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Doctor,
An award-winning magazine you can
read with interest, with pleasure, and
with profit.
GO PLACIDLY AMID THE NOISE & HASTE,
& REMEMBER WHAT PEACE THERE MAY BE
IN SILENCE. As far as possible without surrender
be on good terms with all persons. Speak your truth kindly & clearly,
and listen to others, even dull & ignorant; they too have
their story. § § A void loud and aggressive persons, they are
vexations to the spirit. If you compare yourself with others,
you may become vain & bitter; for always there will be greater
& lesser persons than yourself. Enjoy your achievements as well
as your plans. § § Keep interested in your own career, however
humble; it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs, for the world is full of
trickery. But let this not blind you to what virtue there is; many
persons strive for high ideals and everywhere life is full of heroism.
§ § Be yourself. Especially, do not feign affection.Neither be cynical
about love; for in the face of all, aridity & disenchantment
it is perennial as grass. § § Take kindly the counsel of the years,
gracefully surrendering the things of youth. Nurture strength
in spirit to shield you in sudden misfortune. But do not distress
yourself in imaginings. Many fears are born of fatigue & loneliness.
Beyond a wholesome discipline, be gentle with yourself. § § You
are a child of the universe, no less than the trees & the stars;
you have a right to be here. And whether or not it is clear to you,
no doubt the universe is unfolding as it should. § § Therefore
be at peace with God, whatever you conceive Him to be, and
whatever your labors & aspirations, in the noisy confusion of life
keep peace with your soul. § § With all its sham, drudgery '&
broken dreams, it is still a beautiful world. Be careful.
Strive to be happy. § §
FOUND IN OLD SAINT PAUL'S
CHU~CH,
BALTIMORE; DATED 1692
~iG
and unable to properly evaluate the get-rich-quick
schemes, and above all, totally ignorant of the business into which they are urged to put their money,
doctors have been losing a good portion of their life
savings. Some months ago, The New York Times told
of some specific cases where men had lost $25,000 in
an apartment complex, $60,000 in an automobile
agency, $200,000 in a Florida orange grove that
turned out to be a swamp, $500,000 in a ski resort
that was to be built only to have the money squandered in Las Vegas by the developer, to cite just a
few. Most doctors are ashamed to admit to their
stupidity in making poor investments and one only
hears of the successes. A Los Angeles attorney who
has represented numerous physicians says that "Stealing from doctors is the safest business in the world
because they have plenty of money, will invest in anything, and won't sue even if they are victimized."
The best things to invest in are those that you know
something about. If you do not know anything about
the product in which you put your money, then have
a knowledgeable third party with whom you are familiar look into the matter and explain the risks to you.
E 'en if one does select what is initially a safe investment, money can be lost if the doctor does not have
the time to check on the progress of his investment to
see that the money is used wisely. Unfortunately, the
vast number of dentists are too trusting and too busy
to follow their investments as carefully as they should.
In the final analysis, perhaps a physician's wife was
correct when she said that, "Doctors shouldn't be
trusted with anything more than their lunch money."
DENTAL HEALTH OF POW'S
The Journal of Military Medicine in a preliminary
report on 241 returned prisoners of war from Vietnam
offers the following statistics:
1. About half of the soldiers had some oral or facial
problem resulting from their status as prisoners.
2. Prisoners received a toothbrush every six to 12
months and one tube of toothpaste every two or three
months.
3. In an effort to practice good oral hygiene they
made their own toothpicks from slivers of bamboo and
dental floss from blanket and clothing threads.
4. Dental care was the most time consuming treatment required by the returning prisoners.
5. The high incidence of gingival recession found
was attributed to excessive gingival stimulation since
idleness led to excessive toothbrushing.
6. Infectious diseases and deficiency diseases were
absent.
7. The prevalence of "tooth fractures" was due to
the high incidence of "rocks in the rice."
8. Untreated toothaches in captivity resulted in
despair, anxiety, irritability, and a general inability to
cope with the environment.
9. One officer reported: "The dental problem is
16
one of the more severe problems that prisoners of war
experienced. "
Published monthly by TICONIUM COMPANY
Division of CMP Industries, Inc., Albany, New York
DENTAL DILEMMA
Editor
Contributing
Editors
A dentist was quite flabbergasted
While seeing his technique was mastered.
For in a one hour session
On his fifteenth impression,
He found that his patient was plastered.
Cover Artist
Batavia, New York 14020
(Reprinted by permission from the Bulletin of the History of
Dentist ry. ):'5?;::;:;:::;;~
How to FornI
a Dental Credit Union
Joseph Strack
Arthur S. Freese. D.D.S.
Arthur H. Levine, D.D.S.
Maurice J. Teitelba m, D.D.S.
Edward Kasper
by Ted Schwarz
CONTENTS
Oddments
(Continued from Page 11)
this afternoon to have an aching tooth extracted and
a few minutes later he was carried to the emergency
hospital with a fractured skull and the affected molar
still firm in his mouth. In the meantime, he had
wrecked the dental parlor and caused a commotion
which required a squad of policemen to quell.
Bowers insisted on taking gas against the advice of
Dr. R. B. Leonard. When it was administered, Bowers
started to break up the furniture and to attack the
dentist. Two assistants and a porter came to his rescue, but Bowers had them all down and out in quicker
time than it would have required to extract the tooth.
Finally, in self-defense, Dr. William H. Winter
seized a hammer and struck Bowers upon the head,
fracturing his skull. This floored the man, and,
strangely enough, brought him back to consciousness.
He explained that, in his delirium, he thought the doctors were attacking his wife. When he reached the
hospital he had forgotten all about his toothache. He
will recover from the fractured skull.
Dr. Winter was held in $1,000 bail to await the result of Bower's injuries.
40 Bogue Avenue,
An award-winning
magazine for Dentists,
Dental Assistants, and
Dental Hygienists
JANUARY 1977 VOL. XXXVI NO. 1
,
HOW TO FORM A DENT At CREDIT UNION
The author lists the benefits for dentists
and their staffs
STOPPING THE SKIPPERS
All a ppointment . break ing cannot be
avoided, but this adv ice will limit it
5
BOOKS
Arthur S. Freese, author, critic, booklover, and dentist, is your experienced
guide to what you want
6
PROBLEMS AND SOLUTIONS IN
CliNICAL·LABORATORY RELATIONS
Doctor, here is must reading . Don 't let it
get away from you
8
ODDMENTS IN DENTAL HISTORY:
MAYHEM IN THE DENTAL OFFICE
You 'll love th is!
11
DENTAL ARTS BUILDING
Art critic Freda legman reports on how
one tal e nted de ntist bu ilt his dream office build ing
12
ANGLES AND IMPRESSIONS
Uniqu e information, useful professio nal
knowledge, sophisticated satire, andalways-flrst ·· rate communication
15
Iae
aa I
MEMBER PUBLICAT ION
AMERICA N ASSOCIAllON OF DENTA L EDITORS
Send edit o" al contri butions and corre5pondence 10 J oseph
Strack, Box 407, North Chatham, N.Y. 12132; change-of·
aderess not ices t o C, rculat ion Manager, TIC, Box 350, Albany,
N.Y. 12201
~---o/.~~
"I WONDER IF YOU COULD GET THE DOCTOR ' TO SNIP
OFF SOME OF HIS BRUSHWORK WHILE HE'S UNDER THE
ANESTHETIC."
TIC, JANUARY, 1977
HC is mlcrofllmed by Un iversity Microfil ms, b e., 300 N. Zeeb Road,
Aon Arbor, Mich igan 48100. TIC's Int ernational Standard Serial
Number is: US ISSN 0040-6716 TIC.
