Education of Residents-Reply

In Reply.— Responding to these comments will underscore some issues not fully detailed in our article. In designing this study, we carefully weighed the desirability of observing the residents' prescribing behavior after the change had occurred vs the need to implement proper fluoride dosage in our patients within a reasonable period. The residents were the experimental subjects, not the patients. Before beginning the study, we agreed to allow no more than four months of educational methods and observation before intervening, since a sustained high fluoride dosage can cause fluorosis—a permanent staining of the secondary teeth. 1,2 The six-week "encouragement period" was the beginning of our intervention, and this was followed immediately with an intensive, full departmental effort wherein we rectified the fluoride dosage in all of our pediatric patients in two weeks. Research design need always consider the physician's clinical responsibility to his patients. Addressing Dr Mahan's concern about continuing