From 2013_05-27 MIPD, 2016_05-23 How and why to sue your dentist
2022_02-18 How and why to sue your dentist
J TIM RAINEY, D.D.S.
SCIENTIFIC RESEARCH IN MINIMALLY INVASIVE PREVENTIVE DENTISTRY™
These opinions are my opinions formed over my fifty years of private practice. These opinions are protected by our first amendment rights. If you have a different opinion, you are welcome to share that opinion at your own risk, and are warned that any effort to silence me will be met with fierce resistance.
More than forty years ago, in 1977, I set out intentionally to reinvent dentistry. I knew dentistry was as best described as a trade since there was absolutely no scientific justification in the techniques we were taught during dental school. One of the better known pioneers in dentistry, Dr. G. V. Black, had proposed a technique in operative dentistry based on the circumstances of the 1890’s referred to as “Extension for Prevention” which was at least in part justified at the time assuming the total lack of oral hygiene. Our unscientific curriculum revolved around the unscientific theories of GV Black. Unfortunately, although completely debunked, these theories are still in play today. (Black GV. The management of enamel margins. Dental Cosmos 33:85-100, 1891 Black, G.V. Operative Dentistry. Vol. I Henry Kimpton, London. 7th Ed, p32, 1924 ; Black GV. Lectures on operative dentistry and bacteriology. Chicago: Blakeloe Printing Co.; 1899)
Sigurjons, H Extension for Prevention “Historical development and current status of G.V. Black’s concept.” Operative Dentistry 8(2):57-63, 1983); Tyas MJ, Anusavice KJ, Frencken JE, Mount GJ. Minimal intervention dentistry--a review. FDI Commission Project 1-97. Int Dent J 2000 Feb;50(1):1-12
What if you discovered that organized dentistry had been presented a low cost, effective method for stopping 80% of all decay more than three and a half decades ago? What if organized dentistry did everything possible to ignore the implementation of that finding? What if the dental schools did everything possible to ignore the implementation of that technology? What if the dental schools refused to instruct dental students about simple anatomy and physiology details essential to learning how to be a dentist?
The genesis of 80% of all dental procedures being conducted today has to do with repair of previous dental procedures with a nearly guaranteed future of built in failure due to the microfracturing caused by the high speed drill (Go to :You Tube: paste this URL: https://youtu.be/arfCxvViD1U) and replacement of human tooth structure by the now discredited and obsolete Silver Mercury Amalgam fillings. Silver Mercury Amalgam fillings expand and contract at a different rate than the porcelain like structure of enamel, contributing to the eventual failure of the tooth-filling unit. Because of the technique sensitivity involved with placing composite “plastic” fillings, the failure rate of composites has rivaled Amalgam fillings over the years. In 1985, I introduced a scientifically based procedure to the world that avoided the liability of the high speed drill, Silver Mercury Amalgam and other inferior restorative materials, potentially eliminating 80% of all future dentistry in patients. We still see these now 35 yo or so composite/GIC restorations that were placed according to the science on a weekly basis in our patients. This procedure eliminated the threat of recurrent decay from the microfracturing of enamel, and the revolving door of “drill, fill, and bill” replacement of restorations that were doomed from the start because of the incompatibility of the high speed drill with enamel and the Silver Mercury Amalgam fillings used to fill teeth and replace enamel.
Over the following decades, more and more scientific evidence has accumulated in the peer reviewed literature that supports Minimally Invasive Preventive Dentistry™, a procedure so effective that it can be warranted for the professional lifetime of the provider (as documented in the peer reviewed literature). Hundreds of licensed dental professionals have been taught how to provide this inexpensive, painless, and otherwise little known procedure, and the infrastructure exists to teach and certify any licensed dental professional in this extremely effective procedure of Minimally Invasive Preventive Dentistry™ that may eliminate the need for 80% of all future dentistry in any properly treated patient.
This is a series reflecting how change for the better of the public can be initiated. All of the above is true and provable: despite gains in understanding how to stop the initial decay in teeth, going beyond the 50-year-old technology of plastic sealants, our second opinions are free, and we will take meticulous steps to include you and your loved ones in our diagnostic procedures with you seeing what we see on our big screen TV’s. The most expensive dentistry is dentistry you don't need. If your radar goes off and you suspect that you are being “sold” procedures you don’t need, especially crowns and root canals, trust your instincts. Come see us or other dentists certified in MIPD™.
