Joel, thanks for posting this information.

I take issue with the author's claim that dental schools treat partial
dentures with little consideration for scientific evidence. Even though
it was nearly 40 years ago, my school was already focusing on the
engineering principles of clasp and rest design for cast partials. The
chairman of the prosthetics department was himself instrumental in the
development of the I-bar and guiding-planes concepts.

It's interesting that the article you quoted shows, "Examiners found
that 36.4% of the clasps gave poor retention." I can't imagine any
dental school program that would accept 36% of its clasps being
designed with poor retention. Why not actually apply basic principles
and design the clasps with GOOD retention from the beginning?

Although it can be said that many patients "need" a removable partial
denture, it is also a fact that many patients don't do very well with
them. Most often this is due to poor oral health habits and substandard
hygiene, which is often what caused the original tooth loss, creating
the "need" for a partial denture in the first place.

If people won't bother to take care of themselves, they can't expect
that some magic appliance will suddenly take care of them.

It is also worth noting that the article classifies "oral health" of
the patients into three categories: "poor," "reasonable," and "good."
How can a level of oral health, that does not even reach the level of
"good," be termed "reasonable?"

If it doesn't reach the level of "good," perhaps it would be more
accurate to describe it as "NOT good!"

And if it is NOT good, then perhaps the plan of treatment should be
modified in order to obtain a better level of oral health.

A final word on the closing lines of the article: "Managed Care is on
the rise. Most insurers are very particular about paying out for
"fixed" restorations (i.e. Implants and Crown and Bridge), limiting
treatment plans."

It is illegal for an insurer to "limit" treatment plans. It is
perfectly legal for an insurer to follow the exact terms of its
insurance contract and to pay only for treatment included in the
contract, as the patient still retains the right to have any care he
wishes to pay for. The law on this matter is very clear.

The distinction is very important. Too many dental patients act as
though their dental choices are limited to what some inadequate,
non-comprehensive "dental plan" may happen to cover. Yet those same
patients go out and buy $25,000 automobiles without expecting some
"auto plan" to buy the car for them.

It's a free country and people can buy what they wish -- whether it's a
car, beer and cigarettes, or (preferably) first-class dental care. The
choices are theirs. They are NOT limited to what some rich insurance
company executive wants to dole out for them.

- dentaldoc