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This column reviews three studies on coping that provide nurses with a base for identifying individuals with particular coping needs and styles. The studies focus on Type A behavior and coping. Type A behavior and gender differences, and responses of spouses of patients with a first myocardial infarction.

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In the March issue of the JOURNAL OF PERIODONTOLOGY, I have read with interest the article, "Cleansing Subgingival Space," by Gilbert J. Parfitt, page 133 to 139 inclusive. I should like to comment on some of the untruths, half truths and contradictions which appear in the work.Behold a few samples: page 133, "The ordinary methods are easy to perform but do not clean the teeth and commonly cause damage." This is an untruth. If it be so, the elderly, the middle aged and the youthful members of the profession doing periodontia have been dreaming, when they behold the miraculous results of "ordinary methods" of brushing and interdental stimulation. Again on page 133: "The bristles are too stiff in the unmistaken assumption that debris will be removed more efficiently from the tooth surface by a hard brush and that the gingiva will be beneficially stimulated." This again is an unsubstantiated statement along with confusing sentence construction. Even using an incorrect cross stroke, common sense tells us debris will be removed more efficiently when using a stiff brush. This is not dust on the piano we are to remove, but a gelatinous plaque adhering to a vertically grooved surface. On page 134: "The hard bristle . . . causes abrasion of the gingival margin and the patient stops brushing their teeth when they see blood on the brush . . . (the bristles) pierce the soft tissues and cause pain and bleeding. The patient promptly stops brushing this area. ..." This is a half truth. If patients are given correct brushing instructions at the proper time in the treatment plan and carefully checked on the use of the brush, they will not cause abrasions and resultant bleeding. This is an injury and our patients are shown how to avoid injuring themselves. If they see blood on the brush and it is not coming from improper use, but just from the pressure of the bristles (massage), they are encouraged to massage more and not avoid the area. If a patient "promptly stops brushing" his fault is pointed out to him, corrected and he is encouraged to return to the routine. Again on page 134: "Even when the teeth are in perfect alignment a large percentage of the surface of each tooth is inaccessible if the teeth are normally close together." This is not true. One has but to notice how light is reflected from a set of teeth in "perfect alignment" and compare them with the malpositioned set, proving if a greater area is subject to light reflection the same greater area must be accessible to the brush. Again on page 134: ". . . surfaces of the lower teeth are rarely cleaned by the ordinary patient carrying out his usual routine care." From my neck of the woods, the "ordinary patient" is a pretty smart and well trained user of a toothbrush. There are no areas in and about his dentition which are not reached and cleaned. If he is "clumsy and does not apply the brush efficiently-although going through the proper motion," this is where the instructor steps in and aids the patient in attaining good brushing results. The "ordinary patient" is warne...