The most common indicator for recommendations for needing dental work is seeing a new dentist! Dentists are being taught how to “Sell” dentistry, with little emphasis on prevention. This is reflected in the fact that the majority of “Continuing Education” being attended by dentistry best falls under the heading of “Practice Management”. The vast majority of dentistry being done today is also an indictment of the sordid current state of dentistry, with more than 80% of dentists’ time being spent to “fix” previous dentistry!
Again, the best dentistry is NO DENTISTRY, a reoccurring theme you will see throughout our articles. And think about this fact: We did present a reliable, easy-to-implement procedure designed to replace “Sealants” to the profession nearly FOUR DECADES ago. If dentistry had implemented this technology, 80% of CURRENT dentistry being proposed to the now forty-five year old and younger dental patients would likely have been eliminated. This would also have drastically affected the need for training current dentists, and would eliminate thousands of jobs related to dental education and the hundreds of millions dollars being spent educating dentists. The savings to patients and taxpayers regarding dentistry that could have been avoided is now in the TRILLIONS!.
How successfully did the dental schools and organized dentistry block implementation of this nearly forty year old technology? In the late 1990'sand early 2000's, we shared ALL of our teaching aids and technology with both University of Texas Dental Schools. The schools have completely dismantled and discarded this information. In 1996 we began to publish startling new information related to the physiology and morphology of teeth, and have unselfishly shared ALL teaching aids related to this now nearly forty year old information. This information has completely been ignored by organized dentistry, and dental schools continue to teach from drawings originating in the 1700’s that are just plain wrong.
Why can’t dental schools teach modern, scientifically based dentistry? Other than the obvious assumptions regarding the fact that the old, entrenched dentists in charge would have to adapt new technology and write new curriculum, there has been a predictable stonewalling by the Texas State Board of Dental Examiners and the Texas Dental schools. Go to “Articles”, and down load the “Open Records Requests”. It will take some intense reading to understand the depth of the depravity. One of the most egregious offenses is documented in how the Texas State Board of Dental Examiners defended their indefensible position. Regardless that extensive mutilation of teeth to accommodate amalgam filling materials was discredited in the 1930s, organized dentistry has continued to embrace the dogma proposed in 1891 (that’s not a misprint: 1891!)
The TSBDE continues to this day to support that disproven dogma, and the Texas dental universities refuse to protect their scientific research supporting conservative restorations. This easily leads to another obvious question: “If the Universities can’t teach according to the scientific evidence and the TSBDE can’t set modern standards for licensure, what do we need these organizations for? Time to defund these bureaucracies. Follow the “string” in the “Open Records Requests”. As a testament to the continuing collusion against the interests of the dental patient, it is important to note that most requests were stonewalled, violating Texas law.
These are very complex subjects that are difficult to address in a written media. For a better understanding, go to our website and download our interviews that have been broadcast over the internet. is also presents another problem for "traditional" dentistry: this information was made widely available.
How can the public implement change? Inform and consent. Professionals in health care are ethically, legally, and morally REQUIRED to provide information regarding available procedures. This means that telling a parent that sealants have a 50% failure rate while hiding an alternative procedure that approaches 100% success in stopping future decay is not an option. If sealants are recommended, then peer reviewed, alternative procedures must be offered. We also have never seen the predators who must fill their appointment books at the expense of the patient’s health and safety that general anesthesia has been associated with “brain dysfunction” in adolescents (read: Children) nor that steroids can stop growth and shorten stature. (See: Articles: Brain Dysfunction Informed Consent).
How egregious are these intentional omissions? We are now averaging many “rescue” kids a year. Kids whom the pediatric dentists have recommended general anesthesia that we successfully treat with NO anesthesia. You can see a typical “rescue” of a child by visiting our website and clicking on “Videos”. Also, as is typical of these “second opinions”, Stainless Steel crowns were prescribed for teeth that had no decay and have not decayed in the years since we first treated this child. (Go to : You Tube: Paste this url: https://youtu.be/aJwmf36ikiI)
The lack of Inform and Consent is typical in dentistry. We have treated two patients who had gone to the University of Texas Health Science Center Dental School who adamantly refused amalgam fillings. Despite massive, massive evidence that amalgam and associated techniques are extremely damaging to teeth, these patients were ridiculed by the staff and had amalgam placed in their teeth despite their requests.
This is how to eliminate 80% of all future dentistry:
These principles apply to dental care from the time that permanent teeth erupt. The principles are very simple, and are taught in the first 30 minutes of our courses that have been taught world wide. These principles are so simple that even the casual lay person observer “gets it”.
