Wow...this topic has become all wonky. All these things being said at once.
Anyway, I run smcFanControl and I run it all the way up to max (6000 RPM) when I'm doing some intense taxing on the MBP (games, movie editing, etc).
Running your fans and whatever speed is more preference. When it DOES keep your laptop running cool, it makes a lot of noise. And with all things, as a previous poster said, FANS do die...its just a matter of time. My best guess is the fans are sleeve-bearing, which means while that it would be a lot more quiet than ball bearing fans, they typically do not last as long. (From what I know about fans)
For stands, you can use the mStand (I use that now), even without the external keyboard. But you can use any old thing to elevate/circulate air underneath your laptop.
For the record, I opened up my MBP to replace the wireless Airport card to upgrade it to the Wireless N card (Mac Pro Airport Extreme) and I did not see significant amounts of dust in the notebook. Mostly around the speaker grille openings and fan blades. Everything else looks pretty clean.