Copyright, 1977, Titonium Company, Division cf eMP Indu.,!rie., Inc.,
41.3 North Peari St., Albany, ~lew York 12207
Op inions expressed by contributors to TIC do not necessarily reflect
the vie .. s of the publishers.
Pri nted in U.S.A. by Jersey Printing Co., Inc., Bayonne, N.J .
Annual Subscription, $5.00
TIC, JANUARY, 1977
Doctor, of all the fringe benefits you can offer your employees,
none is so desirable as membership in a credit union. In a time of
high interest rares and rising prices, a credit union offers low cost
loans and high interest on savings. It is a fringe benefit that helps
not only the employees but also the dentists themselves. Equally
important is that credit unions can be as safe as banks though they
charge far less interest.
Credit unions are financial cooperatives started by people with
a common bond. Sometimes they are members of a fraternal organization. Other times they work in the same factory or are
connected with the same profession such as dentistry. The
members of a credit union pool their resources in order to make
low interest loans to one another.
In your case the easiest approach to forming a dental credit union
would be through your county dental society. It would be open to
dentists, their employees, and all supportive personnel such as dental technicians and others. This would give it a broad base which
means a larger available fund for making loans.
Credit unions are able to offer lower rate loans and, often, better
interest than banks because they are non-profit cooperatives run
by volunteers chosen from among the membership. It is only when
a union's resources have reached approximately $500,000 that a
full-time credit union manager is needed. Even then all labor and
overhead costs are kept to a minimum.
How It Works
Credit union members are said to hold "shares" in the credit
union when they make a deposit. This is similar to making a savings account deposit except that each share is a set amount determined when the credit union is first established. Usually the shares
are $5 each though they may run as high as $25. All borrowers
must have at least one share to obtain a loan, though the size of the
loan is not determined by the number of shares a person maintains.
The interest paid by the credit union is determined by a number
of economic factors which are similar to those faced by banks.
However, because the organization is non-profit, interest is never
less than 5 percent and often goes much higher so that it remains
competitive with banks. The American Dental Association's Employees Credit Union, for example, is paying 5.5 percent interest
on shares held by the members and had paid as high as 6 percent
in 1975. Even though there was a slight decline due to the drop in
interest rates on treasury bills and other credit union holdings, the
current interest is equal to or better than that which is available
from profit-making institutions.
OURCOVER------------~
We can wish you nothing better for 1977 and all the years
ahead than that you be blessed with Desiderata-desired
essentials to make all those years good ones.
I
Credit unions can be chartered by a state or by the
Federal Government. State-chartered credit unions
can pay up to 8.75 percent interest on members'
shares when the union's income allows it. Federal
credit unions are limited to a maximum interest payment of 7 percent. However, even this lower rate is
still better than any other demand deposit account in
commercial financial institutions. Banks would require you to take a certificate of deposit for from 6
months to 6 years in order to assure such high interest.
Credit unions are also limited in the amount of
interest they can charge for loans. The current
amount is a maximum of 12 percent true annual interest. Banks and finance companies charge from
18 percent to 36 percent. More important is the fact
that at the end of the year all surplus funds are returned to the members in the form of either a rebate
on interest or a bonus dividend for savings.
Credit unions differ from banks when determining
who may take a loan. Banks seek collateral. In many
cases a loan is possible only if your assets are such
that you theoretically don't really need the loan.
Credit unions, on the other hand, make a loan based
on the character of the borrower. This means that
more people will be eligible for help, an incentive for
their staying in your employ.
For example, suppose you have a hard-working
dental assistant who was just recently divorced. Her
work record is excellent but she never had established
a credit record separate from that of her husband.
Banks may be hesitant about granting her a loan and,
when they do, they may limit the type of loan she
can get or charge her the interest rate for a high risk
account. The credit union will only look at the fact
that she has been a responsible individual who is not
financially over-extended. The loan will be granted
at normal rates without subjecting the employee to
needless complications.
interest from credit card purchases, not to mention
another 3 percent to 5 percent from the merchants
themselves. Thus they almost never make loans for
under $5,000 and most have a $1,000 minimum.
Credit unions must be insured to be safe but insurance is easy to obtain. A federally chartered credit
union can take advantage of the National Credit
Union Administration's insurance program. This is
a government plan offering account insurance up to
$40,000 per shareholder. This is almost identical to
the plan insuring your money in banks and savings
and loans. State-chartered credit unions usually have
the option of obtaining state insurance which can be
as good as that offered by the Federal Government.
It is not wise to have an uninsured credit union.
Yet it is interesting to note that even uninsured credit
unions have a remarkable record for soundness. According to a study done a few years ago, 598 credit
unions went out of existence in 1972 due to corporate
mergers or industrial closings. The majority, 5 I 8,
paid their members 100 percent of their money on
deposit. The remaining 80 unions had members sustain average losses of just $15 per person.
Role of Savings
Credit unions rely on the regular deposits of their
members in order to have a continuing source of
working capital. But many times people are borrowing money because their incomes are low and it is
difficult for them to save very much. Some buy only
2
J. Teitelbaum, D.D.S.
Dr. Ralph Ginter, a semi-retired dentist in Mt.
Bethel, Pennsylvania, has a unique retirement program. He is the owner of a gourmet restaurant with
"old world" charm called Charlemagne .... The city
council of Sochi. the Soviet Union seaside resort, has
passed an edict to ban smoking in all public places .. ,
If you want some tax tips on donations, write to the
Internal Revenue offices for Publications 526 and
561. They are free and will tell you which organizations qualify for tax deductible contributions and how
to evaluate non-cash gifts . . . Since the advent of
"no-frill" air flights to cut flying costs, some hospitals
have instituted a "no-frill" hospital program. Patients who are able, make their own beds, tidy up their
rooms, bathe themselves, and cat in the hospital cafeteria. One presumes that these patients recover more
rapidly just thinking about the money they are saving
with hospital costs running as high as $200 per day
· .. Did you hear about the drunk who called up his
doctor to ask if he made souse calls?
OUR AMAZING DENTAL COLLEAGUES
Why People Borrow
Credit unions grant loans for a \"ariety of purposes,
though automobile loans are by far the most popular.
For example, a partial breakdown for the American
Dental Association's Employees Credit Union shows
that the 340 members have pooled funds totalling
$284,000. In 1975 S190,000 in loans were made
and, of that amount, $80,000 went for automobiles.
Personal and debt consolidation loans totalled $30,000 and home improvement loans totaled $18,000.
Another $10,000 was loaned for home furnishings;
$9,500 for real estate purchases; $7,500 for vacations, $4,000 for medical expenses, and smaller
amounts went for a variety of purposes.
One of the major attractions of the credit union is
the fact that banks have stopped granting small consumer loans now that the bank charge cards are so
popular. The banks receive up to 18 percent annual
by Maurice
THISA AND DATA
"HE TURNED IT ALL INTO TRAVELER'S CHECKS
AND TOOK IT WITH HIM."
TIC, JANUARY, 1977
Dr. James Marsters, a Pasadena, California, dentist, inspired the development of a communication
system that combines the telephone with the teletypewriter machine so that deaf people can carryon telephone conversations. Dr. Marsters, who is deaf, working with a deaf electronic engineer has formed Applied
Communications, Corp., an all deaf owned and operated company. Some 14,000 people can now "talk"
on the telephone thanks to this enterprising dentist
· .. Two hundred years ago, a Philadelphia physician,
Benjamin Rush, was encouraging citizens to playa
game that required hitting a leather ball stuffed with
feathers with a stick. Golf, he claimed, was good for
a man's health and would add 10 years to his life.
