. them to ask questions about the control program: tage. ods, systems, and operations that you use in your "I don't think we are going to make any money off what Dr. Rodgers' role is, what techniques the Rod­ Such developments provide valuable assistance in practice. Solid attachment to old ones invariably geres use, what kind of floss they recommend, what the program per se," he says, "but it allows us to do extending one's own capabilities. To deny their use welds an individual firmly to the old ways they typify. so much more for patients. It changes completely kinds of brushing procedures, and so on. is to deny yourself opportunities to attain your full Where this happens, the level of achievement he has "It makes us feel that we've done the right thing," their outlook toward dental services. Where before potential. reached in his professional life is always well below they may have been interested only in minimum re­ he says. • Keep some time open every week for investigation the potential he could have obtained if he had not pairs, after they have been through our training pro­ 13616 Purple Sage of additional moves you might make along lines that done so. gram, I find that they are often interested in the best Dallas, Texas 75240 you are not now covering regularly. • Listen to everyone. The new idea you need may There must be open and free periods for such come from anyone at any time. No man ever reaches steps, regular blocks of time, not just spare moments his full potential without assistance from the ideas of that may-or may not-arise during the working day. many other human beings surrounding him in his • No matter how worthwhile your efforts may be at daily life. His skill at developing these ideas deter­ present, don't allow them to develop contentment for mines the extent of his achievement. STAl E DENTAL AS~OC 1 A.-noN the status quo. This has been the downfall of many • Be a "nut" about your personal health. Careless­ a professional man, for attrition in a practice is always ness in this area has voided the full potential of many present and unless steps are taken continuously to a doctor-sometimes permanently. counter this loss full potential is almost impossible ,. • Build a solid base from which to grow. The shaky to obtain. one will require every spare moment of one's life to • Associate with the men who still have ambition keep it alive, and leave little or nothing for growth. and drive. It is most catching if you are around it Once you realize you are going to need the help of enough. lots of other people in the profession, you will be The continuous drive every professional man needs ready and anxious to help them-if only to be sure today is almost impossible for him to generate alone. you will receive the assistance you must have. He must have assistance and inspiration, and one of • Finally, get rid of any and all feelings you may the very best sources of both is association with other have about limitations on what you can achieve. Ac­ men with like ambitions. cept them only after experience proves them to be • Plan the financial side of your life in order to es­ right. Then reach out, more than ever, for the goals tablish an ever-present cushion for doing such things you can achieve. as these in pushing toward your potential. 13900 SE Highway 212 "WE HAVE A LONG WAY TO GO-HE'S A SECOND STORY MAN." Where personal, or professional, financial pres- Clackamus, Ore. 97015

4 TIC, JANUARY 1973 TIC, JANUARY 1973 13 CONTINUING EDUCATION a group of Amencan dentists who toured Moscow and The Journal of Dental Education states that six Leningrad. states now make continuing education a requirement Some of the interesting observations were as fol­ for relic ensure of dentists. Eighteen other states are lows: investigating the revision of state practice acts with • There are about 80,000 dentists in the USSR and continuing education requirements in mind. Dr. Erik the majority are women. However, there is a marked Olsen, Executive Director of the Academy of Gen­ shortage of dentists to handle the population of 270 eral Dentistry, says: "The current emphasis on im­ million. proving the quality of oral health care and the delivery • Dental caries is a widespread disease with an esti­ system makes it incumbent on the dental school to mated 98% suffering from decayed teeth. deliver high quality health care throughout their en­ • The emphasis seem to be in pedodontia, preventive tire predoctoral and postdoctoral careers." It was dentistry, and periodontia. Patients getting regular his opinion that continuing education was equal to, if treatment are those between the ages of 6 and 19, not greater than, undergraduate education. with children required to report for dental examina­ tions twice a year. Adults do not seem to get regular YOUR WIFE THE WIDOW care but are relegated to emergency service. There is by E. E. Craven and happy by others. Some won't like it at all. Time and again one hears about the widow who un­ a long waiting time for dentures, and the visiting team The anti-noise ecologist resents lyrical pollution dergoes great difficulties in managing the estate left saw little evidence of partial dentures, very little and dedicates himself to removal of all music from by her husband because bridgework or porcelain Background music: Some doctors wouldn't touch public air. He declares that Musak's processing she was never prepared for jackets, but a multitude of his