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Reasons why
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vic |

ished monthly by TICONIUM A MAGAZINE FOR DENTISTS, DENTAL ASSISTANTS, AND DENTAL HYGIENISTS |

N. Pearl St., Albany 1, N. Y.
Copyright, 1956, Ticonium
Anaual Subscription, $2.50

EDITOR, Joseph Strack

CONTRIBUTING EDITORS
Arthur H. Levine, D.D.S.
Joseph Murray, D.D.S.

1956 Vol.XV No.9

SNTENTS

: YOUR PATIENTS

Mother practical, profitable
Milicle on “selling” dentistry by
Sayeteran practitioner. Here is
practice-building advice
patient-education tech-

LITTLE POND
BAsolution to the problem of the
ming dentist whose practice is
a dentist who
Sed and solved that problem 3
me: OFFSPRING AT WORK
man income-tax authority ex-
moans Treasury Department
mungs that may save you
4
NATIONAL
Sihe story of the proposed Na-
Association of Dental
@aukiliaries “to unite the efforts
maa the aims of the various
Seaital auxiliaries and groups of
mental wives throughout the

AND IMPRESSIONS

Brews, commentary, tips, and
by dentistry’s most in-
reporter ........... 7
COURSES BY

BONE AND TELEVISION

Ba fascinating report on the
aspect of modern pro-
techniques. 8
CANCER

mene growth rate, grading, and
Bemsiication of oral malignant

PREREQUISITE: X-RAYS
Be photo-story on “the funda-

| Mental basic of all dental prac-
12

Mite first of a series on the den-
fm program of the Veterans
Seuministration — the largest of
Be) civilian agency in the Unit-

expressed by contributors to
eazine do not necessarily reflect
Me views of the publishers.

Printed in U.S.A. by
Jersey Printing Co., Inc.
Bayonne, N. J.

Mover artist, Edward Kasper

Tell Your Patients

by C. W. Garleb, D.D.S.

If dentistry were managed with the acumen typical of big busi-
ness we would need many more dentists to handle all the patients
clamoring for dental care.

Manufacturers are constantly extolling their products to interest
more and more buyers. The more we tell people about the bene-
fits of dentistry, the more dental work they will want done, and the
more intelligently they will inform others of dentistry’s benefits.

We dentists are poor salesmen. We need the public to promote
for us. Dentistry is “spotty” in some areas. Many of us are not so
busy as we were a few years ago. Beginners find it takes longer to
build up a practice these days.

It is not enough just to tell patients what they need and then
proceed to do their dental work. We should explain why they
need it, describe the various ways in which we can help them, and
make clear why one device has advantages over others in appear-
ance, in service, in comfort, and in wearing quality. This is not
a waste of time. It is the correct way to “sell” the most fitting, in-
dividualized services to each patient.

Let me illustrate further: A patient wanted a bridge and asked
my fee. I studied her case and told her that the work could be
done in several ways and described the bridge I thought she should
have, showing her why it had advantages over the other appli-
ances. The fee would be between $125 and $150, I said.

“That’s what I want,” she said promptly. “Another dentist
wanted $85 to bridge the gap but he didn’t tell me what kind of
gadget it would be.”

Another patient whose left cheek was thinner than her right
came to have this condition corrected if possible, and she wanted
to know what it would cost. I advised a removable bridge with
rests and clasps and a sizeable bulge to hold her cheek out fuller.
I informed her that a cheaper appliance could be used but none
would improve her appearance as much as the one I suggested, and
I quoted my fee. (My mention of a cheaper service prepared her
for my higher fee.) Unhesitatingly she agreed.

But under no circumstances should we think only of fees. Bene-
fits to patients—appearance, comfort, lasting qualities—should al-

Page One

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CEC September 1956

ways come before anything else. For example, a war
veteran came in with an order for $158 worth of
dental work. I disliked the type of work suggested
by the VA, so they changed it to suit. I was paid
$113, and the patient is still happy about the work
after nine years.

However, we cannot always expect 100 percent
success in judging the life of appliances. Experience
will better qualify us to judge the efficiency and life
of various devices and services, and, as the years pass,
we also learn more about the biting power of differ-
ent individuals. As a rule, a large strong man with
powerful jaws wears out crowns, cracks off teeth, and
breaks dentures more often than a frail person. This
knowledge gives us valuable clues in determining
which type of appliance to use, how strong to make
it, and what materials to use. I once saw a very thin
pivot tooth last a ninety-pound woman eleven years,
but a heavy hauler might have broken it within a
week.

Variety of Benefits

We should frequently remind folks that dental
work benefits them in many ways. “If I were you,”
we might advise ailing folks, “I wouldn’t put off this
work any longer. You need it now. If you wait un-
til your ills become chronic it will be harder for you
to go through with it.” They usually do not need
much ethical prodding. A few sound points will
help to convince them. But do not use highpressure
tactics. One dentist gives this warning illustration:

“One of my long-winded selling talks sounded as
if I were more interested in my patient’s money than
in his personal well-being, I found out later—from
another dentist who did the patient’s work. And
now I’m not the eager-beaver I once was. I always
stop my sales talks in time—I hope.”

Even if a patient is healthy and his mouth is com-
fortable we must still show him how dentistry can
improve his appearance, build his morale, and pre-
vent trouble. Hand him a mirror and explain his
needs to him. Show him his gingivitis and explain
that it might lead to the loss of his teeth early in life
unless he has something done in time to prevent it.
Surely all of us believe in preventive dentistry.

I once saw an old man who had the right idea. He
sat on a box at a street corner carving on peach
stones. On the box he had stuck a crude sign that
read, “Get you a Good Luck charm today—tomorrow
may be too late.”

Don’t hesitate to tell patients that much of our
work gives them a more youthful appearance, pre-
vents suffering, and should never be postponed un-
til rampant decay and diseased oral conditions make
it impossible to restore the mouth satisfactorily.

The matter of health is always a good talking
point with which to impress patients with the bene-
fits of dentistry. Doctor Charles Mayo once said,

Page Two

“Dentistry can add ten years to human life.” That
statement by so eminent a medical leader carries a
lot of weight.

What prominent individuals do and say impresses
many people. Not many years ago Mrs. Eleanor
Roosevelt had an accident that broke some of her
teeth. She did not seem too upset about it. In fact,
she said, ‘““Now I can have pretty teeth!” And what
a handsome difference her new teeth make! I keep
several pictures of her. Pin-up dentistry!

