On the Instability of Amalgams
The symbiosis between the dental and industrial communities and their scientific journals
Articles
The symbiosis between the dental and industrial communities and their scientific journalsAuthor: Ulf Bengtsson
Original article
August 1st, 1993
Rev. April 3rd, 1994
Rev. April 9th, 1995
Contents of article
Abstract
Chart 1: Organizational amalgamation of the dental and industrial communities and their scientific journals.
Chart 2: Organizational amalgamation of the dental and industrial communities and their scientific journals. The US perspective.
In spite of the intense debate about amalgam and other dental materials in Scandinavia, USA and other countries, connections between the dental community and the manufacturers of dental materials has not been on the agenda. The industries strong urge for a positive image of their products and the dental professions strong defense of amalgam and other dental materials warrants such an investigation. True understanding of the defensive position of the dental community in the dental materials issue can not be reached without investigating the organizational amalgamation of the dental and industrial communities.
In order to get a reference in a closely related field the organizational connection between two international medical organizations and the pharmaceutical industry has been investigated.
Such connections could not be found in the case of the Council for International Organizations of Medical Sciences, CIOMS (1). However, through FDI World Dental Federation, a member of CIOMS, a link to the dental industry could be traced.
The World Medical Association, WMA, has no affiliate member organizations from the field of pharmaceutical industry (1, 10).
The organizational connection between scientific and industrial fields seems to be unique to the dental community.
It is obvious that there has got to be a sound co-operation between the industry being the provider of dental materials and the dental profession being the users of these materials. It is however equally obvious that an ethical debate on the organizational symbiosis between the dental and industrial communities has got to take place.
This report is not published in any scientific journal and therefore the reader is urged to return to the sources of information to confirm any quotation or statement made in this paper.
FDI World Dental Federation. (1, 3).
Exec dir: Dr Per Åke Zillén
Headquarters: 64 Wimpole Street, London W1M 8AL, UK.
Telephone: (44 71) 935 7852 to 7855.
Fax: 486 0183.Most countries have their own national dental association. 92 of these are members of the worlds largest dental organization, the FDI having a total of over 550.000 dentist members. The organization publishes two scientific journals: FDI Dental World and International Dental Journal.
The FDI has no less than 21 affiliate member organizations, the majority being associations for dental specialists. Four affiliate member organizations are of interest in this investigation. One of these is IADR, International Association for Dental Research. This association organizes most of the worlds dental researchers, see below.
The other three are:
ADDE, European Dental Dealers Association,
FIDE, Federation of the European Dental Industry, and
IDM, International Dental Manufacturers.
They are all described below.In other words: FDI, the head-organization of the worlds dentists also organizes both the manufacturers and dealers of dental materials.
In a leaflet from the FDI separate companies are invited to become an FDI Corporate Partner (2). The leaflet says that an increasingly important task for the FDI is to co-ordinate the world's expertise, to produce and disseminate policies and "state-of-the-art" consensus reports. The FDI states that: "Obviously, the Industry and the FDI have many of these interests, concerns and goals in common."
A corporate partnership brings a number of benefits to the company including invitation to Annual Partners' Meeting with FDI leaders.
FDI is in the process of changing the membership dues for the industrial sector. Ivar A Mjør, IADR's representative to the FDI says: "Special memberships for the Dental Industry have been suggested: silver, gold, and diamond memberships, ranging in price from £1000 to £10,000 per year." (3, page 1678).
IADR, International Association of Dental Research,
AADR, American Association of Dental Research. (1, 3).
Headquarters: 1111 14th Street NW, Suite 1000, Washington DC 20005, USA.
Telephone: (1 202) 898 1050.
Fax: 789 1033.IADR is organized in 22 divisions and sections, for example: AADR, American Association for Dental Research, SADR, Scandinavian Association for Dental Research and BSDR, British Society for Dental Research. It has a total of over 9.700 members and the biggest division by far is AADR having around 4.980. BSDR has 631 members. The influence of AADR is in fact so big that the organization is often referred to as IADR/AADR. The two organizations have the same executive director (14, page 1081) and a joint finance committee (14, page 1133).
The association publishes a number of scientific journals: Journal of Dental Research, Journal of Implant Dentistry, Program and Abstracts, Advances in Dental Research. The first one of these, J Dent Res, is regarded as the most distinguished scientific journal within the field of dentistry.
IADR is an affiliated member of the FDI. An FDI Programs Advisory Committee has been formed under the leadership of Prof. Ivar A Mjør, head of the Scandinavian Institute of Dental Materials, NIOM, in Haslum, Norway. The committee consisting of six members has been created to develop proposals of scientific programs for the annual meeting of the FDI.