Of course, there weren't any sand traps in those days
· .. Scientists of Emory University report that composite restorations, e\"en though they are highly
polished, collect plaque more rapidly than metallic
fillings or sound enamel. Although the best polishing
agent for composites was found to be aluminum oxide,
methods of obtaining a smoother surface are still
needed to ward off plaque ... Ten years ago less than
TIC, JANUARY, 1977
2,000,000 Americans carried some dental insurance.
Today, over 25 million receive dental insurance benefits. The forms piling up on our desks testify to this
... A New York dentist who wanted to advertise a
specialty in the Yellow Pages of the telephone directory was pre\ented from doing so by the State Board
of Dentistry. The dentist has brought suit for $1 million, claiming that constitutional rights were violated
... Think you could pass the entrance examination
for the University of Michigan Dental School given
in 1881 ? Well, here arc five of the 20 questions:
( I) What is the transit of Venus?
(2) What is the distance of the Earth from the
sun'?
(3) Give the square root of 64,400.
(4) What is the length of the equator, in yards,
giving 69Y2 miles to the degree?
(5) What is a curved line?
Wonder if they expected dentists to serve on sailing vessels?
Dedicated Dentist: A dentist in Rome saved all
the teeth he extracted in the 36 years he practiced.
When they were finally counted he had amassed a
total of 2,000,744 teeth! Wonder how many fillings,
if any, he did ...
THE GET-RICH-QUICK SYNDROME
Among all professional men, physicians seem to
suffer most from the get-rich-quick syndrome, followed closely by dentists. With sizable incomes, doctors, reluctant to pay a large portion of their net profit
in taxes, endeavor to invest their money so as to obtain yearly profits and tax write-offs. Doctors are
deluged with offers to invest in real estate, syndicates,
gold mines, movie productions, land developmentbusiness adventures of every sort. Each month, articles in professional magazines written by investment
"experts" tell us how to invest our money to accrue
large profits and obtain tax shelters.
According to accounts by numerous practitioners
and business' consultants, the trusting and ofttimes
greedy doctors, are not faring too well in the hands
of their "friendly" business counselors. Too many of
them have been found to be unscrupulous con men
out to fleece the innocent lamb. Naive about business
15
castings, around his home. (He owns an arc welder
and acetylene torches.) His greenhouse can be seen
as you approach his home. And he is a tree fancier,
proudly showing, among the more popular, a small,
flowering-from yellow to orange in one blossomlantana from Florida and a magnificent copper beech
that stands front and center at the entrance to his
home, with bottom branches caressing the grass, like
many a majestic conifer sentinel.
The shrubbery in front of the office includes a
flowering yucca. A Japanese red maple-turning red
in the sun while the part in the shade is still green,
supposed to stay miniature, graces the minigarden of
shrubs and trees at the rear entrance from the parking
lot.
Kishel was commissioned as a result of teaching the
Slavin sons at Burris School, a laboratory of Ball State
University, a traditional and tough name to compete
with in Muncie. There were also social contacts and
Dr. Slavin's observance of Kishel's work. (The unidentified, red, standing, steel abstraction in front of
the old gas company building, plus turtles on midwestern playgrounds, among others. )
Says Kishel, "I don't think either of us knew what
we wanted until I started working with scale models.
It was a real challenge and a beautiful 'in'-I could
go in any direction-a real chance for freedom of expression-what most artists would like to do all the
time. I respected Dr. Slavin for giving me this freedom in creating. At that time, most clients wanted
realistic designs. Materials usually inspire and guide
the design-sometimes they even dictate, Frank Lloyd
Wright said, but if the client doesn't give this freedom ,
down inside you the need to please the client is bad
for the artist. It would be beautiful to do many more
Slavin buildings with that freedom."
The Slavin Garden
The Slavin garden is enhanced with Kishel's
"Whooping Cranes" of high-carbon steel, bronzed.
Purchased about the same time the abstract walls were
commissioned, and meant to be a fountain, the sculptured composition was at first in the Dental Arts building, but subsequently had to be moved to the Slavin
home for lack of office space. Just prior to sale, it won
first prize of $350 at the Indiana State Fair.
Because he felt the "Whooping Cranes" needed
something to build up their pattern in his garden, Dr.
Slavin flanked them with metallic, Hong Kong cattails. He calls them "cheapies" because he had to go
over them with chrome-red antirust paint and dark
bronze to match the "Cranes" - and to keep them
from being destroyed by inclement weather.
Dr. Slavin also likes to show the newel post from
the old Muncie courthouse supporting a contemporary
urn, holding geraniums on the wide expanse of his
home's front lawn . But, antique buff that he is, he's
especially proud of the two old front-door urns , that
14
came with the property, also sprouting flowers . (Muncie seems more flower-bedecked and fragranced than
many another city.)
Dr. Slavin's office and his home reflect the amalgam
of a contemporary practitioner with a love for old
ideas, a deep appreciation of the beautiful in the past
and the present.
Prior to the office expansion, he had a "1900" conference room for personnel communication.
The front abstract wall was just put on at the time
the building was built; the west wall was stored in 18
blocks in the backyard until six years ago, when the
Slavins decided they had to add onto the first floor
(and probably wouldn't add the second). Instead,
the basement, heretofore rented out, is being renovated into five operating rooms and a waiting room.
When the expansion and remodeling are completed,
three Tiffany-type lamp shades in a modern motif will
be hanging in the enlarged business area on the first
floor.
The basement will be somewhat in contrast to the
upper, main floor, with early 20th-century and contemporary fixtures. Some will be from the old homes
demolished for the Dental Arts building and its parking lot, like the glass-and-chrome door into the basement area. There is room for only one roll-top desk,
and one is already on hand.
Dr. Slavin has also converted some lovely old tole
and brass fixtures into wall lamps, only awaiting wiring. And there are more in the wings. An old metal
fire extinguisher will be converted into a lamp base.
Kishel, an artist as versatile as Picasso, likes to go
where he hasn't been, in everything. He took on the
project as an experiment, to sell the idea to construction people. This is perhaps a first for the whole
country. Dr. Slavin says there is probably not much
difference in the bas-relief blocks' cost from that of an
ordinary building front as an experiment, but it will
be more so for others now.
Kishel confirms this, if only from the fact that since
the time those exterior-wall abstractions were made,
labor costs alone have doubled. It took four men to
pour the concrete, which has to be poured quickly.
Of all the 36 blocks, the modest Kishel inverted a
"K" into the design in only one place as identification
of his creation, Dr. Slavin points out.
And aside from the questions of the designs and
the artists coming to make tracings, Dr. Slavin's endeavor to get away from boxiness gives him the personal satisfaction of the distinction of doing something different.
Carl Sandburg once said, "A man should be proud
of the place where he lives and the place where he
lives should be proud of him." This seems to apply
aptly to Dr. Charles N. Slavin and Richard Kishel and
Muncie.
Freda Zegman,
YWCA, 310 E. Charles St.
Muncie, Indiana 47305
TIC, JANUARY, 1977
"the best approach to interest"
Credit unions not only offer lower rates for
loans than most other financial institutions, they
also offer the best approach to interest. Instead
of paying interest based on the amount borrowed, you pay it on the declining balance.
What does this mean? Suppose you had a
loan for $1,000 with an interest rate of 1 percent per month. If your loan was based on the
declining balance and it was to be paid off in
one year (12 payments) , the principal you
would have to payoff each month would be
$83.33. Thus the first month's payment would
be 1 percent of $1,000 or $10 interest plus
enough shares to be able to obtain a loan which may
be quite substantial. Thus it is important when starting a credit union to try and make it as easy as possible for members to make regular share purchases.
The best approach may be a slight nuisance at first.
This is to have automatic payroll deduction of whatever amount of money the employee wishes to have
placed in credit union's savings. This is a simple
matter if you are computerized in handling payroll
but is worth considering even if you are not. Not
only is the credit union strengthened in this manner,
employees also like the approach because they are
not tempted to spend money they don't receive. They
build substantial savings painlessly.