death. Since mortality it with a 10-foot needle. Some supply it by radio. failed to get rid of toxic material and further main­ stainless steel ant e rio r Some record their own long-playing tapes for office tains that music's pure beauty has been doctored to tables are unanimous in crowns. use. And then there is, and perhaps shall be forever­ death by Musak. This crusader against aural smog showing that your wife will • The equipment was old­ probably outlive you, per­ fashioned by American more, Musak. might agree that there are specific times when suitable haps you ought to prepare standards with belt-driven Music-haters and music-lovers have equal con­ music is helpful. her for the eventuality of engines and pump chairs. tempt for Musak; not only is it an alteration of the Joy, sadness, and hope have been set to music. widowhood . . . and then Anesthesia was rarely used word, "music," but also an alteration of music. Americans sang their way through the Great Depres­ go on living! for operative work, nor sion, expecting to find prosperity around the corner ( 1) Be sure your will is Musak is designed with the intention of remaining were carbide burs and dia- and pennies raining from heaven. in good order. Familiarize appropriately in the background, filling quiet spaces C1/ rfo mond stones used. Most in banks, restaurants, and dental offices. Well-be­ Rage, patriotism, struggle, and victory are sug­ her with its contents and cavities were opened with haved background music in the office is for mood and gested in military music. It was a potent weapon in where it is kept. abrasive stones and cleaned World War II. The powerful three G's and E-flat that (2) Educa te her in out with excavators. effect. Never should it obtrude. Never should it be open Beethoven's Fifth Symphony money matters by having • The most impressive listened to, and never is it for dancing. is perhaps the most her handle the household piece of equipment was a Whether you decide to play or not to play music, familiar four-note phrase in symphonic music. And expenses with her own checking account. type of x-ray machine that, with a short exposure dur­ you can't satisfy every ear. There's no such thing as was used during World War II as the victory slogan. (3) Keep her abreast of any changes in your es­ ation, produced films that were described as "truly one song for all people. Three dots and a dash correspond to "V" in the tele­ tate plan. Let her know about any changes in insur­ graph code. beautiful ... with much detail, clarity, and slight If hooked on background music, the addicts suffer ance policies or investments. magnification. " withdrawal symptoms without it. They may not know About this time, the singing commercial was a ( 4) Be sure that your safety deposit box is in both • The American dentists were also impressed with names if you keep your will and insurance papers what ails them, they fidget and ask, "What stopped?" howling infant. Some civilians said they'd rather face the orthodontic work being done and the emphasis on the enemy than hear the inescapable blare of obnoxi­ there. periodontia, although and its uses in den­ This is one of several reasons why many doctors sup­ ous commercials. Because air conditioning was a (5) Give your wife a list of all the people she must tistry was practically unknown. ply piped-in music or some other form of musical youngster too, windows were open and singing com­ contact in case of your death. She should have the • In a program of continuing education, the Soviet background. names and addresses of your broker, insurance agent, dentist must return to school every three to five years mercials never stopped at the property line. lawyers, banker, etc. for refresher courses. Music Has Impact But, in America, we were able to sing louder and (6) Keep your dental accounts in good order so • There are very few private dentists and those were I am convinced that music is effective-not always with more feeling than radio ads. The girl wouldn't all debits and credits are easy to ascertain. only located in the large cities. In the dental clinics for good, not always for bad but effective. sit under the apple tree with anyone else when he was (7) Inform her of her possible financial position there was no choice of dentists by the patient. flying into the wild blue yonder. should you die. For example, she should be aware of A half-forgotten melody from bygone days refreshes your assets and the benefits she may receive from the memories. Rock of any variety: soft, soul, hard or While we were winning the war, Musak was gaining r------government, such as Social Security, veterans' bene­ Editor's Note gospel, will tickle the toes of teens. "Nearer, my God, a firmer foothold throughout the country. In time, fits, etc. Dr. Teitelbaum is co-author, with cartoonist Don to Thee" in a doctor's office may be either soothing or professionals and piped-in music took over; people Johnson, of the cartoon/humor dictionary, Mangled unnerving, depending on interpretation by different were'rarely heard singing softly to themselves in pub­ SOVIET DENTISTRY M edicine, just published by Medical Economics Com­ patients. lic anymore. For better or for worse (?) man stopped The Journal of the Louisiana Dental Association pany. The clever, handsome book is aimed primarily Trained music therapists report a variety of re­ singing his song and started doing his thing. has published an interesting and detailed report of at those who have studied medicine or anatomy. dentistry in the U.S.S.R. as reported by a member of sponses. The same melody is called sad by one person Today's music is still capable of creating moods:

