One Man's Treasure

One Man's Treasure

James P. Hughes, D.D.S.*:

WARNING !

All dentists, both teachers and practitioners, whose minds are closed to new ideas, new technics, and information based on scientific facts; who have been lulled by the myths of the unscientific authorities and like it; who are tired and happy in their lethargy, are most sincerely advised that this book was not written for them and by reading it they will only be disturbed and irritated and gain nothing.

Hush! Lest we awaken them.

Instead of a preface to Dr. Jones' book, there was a Warning!





When we received an inquiry from Dr. Jim Hughes about any interest there might be in the following article, the Publications Committee responded with their version of "Cool - hit it out of the park!"  After all, how many quirky, strong-willed, out-of-the-box-and-into-the-frying-pan dentists can the history of the profession have produced?

Once you stop laughing, dear readers, we invite you to enjoy, savor, relish, and digest this unique little saga, and if it should nudge a memory or two, we would love to hear from you, too.

Our thanks to Jim Hughes for this charming piece and the smiles that broadened as we read.

The Editors

Introduction

While going through some old boxes of treasures recently, I came across a letter written to my mother in 1975 from Dr. Walter E. Jones, a dentist she knew from the 1940s.  At that time, she worked as a receptionist for the physician across the hall from Jones, above the proverbial drug store on West Seventh Street in Saint Paul.  She and Dr. Jones communicated on an irregular basis for years after she became a stay-at-home mom. When I was admitted to dental school, she wrote to him of the news.  His reply was the three-page, typewritten, single-spaced letter excepted on the facing page.  In that letter, among other things, he wished me the best, and then went on to offer a detailed description of his 35-year campaign to get his design for three-quarter crowns included in the University of Minnesota School of Dentistry clinical curriculum.

Neither Dr. Jones’ letter nor, for that matter, his crown design bear much relevance today. However, I could not bring myself to discard it along with my old grade school report cards and 25-year-old drawings from my daughters. I do remember studying his technic (i.e., technique) in my second year, although I do not recall ever having prepared a tooth per his design. He called it The Scientifically Designed Partial Veneer or Three-Quarter Crown.

 

How They Used to Make Them

Dr. Jones’ story was one of amazing persistence and tenacity. He believed in this design and fervently approached numerous University of Minnesota School of Dentistry department heads, and four successive deans, trying to convince these clinicians to appreciate his brainchild.  He presented table clinics at the American Dental Association Annual Meeting for 11 years, the Chicago Midwinter Meeting for seven years, and the Minnesota Dental Association’s annual meeting for 12 years. He even went as far as to make models of teeth restored with the Jones crown seven times natural size out of white marble and brass castings. He had his design analyzed by the head of the Physics Department in the School of Engineering, who proclaimed, “This one [Jones’] is well designed to take care of the various forces and their effects. This other model  Tinker’s] shows no such design.” This must have made Jones’ heart sing.

 The design itself appears to have been an improvement over the Tinker crown, which was an improvement over the Carmichael crown. (Do these names sound familiar to any readers?) With all the charm, I imagine, of a pit-bull, Jones approached Tinker at a dental meeting, pointing out the shortcomings of the Tinker crown and suggesting that his design was superior to Tinker’s …

 Tinker asked Jones where he practiced, and then suggested that he go back there and practice some more.

 Jones snapped that he would not make the crown as Tinker advocated, and by so doing, he would not be responsible for Tinker’s shortsightedness.

 Imagine, harsh words between dentists at the normally collegial dental meeting!

 As a student, I asked Dr. Hubert Serr, head of the U of M Prosthodontics Department, if he had known of or dealt with Dr. Jones.

“Yes, I knew him,” he said.“He was a very abrasive man.”

I guess one person’s persistence is another person’s abrasiveness.



This illustration is from Dr. Jones' book The Scientifically Designed Partial Veneer or Three-Quarter Crown, Its Technic, Analysis, and Comparison, published by Burgess Publishing Company, Minneapolis, Minnesota, 1952, written and paid for by Dr. Jones ".

A Little Clinical History

For the newbies out there, dentists of the time restored anterior teeth with partial crowns that started on the mesial, wrapped around the lingual, and onto the distal; thus the term three-quarter crown. For resistance to apical displacement, the incisal edge was also covered. And they used gold for these restorations.

 In the early part of the century, porcelain had few of the qualities that it possesses today, giving gold advantages over porcelain. Among them: gold usually affords a more conservative preparation; gold is fracture-proof; and, because of its composition, dental gold wears at about the same rate as the opposing enamel, which helps to maintain the occlusion.

 Gold Nuggets

The main objection to gold dental restorations is, of course, esthetics. So, at a time when patients were just starting to appreciate and value esthetics, Jones was preaching his crown, which revealed, unfortunately, even more gold than was the norm for the day.

 He argued, “It is the duty of the operator to educate his patients to appreciate and demand fine workmanship based on good judgment and sound engineering.” Further, he warned, “When we let [the patients’] whims take precedence over our better judgment, we cease to be professional and are laying up trouble for both of us, for there is no fiercer hell than failure.” That was his philosophy of dental practice. What a difficult path he chose for himself. And have we not all, on occasion, abandoned the preferred treatment plan because of patient objection.

 One Man, One Dream

Esthetics was a tertiary consideration at best for Dr. Jones, after function and long-term retention. He saw other points of view as shortsighted, held by dentists with “closed minds”. And so, he spent 35 years presenting his crown design to anyone who would listen, to little avail, until Dr. Erwin Schaffer became the dean at Minnesota. Schaffer listened with interest, and the next summer the Department of Biomaterials completed a study that “concluded that there was less [marginal] leakage with the Jones three-quarter crown than there was with the Tinker three-quarter crown.”

 In addition to making this serious man doubtless giddy with vindication, the study ensured the Jones crown would at last be included in the Fixed Prosthodontics curriculum at the University of Minnesota.

 So Jones finally realized his dream after three and one half decades. And though I have no doubt that he felt pride in this accomplishment, I also have no doubt that his prime motivator was neither personal recognition nor profit, but a sincere belief that this crown design was better for patients.

 Afterword

My family visited Dr. Jones and his wife Ruth, also a dentist, at their retirement home in Florida on several occasions. My memories are dim, but I do remember his house was filled with wondrous and innovative ideas brought into function with levers, cables, and trap doors. They grew their own vegetables, made much of their own clothing, and cut each other’s hair. They spent their time and money on trips to exotic places in the world. We would spend hours viewing his photographic slides, which he narrated. I don’t know when he passed away. The last time we corresponded was in 1983, and he and Ruth were both in failing health. What an interesting man he was.

 

*Dr. Hughes is a retired general dentistwith a Master’s degree in oral pathology. Hecurrently lives in Winona, Minnesota, but isplanning a move to Texas in the near future.Email is 7ku36ir8@hbci.com