Thinking the Unthinkable

I write this column just 3 days after the World Trade Center has tumbled to the ground. Following the shock and revulsion about the hijackings, a sense of the enormity of the consequences of these actions is just beginning to set in. We are forced to ask ourselves how such desperate acts can be contemplated and we watch nervously as we brace for the aftershocks.

Like many Canadians, I have family who live and work in Manhattan, bringing the tragic events very close to home. Once I established that these family members were safe, some other unpredictable effects of the tragedies surfaced. With the grounding of all aircraft in North America for a number of days, it became impossible for CDA to run the scheduled meeting of its board of governors. While we had initially hoped to delay the gathering by a day and run a shortened meeting, events overtook us and we had to defer it to a later date.

Because of this cancellation, the installation of Dr. George Sweetnam as CDA president was also deferred. The board meeting has been rescheduled to November 16 and 17, with Dr. Sweetnam’s installation now scheduled for November 16. Dr. Burton Conrod remains as CDA president until November. As a consequence of these unpredictable events, we are not running a president’s column in this edition of the JCDA. We are, however, publishing the scheduled profile of the incoming president in the pages following this column.

Shocked by the proximity and scale of these disasters, CDA has indicated in a letter to the Prime Minister and another to our colleagues at the American Dental Association (ADA) that Canadian dentistry is willing to be of assistance to our neighbours, if required. We can only imagine the enormity of the task of identifying victims of these events, given the traumatic fashion in which death came about. At times like this, we are reminded of the invaluable role of forensic dentists and our responsibility to maintain excellent dental records.

Canada has developed an impressive capacity in the discipline of forensic dentistry in recent years, and the events of September 11 are evidence that we can never predict when any of us will be called on to assist in identifying disaster victims. Be prepared for the unthinkable is the message I take from this set of events.

Yet we continue to plan for the future, on the assumption that we can mould our environment if we act in a coordinated manner. That is one of the central assumptions underpinning the ADA’s Future of Dentistry report, which arrived on my desk the day before the dramatic events in the eastern U.S. Our American colleagues have produced a very comprehensive document which examines the major trends affecting the U.S. dental profession, attempts to envisage what is going to happen in future, and makes recommendations for the strategic positioning of the profession over the next 15 years or so.

The first recommendation in the report indicates that there is a need for comprehensive studies into the capacity of the dental workforce to meet the needs of the population in the years ahead. This issue is also being studied in Canada. The Oral Health Care Human Resources Study is currently being conducted by Human Resources Development Canada (HRDC) in conjunction with CDA and the national associations representing dental hygienists, dental assistants, denturists and dental technologists.

Given that this edition of the JCDA is devoted to prosthodontics, it is interesting to note that there is a major shortage of dental technologists reported to be on the horizon in North America. It is safe to say that dentists providing prosthodontic services depend greatly on the skills of laboratory-based team members. At this stage, it is anyone’s guess whether we will have enough technologists or other members of the dental team in the years ahead.

The study with HRDC is meant to create a scientific basis for future dental human resources decisions. Given the disparity of views on this topic that we have published in recent months, we certainly need better information for planning dental human resources. Yet we all know what can happen to the best-laid plans.

John O’Keefe
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