12 TIC, JANUARY 1973 TIC, JANUARY 1973 love, laughter, peace, and calm. It can also stimulate joints during seizures-rock victims seem to exceed activity. the anatomic limits of motion. Here is a note of musical movement which you, too, Should your patient be literally carried away by may have experienced: music, don't worry. He'll return after he lands. Ef­ A doctor hired some carpenters; they were to be fects of the spell are short-lived. Stability is estab­ paid by the hour. During the morning, all went well. lished with a few bars of Brahms' Lullabye. Careful After lunch, the work progressed little, if at all. The selection of background music should prevent recur­ men hit one nail in 10 squarely on the head. The other rence of the malady. nine were badly bent, then slowly removed. They Fans of Engelbert Humperdinck, Tom Jones, Dean worked slower and slower with each successive ham­ Martin, and Kris Kristofferson know no generation mer-blow. One man wound down completely and fell gap. Miss, Mrs. or Ms, they only love the men and asleep. their music. by Maurice J. Teitelbaum, D.D.S. This lack of labor gave the doctor a pain which Unless you can unscramble eggs, you know there's hurt like $! no middle ground with patients who've got rhythm Action was indicated, and taken. Swinging stereo and 20/ 20 hearing. You just turn the music off when DENTAL THISA AND DATA presented, including alterations in the gingival and -with controls wide open, full bass, full treble, and every selection turns them on. Clinical studies are going ahead with the new adjoining tissues and structures .... Health surveys "caries removable" solution GK-10 1, developed by reveal that residents of farm areas lose the least full volume-was the treatment. Radio for background music: Not unless you're sure of your patients and the advertisements the sta­ Drs. Golman and Kronman of Tufts University School amount of time from jobs due to sickness, that South­ Sleeping Beauty woke with a magic hammer that tion carries. If you're not Dr. XYZ, you'll not want of Dental Medicine, but the ADA has cautioned erners are sick more frequently, and those living in could hit nails. The doctor's bank account was saved against publicizing this new, possible breakthrough the North Central States enjoyed the most days of his commercial inviting your patients to his newly and everybody felt good about the whole thing. until its effectiveness and safety have been positively normal healthy activity ... . What does a condemned furnished offices for a discussion of EZ terms and a ascertained and passed by the Food and Drug Admin­ man ask for as a last request? Steak and strawberry But what about that Bubbling Beauty in your chair free booklet. who can't sit still after a ditty of champagne music istration .. . . A New Jersey County dental society shortcake? Words with a beloved? A meeting with Theoretically, there is a built-in safety valve in has instituted a program whereby dentists have been his religious leader? Well, when Premier Tojo was with a twist of polka? How can you hit, fit, fill or drill piped-in music and it may be safer than your own taking the blood pressure of their patients to test for about to be hanged, for his last request he asked to a moving target? There are times when quiet must records at speeds of 33 or 78 rpm. Its mild effect hypertension. This is being carried out with the local wear his dentures. The request was denied ... Ac­ reign. may incite occasional foot-tapping in you and your medical society and with the help of the American cording to Business Insurance, a major insurance in­ Volume is never low enough to subdue the beat­ staff. The ordinary patient will simply curl a toe or Heart Association .. . . There has been an urgent call dustry trade publication, unless state insurance de­ beat-beat of Grand Funk Railroad. Fans are likely two-while the composer turns over in his grave. for dental help for the inhabitants of Bangladesh. For partments serve changing consumer demands better, more information write to Dr. Barry Simmons, 847 the Federal Government will usurp the insurance reg­ to rock, roll, and wriggle out of chairs. Seat belts sel­ 6132 Yearling Street S. Milledge Ave., Athens, Ga. 30601 . .. Acupunc­ ulatory function . . . . Woman power is being felt in dom help because odd things happen to the and Lakewood, Calif. 90713 ture needles inserted in the hand have produced suc­ the formation of a new women's organization called cessful anesthesia for the extraction of a tooth. Those Citizen Action to Save Teeth. The objectives are: dentists witnessing the procedure were amazed at the dissemination of a preventive program; development results and unable to offer any valid explanation. The of a network of community health information cen­ New Equipment Time Has Come When . .. feeling among the dentists was that it certainly worked ters ; promotion of fluoride; and the inclusion of den­ but they didn't know how it worked. It has also been tal services in all comprehensive health programs .... Present uni t, . how immediate signs of we r and Old equipment can be replaced by a new unit used for root canal therapy anesthesia .... A more A young man of 23 was asked, after a was therefore