How to Set Up a Credit Union
The credit union should include as broad a membership as possible. That is why I suggest it be started
by the dental society for your county and be open to
all supportive personnel as well. From this group you
will choose a board of directors who will formulate
credit union policy and its affairs, subject to the approval of the members. Generally there will also be
an executive staff consisting of a president, one or
two vice-presidents, a treasurer, assistant treasurer,
and secretary. The latter officers handle such problems as day-ta-day administration, and the maintenance of records of all transactions.
The treasurer acts as general manager so long as
your credit union is small. Most credit unions try to
have a treasurer who has some background in finances
and that person is paid a part-time salary to handle
credit union records. A dental office manager is an
ideal person to assume such a role. However, even
if your treasurer is inexperienced there is help available. A home-study training program for credit union
staff members is available at low cost and provides
all the basic information necessary. It is called the
Certified Credit Union Executive Program and is
available from the Credit Union National AssociaTIC, JANUARY, 1977
$83.33 for a total of $93.33.
The second month your principal has dwindled to $916.67. If you are paying based on
the declining balance, that 1 percent would be
down to $9.17 . Your full payment for the
month , adding the constant $83.33, would be
$92.50. Then it would drop to $91.66 the following month and so on.
By the end of the year your interest payments
will total $72.51. This is roughly 7.25 percent
instead of the $120 you would have paid if the
interest was always based on the original principal as many financial institutions insist upon.
tion, Inc., P.O. Box 431, Madison, Wisconsin 53701.
Loan applications should be screened by a fivemember credit committee which makes the decision
about granting a loan. The committee will decide
the amount of money to be loaned, the security to be
required (new car title, for example) and the interest
rate up to the maximum allowed.
Finally there is a three-member supervisory committee which oversees all operations and makes quarterly checks of the transactions being conducted. This
watchdog group protects everyone's interests.
There are various other requirements such as a
reserve money fund whose size is determined by state
or federal law. This information as well as in-depth
technical details concerning insurance, whether to be
state or federally chartered, and so forth can all be
learned by contacting your state credit union league.
The addresses for all state leagues are at the end of
this article.
Fringe Benefits
The potential of a credit union is far greater than
just the lending of money. Members qualify for numerous benefits that would otherwise be extremely
expensive. For example, if your credit union so
chooses it can arrange for group medical, hospitalization, and accident plans. Life insurance (usually
term, only) can be offered. There can also be information on auto and appliance pricing, charter vacation services, and income tax information, counseling
and preparation, just to name a few of the more popular possibilities. In fact, the credit union can help you
provide fringe benefits far in excess of anything you
could afford on an independent basis.
You may not have time to get very involved with
the credit union's operation. However, there are two
services you can perform. The first is to help initiate
the credit union through your local dental society.
Not only will you be able to offer one of the business
3
world's most desirable fringe benefits, you will also
have an inexpensive source for borrowing money for
some of your purchases.
The second assist you can give a credit union is to
provide space for the treasurer to meet privately with
loan applicants. This may be a cubbyhole somewhere
or even a small, empty office in a dental building
complex. You might also want to have a place where
the loan screening committee can meet, though they
will be meeting after hours so almost anywhere will
suffice. Eventually the dentists in your area may want
to each make a small contribution which , when com-
bined, will cover rent, a telephone, electricity, and
various supplies that are part of the necessary overhead.
Forming a dental society credit union can be the
smartest move you ever made in terms of employee
relations. Credit unions increase job satisfaction and
provide an incentive for employees to remain on the
job. Next to a substantial raise, most career employees feel that access to a credit union is one of
the best reasons to remain with a particular employe r.
505 I East Scarlett Street
Tucson , Arizona S5711
CU's IN THE UNITED STATES
The following are the names and addresses of all
United States Credit Union Leagues and Associations .
By contacting the one for your state you can learn the
ALABAMA CU Lea9ue
617 37th St. S., Birmingham 35222
ALASKA CU League
Room 200, 3500 Eide St., Anchorage 99503
ARIZONA CU League
3611 N. Black Canyon Hwy., Phoenix 85015
ARKANSAS CU League
P.O. Box 425, Little Rock 72203
CALIFORNIA CU League
2322 S. Garey Ave., Pomona 91766
COLORADO CU League
4905 W. 60th Ave., Arvada 80003
CONNECTICUT CU League
110 Hartford Turnpike S., Wallingford 06492
DELAWARE CU League
100 S. Gerald Dr., Newark 19713
DISTRICT OF COLUMBIA CU League
525 School St., S.W., Washington 20024
FLORIDA CU League
2821 W. Pensacola St., Tallahasse 32304
GEORGIA CU League
1541 Dunex Hill Lane, Atlanta 30329
HAWAII CU League
1654 S. King St., Honolulu 96814
IDAHO CU League
2770 Vista Ave., Boise 83705
ILLINOIS CU League
1035 S. York Rd., Bensenville 60106
INDIANA CU League
2719 N. Arlington, Indianapolis 46219
IOWA CU League
3206 University Ave., Des Moines 50311
KANSAS CU League
8410 W. Highway 54, Wichita 67209
KENTUCKY CU Lea9ue
3615 Newburg Rd., Louisville 40218
LOUISIANA CU League
1440 Canal St., Suite 804, New Orleans 70112
MAINE CU League
2273 Outer Congress St .. Portland 04104
MARYLAND CU League
2343 Foster Ave., Baltimore 21234
MASSACHUSETTS CUNA CREDIT UNION ASSOC.
84 Cambridge St., Burlington 01803
MICHIGAN CU League
15600 Providence Dr., Southfield 48075
MINNESOTA League of CUs
575 University Ave., St. Paul 55103
MISSISSIPPI CU League
329 N. Mart Plaza, Jackson 39206
MISSOURI CU League
6526 Lansdowne Ave., St. Louis 63109
4
specific requirements for your county as well as obtaining advice concerning state or federal charters,
insurance, and related materials.
MONTANA CU League
1236 Helena Ave., Helena 59601
NEBRASKA CU League
4315 Frances St., Omaha 68105
NEVADA CU League
4221 S. McLeod Dr., Suite A, Las Vegas 89121
NEW HAMPSHIRE CU League
130 N. Main St., Concord 03301
NEW JERSEY CU League
Ward St., Hightstown 08520
NEW MEXICO CU League
8402 Zuni Rd., S.E·, Albuquerque 87108
NEW YORK STATE CU League
1211 Western Ave., Albany 12203
NORTH CAROLINA CU League
1021 Homeland Ave., Greensboro 27 405
NORTH DAKOTA CU Lea9ue
1929 N. Kamey Dr., Bismarck 58501
OHIO CU League
1201 Dublin Rd., Columbus 43215
OKLAHOMA CU Leag ue
214 E. Skelly Dr., Tulsa 74105
OREGON CU League
212 S.E. 18th Ave., Portland 97214
PENNSYLVANIA CU League
4309 N. Front St., Harrisburg 17110
PUERTO RICO FEDERATION of CUs
P.O. Box 177, GPO, San Juan 00936
RHODE ISLAND CU League
89 Jefferson Blvd., Warwick 02888
SOUTH CAROLINA CU League
'T 26 N., Columbia 29202
SOUTH DAKOTA CU League
3011 S. Phillips Ave., Sioux Falls 57105
TENNESSEE CU League
703 Dodds Ave., Chattanooga 37404
TEXAS CU LEAGUE
3528 Forest Lane, Dallas 75222
UTAH CU League
1706 Major St .. Salt Lake City 84115
VERMONT CU Leag ue
143 River St., Montpelier 05602
VIRGINIA CU League
1207 Fenwick Dr., Lynchburg 24502
WASHINGTON CU League
15440 Bellevue Redmond Rd., Bellevue 98009
WEST VIRGINIA CU League
Box 143·A, Rte. 5, Parkersburg 2610 I
WISCONSIN CU League
10025 W. Greenfield Ave., Milwaukee 53214
WYOMING CU League
864 S. Spruce St., Casper 82601
TIC, JANUARY, 1977
cut so that rain and snow drain off-no water will remain, preventing cracking."
