The Great Toothbrush Abrasion Caper

It could only happen in Illinois, the home of the American Dental Association and the stage for notable 1920s mobster Al Capone. Capone comes to mind because the current Trimarco vs. Colgate Palmolive suit in which the plaintiff seeks compensation for his toothbrush abrasion "disease" seems to aim a symbolic "gun" at the heads of eight manufacturers of toothbrushes (and the ADA and its Seal of Acceptance program).

The suit alleges that toothbrushes are "unsafe and unreasonably dangerous" and should carry package warnings on the "risks of toothbrush abrasion" as well as instruction on how to use brushes to avoid abrasion according to the report in the April 19 ADA News. The ADA is named along with the manufacturers in the suit because it allows the display of its Seal of Acceptance on packages without requiring warnings about harm caused by toothbrushing as a condition of displaying the ADA Seal.

Washington columnist George Will probably provided the best characterization of the trend displayed by this suit when he stated in a May 10 Newsweek commentary, "This suit is just part of a great American growth industry -- litigation that expresses the belief that everyone has an entitlement to compensation for any unpleasantness, litigation that displaces responsibility from individuals to corporations with money."

It is remarkable that individual dentists and hygienists who have provided dental treatment and preventive instructions to the plaintiff over the years were not also included as defendants in this case. After all, the complaint alleges that "manufacturers knew or should have known about the disease/injury/clinical entity (of toothbrush abrasion) since at least 1949." While many of us practicing dentistry today were in grade school at that time, we should have learned long since that we must engage in informed consent discussions with our patients about the dangers of the dreaded "disease known as toothbrush abrasion."

Fortunately, Trimarco and his counsel correctly concluded that dentists’ pockets are not as "deep" as the likes of Colgate-Palmolive, Butler, Johnson & Johnson, or even the ADA, to list but a few of those named in the suit. However, at some future time, when toothbrush package disclaimers have been added to remove manufacturers’ liability for incorrect use of the toothbrush (this suit makes that inevitable) dentists and dental hygienists who bear responsibility to instruct patients in the proper techniques of brushing could bear the brunt of future litigation if there is a continuing trend in society for individuals to blame others for their failures, and to expect a monetary reward from sympathetic juries in return.

There is another aspect of this caper that is unsettling. Based upon the reporting of events in ADA News, the suit was filed on April 1 and stories broke in the Chicago media on April 12. Eight days later, on April 20, the Council on ADA Sessions and International Programs canceled Dr. Gordon Christensen’s agreement to present at the annual session in Hawaii in October of this year. This action appears to convey guilt and a punishment for Dr. Christensen’s involvement in this matter, which involved his signature on an affidavit regarding warnings on toothbrush packages that was signed in August 1998 and used in the toothbrush abrasion suit.

On April 27, Dr. Christensen filed a letter with the plaintiff’s attorney withdrawing the statement. Further, on May 4, 1999, he signed a sworn statement recanting portions of that statement that had pertained to the ADA and its Seal Program; and, on May 6, he granted a telephone interview, fully explaining the contacts and activities that led to his signing of the statement in question.

Dr. Christensen’s explanation provided by ADA News appears to show that he was deceived into believing that his statements and the affidavit were to be used in an effort to secure warnings on toothbrush packages, rather than to support the rather outrageous lawsuit on toothbrush abrasion (which he claims he knew nothing about at the time). Dr. Christensen was quoted as saying, "The ADA has now cleared me of any involvement with this suit." To this observer, that is not the end of the story.

The continuing involvement of the ADA and its Seal program in the lawsuit may be preventing a more open discussion of some issues, including Dr. Christensen’s views or statements relating to the Seal program. Despite Dr. Christensen’s expertise and standing within the professional community, it would have been inappropriate and unwise for him to make public comments that might link the ADA Seal program to any discussion on toothbrush abrasion without the prior knowledge and approval of the appropriate ADA agencies. As of May 17, it is unclear as to whether this explains the reason for the sanction permanently removing Dr. Christensen from the 1999 Annual Session program. Because of the incomplete explanation, this can only be an assumption. It is unfortunate that a complete explanation of events could not have been made to the profession in a more timely fashion. It is our hope that full explanation and closure will be forthcoming to this entire caper, even before these words appear in print.

It is also unfortunate that the legal system would encourage such an outrageous plan to be hatched, that would entangle the resources of members of the dental industry, the ADA, and Dr. Christensen, when so many more important scientific issues that would benefit the profession and the public are before them.