Informing people of the benefits of dentistry is
one of our professional duties. So long as patients
use hot packs instead of cold; burn their mouths with
iodine, undiluted aspirin tablets, and even horse
liniment; rinse with hot salt water to check hemor-
rhage after extractions, instead of biting on cotton
packs; think all dentures should fit tight no matter
what; believe dentistry is easy and very profitable,
and otherwise show that they know almost nothing
about our profession—just so long should we con-
tinue to tell them more and more about the benefits
of dentistry.

One more big problem that always confronts den-
tists: people’s laxity in getting gingival care. Some-
how we dentists are neglecting to show patients the
benefits to be gained from good home mouth hy-
giene in the prevention of stubborn gingival dis-
eases.

Gum-line neglect, as we know, is responsible for
the loss of millions of sound teeth every year. I hope
that some dentist will soon come up with a workable
plan that will save these teeth from pyorrhea by cor-
rect gingival cleansing with properly-designed
brushes and helpful dentifrices, just as fluoride is
now saving millions of teeth from decay.

Doctor, if we each make an extra effort to show
the many ways in which our work benefits people
we will create a greater demand for, a higher respect
for, and a wider appreciation of dentistry.

6408 Chippewa Street
St. Louis 9, Missouri

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The Aging Dentist:

Recently I received a letter from an old friend who
is practicing in a medium’ large city in the Middle
West. I had noticed in the last three years that his
letters indicated his practice was falling off. In his
last letter he wrote that the previous month’s income
was very poor. (I stop to mention he is a Spanish
War veteran and draws a pension. You can guess his
age.) His former patients are going to younger den-
tists.

In his last letter he asked if I would advise him to
stay where he is or relocate in a small, one-dentist
town. His experience is similar to that of many city
dentists when their hair gets pepper and salt in it
and their hairline gets higher and higher. Their
practice grows smaller year by year, but they hang
on, hoping that when fall comes their practice will
improve. However, when a man’s practice begins to
leave him for younger dentists, there is little he can
do about it.

My friend’s wife had miserable health and he
wrote he could not relocate in a small town and take
her into just any kind of house he could rent. This
is what I wrote him:

It isn’t necessary that you rent just anything.
You own a very fine, comfortable home where you
are. You can sell it now at a nice increase over
what you paid for it years ago. The money the
place would sell for now would enable you to buy
a better one in a small town where real estate valu-
ations are low.

In a small town they don’t care if you have gray
hair or not, or what your age may be. They look at
it as a mark of experience in your profession.

In selecting a small community, be sure it has
a large territory around it without too close pro-
fessional competition. Note if the soil is productive
and the farm buildings are good. Good buildings
indicate the farmers are prosperous. Your small-
town practice will not bring in as much money as
your city practice did a few years back, but that
would be offset by lower expenses.

My advice is, seek a small town where you can
at least make a living, rather than stay in the city
and ante away each month the money you have
saved during the past years.

You wrote me that if things did not get better,

816 Fist...”
4/TTLE

by Rolland B. Moore, D.D.S.

you would have to close up your office and quit—
even though you cannot afford to give up your
profession. I repeat: Go look for a desirable small
town. Buy a home there and people will know
you are there to stay. From the first day you open
your office, you will have patients.

I feel my advice to my friend was good. I know of
a city dentist who had a large and lucrative practice.
He was considered an outstanding dentist in his city
and state. He had held every office in his state den-
tal society and had taught at a leading dental college.
But age was creeping up on him.

His patients began leaving him to go to younger
dentists. As his income dropped, he raised his fees
to offset it—until his fees were twice as high as those
of other dentists in the city. Finally he had to give
up—after not having made expenses for three years.
Today that man is working in a factory. He wouldn’t
relocate in a small town. His professional fees would
not allow him to.

I too was a city dentist but I saw the handwriting
on the wall. When my practice began to dwindle
month after month, I knew it was time for me to seek
a good small town and set up a country practice.

Many aging dentists may read this article. They,
too, may be losing practice to the younger men.
There isn’t a thing in the world they can do about
it. They can’t turn the clock back. If they can’t af-
ford to retire, they should go to a small town. There
they can at least make a living in these times of high
living costs.

It is true, of course, that we small-town dentists do
not get the high fees of the dentists in the cities, but
our money goes farther. Rent, heat, light, telephone
and water cost less in a small community.

I can’t say that I enjoy living in a country town
as much as I did in the city. There is not much go-
ing on. At night the streets are deserted, but I would
rather live here at my age than barely “hang on” ina
city.

I'd rather be a big fish in a little pond than a little
fish in a big pond—and get eaten up!

Box 237
Allerton, Iowa

Page Three

September 1956 CEC |

vé september 1956

Dentists worried by the high cost of rearing and
educating their children may now get a material
assist from the Treasury Department, thanks to
liberalization of the rules in respect to income which
dependent offspring may earn without being dis-
qualified as dependents for income tax purposes.

It is now possible that a dependent child may earn
more than the amount of his exemption value

($600) as a dependent and the parent may still count

the child as a dependent for income tax purposes.
This, in effect, amounts to a double exemption: (1)
taken by the dependent child in filing his own in-
come tax return and (2) taken by the parent.

However, as in the past, there are certain limiting
qualifications which need to be understood and ob-
served carefully, lest a dentist lose this advantage.
There is still an actual ceiling on a dependent child’s
earnings although now it is not an arbitrary $600
ceiling, as heretofore, except for one category of de-
pendent children. Now a taxpayer-parent must de-
termine what the earnings ceiling of a dependent
child is in the light of individual circumstances.

It must be emphasized that a dentist’s child may
earn less than $600 and not be eligible as a depend-
ent for income tax purposes; or, a child may earn
more than $600 and still qualify as a dependent. The
determination of dependency rests upon the circum-
stances surrounding each child and each parent.

Prior to passage of the new Code, a dependent
child could earn up to $599.99 and the parent could
claim him as a dependent. The one qualification was
that the parent furnish more than one-half of the
child’s support. If the child earned $600 or more a
year, the exemption was lost even though the parent
contributed more than one-half of the support.

Now, two categories of children can earn more
than $600 and still be counted as dependents by a
parent. However, the old rule still prevails in re-
spect to the parent being obliged to contribute more
than one-half of the child’s support. Thus, a dentist
should not assume there is no earnings ceiling be-
yond which his dependent son or daughter may not

In the past, the ceiling was $600 in any case. Often,
it was less in practice, because of the more-than-one-

Page Four

DANGER:
Offspring
at work!

by Harold J. Ashe

half rule. The ceiling may still be less than $600 if
the contribution by the parent does not exceed the
amount earned by his offspring. On the other hand,
a child may earn far more than $600, even $1,500
or $2,000, provided only the parent contributes more
than one-half of the support.