First, as eluded to in the prologue, the dentist MUST understand both the anatomy and physiology of the teeth entrusted in their care. The genesis of the majority of decay is in the quirks of development of human teeth. Unlike the sharp, pointed spikes that represent our reptilian ancestors, as mammals evolved, so did their teeth to adapt to different tasks other than seizing prey, ripping off pieces, and swallowing whole. As we split off with our cousins, the primates, and evolved into Homo Sapiens, so did our teeth. The individual spikes that represent our reptilian ancestors’ teeth, the spikes tended to drift together to form the back teeth that literally look like clouds running together to form the four main cusps of the back molar teeth, and the two cusps of the bicuspids. The anterior teeth also adapted to our changing diet and habit, and in primates, evolved into shapes that were better adapted to our omnivorous diet.
There was no need in our evolutionary future for these melding cusps to become completely fused like in other mammals, and we developed a pit, fissure, and groove system because of the lack of need for complete fusions, with another possibility of these systems providing support and stress release during heavy function. Therein lay a weak point that left teeth susceptible to the disease "caries" or decay, when decay promoting carbohydrates became a common part of our diet beginning in the late 1500’s to today. When introduced to the open pit, fissure, and groove system, any pit, fissure, or groove joining the main cusps that were faultily mineralized and poorly fused became a convenient cauldron for a microbial soup.
When fueled by the carbohydrates in our modern diets, this soup tends to promote the growth of the group of microbes that do very well in the presence of acid. In an acidic environment, a good percentage of the pathogens occupying these otherwise harmless defects in the chewing surfaces of teeth produce more acid which promotes the removal of the major building blocks of enamel, Calcium and Phosphate ions (decay). Other microbes that proliferate in an acidic environment also excrete enzymes that are essential to the breakdown of the collagenous tissues and proceed to break down the dentin that supports the overlying enamel. The acidic cauldron containing pathogens fueled by carbohydrates will eventually and literally eat away the tooth host, resulting in a cavitation commonly referred to as a “cavity” in lay person’s terms.
How important is the continued ingestion of carbohydrates to the “decay” (technical term for the disease of “decay” is caries) of teeth? Upon death, obviously there is a cessation of carbohydrates fueling the disease of caries, and the entire structure of the body begins to “decay” as the microbes begin the process of breaking down the dead tissues. With the exception of the teeth. The decay of teeth is so dependent on a continued nourishment by carbohydrates that months, years, decades, centuries, and millennia later, often the only remaining trace of a previous living creature are teeth! Decay in teeth is situationally and diet supported.
Now we have described the weakness in teeth that leads to the disease of “caries” in living humans. First, the naturally occurring defects in the pit, fissure, and groove system of the teeth must be defective and large enough to support the soup that fuels the cauldron supporting the microbes that are now literally eating the teeth! Second, fuel the cauldron with carbohydrates!
The logical and scientific method of preventing decay is now available through the principles of Minimally Invasive Preventive Dentistry™. 80% of all future decay can be eliminated by identifying the unsound pit, fissures and grooves in the posterior teeth, and eliminating access to the pit fissure and groove systems. That is logic and common sense, and is not part of the curriculum of Dental Universities! Target the unsound pit, fissures, and groves, remove the starting point of decay!
These universities and associated dental schools insist on continuing to teach the inferior method of applying sealants!!!
Dentistry has been unduly focused on sugar as the culprit behind decay. I will point out that although eliminating fermentable carbohydrates in the diet starting with sugars may be a good idea, it is simply impracticable in today’s world. Eliminating access by fermentable carbohydrates to the pit, fissure, and groove system is easy and practicable.
These are the principles of Minimally Invasive Preventive Dentistry™:
1. Identify the UNSOUND pit, fissure, and groves in the chewing surface of posterior teeth.
2. SELECTIVELY remove the unstable contents of the pit, fissure, and grove system with air abrasion, utilizing a miniature sand blaster.
3. Fill with a material that will last for decades, bonds to the remaining stable tooth structure, and inhibits microbial growth within a millimeter.
How to clean teeth effectively.
1. Alter the resting pH from acidic to basic with Baking soda
2. Break up and remove the plaque accumulating along the gumlines with an ultrasonic brush
3. Break up and remove the plaque in-between teeth with interproximal bushes
The ”How” of the how and why to sue your dentist is to first understand the basics of the above.
The “Why” in the “how and why to sue your dentist.
It is important in the “Why” to note that the healthy and sound tooth structure has NOT been compromised in any way utilizing principles of Minimally invasive Preventive DEntistry™ since only unsound tooth structure was removed. The tooth is at least as strong as it was before the procedure.