efficiency begins to decline. that will encourage better and more efficient work easily explained technique for extracting teeth has removed from his oesophagus in an emergency oper­ A unit has bee me obsolete and consequently performance by the staff. been developed with support from the N.I.D.R. It is ation, how it happened. He replied, "I like to brush my teeth way back in my mouth." However, nobody is reducing the productivity of the office. The purchas of a needed new unit can be made is the use of a high-speed oscillating instrument that rapidly rotates the tooth quickly, detaching it from ever suggested he include his tonsils. Required accu racy becomes more and more without too great a financial strain. questionable. connective tissue with apparently less trauma and loss Freight, installation, and other cost will soon of blood than conventional methods of removal with CHEMICALS IN FOOD Better and more reliable units are available that be greatly increa .. ed. a forcep. So far, the instrument has been used only A Congressional inquiry is under way into the po­ a 'sure greater productivi ty, effi iency, and safety. in animals and fresh cadavers, but it is felt to have tential health hazards caused by the addition of chemi­ There i still ome salvage or resale value left An old unit can be replaced by a modern one great promise . . . The Vietnam Dental Education cal preservatives, stabilizers, coloring agents, flavoring, with additional features that offer increa ed earn­ in the old unit. Project is entering its sixth and final year of a success­ etc. in food. Today, more than 3,000 chemicals are ing potential for the practice, such a substantial Definite professional advantages, n t now other­ ful effort to improve the number and training of Viet­ deliberately added to our foods. The potential dan­ reduction in the time required to use it. wise obtainable for the practice, can be realized namese dentists . . . Dental students in California ger areas are: cancer, birth defects, and gene damage. Safety for personnel as well as for supplies and with ne equipment. have received loans from the Dental Foundation of Three basic questions to be raised are: (1) How California over the past three years of over $600,000 much do we know about the actual damage to human materials is endangered by a unit's use. A modern replacement v ill permit desirable n w . . . Pathology of Oral Manifestations of Systemic health from these chemicals? (2) How much assur­ The co t of operating and maintaining a unit has service to patients not possible with the present Diseases, by Dr. A. E. Gardner, is a useful book in ance of chemical safety should we require? (3) What ri en sharply. unit.-E.W.F. its correlation of both medical and dental practice. should the Federal Government do to safeguard the The oral signs and symptoms of various diseases are public's health?

6 TIC, JANUARY 1973 TIC, JANUARY 1973 11 brain tumor, they are also used in orthopedic surgery, patients, saved countless lives, and opened the way to and they can carve a realistic human ear from cartilage. forms of life-saving surgery never before possible. In Bob Hall finds himself lecturing on an average of at 1966 he received a "Master Design Award" for his least twice a month to universities, hospitals, medical tools, and in 1968 he received the highest honor of all conventions, and what-have-you. He's delivered some -a permanent display of his tools in the Hall of Medi­ 50 papers around the world, while his film on the "Hall cine of the Smithsonian Institution's Museum of His­ Technique" has been shown in more than two dozen tory and Technology. The Dentist countries. And he's had his share of odd events in his The next time you go to Washington, D.C. you can crusade to help the world by improving its surgery. see this display for yourself-an animated life-like One time while he was dashing across a foreign airport exhibit of five surgical operations performed with the to make his plane his suitcase opened and those about air-powered tools of a fellow-dentist, Dr. Robert M. Who Made were startled to see a skeleton pop out. And Hall him­ self had to scramble about trying to gather the scat­ Hall. Realistic hands hold the surgical instruments as tered bones of his demonstration skeleton while they are used for a craniotomy, reaming a hip socket, amazed passengers and custom officials looked on. doing a spinal fusion, pinning a fractured hip, and In 1966 he was invited to Russia as an exchange wiring a fracture. The realistic effect is total, even to a Million! scientist at a time when that was still a rare thing. In the blood, the bony structures, and the tissues of the order to do so he had to form the Hall Foundation (at patient. The acting director of the Institution has said the request of our own State Department) because he it's one of their most popular displays. would not have been welcome as the president of an Truly, Robert M. Hall is the kind of dentist many American corporation, but would be as the director of practitioners see themselves as when they daydream a foundation. In this way he was able to bring back about what they might have been if they could have information about the medical and surgical care in done what they really wanted to! by Arthur S. Freese, D.D.S. that country. 