Ordinarily, a dependent child will not be em-
ployed by a dentist, unlike many parent-offspring
employment relationships in business. However, if
a dentist has business interests or is in a partnership
offering employment opportunities to a dependent
child, the employment relationship should be “at
arm’s-length.” The employment must be bona fide,
and the child must perform services consistent with
the wage or salary paid. On this point the Tax
Court has said: “Whether payments for such services
(by relatives) are reasonable must be determined in
the light of the entire situation and consideration
must be given to what amounts would ordinarily be
paid for like services by like enterprises under like
circumstances.” The employment relationship must
not be a subterfuge designed to distribute some of a
taxpayer’s earnings to his child as unearned wages
to reduce the taxpayer’s net income and, in turn, his
income tax. Such “employment” and payment is
easily ascertainable as to the facts on check by the
Internal Revenue Service.

Three Categories

For purposes of exemption, dependent children
fall into three categories. The offspring must be
either:

(a) under 19;

(b) 19 or over, and not a student (in this cate-
gory the child’s gross income must still be less than
$600) ;

(c) bea student on a full-time basis in a school or
college, attending school over a period of five or
more months during the tax year.

The limitation on category (b) dependents under-
scores the importance of encouraging children to
stay in school after they reach nineteen. This
liberalization of the rules has the salutary effect of
making the cost to the parent substantially less than
the out-of-pocket educational outlays he makes. The

tax saving made available to the taxpayer can be a
substantial contribution toward the dependency
support. Example: A dentist is in the 50 percent tax
bracket. The value of the dependency exemption is
$300 in tax savings. This makes the dentist’s more-
than-one-half contribution less burdensome.

The One-Half Rule

Let’s consider an example of how the over one-
half rule works. A dentist’s son is attending college.
His total support costs, including meals and lodging
at school, tuition, and other expenses, are $2,500.
This figure includes a scholarship worth $300. Ex-
cluding the value of the scholarship, the cost of sup-
port is $2,200. At school and during summer vaca-
tion the son earns $1,000 and the dentist contributes
$1,200. The dentist is entitled to the exemption.

On the other hand, another dentist contributes a
like amount to the support of his son who is in col-
lege. However, the total support is $2,600 with the
son earning $1,400 toward his support. The exemp-
tion is lost. The dentist is in the 50 percent tax
bracket. Had the dentist contributed slightly over

DENTISTRY AROUND THE WORLD

$200 more to his son’s support (or the son had set
an earning ceiling of a slightly less than $1,200) , the
dentist would have netted a tax reduction of $300.

Moreover, a dentist may need a sharp pencil and
an hour’s time to calculate the real value of his con-
tributions. Loose estimates may prove his undoing.
In determining the amount of support contributed
to a dependent domiciled in a taxpayer’s home, the
Internal Revenue Service insists that household costs
be apportioned equally among those in the house-
hold.

As in the past, a dependent child must file an in-
come tax return if he earns $600 or more. Regardless
of how small his earnings, he should file an income
tax return if there have been income tax withhold-
ings from his earnings. Because of his part-time
employment, and the fact income tax withholdings
are calculated on the assumption of full-time em-
ployment, he will receive partial or complete refund
of withholdings. This refund, coming after year-end,
will also help with school expenses.

P. O. Drawer 307
Beaumont, Calif.

September 1956 CEC

Little Charlie Wind-in-the-Forest is all smiles now, but his Ojibway Indian boy pal, Frank, seems a little
apprehensive as Charlie settles back in the chair of the Canadian National Railways rolling dental clinic.

Up in the vastness of northern Ontario the dentist is brought to the people. A CNR sleeping car has been
converted into a modern dental clinic and moves from town to town on regular schedule. The dentist,
Doctor Ralph L. Hicken, is now following a schedule that will keep him ovt on the line until Christmas.
The doctor is covering towns and settlements on a ‘‘beat'’ of 1,700 miles. (Authenticated News)

Page Five

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CE C September 1956

Dental Wives:

Watch out for the woman with an idea! She is
apt to stick to it until it reaches fruition. If it is a
poor idea, there is trouble ahead. If the idea has
value, something splendid springs into being which
may benefit everyone.

Right now a great many dental wives throughout
the nation are concentrating on the same idea. They
believe in it and they feel that it has great value.
Their slogan might well be “Let’s go National,” for
their goal is a National Association of Dental Aux-
iliaries to unite the efforts and the aims of the vari-
ous dental auxiliaries and groups of dental wives
throughout the country.

It is their earnest hope that the American Dental
Association will recognize this newly formed group
as a fully accredited auxiliary to the Association,
when the American Dental Association holds its na-
tional convention in Atlantic City in November.

In the meantime, because they feel that the time
is right for a national organization of auxiliaries,
the women have been going ahead with the first or-
ganizational plans.

Last October, at the A.D.A. national convention
in San Francisco, representatives from auxiliaries of
eighteen states met to discuss the matter and eleven
of these representatives favored the formation of a
national group, while seven states and Hawaii
“passed” the vote and instructed the delegates to ob-
tain further information but not to commit their
states at that moment. There were no negative votes.

At that time a proposed constitution and by-laws
came into being patterned after the Auxiliary to
the American Medical Association, with certain
minor changes, and it was moved and seconded that
Mrs. Cecil W. Neff of San Diego, Calif., be appointed
temporary chairman, and Mrs. Don J. Fitzgerald, of
Mason City, Iowa (then president of the Iowa Den-
tal Auxiliary) be temporary secretary.

The appointment of Mrs. Neff was a fitting one,
for she has long been an ardent worker in the cause
of a national organization of auxiliaries. She has
diligently sought information about auxiliaries and
groups of dental wives in other parts of the country
and has conducted a voluminous correspondence
with other auxiliary officials, the letters being pub-
lished in the clever “Mail Bag” feature in Newsy
Extractions, the publication which she edits for the
San Diego County Dental Auxiliary.

The Los Angeles California Dental Auxiliary al-

Page Six

Let’s Go National!

by Kay Lipke

so publishes a clever periodical called Dental Mir-
ror, which features articles about the organization of
a national auxiliary. Elsewhere throughout the coun-
try interest has been stimulated regarding the na-
tional organization, and many dentists have ex-
pressed their approval of this new project. The wo-
men now await the decision of the Trustees of the
American Dental Association.