IADR/AADR has not only individual scientists as members but also dental manufacturing companies including several of the worlds leading amalgam manufacturers (3, page 1742). Today AADR has at least 37 corporate members. IADR/AADR has even had one president from the industrial sector (15). The association has a very close co-operation with the industry indeed and is planning on deepening that collaboration (14, page 1132).
The industrial influence on scientific programs is substantial. Under the headline Planning Process for Future ICOB Meetingsis stated: "Following approval by the Board, the Committee Chair will form a small scientific committee, including the Executive Director and a Unilever representative, to plan the program" (3, page 1681). As a response to a proposal by two member countries of IADR it is stated: "Dr. Purdell-Lewis(representative of Unilever Research UK, my comment) was of the opinion that none of the proposals offered the type of program that the committee and the sponsoring agency had in mind, and he proposes further analysis by the committee to develop a program that will be highly successful." (3, page 1681). In the visiting lecturer program Unilever ¨ has been very active indeed both in financing and planning the program (14, page 1098).
Max A Listgarten, president of the AADR says: "An area that need immediate attention is that of cooperative ventures with Industry. It is clear that, despite the generous financial support of Industry in the past, there is a perception within Industry of a lack of communication between our Association and the industrial community. A number of possibilities exist to improve our relationship. The AADR/IADR could identify spokespersons to discuss, in a suitable form, timely scientific issues of interest to Industry and the private sector. The Association could sponsor consensus conferences on relevant scientific issues. Qualified researchers from Industry should be encouraged to participate in the activities of IADR/AADR Committees. Industry could assist our Association in fulfilling its aims by expanding their financial support for fellowships, sponsoring conferences and symposia, and supporting a science communication staff person in the Central Office. There is also a need to facilitate the participation of Universities in the testing of new equipment and products. This can be achieved in part by Industry making such products and equipment available to university-based researchers for independent testing and studies. This is by no means a comprehensive listing of potential areas of interaction. We hope to meet with Industry representatives in the next few months to explore means of implementing some of these and possibly other initiatives that may be of mutual benefit."> (3, page 1706-7).
In the proceedings of IADR's Council Meeting it is said under the heading Science Communication (3, page 1695): "The IADR/AADR have commenced discussion with industry on obtaining support for an in-house staff person to develop improved science communications with media, public, and industry".
IADR has a Committee on Ethics in Dental Research preparing a Code of Ethics. Even in this work the industry has been represented; Dr DJ Purdell-Lewis from Unilever Research, UK (3, page 1677). At least one of the meetings has been financed by the industry (14, page 1095). The industry is also very active in sponsoring IADR/AADR with travel and research awards.
Strong links exist between AADR, AADS and ADA (13, page 1197, 1176). AADR's National Affairs Committee (NAC) works with AADS and ADA to promote dentistry's message to Congress (13, page 1201). NAC is financed by the institutional section (industry and schools) with AADR (14, page 1156; 3, page 1712). NAC is also operating a "cohort letter-writing program" (13, page 1201). A number of key-persons in research, education and industry can be called upon to write, fax, call or visit decision makers in order to provide a strong unified message on dental issues.
AADS, American Association of Dental Schools. (4).
1625 Massachusetts Ave. NW
Washington, DC 20036Founded in 1923 and has 3600 members primarily from schools of dentistry in US, Canada and Puerto Rico. Organizes LAC, Legislative Advisory Committee (13, page 1201).
Strong links exist between AADR, AADS and ADA (13, pages 1197, 1176). AADR's NAC, National Affair Committee has held joint workshops with AADS's LAC to formulate areas of future co-operation between the organizations with regard to advocating dental research and education issues before Congress (13, page 1201).
ADA, American Dental Association. (11).
Headquarters: 211 East Chicago Avenue, Chicago, IL 60611
Telephone: (312) 440-2500The national association for dentists in the US was founded in 1859. Its 140,000 members are organized into 55 state societies (constituent) and 520 local societies (component). The association produces most of the dental health education material used in the U.S. Eleven councils address various issues of interest to the Association. The ADA publishes three main periodicals for the profession: The Journal of the American Dental Association, its premier monthly scientific journal; the ADA News, a newspaper published 22 times a year; and Dental Teamwork, the magazine for hygienists and dental assistants published bimonthly. Politically active through American Dental Political Action Committee. The ADA's Council on Scientific Affairs is a member of AADR (3, page 1742).
