The "metal-free" myth.

There are many ways to develop and market a practice, I am hearing more everyday about the "metal-free" practice. In fact, anymore it seems a practice is looked down upon if metal is used. What exactly is "metal-free," and why is it promoted as the best way to practice dentistry? Does it mean implants should be nonmetalüc? Is orthognathic surgery wrong when metal plates and screws are placed? If a post and core is made out of a stainless steel post and an amalgam core, is it an unacceptable restoration? What about the patient who has a removable partial denture made of metal? Perhaps, the entire partial should have been made of composite? A friend of mine still has the original Maryland bridge replacing a maxillary first molar that I placed for him when I was in dental school. The framework is made of metal. Perhaps I should advise him to have it replaced, even though it has provided him with 15 years of trouble-free service? Is orthodontics a second-class specialty since it frequently is not performed "metal-free?" I know it strikes a nerve, but we all have seen many, many amalgam restorations perform excellent service for long periods of time. The often quoted problem of expansion and fracturing of teeth with amalgam is more hkely an occlusal problem than a metal problem. We need to look at the science, not the hype. Also, "metal-free" must certainly mean never placing a gold restoration at anytime, anywhere Jn any patient's mouth. This would be a violation of every principle known to "metalfree" dentistry. Perhaps if we keep our blinders on and attempt to see things as only black or white, we can let the tail wag the dog of our practices. The "tail" being "what the patient wants." At the end of the day. we are still doctors who practice a healing art. However, let's not forget that we are also trained as analytical scientists. It seems more prudent to keep available to the patients the advantages of all materials, while maximizing the usage of their unique properties. I find the term "metal-free dentistry" to be overly simplistic, misleading, and demeaning to thinking professionals. At first blush, it sounds very noble and in the best interest of our patients, when it may in fact be nothing more than a marketing gimmick which happens to work, while ignoring reason and scientific principles. Are you building a practice on the "metal-free" myth?