Let not the idea emerge that this national plan
means that the women are “taking off” on an expedi-
tion of their own. Nothing could be more remote
from the truth.

The women who belong to dental auxiliaries
throughout the country are first and foremost de-
voted wives of dentists. They believe sincerely in
both their husbands and the profession which is
their life work. They believe in the cause of dental
health and education, and it is to help their hus-
bands, and the dental societies to which their hus-
bands belong, in this work that they have banded to-
gether and formed auxiliaries. The objectives of the
auxiliaries are in themselves interesting and worth-
while. As expressed by the organization to which I
belong, they are, briefly: to bring its members into
more active affiliation with the dental profession; to
initiate or assist in any activity that may be approved
by the dental profession; to extend the aims of the
dental profession to all organizations which seek the
advancement of dental health and education; to pro-
mote fellowship among the families of dentists; and
to promote the welfare of dentistry.

The welfare of dentistry—and the cause of dental
health and education! These are stirring reasons
why the wives who belong to dental auxiliaries
would like to unite their forces in one national or-
ganization, acting under the auspices of, and recog-
nized by, the American Dental Association.

They are women with an idea—and a good one.
We hope it succeeds. P. O. Box 350

Albany, N. Y.

DENTIST’S VERSION

(With apologies to Henry W. Longfellow)
Lives of great men oft remind us,
Though our own be not sublime,
We can leave this mark behind us:
Tooth-prints—record of work done on time!

Barbara Becker ———

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by Maurice J. Teitelbaum, D.D.S.

Dental Thisa and Data

Within a 12-month period, two verdicts of almost
$250,000 each were awarded to defendants in Califor-
nia who had brought suit against physicians for mal-
practice. Consequently, all physicians have been
cautioned (and dentists might take heed) to increase
their malpractice insurance. The emphasis for ade-
quate protection, it seems, is needed, above all, for
doctors in California, Florida, New York, New Jer-
sey, Illinois, Connecticut, and Maryland. . . . The
inclusion of dental treatment under some type of
Blue Shield system which now services the medical
profession might be a boon to dentistry. One physi-
cian, for example, is reported to have been paid
$200,000 for the care of Blue Shield-covered patients
during a single year! . . . Statisticians of the Metro-
politan Life Insurance Company, who always seem to
be hung up with a string of zeros, have just come
out with another one. They predict that the United
States will have some 63,000,000 children under age
18 by 1965—approximately 8,500,000 more than we
have now. So take heed all pedodontists! . . . The
School of Dentistry of the Hebrew University in Is-
rael is now getting ready for its third year of opera-
tion. The clinical facilities are under construction
and will contain a ‘‘ten-chair unit for restorative and
prosthetic dentistry; a three-chair unit for minor
oral surgery and exodontia; a lecture and demon-
stration room which includes a complete dental unit
and a clinical investigation lab.” A convalescent sec-
tion in the medical center will be converted into a
technical dental lab. It will include 30 individual
benches for students, a special plaster room, a casting
lab, and a room reserved for acrylic and porcelain
work. The Alpha Omega dental fraternity has been
campaigning for funds for the dental school. At the
University of Pittsburgh, fraternity members pledged

September 1956

$1,000—most of it raised through the donation of
blood.

Inci-dentals

In Detroit a woman brushed her teeth so vigor-
ously that she swallowed the toothbrush. . . . A Mil-
waukee doctor can spell “doctor” three different
ways. He is an M.D., a D.D.S., and his name is John
P. Docktor.

Tie Tips

Fogged roentgenograms, all too common in the
processing of dental films, are a serious detriment to
proper X-ray interpretation. To avoid fog on films,
take the following precautions:

Don’t use film after the manufacturer’s expiration
date.

Be sure that the processing room has no light leaks
and that a proper safety light is used.

Keep film stored in lead-lined containers.

Use fresh developing and fixing solutions.

Gagging

A patient presented himself to a young dentist and
complained of a sore on the roof of his mouth. The
dentist examined it carefully. It was a most unusual
type of eruption and he was at a loss as to what it was.

“What is it, doc?” asked the patient.

Not wanting to lose the patient and hoping to be
able to treat the case, the dentist answered: “It’s a
rare condition called Eruptive Confusiformis.”

“Thank God,” said the patient, “the other three
dentists I showed it to didn’t know what it was!”

446 Clinton Place
Newark 12, N. J.

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Page Seven

ve C september 1956

Dental Wives:

In the meantime, because they feel that the time
is right for a national organization of auxiliaries,
the women have been going ahead with the first or-
ganizational plans.

The appointment of Mrs. Neff was a fitting one,
for she has long been an ardent worker in the cause
of a national organization of auxiliaries. She has
diligently sought information about auxiliaries and
groups of dental wives in other parts of the country
and has conducted a voluminous correspondence
with other auxiliary officials, the letters being pub-
lished in the clever “Mail Bag” feature in New
Extractions, the publication which she edits for the
San Diego County Dental Auxiliary.

The Los Angeles California Dental Auxiliary al-

Page Six

Let’s Go National!

by Kay Lipke

Let not the idea emerge that this national plan
means that the women are “taking off” on an expedi-
tion of their own. Nothing could be more remote
from the truth.

They are women with an idea—and a good one.
We hope it succeeds. P. O. Box 350

Albany, N. Y.

DENTIST'S VERSION

(With apologies to Henry W. Longfellow)
Lives of great men oft remind us,
Though our own be not sublime,
We can leave this mark behind us:
Tooth-prints—record of work done on time!

Barbara Becker

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by Maurice J. Teitelbaum, D.D.S.

Dental Thisa and Data

Within a 12-month period, two verdicts of almost
$250,000 each were awarded to defendants in Califor-
nia who had brought suit against physicians for mal-
practice. Consequently, all physicians have been
cautioned (and dentists might take heed) to increase
their malpractice insurance. The emphasis for ade-
quate protection, it seems, is needed, above all, for
doctors in California, Florida, New York, New Jer-
sey, Illinois, Connecticut, and Maryland. . . . The
inclusion of dental treatment under some type of
Blue Shield system which now services the medical
profession might be a boon to dentistry. One physi-
cian, for example, is reported to have been paid
$200,000 for the care of Blue Shield-covered patients
during a single year! . . . Statisticians of the Metro-
politan Life Insurance Company, who always seem to
be hung up with a string of zeros, have just come
out with another one. They predict that the United
States will have some 63,000,000 children under age
18 by 1965—approximately 8,500,000 more than we
have now. So take heed all pedodontists! . . . The
School of Dentistry of the Hebrew University in Is-
rael is now getting ready for its third year of opera-
tion. The clinical facilities are under construction
and will contain a “ten-chair unit for restorative and
prosthetic dentistry; a three-chair unit for minor
oral surgery and exodontia; a lecture and demon-
stration room which includes a complete dental unit
and a clinical investigation lab.” A convalescent sec-
tion in the medical center will be converted into a
technical dental lab. It will include 30 individual
benches for students, a special plaster room, a casting
lab, and a room reserved for acrylic and porcelain
work. The Alpha Omega dental fraternity has been
campaigning for funds for the dental school. At the
University of Pittsburgh, fraternity members pledged

September 1956 EL

$1,000—most of it raised through the donation of
blood.