13 7 East 36 Street He's had his satisfactions. Most important to him is New York, N.Y. 10016 Part one of a two-part series Dr. Robert M. Hall, president of Hall International, a subsidiary the fact that his inventions have made living easier for Concluding installment next month of the 3M Company. BOB HALL is the sort of dentist most practitioners dream of becoming-successful in his profession, as well as cousins, are dentists. So it was only natural moving first into a specialty, then changing into an in­ that Bob should go to the University of Pittsburgh ventor and brilliant innovator, founding a whole new School of Dentistry. But he worked at the Atlantic world of medicine, turning virtual bankruptcy into millions, and finally seeing an entire exhibition in the City race track during his vacations to earn the money to help pay for his dental education. famed Smithsonian Institution devoted just to his in­ ventions and techniques! So it was that in August, 1951, just before his senior Who could ask for anything more? Bob Hall for one year at Pitt, he was driving to the race track. A pick­ does ask for more-for more and more ideas which he up truck suddenly pulled out in front of his car and he can turn into practical working devices for both the plowed into it. A physician in the car immediately medical and dental professions, for a new world of behind him treated those in Bob's auto (and, inci­ international business! dentally, confirmed that Bob was actually driving be­ Dr. Robert M. Hall is really the American dream low the normal speed and that the truck was entirely come true-the entire rags-to-riches bit-for although at fault). he may not have started with rags, he was at a truly Bob came to in the operating room just long enough low point a number of times before his drive, ambi­ to hear the surgeon say, "Let's take his arm off at the tion, and brilliant persistence pulled him through. In elbow"; then he passed out again from the concussion fact he recalls awakening in a hospital operating room he had suffered. He awakened three weeks later in a just before his last year in dental school to hear a Pittsburgh hospital to find that his father and brother surgeon say, "Let's take his arm off at the elbow." had flown him there to save his arm. And this was Out of this stuff Bob Hall was made. really the beginning of his career, although he didn't Actually, dentistry is a family tradition with the know it then. Despite a full cast from his shoulder Halls. Bob's father was an oral surgeon for 40 years down, he lost only three weeks of his senior year and in Pittsburgh; and both his older and younger brothers, graduated with the rest of his class nine months later. But the bone graft was to later fail and had to be Dr. Freese writes on medicine, dentistry, and science for redone. This set him thinking, for if that graft had many national magazines. He is a contributing editor at been done with the proper preparation and as preciseiy Science Digest, and the author of Careers and Opportunities as dentists are accustomed to make inlays, it would in the Medical Sciences and The Temporomandibular Joint Hall "Jet-Age Surgery" exhibit in the Smithsonian Institution. Mr. Silvia A. Bendini, Acting Director of have succeeded. But at that time the tools for such the Museum of History and Technology, is shown with Dr. Hall viewing the Hall Ortho Drill that is used Problem. His new book, on medical subjects, will be pub­ in hip surgery. Just above, the Hall Air Drill is shawn as it is used in a spinal fusion procedure. lished this year. work just weren't available to the medical profession.

10 TIC, JANUARY 1973 TIC, JANUARY 1973 7 After graduation, Bob took his D.D.S. into the oral surgeon at Camp Lejeune and then, after his tour of air-powered tools for surgery. Actually, Hall would Navy for two years and came out in 1955 to get his of service, he put in two years as a resident in oral have to devise new ideas and techniques of production; training in oral surgery and enter the family practice surgery, followed by a graduate course at the Uni­ new concepts for his business setup; everything new, in Pittsburgh. Before long there were two offices, one versity of Texas. in fact, all along the way for every step he took. in downtown Pittsburgh and the other in the suburbs So it was that in 1958 he began using a converted All this involved production, engineering, patents, -and a very large practice with 13 nurses, nurse­ dental air rotor for oral surgery and, after 200 to 300 marketing and, most basic of all, a new device for a anesthetists, and what-have-you. It was in this frame­ cases, published his first paper on the use of high­ vast step forward in surgery-a world in which drills work that he attended the Chicago Mid-Winter Dental speed air rotors in the Journal of Oral Surgery-the would provide the means for cutting and precision Meeting in 1957 and saw his first air rotor. first of some 50 papers he was later to present. But bone sculpturing for over 500 different surgical pro­ the dental handpiece wasn't the proper tool for surg­ As he recalls: "All the way home in the plane it cedures. ery because it had too little torque, it needed electri­ bothered me that I had to do an impaction in the way So it was that an oral surgeon turned to industry to it had always been done-as bone surgery had been city and water, and its burs were all wrong for this new purpose. provide a new surgical instrument and as Hall puts it: done throughout medical and dental history-with "It was a tough five years later, in 1963, that we had hammers and chisels