"Green" Dentistry vs "The Law of Unintended Consequences" - Elite Dental Care TN | Elite Dental Care TN
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“Green” Dentistry vs “The Law of Unintended Consequences”

For years people have been concerned about the way humans pollute our own environment. The concern is not only here in the US, it is also in Europe where the “Green Party” has sprung up in several countries and influenced politics in the respective countries. In Germany the push has been rather strong and the Greens were able to push through some legislation that rewarded Germany’s renowned car manufacturers to use biodegradable insulation in their electrical systems. Though the insulation worked quite well in the cooler climate in Germany, in southern climates the biodegrable insulation did just that… it degraded. Thus the infamous “Law of Unintended Consequences” was fully evident and caused cars like Mercedes Benz and BMW, etc to encounter millions and millions in replacement costs and loss of their long-standing reputation for superb engineering. It didn’t take Mercedes long to realize what was occurring and switch back to more permanent insulation and see their reputation restored. They are now making exceptional cars again.

I want to discuss a situation that was reported by the ADA news on Nov 15th. First, I actually Googled the “Law of Unintended Consequences” to find out who was the first to describe the phenomenon. There appears to be some debate who first described it, but several people started describing the components of the “Law”. The first and most complete analysis of the concept of unintended consequences was done in 1936 by the American sociologist Robert K. Merton. In an influential article titled “The Unanticipated Consequences of Purposive Social Action,” Merton identified five sources of unanticipated consequences. The first two—and the most pervasive—were “ignorance” and “error.”
Merton labeled the third source the “imperious immediacy of interest.” By that he was referring to instances in which someone wants the intended consequence of an action so much that he purposefully chooses to ignore any unintended effects. (That type of willful ignorance is very different from true ignorance.) The Food and Drug Administration, for example, creates enormously destructive unintended consequences with its regulation of pharmaceutical drugs. By requiring that drugs be not only safe but efficacious for a particular use, as it has done since 1962, the FDA has slowed down by years the introduction of each drug. An unintended consequence is that many people die or suffer who would have been able to live or thrive. This consequence, however, has been so well documented that the regulators and legislators now foresee it but accept it.

“Basic values” was Merton’s fourth source of unintended consequences. The Protestant ethic of hard work and asceticism, he wrote, “paradoxically leads to its own decline through the accumulation of wealth and possessions.” His final case was the “self-defeating prediction.” Here he was referring to the instances when the public prediction of a social development proves false precisely because the prediction changes the course of history. For example, the warnings earlier in this century that population growth would lead to mass starvation helped spur scientific breakthroughs in agricultural productivity that have since made it unlikely that the gloomy prophecy will come true.
Merton later developed the flip side of this idea, coining the phrase “the self-fulfilling prophecy.” In a footnote to the 1936 article, he vowed to write a book devoted to the history and analysis of unanticipated consequences. Although Merton worked on the book over the next sixty years, it remained uncompleted when he died in 2003 at age ninety-two.

The law of unintended consequences provides the basis for many criticisms of government programs. As the critics see it, unintended consequences can add so much to the costs of some programs that they make the programs unwise even if they achieve their stated goals. This is the topic I want to discuss now related to dental health.
As noted above, the ADA News reported that a city in California has started to try to ban Dental Amalgam from the city. While this may sound like a good idea to “eliminate ” mercury from the city, it presents other problems. If Costa Mesa were to do this ban, if would then remove an inexpensive, valuable restorative material from use in their city. Who would this hurt…. the poorer people who live there and get dental treatment there. Amalgam has been used for well over 100 years with few if any true documented injuries to any patients.
The effects of the “Law” are several, but I will discuss two today. First, unintended consequence is that, if the city of Costa Mesa were to ban amalgam, that would necessitate that all restorations placed would be tooth-colored composite restorations or expensive veneers or crowns. Composites are, on average, about 20% more expensive to place because they require more chair-time. They are slightly more susceptible to wear so they have to be replaced more frequently. They also contain a chemical, BPA, which is a component which is under scrutiny by the FDA for showing signs of being an Estrogen analog. If long-term exposure to it is proven to cause hormonal changes, even in men, one could forsee a time when it too could be banned by the FDA and no restorative material would be allowed to the detriment of ALL of US.
Secondly, if Costa Mesa bans amalgam due to the mercury, what will they do with the mercury in new CFBs (compact flourescent bulbs) that peolple are starting to use more frequently now. These new bulbs have a significant amount of mercury in them and require special handling in the landfills due to this fact.

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