It is important in the “Why” to note that since live, healthy dentin is not indiscriminately cut as when the tooth is literally gutted by a high speed drill, there is NO pain and NO need for anesthesia in otherwise normal and healthy teeth that are in the process of eruption. This procedure, when properly applied, will eliminate the vast majority of the 10% of victims of otherwise unnecessary anesthesia who become dental phobic because of the needle and drill. The Why? If you were not offered during the inform and consent part of the treatment plan the option of MIPD, you or your children have most likely been assaulted, in my opinion. What course of treatment is not an option for the dentist to decide.
It is important in the “Why” to note that from the introduction of the high speed drill in the early 1950’s it was immediately documented that the high speed drill is incompatible with the porcelain like structure of tooth enamel. This was proven by high speed videography. The microfracturing of enamel was one of the first videos shown to my freshman class. It is commonly known, and commonly overlooked. Microfracturing is a Dead Elephant in the living room of dentistry.
It is important in the “Why” to note that the subsequent filling of the gutted tooth with a material long known to be incompatible, Dental Silver Mercury Amalgam, with the porcelain like structure of enamel (because of the similarity of enamel to porcelain. The building blocks of both porcelain and enamel is a mix of Calcium and Phosphate.) Porcelain and enamel both are good insulators, slow to expand and contract, while Silver and Mercury are both very good conductors of heat and cold and expand and contract rapidly. The rapid expansion and contraction due to heat and cold of these elements eventually exacerbates the fractures in enamel caused by the high speed drill.
The incompatibility of Amalgam and tooth enamel is taught in every single dental school in the prerequisite dental materials courses. In the myriads of excuses offered for the continued teaching of the gutting of teeth to accommodate the idiosyncrasies of Amalgam filling material, the American Dental Association stands in the shadows, having defended the use of the draconian and antiquated methods associated with Amalgam fillings.
It is important to note that people with healthy mouths and healthy teeth simply live longer. Filling a tooth with Dental Silver Mercury Amalgam is often a death sentence for that tooth. Infected teeth adversely suppress the immune system of the patient, and leaves the patient open for diseases that can lead to death.
It is, and always has been that the ADA has stood in the way of progress because of the need to defend the defective material just like any other corporation that has been humbled by the discovery of otherwise defective and fatal flaws in their product. (RE: Firestone and defective tires. Chevrolet with a less-than-one dollar fix for a defective ignition switch. Ford by not widening the production line to accommodate newer models, a decision that added a fatal flaw of a too narrow wheel base that contributed to fatal roll overs.) And the list goes on, including the ADA which was, in my opinion, defending a defective material because the ADA owned patents on Amalgam and made the defenseless decision to continue to defend the draconian. traumatic, and life threatening use of Amalgam instead of admitting to a mistake and correcting that mistake, along with, in my opinion, their partners in crime, the Dental Universities.
The smoking gun:
1. United States Patent 4,018,600. Waterstrat April 19, 1977. Method for eliminating gamma.sub.2 phase from dental amalgam and improved dental amalgam composition. Inventors: Waterstrat, Richard M. (Gaithersburg, MD). The assignee is American Dental Association Health Foundation (Chicago, IL). Appl. No.; 617,594. Filed September 29, 1975.
2. United States Patent 4,078,921. Waterstrat March 14, 1978. Method for eliminating gamma.sub.2 phase from dental amalgam and improved dental amalgam composition. Inventors: Waterstrat, Richard M. (Gaithersburg, MD). The assignee is American Dental Association Health Foundation (Washington, DC). Appl. No.; 713,849. Filed August 12, 1976.
Dental schools and dentists, particularly the pedodontists, have a myriad of excuses regarding why they won’t provide this effective preventive procedure. My answer to “it’s too hard to do” (is that REALLY a viable reason/excuse?) is to please explain the picture of my hygienist and chairside assistant providing this life saving procedure off the back end of a banana plantation loading dock in the Dominican Republic. End of argument.
Dentistry was introduced to the flawed idea of “sealants” five decades ago. Etch the chewing surface of a tooth and take an oil based material and slop it over the surface in a wet environment. That works so well that there have been innumerable revisions and formulations since I first challenged the procedure in the late 80’s as being hopelessly flawed. If it was reliable, why were there revisions? I first challenged the premise that sealants were permanent as first promoted. Then the profession recommended “replenishing” every five years, which was a disaster. Then instead of adopting and endorsing the procedure outlined above, the profession moved to recommending “replenishing” sealants every three years, recognizing that sealants were flawed. This is malpractice, in my opinion, when Inform and Consent has been circumvented.
