Dentist blames smoking for problems on which a unique practice is based : He Rebuilds Faces Ravaged by Cancer

Dentist W. James Nethery was in his Santa Ana office talking about the damaging effects of tobacco when he told the story about the couple that had been stranded on a deserted island for five years when the woman became pregnant.

“They looked at each other,” he said, “and the man asked, ‘OK, who’s the father?’ ” It was Nethery’s way of illustrating what he considers the nonsensical contention of the tobacco industry that there is no scientific proof that smoking causes cancer.

“Like the couple,” he added, “the circumstantial proof is overwhelming,” a finding about tobacco he considers irrefutable since 90% of his patients have oral cancer and all are smokers. “And last year 350,000 people died because of smoking,” he said.

As a dentist, Nethery has never filled a cavity beyond graduation from the Loma Linda Dental School.

Artificial Facial Parts

“I never really did get much satisfaction from doing a filling,” he admitted, preferring instead to reconstruct mouths, eyes, ears, noses, jaws and palates of patients ravaged by surgery and radiation treatment to control cancer that he believes was caused by smoking.

Although he still calls himself a dentist, his entire practice consists of creating maxillofacial prosthetics (artificial facial parts). He says he is “probably the only one in the United States doing this in private practice as the sole means of making a living.”

Nethery, 48, says there are others in his field, but all of them are connected with universities, hospitals or veterans treatment centers.

Dr. Jerry Gardner, president of the 1,050-member Orange County Dental Assn., agrees with that assessment. “He’s about the only dentist I have ever heard of who has a practice like his,” said Gardner, while oral surgeon Dr. Robert Pike notes that Nethery is “the only one I know of with a practice like his in Orange County.”

Dr. John Beumer III, who directs the UCLA Dental School maxillofacial prosthetics training program, said Nethery “is one of the first people to market the service (in private practice).”

Steve Stuyck, a spokesman for the University of Texas, where Nethery interned, said that “there are not many people involved (in maxillofacial prosthetics) in private practice because it’s a very complicated skill.”

It was Nethery’s internship at the University of Texas combined with a problem with his eyesight that caused him to sidestep a regular dental practice.

“I was having difficulty seeing line angles on the inside of a tooth,” he reported, but during his training at the university’s M.D. Anderson Hospital and Tumor Institute in Houston, which deals only with cancer patients, “I found I enjoyed pathology as well as the study of tumors.”

This led him to master the skills of oral prosthetics, and according to Kathleen Riddle, chief radiation therapy technologist at Loma Linda University, “he’s fantastic. Nethery makes people beautiful again. I haven’t seen another one like him and I’ve been in the field for 20 years.”

Nethery constructs the artificial parts through a complicated process that includes impressions and molds of the affected part. Polyvinyl, acrylic and silicones are used to simulate skin and teeth, which are attached with tape and liquid adhesives that can be removed for cleaning and inspection for cancer reoccurrence.

Career Start Recalled

He performs the work in his Head and Neck Regional Institute laboratory in Santa Ana, a part of his patient offices. Nethery’s memories of his earlier days at dental school include one of fitting a patient with a prosthesis to close a hole in the roof of his mouth, the result of radiation therapy to remove a tumor.

“That sort of started my career in 1962,” said Nethery, who was born in China, the son of missionaries. “That man is 90 years old now, and he’s still a patient of mine.”

It was that success and others like it that prompted Nethery to develop a private practice aimed at patients with oral cancer. “I can’t think of anyone who needs more help than a cancer patient,” he said.

One even became his wife.

“I was brought in as a consultant by a doctor who was having a difficult time trying to diagnose Joyce’s problem,” he said, “which we later learned was a tumor at the base of her tongue. The cancerous tumor was successfully treated and during one of her visits she said the magic words of ‘how would you like to come to dinner?’ The rest is history.” That was 10 years and three children ago.

But all too often, says Nethery, an Anaheim Hills resident, the ending is not happy. He cited statistics from the American Cancer Society that last year 350,000 people died as the result of smoking-induced cancer.

“Even with those statistics,” he moaned, “only about half the people I treat give it (smoking) up. I’ve heard of people going home from the hospital and the first thing they do is light up. It’s so addictive.”

He is a national director of the American Cancer Society and once was president of the Orange County unit.