Kishel adds that his designs were also created without undercuts to facilitate withdrawal of the concreteblock designs from the Styrofoam molds, "just the opposite of dental fillings."
Says Dr. Slavin, "The front wall has been up now
about 14 years and to date the little designs have
changed shape none. As far as the total design itself,
it was to be a complete abstraction, so as to be anything anyone thinks it is. Persons walk in and ask if
it is Egyptian or Indian or Mayan or whatever. It's
whatever you think it is." And whatever you think it
is, the total concept is not related to dentistry, either!
Kishel reveals more. He says the blocks contain
tree forms and shell shapes, abstracted; that he was
"more conscious of shapes than of tree forms," although there are such forms in the blocks. "They are
good walls for blind persons to touch," says the sculptor in Kishel, who studied art at the Cranbrook Academy of Art in Bloomfield Hills, Michigan, and biology
and art at the University of Minnesota, Duluth branch.
From that biology background, and undoubtedly from
the woods of his native northern Minnesota, he looks
for designs in Nature constantly.
"Artists have come to do rice-paper tracings," reports Dr. Slavin, who has an unusual, rice-paper tracing hanging is his office hallway.
Frank Lloyd Wright's modern concepts might have
unconsciously inspired Dr. Slavin, a long-time admirer
of the late architect.
ing antiques, oil painting, iron work-all show the influence of the two years of academic art training Dr.
Charles N. Slavin received at the University of Iowa
before he went into dentistry. (Coincidentally, Kishel
received his master's degree in art from the University
of Iowa, but in a different year.) While studying art,
Dr. Slavin didn't know he was going into dentistry.
His father was an Iowa "country doctor" and his late
brother a surgeon in Las Vegas.
Grant Wood's son-in-law studied orthodontics the
same year Dr. Slavin did, and he got to know Grant
Wood then. The daughter and son-in-law had an
apartment above the Woods , but ate with them. Thus,
their kitchen became Grant Wood's studio.
Dr. Slavin chose dentistry to keep his hand in the
creative arts and as a "diversion" from the family
pattern, but primarily for "convenience in living," a
digression from the hour pattern of physicians. "This
way, you have time to enjoy your family," he says.
And time for his many hobbies. He once owned a
race horse, a direct descendant of Man 0' War. Yes,
his horse did earn money before he developed leg
trouble. From filigree iron castings he bought, he designed and built the gates. comprised of the smaller
Slavin Dental Clinic
The office was originally built for Dr. Slavin's own
practice, but it had to be expanded when his two sons,
Stephen and Charles P . (Chad) joined him about 10
years ago. Recently, Stephen was killed in an airplane
accident, which Chad and a friend survived. "Now,"
says Dr. Slavin, "the need is to carryon from the
tragedy-to bring in other young men." At this writing, four are expected, including Chad.
By consensus of the present dentists , the name is
being changed to Slavin Dental Clinic, complete with
dentists' nameplates outside, but Dental Arts, the original name on the concrete blocks, will probably remain on the front wall, just because Dr. Slavin likes
it there. He says Dental Arts is the name of the building, while the other is the name of the practice.
The creative arts are not limited to the building exterior only. The waiting room has a wood bust by
Stephen on a wall shelf near one with a driftwood-andmetal bird sculpture by the senior Dr. Slavin. Across
the room is a Greek-key frame of aluminum and wood
made by the latter for the painting it holds. And the
dentists wear shirts of bright colors instead of plain
white.
Dentist as Artist
Sculpture, jewelry-making, refinishing and modifyTIC, JANUARY, 1977
\
A"
\-_
Closeup of the west wall of the building showing recessed designs
complementing those standing out from the basic concrete bl·o cks.
13
--I
Dental
SJ;P;;;;;-- _. - - . . . . . ---- - ---1
~.
~
-_ ...... _-----_ .... _-----_. __ .. -.. _-----------_ ...... _--
.... .
Arts
t
Building
Text by Freda Zegman
Photos by Randy Hedge
J.
....;i
""~~~
.....!.
"""'~
Dentist Charles N. Slavin of Muncie, Indiana, commissioned artist Richard Kishel to create
the Dental Arts Building. Here is the concrete· block front wall of the unique structure.
W
hen Charles N. Slavin, D.D.S., gave artist Richard (Dick) Kishel carte blanche to create an abstract
art form for the front of his new building- to break
up the "boxy" feeling of most dental offices-little did
he know that he would possibly be making the single,
most beautiful construction contribution in more than
a decade to the visual environment of all of Muncie,
Indiana, if not a much, much wider radial expanse.
As one walks from the little downtown area into a
transitional residential-business periphery, a modestsized building emerges from shrubbery and trees as a
scenic surprise-a jewel in the midst of an otherwise
prosaic neighborhood of Victorian and 20th-century
homes and offices and conversions.
What greets you first is a reddish-tan wall of unique,
little, bas-relief designs, and, as you explore, you find
another such wall around the side. If you are curious
enough to ask why and how, both the owner and the
artist are ready and willing to discuss your discovery
-their project.
"So many small buildings are nondescript," says
Dr. Slavin, "you feel like you're always working in a
box. At first, the objective was to create something
that would be of interest, away from the boxy type
building."
The blocks of bas-relief designs were to distract
from the boxlike quality - "to concentrate on the
blocks instead of the shape of the building," he says.
"The visual content of the building is the focal point."
No dilettante dentist he, Dr. Slavin pitched right in
from the very beginning and worked with Kishel on
the total design, but Kishel actually did the work. They
also collaborated on the best means for achieving their
12
goal. And local sculptor Wendell Moore, whose sandstone "Twin Bears" frolic in the back yard of Dr.
Slavin's home, was called in to help in the final designs
when time was running short.
The front wall, as well as the west wall, is comprised
of 18 blocks, each block roughly four by three feet of
eight-inch-thick concrete, each block weighing about
1,300 pounds.
There is no repetition in the individual, little designs; each is unique.
Dr. Slavin explains:
"We initially tried molding sands, used in the castiron and steel industries. But because of the viscosity
of concrete, to get rid of the air bubbles in it, a vibrator had to be used, making sand molds impractical.
To compensate for that, we started forming things in
their full sizes in Styrofoam, and everything was cut
in reverse on the Styrofoam base with various types
of instruments: hot spatulas; special, sharpened
butcher knives; nichrome wire; an electrical tool with
ampere control provided by a part from a toy train to
heat the wire for cutting the designs in the Styrofoam;
and even an ordinary wood saw."
"Without Styrofoam, we couldn't have had the
quality we achieved from its plasticity. The material
lent itself to sanding, cutting, sawing, burning-you
literally can rip the material out to achieve certain
textures. We even hammered some areas for special
effects," amplifies Kishel.
"Then the castings were made," says Dr. Slavin.
"Dyed concrete was used for the art work only to
simulate sandstone. The individual, little designs were
TIC, JANUARY, 1977
Skipped appointments have been a major source of
irritation in dental practices throughout the country.
They are upsetting to the office routine, unfair to those
patients seeking appointments, and in dollars-andcents represent an irretrievable loss. In some cases,
prolonged treatment because of skipped appointments
results in added dental problems. This is particularly
true in tooth movement, gingival recession after impressions are taken and the temporary crowns are in
place too long, and so forth. Yet, despite the frequency
with which appointments are skipped, no one, as yet,
has discovered a surefire method to prevent them.
