Dear All,

Meanwhile, with apologies, here is the second bulletin today.

Yesterday, the ADA announced that it was putting another $3.8 million into propaganda machinery to be “proactive” on several issues with which organized dentistry is being confronted around the country.

The ADA  has every reason to be very worried about huge setbacks to its credibility in several areas: 1) Its continued promotion - and false claims about the safety of  - mercury amalgams; 2) Its poor scientific defence of the outmoded practice of water fluoridation (e.g. their immediate  dismissal of the very important NRC (2006) review of fluoride’s toxicity as not being relevant to water fluoridation!); 3) Its abject failure to get more than 20% of American dentists to treat children on Medicaid and 4) Its opposition to the use of assistants to provide primary dental care in remote rural areas of Alaska, where dentists refuse to go.

We can understand why they feel their reputation has been damaged by these issues, but it would be far better for them - and the public - if they would address these issues at their root cause rather than trying to paper (and ink) over these problems with advertorials (see definition of an advertorial at http://dictionary.reference.com/browse/advertorial).

Bearing in mind how much money the ADA puts into propaganda, and the willingness of the CDC to spend the taxpayers’ money promoting fluoridation - rather than carefully studying its dangers - its amazing that citizens have been able to prevail in keeping fluoridation out of so many communities in recent years. It vindicates a very important principle: truth is more important than money, IF the average citizen is allowed to see that truth.

Thus the role of the media remains of paramount importance here. Are they going to give the truth on this matter or are they going to run interference for the dental lobby? We are going to need well considered and balanced articles and editorials to fight off the ADA’s new advertorials.

More than anything else we need more journalists to go beyond pretending that all they need to do to satisfy the needs of good journalism, is to quote sound bites from the “white coats” versus sound bites from opponents. If it is merely a battle of soundbites the other side will win nearly all the time. After all who can resist the biggest lie ever perpetrated in this matter, namely that “Fluoridation is one of the top ten public health achievements of the Twentieth century” when it comes out of the mouths of the CDC or the US Surgeon General or a state health official. If you haven’t done so yet, please go to our web page and check out our critique of the CDC’s pathetic 1999 review which gave rise to this quote: http://www.FluorideAction.net/CDC.htm

Even if journalists who used this infamous quote were to couple it with a reference to our critique that would be a significant step forward in getting some journalistic balance into this issue. They will also avoid the laughter of history when this ridiculous practice is finally ended.

Going back to Arcata for a moment. Isn’t it extrarodinary that no journalist there has bothered to go to the FDA and ask them why they have not regulated ingested fluoride, the most prescribed medication in the US? Had they done so they would have found the preposterous truth that fluoride was grandfathered in as medicine because it was used as rat poison before 1938!  Instead of finding this out, they went along with the simplistic and disingenuous argument of fluoridation proponents that it is not the job of the FDA to regulate water.  It is, of course, the job of the FDA to regulate medicine. As the water is being used to deliver medicine to millions, it is vital that it gets the normal oversight that new drugs get - ie. careful clinical trials.  In my view, not to have got to the bottom of this central issue is poor journalism.

Meanwhile, win or lose, thanks to Arcata citizens for trying - against huge odds - to right this ancient wrong and get the FDA to do the job we pay them to do.

Paul Connett

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By Judy Jakush

Las Vegas’ÄîThe major issues facing the profession are playing out across the country in individual states, and the Association’Äîthanks to ADA House action last month’Äînow has a tool for working with the tripartite to create a coordinated response to those challenges.

More importantly, the ADA can use this same tool to craft long-term strategies aimed at getting ahead of the issues, rather than responding to them.

The House of Delegates, in Resolution 41H-2006, directed the ADA to “initiate a nationally coordinated, state-targeted, integrated public affairs plan” at an estimated total cost of $3.8 million.

It’s a natural extension of the past two years’ effort to boost the Association’s advocacy through a public affairs approach. Said ADA President Kathleen Roth, “A professional public affairs approach to controlling difficult issues related to dentistry is important in today’s world. And as an issue emerges in one part of the country or a state, we have seen the same or similar concerns in other regions over time. In today’s world of fast information flow, the ADA must use all the latest tools and technology of a professional public affairs approach as well as the expertise of our volunteers and staff to influence public perspective on oral health issues.”

Dr. James B. Bramson, ADA executive director, emphasized this is not a public relations campaign. “It’s a new way of doing business, recognizing the degree to which the lines have blurred between politics and policy. The media are one audience, but only one. To remain competitive in this environment requires integrating your capabilities in advocacy, coalition-building and educating key audiences. It means doing research to understand what attitudes people are bringing to the table, and what people need to hear in order to build trust.”

The resolution calls for the public affairs plan to partner the ADA with selected state dental societies facing significant advocacy issues such as environmental initiatives, scope of practice concerns, the freedom to choose safe and effective restorative materials, community water fluoridation and access to care.

The purpose, the resolution states, is to develop and implement “targeted public affairs strategies in cooperation with the state dental societies in order to position the ADA and the state dental society as the source of the best solutions to providing the best possible oral health care to the greatest possible number of the affected states’ residents.”

The ADA Board is directed to develop appropriate success measures for the program and provide the House with an analysis and report each year. The report should state whether the program is meeting its intent and success measures and include appropriate recommendations to change or discontinue the program.

The rationale and recommendations for the plan are presented in Board Report 14 (found in the members only section of ADA.org).

The report states that the plan “hinges on identifying those states at greatest risk of having problems in one or more of these issues’Äîissues that, if they go badly, could have lasting, negative consequences for dentistry in every state’Äîin 2007 and for the foreseeable future. It lays out strategies for a nationally coordinated ADA/state dental society partnership to help these states preempt these consequences and position themselves to better control the policy environment that, in turn, controls the practice of dentistry.

“The design of such a campaign,” says the report, “goes beyond simply stopping proposals from external entities that could harm the oral health delivery system, although that well may be necessary. Rather it is to build a position of strategic strength and credibility for the dental society and the ADA among target audiences, giving them ability to take the lead on potentially troublesome issues, rather than operating from a defensive, reactive posture.

A prerequisite for the program is that the state societies must want this help from the ADA, and in turn, the experience of these states will be of help to other states and the tripartite as a whole. Said Dr. Roth, “As the ADA begins to create a public affairs approach to targeting key issues and states where those issues come to light initially, our members will recognize our profession’s strong response and appreciate the public’s understanding of issues in a timely fashion. It is very important for us as a profession to get our message and perspective expressed to the public, legislatures and our membership regularly and consistently. This will have impact across all levels of the tripartite.”

Dr. Bramson also stressed the national effect. “At the same time that we’re ramping up our advocacy capabilities nationally, we can’t afford to ignore what’s going on in the states,” he said. “The House of Delegates showed real leadership in recognizing this, and in funding this initiative.”

The program is designed to be flexible, providing varying levels of activity in states. The model for action incorporates interdisciplinary teams comprising:

The activities to support these efforts would include:

“State dental societies largely have succeeded in beating back legislative and regulatory threats in the past,” the report states. “But the stakes are raised. Adversaries are better resourced and better organized than ever before. Recent events have cast in stark relief the peril of pursuing dentistry’s policy goals in a reactive mode. The great success of American dentistry stands on the principles of prevention and early intervention. Dentistry must now dedicate its energy and resources toward applying those same principles to advocacy and public affairs.”