ADA has economic interests in the dental materials business (15). In the mid-1960s, the ADA established the ADA Health Foundation. ADAHF as a non-profit subsidiary devoted to education and research (16). Most of the ADAHF scientists work at the Paffenbarger Research Center, PRC, located at the campus of the National Institute of Standards and Technology, NIST, in Gaithersburg, Maryland.
The research at PRC is partly funded by NIH grants and partly by license fees from industries manufacturing the new products developed at the PRC. The list of products from PRC/NIST includes calcium phosphate cements, dental adhesives and glassceramic inserts (17). ADA began a collaborative agreement with the federal government in 1928 with a lot of inventions including the spherical alloys for dental amalgam invented by an ADA research associate (17, 19, 20).
The ADA is also active in developing specification tests for dental instruments, equipment (18). Using these tests, the ADA evaluates dental materials, devices and equipment. Also, the Associate evaluates therapeutic products useful for the dental profession and the public. Some of these products tested may in fact be developed by ADA/PRC and manufactured by the dental industry under license agreement with PRC (16, 17, 18).
SADR, Scandinavian Association for Dental Research. (1).
Secretary general: Dr Knut A Selvig
University of Bergen, School of Dentistry, Aarstadveien 17
N-5009 Bergen, Norway
Telephone: (47 5) 29 48 60.
Fax: 29 49 70.Founded in 1866 in Stockholm. Scandinavian sector of IADR.
SDA, Swedish Dental Association.
President: Göran Koch
Headquarters: Nybrogatan 53, PO Box 5843, S-102 48 Stockholm
Telephone: 08/666 15 00.The national Swedish association for dentists with approx. 10.000 members.
ADDE, European Dental Dealers' Association. (1)
Gen sec: Lars Tyrfors
Headquarters: c/o DAB Dental AB, Box 423, S-119 04 Upplands Väsby, Sweden.
Telephone: (46 760) 99 700.
Fax: 89 893.Organizes national dental trade associations in 12 countries. Affiliate member organization of the FDI.
FIDE, Federation of the European Dental Industry. (1, 8).
Sec: Harald Russegger
Headquarters: Pipinstrasse 16, D-5000 Köln 1, Germany
Telephone: (49 221) 21 59 93.
Fax: 24 50 13Founded 1957. Organizes national dental industrial associations in 11 countries. Affiliate member of FDI and IDM.
Lars Tyrfors, DAB Dental AB is at present a member of the FIDE Working Group on Standardization.
Bengt A. Andersson, Nordiska Dental AB is a member of the executive Committee 1993/94.
Norman H. Whitehouse of the British Dental Association (UK:s national association for dentists) is a member of the FIDE Working Group on Dental Materials.
IDM, International Dental Manufacturers. (1, 9).
Exec dir: Dr Edward B Shils
Headquarters: c/o DMA 123 Broad Street, Fidelity Building, Suite 2531, Philadelphia, PA 19109, USA (address somewhat uncertain due to bad telephone-line)
Telephone: (251) 731 9975.The FIDE secretariat informs that the IDM secretariat has got the following address:
IDM Secretariat
Mr. Nikolaj M. Petrovic, CAE (see ADTA below)
c/o American Dental Trade Association
4222 King Street West
Alexandria, VA 22302-1597
USA
Fax: 703-931 94 29Organizes national dental industrial associations in USA, Japan and Australia and one regional organization: FIDE. Affiliate member of the FDI.
DMA, Dental Manufacturers of America. (4).
Exec dir: Dr Edward B Shils
Headquarters: 123 Broad Street, Fidelity Building, Suite 2531, Philadelphia, PA 19109, USA (address somewhat uncertain due to bad telephone-line)
Telephone: (251) 731 9975.The association was founded in 1932 and organizes 150 manufacturing firms of dental equipment and supplies.
ADTA, American Dental Trade Association. (4).
Pres: Nik M Petrovic
Headquarters: 4222 King St., Alexandria, VA 22302, USA.
Telephone: (703) 379 7755.The association was founded 1882 and organizes 90 manufacturing companies and 50 distributors. Membership represents 400 dental supply houses and 90% of the total sales in the dental industry. The president of ADTA Nik Petrovic was a special guest at the 1992 annual meeting of AADR (3, page 1648).
DDA, Dental Dealers of America. (4).