Inci-dentals

Tic Tips

Fogged roentgenograms, all too common in the
processing of dental films, are a serious detriment to
proper X-ray interpretation. To avoid fog on films,
take the following precautions:

Don’t use film after the manufacturer’s expiration
date.

Be sure that the processing room has no light leaks
and that a proper safety light is used.

Keep film stored in lead-lined containers.

Use fresh developing and fixing solutions.

Gagging

“What is it, doc?” asked the patient.

Not wanting to lose the patient and hoping to be
able to treat the case, the dentist answered: “It’s a
rare condition called Eruptive Confusiformis.”

“Thank God,” said the patient, “the other three
dentists I showed it to didn’t know what it was!”

446 Clinton Place
Newark 12, N. J.

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Page Seven

‘

Setting up the “‘show."" The cameras focus on former Dean Allan
G. Brodie at the opening of the i

—

(Photo, University of Illinois College of Dentistry)

Close-up of a demonstration showing drawings and articulator with
plaster model. Doctor Balint Orban, the instructor, uses chest-type
microphone, permitting free use of both hands.

(Photo, University of Illinois College of Dentistry)

The television camera is able to look over Doctor John Spence's
shoulder into the patient's mouth. The dentists view the close-up
picture of the complete operation. (Chicago Sun-Times)

Page Eight

Postgraduate
Courses by
Telephone

and Television

Imagine getting a good look at physiological
specimens under a microscope at the same time that
400 other dentists are viewing the same sight. Im-
agine observing the innermost recesses of a patient's
mouth without your instructor’s thumb or shoulder
blocking your view. Imagine a mouth magnified
while you are holding a duplicate model and each
technique thoroughly explained to hundreds of men
in six different cities.

As you picture these phenomena, you can begin to
understand why television is becoming: a powerful
medium in the teaching of dentistry. The University
of Illinois College of Dentistry television courses are
the outgrowth of their well-known telephone exten-
sion program, which was discussed in August TIC.

Back in 1950, the Illinois dental school first ex-
perimented with television and broadcast a closed
circuit session to a small group within the dental
building. Each year the curriculum expanded. The
1956 series includes six one-day courses to be pre-
sented within the college and one four-session course
to be broadcast simultaneously to six different cities.

Subjects covered are carefully selected so that they
are best adapted to the advantages of televising.
Courses offered this year include: Interceptive Or-
thodontics in General Practice; Newer Concepts in
Endodontics; Early Treatment of Malocclusion;
Treatment and Execution of Mouth Rehabilitation
in Periodontics; Current Advances in Dental Assist-
ing, and various other phases of dental treatment.

Doctor Saul Levy, coordinator of postgraduate ex-
tension courses at the dental school, points out that
while television is exceptionally effective for teach-
ing, it can be only as good as the instructors. There-
fore, the best men available in their respective fields
teach the courses. Regular faculty members repre-
sent more than ten different universities from the
United States and Canada, and guest lecturers are
called upon regularly.

“The greatest advantage of TV,” says Doctor Levy,
“is that the number of students we can teach is
limited only by physical space. Depending upon the

ve A September 1956
Tr
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by Melvin M. Meilach, D.D.S., and
Dona Z. Meilach

subject, it is possible for one instructor to perform a
demonstration before hundreds of students in the
same time it would take him to show only a few in
a classroom.”

For courses given within the dental building on
the University’s Chicago campus, a camera crew
works from the studios on the tenth floor. Here,
complete equipment is installed and the actual
“shows” are done “live.” Coaxial cables lead to the
lecture halls and laboratories where students are
gathered. ‘Twenty-one-inch television sets are
mounted at the front of the halls in easy view of the
entire room.

When laboratory demonstrations are presented,
each student becomes a participant. He is supplied
with a duplicate plaster model of the patient’s mouth
tobe operated on, an articulator, and all instruments
required. Proctors are present in each room to assist.
The set-up is similar to a national “do-it-yourself”
program which you may watch. However, an im-
portant difference is that you would not be supplied
all the materials and tools before the show started.

Says one Chicago dentist who recently attended a
course, “It’s amazing how the camera can get inside
a patient’s mouth. Never before was it so easy to
watch dental operations and techniques in such
detail.”

A Milwaukee oral surgeon enthusiastically re-
ported, “The possibilities of TV are unlimited! The
instructor performed an actual operation before the
cameras. He showed the condition of tissues at var-
ious stages of intermediate healing through the
microscope. Can you imagine how little you would
see if 200 or more students had to file past a micro-
scope for a hasty glance?”

A periodontist from Indiana said, “Televised
courses have a great deal to offer. I’ve been com-
pletely satisfied with the way the material is pre-
sented, the visibility and quality of the televised
picture. The illustrated manuals used in conjunc-
tion with the broadcast are as complete as you could
possibly want. Much thought and planning has been

A patient is ready for a student-participation course. Each dentist
is given a duplicate model of this man's mouth so the dentist can
follow the technique in detail.

(Photo, University of I\linois College of Dentistry)

Students work on the duplicate model using articulators and neces-
sary instruments. On screen is a picture showing, on a model,
what the instructor is about to do. Then the camera shows the
instructor doing it to the patient.

(Photo, University of IIlinois College of Dentistry)

Classroom set up for a television lecture program.
(Chicago Sun-Times)

Page Nine

September 1956 CEE

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CEC September 1956

put into every detailed phase.”

Each day’s demonstrations are followed with a
round-table discussion. This discussion is also tele-
vised, making it possible to reach a larger audience
than could be accommodated in the most spacious
hall on the campus.

This year, for the first time, a four-session course
is being televised simultaneously to six midwestern
cities. This presentation involves the same proce-
dures and hookups but on an enlarged scale. Instead
of coaxial cables only in the dental building, special
cables will be run to a hall in each city where a
registered group will view the televised demonstra-
tion.