The ”How” of the how and why to sue your dentist 1. Understand the basics of the above.
Many other revisions have been added, including resurrecting the now 100 year old technique of “odontotomy”, wiping out the pit fissure and groove system with a rotary bur, which requires anesthesia and a rubber dam to be effective (1920’s (Hyatt TP: Prophylactic Odontonomy: the cutting into the tooth for the prevention of disease. Dent Cosmos 1923:65:234-241.) If the patient was traumatized by needless anesthesia and the rubber dam, this is, in my opinion, assault. The initial etch and slop system has now been replaced with a recommendation including six separate steps. If the procedure is so effective, then why is it necessary to keep adding steps and “replenish” every three years when it can be done with a permanent, two step procedure that can be done WITHOUT the trauma of ANESTHESIA and in a wet environment? By the rules of Inform and Consent, substituting an inferior system without referring the patient to a dentist competent in MIPD is in my opinion, malpractice.
The ”Why” in How and why to sue your dentist”.
All professions involved in treating the individual person are held to a common standard called “Inform and Consent”. We are obligated to inform the patient of any reasonable, peer reviewed procedure. We CANNOT ethically, morally, and legally make a decision without first informing the patient of alternative procedures and briefly discussing those procedures before obtaining CONSENT to proceed.
One vivid example of the principles of Inform and Consent being violated by the arrogance of a medical staff was when I personally intervened in the ”standard operating procedure” of the staff of a major hospital in South Texas. When a relative needed gall bladder surgery, I asked about laparoscopic surgery. The excuse and answer of why laparoscopic surgery was not being offered was that it is not in our protocol “Since we are the senior physicians, we get first choice. We senior surgeons of the staff haven’t taken any of the training courses in laparoscopic surgery although some of the younger surgeons have. So laparoscopic surgery is not in our protocol.” I gave them 12 hours to call an emergency staff meeting and make laparoscopic surgery part of their protocol. They did.
Dentistry is now in the exact same position as those hapless surgeons were in the 1980’s when confronted by a very angry young dentist. Since the initial introduction of Minimally Invasive Preventive Dentistry™ in 1985, yes, more than 3 and a half decades ago, dentists in the developed world had numerous opportunities to adopt and practice the now proven principles of Minimally Invasive Preventive Dentistry™. What has NOT changed since the Hippocratic oath was first introduced 2500 years ago is Inform and Consent!
In my opinion, if you are within that age range that should have benefited when MIPD™ first appeared in the published literature in 1985, (born around 1975) you have three clearly defined targets for the damage and insult of not providing you or your parents with the choice of MIPD™ over sealants and/or Amalgam fillings.
1. The American Dental Association
2. In my opinion, the ADA’s partners in crime, the dental schools.
3. Your dentist (dentists) who made the choice for YOU to keep providing antiquated and outdated procedures.
Amputation of extremities was the standard of care in the Civil War up to the early 1900’s. Amputation of sound tooth structure was proposed and accepted by dentistry as the standard of care in the 1890’s and is still promoted as the standard of care in the 2020’s!!!!
Dentistry will NOT CHANGE unless you, the patient force that change on this reluctant, self-serving, unprofessional, and antiquated trade of dentistry. This information regarding MIPD™ was widely available by the mid 1990’s. Treated according to the principles of MIPD™, you would have been spared the damage of traditional “Drill, Fill, and Bill” dentistry had your dentist kept up with change. If you think you, or more importantly, your child, has been damaged through treatment without being provided with an adequate “Inform and Consent”, my opinion is that you may want to talk it over with an attorney. (These rules concerning “Inform & Consent” were under ADA Section III, Code of Professional Conduct.A, and the similar TSBDE Rule 109.173 during the 1990’s and early 2000’s. As the rules are updated, they will be in new sections.)
My Regards to All Friends, Confusion to All Enemies. May God bless All
This and more opinion articles are available on the www.jtimrainey.com website. Dr. Rainey has lectured worldwide on these topics can be reached @ firstname.lastname@example.org or 361 526 4695. Dr. Rainey maintains a private practice in Refugio, Texas @ 606 Osage
. ADA section III, Code of Professional Conduct:
1.A Patient involvement. The dentist should inform the patient in the proposed treatment, and any reasonable alternatives in a manner that allows the patient to become involved in the treatment alternatives.