There are, however, many ways to reduce the number of skipped appointments in your practice.
( 1) Calling the Patient
Contacting the patient by telephone 48 hours before
the scheduled appointment serves not only as a reminder for the recalcitrant patient but allows you the
opportunity to utilize the time for someone else should
the patient inform you that he cannot keep his appointment.
these charges but it is a good idea to make the chronic
appointment-skipper pay for his inconsideration. Patients who refuse to pay and continue to skip appointments should be dropped from the practice.
Perhaps the most important way to reduce skipped
appointments is to make the patient aware of the time
and money lost. This should be done at the initial
meeting. Naturally, the dentist who is lax about being
prompt with his patients and is constantly calling patients to reschedule appointments cannot expect
promptness from his patients. It is wise to remember
that the patient's time is also valuable to him.
In arranging appointments, try to make them on
same days and hours so that patients can more easily
remember them and schedule their own time for dental visits. When confronted with the habitual appointment-breaker do not give him definite time but instruct him to call when it will be convenient for the
next visit and try to fit him into the first available spot.
It is a good way to impress the patient with the value
of being prompt with definite appointments.
M.J.T.
(2) Send Reminder Cards
Some patients appreciate reminder cards, especially
when their appointment has been made weeks in advance. These cards should be sent out at least five
days ahead of the scheduled time to insure delivery
with today's uncertain mail service.
(3) Request for 24-Hour Notice
Most appointment cards, handed to the patient in
the office, contain the appointed time plus a request
that the patient notify the office at least 24 hours
ahead of time if the appointment cannot be kept.
Patients should be made aware of this when the cards
are handed to them.
( 4) Previous Day Calls
Some patients request that a call be made the day
before or morning of their appointment as a special
reminder. This should be noted in the appointment
book so that the patient can be contacted in time.
(5) Broken Appointment Charge
As with the 24-hour notice, it is customary to note
on the appointment card that a charge will be made
for failure to keep an appointment without notifying
the office. Actually, few dentists bother to collect
TIC, JANUARY, 1977
.'
t~
"THE DOCTOR IS 0
AN EMERGENCY. I'LL BE GLAD TO
LISTEN TO ANY AILMENTS YOU WANT TO DRONE ON
ABOUT."
5
Some thought should be given to the fitting of the
casting without the presence of rententive clasps.
Wrought wire is the ideal material for this approach.
In particular, the wrought wire "I" bar should be considered, designed and fabricated within this relationship between dentist and auxillary.
The concepts expressed in this paper may require
some further exploration into the all but forgotten
phases of dental prosthodontics. It will be with this
type of continuing education that removable prosthodontics will continue to be a professional act rather
than a purchased article of commerce.
REFERENCES
1. Kratochvil, F. 1.: Influence of Occlusal Rest Position and
Clasp Design on Movement of Abutment Teeth, 1. Prosthet. Dent. 13: 114-124, 1963 .
2. Kratochvil, F. J. and Caputo, A. A.: Photoelastic Analysis
of Pressure on Teeth and Bone Supporting Removable
Partial Dentures, 1. Prosthet. Dent., 32: 52-61, 1974.
3. Brudvik, J. S. and Wormley, J. H.: Construction Techniques for Wrought Wire Retentive Clasp Arms as Related
to Cla8p Flexibility, 1. Prosthet. Dent., 30: 769-774, 1973 .
(The opinions or assertions contained herein are the private
views of the author and are not to be construed as official or
as reflecting the views of the Department of the Army or the
Department of Defense.)
Oddments in Dental History: Mayhem in the Dental Office
Biofeedback: Behavioral M edicine edited by Lee Birk,
209 pp., $13.00, New York, Grune & Stratton, 1974.
Increasingly there is interest in biofeedback in the
dental profession-one can see this simply by noting
the papers delivered at meetings and published in
journals. Certainly in medicine too biofeedback has
aroused considerable interest-and as for the public
no one can count those who are "into alpha" these
days. Altered states of consciousness in a whole range
of forms are the thing for young and old alike, in a~d
out of the professions. In fact, biofeedback is now
being touted for temporomandibular joint problems,
migraine, hypertension, insomnia, contraception, and
just about you-name-it.
But with all of this one rarely hears a balanced
thought about this new thing. For example, in general there is complete-or almost complete-silence
on the simple fact that no one really knows what
brain waves mean. What is accomplished by being in
an "alpha" state-or is it just a matter of showing off
your electrical muscles, proving that you can set off
certain brainy electrical activity? Until we really know
what the alpha waves indicate, much of biofeedback
lies in a sort of neurological never-never land, something which happens but we really don't know why or
what it means.
It's good to find a careful, in-depth, scientifically
objective and rounded presentation of the field. Dr.
Birk, a Harvard assistant professor of psychiatry,
points out that Benjamin Rush-signer of our Declaration of Independence, physician, and the Father
of American Psychiatry-during a yellow fever epidemic got out of his carriage on a hilltop overlooking
Philadelphia and shook his cane at the city crying:
"Bleed and purge all the city!" In short, caught up in
a furor therapeuticus, Rush wanted to blindly follow
his latest treatment. This would seem to be the current stage of biofeedback and some cold objective
thinking is called for. As Drs. Stroebel and Glueckpsycho-physiologists and scientists-point out: "Analysis ... lends support to the concept of biofeedback
6
procedures as an 'ultimate placebo' . . . . The public
has come to expect a 'magic-bullet' pill or a 'sixtyminute TV-doctor cure' .. .. " And this is the weakness of biofeedback, that there really is no hard , scientific, double-blind proof that biofeedback can do
anything beyond relieve some muscular problems!
Here in this book you will find the champions and
the doubters; chapters on the uses of biofeedbacks in
tension headache (Budzynska and Stoyva have done
the basic work in this field); in migraine headache
(Sargent and Green at Menninger started this approach) ; in vascular and cardiac problems; in psychotherapy. As the title of the book puts it, this is behavioral medicine and the same problems apply, for
there is no proof that the current rage in psychotherapy, behavioral therapy, is truly effective. Those who
have founded the field of biofeedback are often appalled at the way their work has been distorted to
promise and offer all sorts of medical results up to and
including fertility contro\.
In short, there is a need for old-fashioned scientific
skepticism, something which has disappeared with the
rush to the quick answers, to the occult, and to the
fads which have swept medicine and dentistry in the
last few decades. In part, this is, from a psychiatric
point of view, the result of the current desire for instant gratification, the inability to put off satisfaction
(as a child, you have to wait to get a dime or your ice
cream or whatever until the end of the week, or the
bicycle will come at Xmas, and the like),
But this book warrants reading for anyone interested in biofeedback, for it is balanced----'-as far as balance can be had in so new and unproven a field-and
with dentistry wetting its toe in the waters of biofeedback it behooves the practitioners to learn enough to
be skeptical. This book is worth your reading and
attention.
Immullology (Readings from Scientific American)
with additional material by F. M. Burnet, 275 pp.,
TIC, JANUARY, 1977
by MALVIN E. RING, D.D.S., M.L.S.
Dentistry, which gave to mankind one of its greatest boons, anesthesia and freedom from pain of surgical procedures, has unfortunately been long associated
in the public mind with causing pain. The average
patient's dread of a visit to the dentist was enhanced
by using the dental office as the setting for innumerable jokes, cartoons and humorous bits and pieces in
the literature all exaggerating the discomfort of the
dental experience and holding up the frightened patient as a fitting object of humor. Professor Gardner
Foley expanded on this theme in his excellent article
"Dentistry and the Nineteenth Century American
Humorists." (Bulletin of the History of Dentistry,
July 1968.)