It is too bad television requires such a tremendous
expenditure, for the response from the profession in
enthusiasm and enrollment shows a great demand
for the courses. The present program budget can
only be handled because of the financial assistance
provided by the Kellogg Foundation. Funds from
fees and normal University support are insufficient.

One feature credited to TV is the reduction in the
number of personnel necessary to assist in a demon-
stration. Where one lecturer might give the same
lecture several times, and his various assistants would

Oral Cancer

by Joseph Murray, D.D.S.

Part9
Growth Rate, Grading, and

Classification of Oral Malignant |

Tumors

When a squamous-cell carcinoma is examined
histologically, it may exhibit various degrees of dif-
ferentiation. As a rule, the more benign the lesion,
the more the tumor cells resemble those of the nor-
mal adult squamous epithelium. The more malig-
nant the neoplasm, the more undifferentiated are the
cells.

On this premise, therefore, Doctor A. C. Broders,
a Mayo Clinic pathologist, classified epidermoid
carcinoma into four grades of relative malignancy

Page Ten

be required to be present at each lecture, with Ty
the lecture would be presented only once with only
a few aides present to assist. However, the saving is
offset by the staff needed to produce the mechanical
phases of a broadcast. The crew usually consists of a
director, a floor manager, an engineer, three camera
men and two utility men. The cost and mainten-
ance of TV equipment and the renting of sets and
laying of cables take a big bite out of the TV budget.

Before long, the University hopes to utilize TV
on the undergraduate level as well as on the post-
graduate level. As a pioneer project in TV teaching,
these programs have been followed with interest.
While the University of Illinois is the only dental
school producing courses on a large scale, other uni-
versities are also beginning to use TV to great ad-
vantage.

It will be interesting to watch the growth of tele-
vised teaching and what this phase of scientific
accomplishment will lead to in the future. As Doctor
Levy says, ‘““When we began our telephone extension
courses, the possibility of television was considered
quite remote. Who knows what will follow?”

7005 S. Normal Blvd.
Chicago 21, Ill.

This is an unusual view reflected on a mirror so as to show a
squamous cell carcinoma, Grade 4. This early lesion, in a Negro
male, was soft (unusual and atypical) and appeared similar to 4
localized area of gingival hypertrophy. Biopsy showed high grade
carcinoma. (Photo and legend by Doctor S. Gordon Castiglione)

and claimed that the prognosis could often be de-
termined by the grade of the lesion:

Grade 1: Here, 75 percent of the cells are differen-
tiated, indicating a low-grade malignancy.

Grade

Grad

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September 1956 CEC

Grade 2: Because 50 percent of the cells are differ- SITE PERCENT METASTASIS

entiated, this is considered a low-medium (Approximate)
grade malignancy. 1. Basal-cell carcinoma face............... 0
2. Squamous-cell carcinoma face .......... 12-15
Grade 3: This type shows 25 percent cell differen- 3 Meee 90-25
tiation and the malignancy is considered ‘ hard palate .. . .25-30
high-medium grade. 5. superior gingiva 30-35
Grade 4: This lesion shows a high-grade virulence 6. buccal surface . . 20-25
because less than 25 percent of the cells 7 inferior gingiva. 60
are differentiated. 8. oral tongue .... 60
9. floor of mouth.. 65
Thus, if a cancer is classified as Grade 4, it exhibits 10. soft palate... .. 70
the highest degree of malignancy. Moreover, it is 11. root of tongue.. 75
known that the less differentiated the cells, the more 12. a eT 80
radiosensitive the neoplasm. Consequently, high Since the local lesion and the metastatic disease
radiosensitivity and greater malignancy frequently present two different problems, Doctor Castigliano
go together. has classified oral epidermoid carcinoma on that ba-

However, microscopic findings and interpretations sis, grading each separately:
should not be the only means of arriving at a prob- LOCAL LESION
able index of tumor virulence and prognosis. Often,
tisue examined from the same growth, but from
another area, may reveal a different hist-pathologic
picture. Therefore Doctor Broders’ classification is
not infallible, but should act as an invaluable guide
in combination with other clinical signs.

Many cancer experts consider the following fac-

Stage 1: Under Icm.

Stage 2: 1 to 2.5cm in large diameters and con-
fined to local anatomic site, viz., tongue,
palate, floor of mouth and so forth.

Stage 3: 2.5 to 4cm. in one long dimension.

Stage 4: Over 4cm.

METASTASIS
tors to have a bearing on the index of malignancy: :

e site, size, microscopic type, and grade of tumor; A: Sinel de. freel bl
the age and sex of the patient; the presence or ab- B. d bl
sence of metastasis; pain or lack of it; patient coop- C.
eration, history of previous treatment, and so forth. ee ee

Th -d D: Fixed mass of nodes.

us, epidermoid carcinoma of the basal-cell type,

found only on the skin (never primarily involving

the mucous membrane of the oral cavity or the ver- has: py al eatom kets than mae in dimension without
milion zone of the lip) is less malignant than squa- clinical evidence of metastasis would be classed Stage
Hous-cell cancer of the face. The former grows 1-0. The same cancer with bilateral metastatic di-
slowly, does not metastasize, and is fatal only after ke would be Stage 1-C. : ete

years of inadequate treatment. Only occasionally is , — another example, a lesion 3cm. in diameter
Be srowth rate rapid. with metastasis to a single node, would be classed

Stage 3A, whereas the same growth without metasta-
tic spread would be classified Stage 3-0.

1358 46th Street
Brooklyn 19, N. Y.

On the other hand, the squamous-cell tumor varies
in growth rate and in cure rate, depending on the
location of the lesion. For example, a squamous-cell
carcinoma of the face is usually less virulent than
one situated on the lip. And a lip cancer of the squa-
mous-cell variety, on the average is less malignant
than its counterpart within the oral cavity.