and all that such trauma did to But as he sees it: "I learned this was the wrong ap­ our first product: a two-stage air turbine with a ser~es the patient, the operator, the tissues involved, and the proach but like the Wright airplane it proved that the of unique characteristics-finger-tip control, all al:­ result." concept was valid and workable. More development powered with no electricity (so it would be safe ill The then young 30-year-old oral surgeon (he was was essential-the tool at its initial stage just couldn't operating rooms where explosive anesthetics were born in 1928) bought a used Weber air rotor. He do the job by itself. And even the answer proved what used), no water or oil such as the high-speed dental says: "I started to cannibalize it, to wheel it around, it had with the airplane-we had to turn to industry handpiece uses, and with new attachments and port­ and to cut extracted teeth with it." But the memory of for such radically new and different devices." ability (it's only six ounces) and more powerful." the inadequate preparation of his own arm bone graft Bob Hall also had to come up with new patents to re-entered the picture and he got bones from the Entering a New World protect his amazing inventions and developments. He anatomy laboratory and began cutting them with his At this point it was Bob Hall's vacationing father finally introduced his new drill in 1963 but it took air rotor. down in Florida who made a contact with another another year to iron out all the bugs. In fact, such is But Bob Hall's involvement with mechanical things proud parent who was chairman of the board of direc­ the basic professional integrity of the man that has car­ went back beyond dentistry, to his boyhood when he tors of ARO Corporation, which manufactured air­ ried over from his training as a dentist into his indus­ Dr. Hall holding sternum splitter he developed for use in open was interested in what made mechanical things tick. powered tools. Discussion of their children led to in­ trial role that when the first hundred or more drills heart surgery. But it was fortunate for medicine that his interest and terest on the part of the industrialist, and Bob Hall had were already in use in the field, applied by surgeons training were in oral surgery, rather than operative or his first contact with the concern that was to help solve all over the country in fact, he devised a new improve­ A Success Story prosthetic dentistry. In the Navy he'd been attendillg the engineering and shop problems for his new ideas ment. Never hesitating, he promptly recalled all those By 1965 he was broke, completely, for he had used drills in use so that he could incorporate his final im­ up all his savings and the bank wouldn't lend him any provement, despite the very considerable expense to more. However, his father secured a $25,000 bank himself. Which is probably why his devices have at­ loan using his paid-up insurance policies; and his tained the reputation they have, why they're today in suppliers trusted him enough to go along with him. use by tens of thousands of surgeons in more than 60 At this point, Bob Hall had to mortgage his $36,000 countries all over the world. home, cash in his life insurance, even sell his wife's But it also took a brilliant businessman with vision inheritance. It was this money from his wife-the last to accomplish all this; the technical aspects were only $40,000-that finally turned the trick because it the beginning. As Bob Hall now admits: "If I knew stemmed the tide for six months in 1965 and by the when I started what I know now, I don't think I would end of this short period the business was on its feet. have had the guts to go through it al1!" An experi­ In three years the former oral surgeon had moved enced industrialist today, he knows now that statistical­ from millions in debt to the possession of a business then worth $7 million! ly someone with the background he had at the begin­ ning had no more than 1 chance in 3 6 to succeed! And To sell his air-powered tools, Bob Hall had to take to the road. He's traveled all over the world; in fact, so he understands why everyone-father, friends, three years ago he became an elite member of United's bankers-tried to talk him out of the venture. Million Mile Club. He has carried his message to But he started in 1958 and gradually got in deeper the medical profession-and it has listened. His in­ and deeper, put more and more money into the ven­ struments have reduced the time for many types of ture until by 1962 he had so much tied up in it­ neurosurgery in half, and were the basis of the bril­ money and personal investments-that he could no liant but unsuccessful attempt to save Robert Ken­ longer pay proper attention to his surgical practice. nedy's life after he was shot. Hall instruments are Moreover, it was clear by then that the only way he used in surgery, dentistry, and even veterinary medi­ could turn the thing around and get out with a whole cine. In humans they've been used to carve away the skin was to give up dentistry entirely and go for broke calcified deposits which sometimes block the heart The air·driven Hall Neura Drill saves lime and exhausting labor for the neurosurgeon, making it possible valves, and to penetrate the base of the skull to get at a to remove a section af the skull in a quick circular malion. (Smithsonian Institution exhibit) in his new business.

8 TIC, JANUARY 1973 TIC, JANUARY 1973 9