Two interesting newspaper items which appeared in
the same month about seventy years ago show two
contrasting aspects of the same problem of pain in the
dental office. The first, a little poem appearing in the
Buffalo (N.Y.) Evening News for September 20,1907,
made sport of a child's fears, but inadvertently showed
that the patient's reaction took its toll on the dentistjustifying a greater fee!
The second piece which appeared in the Buffalo
(N.Y.) Express for September 2, 1907, gives a picture
of an extreme and totally unexpected reaction to the
administration of an anesthetic agent. Unfortunately,
this case resulted in severe injury to the patient along
with lesser injuries to the staff of the dental office, all
no laughing matter. And, to compound the disaster,
the hapless dentist found himself in jail! Although
there is no further record of the case in the newspaper,
it is interesting to speculate what an argument for malpractice could have been made of this incident by a
skillful attorney.
NO LAUGHING GAS, THIS
Patient under its Influence wrecks a dental OfficeSobered by Fracture of the Skull.
NEW YORK SUN SPECIAL TO THE EXPRESS.
Washington, D.C., Sept. 1.-George W. Bowers,
an engineer, went to the Washington Dental Parlors
(Continued on Page 16)
THE SYMPATHETIC DENTIST
Me en' pa, we went down town,
Ther dentist fer ter see.
He wrapped me up within a gown
En' set me on his knee.
En' then he squeezed the pincers tightYer outer herd ther squeelin'!
I swung my arms both left an' rightShoved him nigh to ther seelin'.
Then, cuz I hit him in ther eer,
He giv' a sudden jerk.
"Boys' fists," sez he, "I never fearI got to do my work."
En' wurk he did, with all his might,
Me yellin' all the time,
Pa tried his best to keep me qui't
By offerin' me a dime.
En' when at last the job was done,
Pa came, en' held my hand,
He said he thought that I was brave.
En' acted like a man.
Ther dentist sed he'd 'pologize
Becuz he made me hollar,
"But," sez he, to my surprise,
"Thet job is wurth a dollar!"
En' when pa (fool-like) paid ther moke
He bed ther nerve ter say
He thought thet it was such a joke
Ter heer me yell thet way!
-BURDSAL
TIC, JANUARY, 1977
cox
II
t
2b. Blackout wax placed just to the height of contour before block.
out.
3. Powder spray-on deodorant used as an indicator picking up in-
terferences when seating the casting on the master cast. Areas of
initial contact are easily visible with this indicator.
is abraded. When the dentist fits the frame in the
mouth he can use a mixture of gold rouge and chloroform or disclosing wax to find these same areas of interference.
It has been my observation that a partial denture
frame without retentive clasps is by far the easiest for
the technicians to fit to the master cast. It is also
easier for the dentist to verify this fit in the mouth and
do the necessary final fitting if there are no retentive
clasps to get in the way. Before seating a frame with
cast clasps, an intregal part of the frame, the technician must "neutralize" the retentive clasp arm. This
is either done by bending the clasps slightly away from
the stone tooth or scraping the cast where the retentive
terminal is located. Although scraping destroys the
accuracy of the cast it is preferable to bending the
clasp out of the way. Without these precautions the
frame can easily be forced on the cast but it will not
sit passively in the mouth.
Solution to Finishing Problems
Our alternative here has been to advocate the placing of the retentive clasps only after the framework
has been accurately fitted to the master cast and refitted in the mouth . The clasp material best suited
to this philosophy is obviously wrought wire. The
wrought retentive clasp can be easily formed into circumferential or bar clasps and attached to the frame
by soldering its extension onto the retentive meshwork.:l
You can see that an additional appointment is required if the frame is to be fitted without clasps. One
step, complete fabrication can no longer be prescribed.
The result of this additional chair time has been obvious to me. The problems associated with removable
partial dentures have been greatly reduced and the
quality of patient treatment has most definitely been
improved.
Questions may arise concerning the types of wire to
be utilized in this approach. Either 18 gao precious
metal or 19 gao Ni-Cr wire will prove satisfactory.
10
When the length of the retentive clasp arm is very
short, as it may be for a mandibular bicuspid, a wire
of one guage finer should be used to provide the same
amount of retention. In the last three years I have
found a great level of acceptance for the wrought "I"
bar clasp (fig. 4). It does all the things that the cast
clasp does and in addition it is tougher and can be
adapted without fear of breaking. It also allows us to
have the frame fitted to the master cast without the
interference of the retentive clasps.
Conclusion
When the technician and the dentist share the same
philosophy of block out and metal finishing the greatest problems in removable partial dentures are greatly
reduced or eliminated. The dentist must take the initiative in establishing this relationship. He must assure the technician that he understands the problems
in the laboratory and that he expects to do the final
fitting of the frame in the patient's mouth. In turn, the
technician will realize that his product is not the finished one and that the dentist will do what is required
to bring the "raw" casting within the tolerance of the
patient's tissues.
4. Wrought wire "I" bar constructed of 19 gao Ni·Cr wire.
TIC, JANUARY, 1977
250 ill. (135 color), $14.00, San Francisco, W. H.
Freeman, 1976.)
This is probably the hottest area in medicine today,
involving as it does the whole fields of transplants and
rejections cancer viruses and vaccines, and the autoimmune diseases' such as rheumatoid arthritis and
lupus. This is one of a series of volumes put out by
this publisher. These might almost be called the best
of Scientific American. In it you will find the leading
scientists in the field of immunity from Sir Macfarlane
Burnet to Gerald Edelman. Nobel Prize winners rub
shoulders with Dr. John Merrill, who founded kidney
transplantation, and the material ranges from articles
in the 1960s to those of 1976. With dental caries being looked at from the possibility of vaccines and increased concern with herpes, this is an important volume for the professional man. Worth studying.
The Hearing Loss Handbook by Richard Rosenthal,
235 pp., ill., $8.95, New York, St. Martin's Press,
1975.
This is a volume of use to you as well as your patients. Those who used the early high speed handpieces often suffered a good deal of hearing loss along
with tinnitus (that misearble ringing or other bizarre
noises in the ears). It is essentially a book for the
hard of hearing, and the author himself is one. He
has three aims in this book: to prove that those with
hearing loss can hear more, do more, and enjoy life
more; to warn of those patterns among the hearing
professionals which make it more not less difficult for
the hard of hearing; and to find the best possible care
and rehabilitation. An important book.
Epidemics by Geoffrey Marks and William K. Beatty,
335 pp., 16 ill., $10.00, New York, Charles Scribner's,
1976.
As I write this we're preparing for the swine fiu
vaccine drive, there have been mysterious deaths in
Philadelphia, and bubonic plague threatens the worst
outbreak in 50 years. Here is the fascinating story of
epidemics from the Plague of Thucydides which laid
Athens low, to deadly Lassa Fever, which has just reappeared. There's the story of polio for those who
have forgotten and of cholera for those who travel
abroad. This is another book in a series by this excellent team. It's history, detective story, and encyclopedia all wrapped in one. It's a sound and valuable,
even fascinating book. Worth reading today.
of her talented plastic surgeon husband; and his trial
for her murder. Did he or didn't he, and why was Dr.
Hill assassinated? The book is massive and detailed,
reminding one of Truman Capote's In Cold Blood.
Thompson has done a detailed reporting job-but it
reads more like a novel, filled as it is with greed,
money, power, an old man's love of his daughter, and
a young doctor's ambitions. There's Dr. Hill's mistress, his broken and then reconciled marriage. The
murder charge finally reads "murder by omission" but
you have to read it yourself!
Forecasts, Famines and Freezes by John Gribbin, 132
pp., $8.95, New York, Walker and Company, 1976.