Generally speaking, then, the more malignant the

Next Month—tTreatment

BIBLIOGRAPHY
1. Burket, L. W., Oral Medicine, J. B. Lippincott Co., Phila-

tumor, the faster it will grow, metastasize, and de- delphia: 1946.
stroy. Moreover, regarding the site of the lesion, the 2. Castigliano, S$. G., Oral Cancer, reprinted from Oral Med-
deeper and lower it is situated in the mouth, the icine, by Lester W. Burket, J. B. Lippincott Co., Philadelphia:

1952.
3. Martin, Hayes, Mouth Cancer and the Dentist, American
Cancer Society, New York: 1949.

greater the degrce of virulence. Thus, a cancer of
the palate is less malignant than its counterpart in

the floor of the mouth or in the lower gingiva. 4. Robinson, H. B. G., “Diagnosis of Cancer of the Oral Mu-
In the following table, Doctor S. G. Castigliano Sing. Oval Mod.
indicates the average degree of malignancy accord- ‘

: zs 5. Sarnat, B. G. and Schour, Isaac, Oral and Facial Cancer,
ing to location: Year Book Publishers, Chicago: 1950. ‘

Page Eleven

rAd september 1956

The Constant
Prerequisite:

Lower right third molar prior to anesthesia; same area after anes-
thesia was complete. Note apical detail.

by Charles L. Meistroff, D.D.S.

The employment of radiologic intervention is, in
the writer’s opinion, the fundamental basic of all
dental practice. Without it the dentist works blindly,
denies himself the proper guidance of a confirmed
diagnosis, is lost during the course of treatment, and
leaves himself and his patient open to all the un-
necessary and unwarranted complications and trau-

ma of a guinea-pig practice. Is it worth it? Is it worth-
Trismus and pain; before anesthesia was given. After anesthesia; while plunge headlong
note complete detail of impaction and caries of second molar. just to save a few minutes of preliminary survey only

to be tied up for half hour or more in a multitrauma-
tic episode that injures the patient mentally and
orally and damages the operator’s reputation?

No Guesswork

What to do or not to do, to operate or to leave
alone, to extract or not to extract—these decisions
must be made and cannot be left to guesswork. Ra-
diologic intervention is the most revealing phase of
dentistry that we have at our disposal that, in too
many instances, is not used at all and, when used,
quite often is the last to be consulted.

Note missing apical-antral area. Highly sensitive to film; gagging. No Halfway Job
After anesthesia; note the complete detail and perfect root picture. .
| The essence of this theme is to cover only one

facet of the radiologic aspect and to show that radio-
logic work, if done halfway, is worse than not at all.
I have particular reference to those cases that are in
the acute toothache stage where the film cannot be
placed to fullest advantage in positioning. The ac
companying trismus, swelling, and extreme discom-
fort usually preclude the attempt of any patient co-
operation. Regardless of how they are taken, if they
are not completely revealing in their overall picture
they are useless. Films lacking in essential details or
presenting a picture that is doubtful are not to be
considered. To obtain films overriding any inter-
pretive obstacles they must be perfectly adapted to
the area in question before exposure; with the tis
sues already under the overburdening stress of acute

Trismus and extreme pain. Impaction barely visible. After anes-
thesia complete picture of the impaction and surrounding detail.

Page Twelve

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X-Rays

pain, swelling, trismus, and inflammation, the pres-
sure of the film against the tissues does not elicit any
too much patient cooperation.

How to Do It

How do we obtain these films? First, anesthetize
the involved area after a preliminary exposure has
been made. Sometimes this one shot will suffice,
most of the time it will not! After anesthesia is more
manifest, the placing of the film more posteriorly
will be more easily tolerated. It must be remembered
at this time that only the posterior areas of mandible
and maxilla are discussed at this time.

The Second Film

The second film will be found to give all the miss-
ing details and facts that the first film lacked. In the
upper it will reveal the root picture in itself and in
relation to the antrum, tuberosity, and posterior
alveolar walls; in the lower, the root story in relation
to the mandibular canal, ramus and angle of the jaw,
inferior border, and alveolar depth.

The accompanying films show the kinds of results
that can be obtained when anesthesia is used, per-
mitting the placing of films more posteriorly and
consequently making better patient handling pos-

sible. 113 E. Grace Street
Richmond 19, Va.

Lower right third molar, pain and trismus. After anesthesia was
complete the root detail was without doubt.

Lower right third molar; pain and trismus. After complete anesthe-
sia; note the detail of the film.

Lower left third molar area; almost a good picture without anes-
thesia but the apical areas are doubtful.
After complete anesthesia; note good diagnostic value of this film.

Upper left third molar area. Note the missing apico-antral relation.

After th ; nothing g here, procedure without obstacle.

Lower left third molar, barely able to hold film in place. After anesthesia; still somewhat shy of detail
on apex. After complete anesthesia: radiograph is without missing factors.

Page Thirteen

September 1956 CEC’

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FOR LIVING

Every dentist should be interested, personally and
professionally, in the dental program of the Veterans
Administration and how that program is affecting
the dental health and habits of the nation.

Consider these important facts:

VA conducts the largest dental program of any
civilian agency in the United States.

VA facilities in which dental services are available
include outpatient clinics in ninety cities (mostly
regional offices of VA) , and inpatient clinics in each
of 173 hospitals and seventeen domiciliary homes.

Eight hundred and six full-time dentists are on the
staff of the VA dental unit, supported by adequate
auxiliary personnel, including dental assistants, hy-
gienists, technicians, and clerks. More than 60,000
private-practice dentists provide “home town” care
to veterans who are unable to use VA clinic services
because of geographical locations or excessive work-
loads.

The total cost of this dental program in the fiscal
year 1955 was about $27,000,000, $11,200,000 of
which was paid in fees to private-practice dentists.

Fees paid to private-practice dentists are set on a
state basis, to meet varying conditions in the differ-
ent states, in consultation with state dental societies.

Dental-care policies, procedures, and regulations
are developed by dental staff in VA’s central office in
Washington, D. C., within the framework of federal
legislation.

National and international authorities in all den-
tal specialties are associated with VA as consultants,
influencing the quality of dental care and providing
the dental staff with invaluable assistance, guidance,
training, and professional leadership.

VA has an excellent resident training and intern-

Page Fourteen

VA Dentist

by Joseph George Strack
All photos by VA

ship program in which its full-time professional stalf
is encouraged to pursue specialty fields—especially
resident training in oral surgery, periodontics, and
prosthodontics. Through arrangements made with
dental schools, short courses in various phases of
dentistry are made available for a limited number of
VA dental-staff members.

Treating the total patient is standard procedure
in VA hospitals. Oral diagnosis and treatment plan-
ning are integrated with general medical diagnosis
and treatment planning. Outpatient dental treat-
ment is restricted to service-incurred disabilities. The

VA Hospital at Biloxi, Miss.

talf
ally
and
ith
r of

ure
an-
pat-
The

VA dentist enjoys parity of status with the VA physi-
cian, just as the specialty boards of dentistry enjoy
the same recognition as do the specialty boards of
medicine.