Exec sec: Dr Edward B Shils
Headquarters: 123 Broad Street, Fidelity Building, Suite 2531, Philadelphia, PA 19109, USA (address somewhat uncertain due to bad telephone-line)
Telephone: (251) 731 9975.The association was founded 1981 and consists of 11 manufacturers of major precious metals who provide services to the dental profession. The purpose is to provide dental professionals with information regarding current research and literature in the industry. Headquarters obviously shared with IDM and DMA, see above.
FSD, The Swedish Dental Trade Association. (8).
Pres.: Lars Tyrfors, DAB Dental AB, Upplands Väsby
Director: Lennart Uhlmann
Headquarters: Box 1416, S-111 84 Stockholm
Telephone: 08/24 07 00
Fax: 08/21 84 96
NIOM, Scandinavian Institute of Dental Materials. (1, 6).
Dir: Prof Ivar A Mjør
Headquarters: Kirkeveien 71B, PO Box 70, N-1344 Haslum, Norway
Telephone: (47 2) 42 90 10The institute was founded by the Nordic Council 1969 and its activities are aimed at testing dental materials sold on the Scandinavian market to ensure that they fulfil the appropriate technological requirements (no biocompatibility testing). Both the test results and physical or biological properties revealed by the manufacturer to NIOM are strictly confidential (5).
The head of the institute Prof. Mjør, is a member of both FDI and IADR were he has been president. Employees of the institute are members of IADR and the heads of the various departments are also members of FDI.
The IADR/AADR has set up a buildings fund committee. Their prime goal is to take an active role in generating contributions to the fund. One of the members of that committee is Ivar Mjør (13, page 1164). By far the most money in that fund is supplied by the industry (14, page 1073). NIOM has been announced as a Provisionally Notified Body to the EC Commission and will be certifying dental materials for the European market. Dr. Mjør has also been selected to write a policy statement for IADR/AADR on one of the industry's products, dental amalgam.
NIDR, National Institute of Dental Research. (1, 7).
Dir: Harald Löe (retiring from June 1st, 1994)
Headquarters: 9000 Rockville Pike, Bethesda, Maryland 20892, USA
Telephone: (301) 496 4261Having a budget of 160 million dollars NIDR is probably the most significant source of funds for dental research anywhere in the world.
NIDR is planning to increase its collaboration with the industry: "With the advent of the biotechnology industry and the advanced technologies and computer systems that are revolutionizing diagnostics and dental materials fabrication, the possibility for expanding ties to industry is both real and desirable, offering benefits to all involved" (7, page 147).
- Yearbook of International Organizations. 29th edition. KG Saur, London 1992.
- FDI leaflet: An Invitation to World-wide Partnership. FDI 1992.
- Journal of Dental Research 1992;71:1642-1751. Special issue: Proceedings from annual meeting of IADR and AADR.
- Backhus K. Medical and Health Information Directory. Gale Research Inc. London 1990.
- Leaflet from the Scandinavian Institute of Dental Materials. NIOM towards Europe. NIOM 1993.
- Ørstavik D. Personal communication. NIOM 1992-12-29.
- Broadening the scope. Long-range research plan for the nineties. NIDR Publication No. 90-1188. September 1990.
- FIDE. The Federation of the European Dental Industry. Brochure from FIDE, 1993.
- Kreuzer M, FIDE Secretariat. Letter to Bengtsson U. 1992-07-09.
- Orozco A, executive director World Medical Association. Letter to Bengtsson U, 1993-03-15.
- Burek DM. Encyclopedia of Associations. 27th edition. Gale Research Inc, Detroit and London, 1993.
- Journal of Dental Research 1990;69:1350-1452. Special issue: Proceedings from annual meeting of IADR and AADR.
- Journal of Dental Research 1991;70:11021128-1751. Special issue: Proceedings from annual meeting of IADR and AADR.
- Journal of Dental Research 1993;72:1058-1168. Special issue: Proceedings from annual meeting of IADR and AADR.
- Alfano MC. Guest editorial: The AADR, the Dental Industry, and Their Constituencies. J Dent Res 1993;72:1458-1459.
- Marjenhoff W A. Personal fax to Ulf Bengtsson 1994-01-31.
- Marjenhoff W A, George L A. Paffenbarger Research Center. The cutting edge of dental science. Journal of the American Collage of Dentists 1992 or 1993. Enclosed in fax ref 16.
- Stanford JW. Dental instruments and materials/Standards development. NIH Grant N01DE12584. 1993.
- Properties of dental amalgams made from spherical alloy particles. J Dent Res 1962;41:890-906.
- Marjenhoff W A. Personal communication to Ulf Bengtsson 1994-03-22.
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