Dr. Gribbin is former geophysics editor of Nature,
now senior scientist in climate research at Sussex University. His book shows his expertise. With billions
of people on the brink of famine, with the United
States still involved in its energy crisis, it's more important than ever that we understand the relationships
of weather and food and life. A 2 winter temperature
drop could cost us at least $10 billion in fuel, and diversion of monsoon rains in Central India means no
grain for 37 millions. Here is what it's all aboutpredicting climate, what the long-term trends are, and
whether our activities are changing the climate. What
you need to know-read it!
0
Murder for Your Pleasure: The Whodunits .... She's
back again and what are the Odds on Miss SetonHeron Carvic (Harper & Row, $6.95) has another
of these delightful stories about aged Miss Seton with
her sketching pencil and handbag, her penchant for
mystery, both very funny and very suspenseful at the
same time. Here she's sent into a gambling den to
break up a crime syndicate before it erupts into allout war. If you haven't yet discovered Miss Seton,
the bejeweled spinster, read this.
When Agatha Christie died in January at the age
of 85 she had written 87 books, the last of which was
held for publication after her death-Sleeping Murder (Dodd, Mead, $7.95). It is the sixteenth to feature tall, white-haired Jane Marple, who rarely leaves
her tiny English country village, but as she points out,
there's plenty of life to observe there. And in one of
her most sensitive books-"it was real evil that was
in the air last night," as Miss Marple says-Agatha
Christie makes us appreciate her greatness as a writer
and mourn her loss anew. Don't miss this one.
Blood and Money by Thomas Thompson, 450 pp.,
$10.95, New York, Doubleday & Co., 1976.
Thompson is a good investigative reporter and the
book benefits immensely from this, for this is the
strange, bizarre, and still unsolved story of the murder
of Joan Hill, Texan society horsewoman; of the trial
TIC, JANUARY, 1977
7
Problems and Solutions in
Clinical - Laboratory Relations
by
James
S.
Brudvik,
In the practice of dentistry there is no area where
we are more dependent on the efforts of others than
we are in prosthodontics. This dependency has created
a love-hate relationship that continues to plague us.
While we direct the dental technician through our prescriptions we are, especially in partial dentures, completely at his mercy. We have neither the time, materials or equipment to create these prostheses ourselves. Unfortunately, in many cases, we are also lacking in the expertise necessary to adjust, alter or remake
these complex partial dentures when the work we receive from the laboratory is unsatisfactory.
How then can we provide the best for our patients
within the constrictions of the modern practice of dentistry?
Let me begin by telling you as emphatically as I can
how not to do it! Do not ever submit a model (much
less an impression) to a laboratory and expect to receive a finished appliance that will repeatedly meet
the standards we all recognize as essential to success
in the partially edentulous patient. You will be asking
the technician to perform a task that neither he nor
the most experienced specialist in prosthodontics can
be expected to accomplish.
The solution to the problem requires that we interject ourselves into the construction phases as specific
intervals. Consider these specific areas in removable
prosthodontics where we can expect to influence the
outcome w our advantage.
Removable Partial Dentures
In my experience it is not the design but the execution that really determines the success of a removable
partial denture. Most of us would agree that partial
denture design has been greatly influenced by the multiple rests, minimum clasping and prepared guiding
plane concept so well presented by Kratochvil and
others over the past decade. 1 I believe in this concept
and advocate its use routinely. But I also believe that
unless the casting fits the mouth as planned and that
*Colonel Brudvik is serving as Assistant for Dental
Education in the Directorate of Health Education,
Academy of Health Sciences, Fort Sam Houston,
Texas. As a specialist in prosthodontics, Colonel Brudvik has been active in teaching and writing about subjects in the field. Many important assignments in the
U.S. Army support his record.
8
D.D.S., USADC*
this "fit" is maintained during the life of the appliance,
much of our theories go "out the window."
Obviously, for the partial to fit the mouth in this
manner it must first fit the master cast in the laboratory. Recently published research demonstrates that
the frame must be then refitted to the mouth if we are
to achieve the ideaI.2
Blockout
Our first concern must be the technician who elects
to do no blockout at all! He then expects to grind
away a lot of metal in a haphazard manner to seat the
casting. While this is not often the case it does occur
and without a careful understanding with our lab we
might not be aware of this disaster!
More often, in an attempt to reduce the finishing
time and insure a casting that will go easily to place
on the master cast the technician will over blockout
the cast (fig. 1). Now if your philosophy of design
and mouth preparation includes the careful preparation of guiding planes you will want those planes to be
in contact with the framework. With overblockout
and the possibility of over finishing the guiding planes
are negated.
The technician must understand that we cannot allow blockout wax to be placed on the stone teeth above
the height of contour no matter how carefully it is removed later on in the blockout process (fig. 2). In
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nician must either scrape the stone tooth with the
block out rod or leave some wax. This can only result
in an inaccurate refractory cast and subsequently in
. . . ......
1. Overblockout on the master cast with inadequate wax in the
edentulous area.
TIC, JANUARY, 1977
lao Satisfactory blockout with one thickness of baseplate wax for
resin relief.
2. Blockout wax placed above the height of contour.
a framework that will hang up in the scraped area. If
wax is left on the stone cast it will result in the casting
standing away from the natural tooth . Unfortunately,
when a framework " hangs up" it will be arbitrarily
ground away.
We are also concerned with the relief wax that is
placed in the edentulous areas before duplication to
allow a space under the retcntivc mcshwork for thc
rcsin. This procedure is seldom of interest to the dentist and as a result there is a tendcncy for the lab to
make this relief wax just as thin as possible. A very
thin layer of resin between the tissue and the frame
will result. It has been my experience that this very
thin layer will contribute to the soft tissue destruction
that is so commonly seen ncar the gingival margin of
the abutments adjacent to the edentulous spaces. You
will recall that denture resin like all resins docs not
cure well in thin layers. It will be porous and almost
uncleansablc and act as a trap for plaque and food
debris.
time to discuss it with him. He must share your concern about overfinishing. Because the dentist so often
demands a framework that will "go to place" without
any chairside effort on his part the technician, in an
effort to please his customer, will have a great tendency to overfinish. While this grinding will make the
seating in the mouth easier it wiIl certainly negate the
careful mouth preparation that developed the parallel
surfaces. In order to combat this situation the dentist
must be willing to accept a frame that is not over finished and be prepared to do some of this step in the
mouth.
AIl rough edges of the framework must be removed
before the first attempt is made to scat the frame on
the master cast. If the frame is seated before it is
ready, an abraded cast, no longer an accurate duplication of the mouth, will result. It will be on this cast
that the remainder of the seating, finishing and polishing will be done. With some practice the clinician can
learn to relate scraped areas on the master cast with
the probable causes of interference in the mouth. The
spray-on po\vder deodorant used as an indicator (fig .
3) has been a great help to our technicians. They use
it as a disclosing material to find the areas of interference before seating the frame so far that the east
Solution to Blackout Problems
We must make the technician aware of our interest
in this laboratory phase so often completely delegated.
Consider a visit with your lab to examine one of your
own cases at the blockou t stage for:
I. Underblockout or no blockout at all.
2. Overblockout with evidence of wax above the
survey line andlor abraded areas on the stone teeth.
3. Adequate relief pads. Prescribe and demand at
least one thickness of baseplate wax for denture base
relief. (The technician may not be too happy with this
as it may require him to do additional grinding on the
ridge lap of the denture teeth in order to create space
for them.)
Metal Finishing
When the technician reaches this point he is at another critical area where the quality case can be destroyed. In all fairness to the technician, this is difficult, tedious work and not anywhere as rewarding to
him as it should be. It should prove weIl worth your
TIC, JANUARY, 1977
2a. Blockout wax remaining above the height of contour after
blockout.
9