22,000,000 Living Veterans

Although there are approximately 22,000,000
veterans in the United States, present legislation
makes only a small fraction of these eligible for out-
patient dental care, and only a percentage of these
apply for dental service.

These facts, and others, will give the thoughtful
dentist much to ponder about—especially the scope
of the VA program. The average age of the 22,000,-
000 living veterans is thirty-eight. A breakdown by
the wars in which they served and their average ages
today by war groups shows the following:

Korean Conflict* (Total) 4,346,000 average age 26.9
(No service in World War II)

3,503,000 average age 25.2
World War II*......... 15,391,000 average age 36.7
morld Warl.......... 3,105,000 average age 61.8
Spanish-American War. . 68,000 average age 78.6
156 average age 88.3

* Includes 843,000 veterans who served in World War II and Korean
ict.

The largest number of veterans is in the age group
30-34 years—nearly 5,000,000. The next largest num-
ber is in the 25-29 age group—approximately 4,600,-
000. Thus nearly one-half of the entire veteran popu-
lation of the United States is in the 25-34 age group,
which will give you, doctor, some concept of the
Mature and extent of dental care that this substantial
segment of the total civilian population may require
from here on.

In this connection it may be pertinent to point out
that VA dental officials report that approximately
80 percent of all VA patients examined in the in-
patient program have some oral abnormality and /or
manifestation of some disease. One official reports,

At the VA Hospital, Houston, Texas: oral hygiene care in the ward; dental service for a tuberculous patient; and bedside dental care.

“Dental treatment is prescribed for about 67 percent
of those patients examined, and approximately 65
percent of the treatment prescribed is considered to
have a direct and material bearing on the treatment
of the condition for which hospital care is required.
The magnitude of these needs may be emphasized
when one considers the fact that about 572,000 pa-
tients received hospital care during fiscal year 1955,
of which number approximately 41,000 were being
treated for tuberculosis and 109,000 for psychiatric
and neurological disorders; the balance of 422,000
being classified as general medical and surgical.”

The potential for service of the VA dental pro-
gram is obviously a great one. And the forces that
press for such services are numerous and powerful.

The increase in the veteran population from ap-
proximately 4,000,000 prior to World War II to
more than 22,000,000 today has made necessary an
increase in VA facilities since 1942 from 94, including
hospitals, domiciliaries, and outpatient clinics, to its
present 224 similar facilities.

“In appreciation of the service rendered in de-
fense of the country, a grateful nation, through its
Congress, has established these VA facilities for care
and treatment of its veterans,” a spokesman states.
“The primary objective is to return veterans with
service-incurred disabilities to their communities as
useful, self-sustaining individuals. Continuing care
must be provided for veterans who acquired dis-
abilities requiring long-term hospitalization.”

Hospitalization and outpatient treatment may be
afforded veterans whose disabilities requiring treat-
ment have been determined to be service-incurred.
Hospitalization may be provided for veterans with
non-service connected disabilities only if beds are
available and the veteran swears or affirms he is un-
able to provide for his treatment at a private hospi-
tal. There are further restrictions on the furnishing
of outpatient dental treatment, even though the con-
dition is service-connected. These will be discussed
in another article in this series.

Page Fifteen

September 1956 ve A

| B= | >=

CEC September 1956

Of special significance is that dental treatment as a
separate benefit for veterans has been specifically
authorized by federal statute for more than thirty
years, and in the VA dental care and medical care
have a parity status. The wartime veteran was orien-
ted in the need for medical and dental attention and
care while in the armed services. The peacetime
veteran is receiving an equivalent orientation. (How-
ever, the latter is not eligible for VA dental care
unless he has been discharged for disability or is in
receipt of compensation for a service-connected dis-
ability.) This exposure to extensive medical and
dental care and other health education acquired dur-
ing service in the armed forces has been responsible
for a greater appreciation of such health services by
many ex-service men and women. They expect and
demand that VA dental services be of the highest
standards.

Veterans organizations are likewise alert in pro-
tecting and promoting the standards of dental and
other health programs of the VA.

The policy of the Chief Medical Director of the
VA, Doctor William S. Middleton, is that “services
rendered veterans by VA medical personnel must be
of high quality. The dental staffs, like all other
elements of the Department of Medicine and Sur-
gery, are dedicated to carrying out this policy.”

These, then, are some of the factors, potential and
actual, that will help to fashion the public dental
program for veterans in the years ahead—these fac-

tors and, of course, the shifting economic, political,
and social climate of the nation. As a responsible
member of society, as a member of a health pro-
fession, and perhaps as a veteran yourself, you, doc-
tor, will be interested in learning more about the
activities of your professional colleagues in the Vet-
erans Administration. We shall, therefore, follow
this article with others in the months to come.

A NEW CLINIC—A patient is treated in the newly remodeled
orthodontic clinic at Northwestern University dental school.
The clinic is the first one completed in a major $275,000
expansion of clinic and research facilities. Also under way:
two new clinics, one designed especially for treatment of
handicapped children, and extensive remodeling of two re-
search laboratories. (Photo, Vories Fisher)

ADMINISTRATOR
of
Veterans Administration
i
DEPARTMENT OF DEPARTMENT OF DEPARTMENT OF

VETERANS BENEFITS MEDICINE & SURGERY INSURANCE
Chief Benefits Director Chief Medical Director Chief Insurance Director

r
Assistant Chief
Medical Director

for Planning

]
Controller
Department of
Medicine & Surgery

Assistant Chief Assistant Chief
Medical Director Assistont Chief Medical Director
for Dentistry Medical Director for Research & Education
for Operations
T
1
Area Medical Office
Area Medical Director
i i
Outpatient dental care . Dental care provided to
provided by 90 VA clinics ang resident disabled
or by private "fee-basis" in 173 VA hoenitels veterans by clinics
dentists P in 17 VA domiciliaries

Page Sixteen

:
|
|

-TICONIUM.

Bite-raising appliances require com-
plete accuracy. The simple Ticonium
technique insures this accuracy through

proper burnout of wax. Not only is
the wax eliminated, but the mold
expands just enough to allow for
the shrinkage which takes place
when a Ticonium casting cools.
Controlled expansion helps pro-
duce accurate, lightweight bite-rais-
ing appliances every time.

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CEC
413 North Pearl Street, Albany 1, N. Y.

Form 3547 R ste:

»quested
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Ob CF I
ANN ARE TQ

BULK RATE
Postage

PAID

ALBANY. N.Y,
Permit No. 1648

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Full text of "Tic 1956-09: Vol 15 Iss 9"

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