editorials
Dental epidemiology: a new field for service
T h e s p e c t a c u la r g r o w t h o f p u b lic h e a lt h d e n tis tr y d u r in g th e p a s t q u a r t e r o f a c e n tu r y h a s r e s u lte d in t h e d e v e lo p m e n t o f a n e w a r e a o f s e r v ic e — d e n t a l e p id e m io lo g y — w h ic h p r o m is e s t o a c h ie v e a p r o m in e n t p la c e a m o n g p u b lic h e a lt h p ra c tic e s . '
A l t h o u g h d e n t is t r y sh a re s w i t h p e d ia t r ic s th e h o n o r o f b e in g a m o n g th e fir s t o f th e
h e a lt h p r o fe s s io n s t o r e c o g n iz e th e im p o r t a n c e o f p r e v e n t iv e h e a lt h s e rv ic e s , i t h as la g g e d in d e v e l o p i n g o n e o f t h a t s e r v ic e ’ s m o s t im p o r t a n t b r a n c h e s — e p id e m io lo g y . I n its e a r lie s t y e a rs , e p i d e m i o l o g y d e a lt e n t ir e ly w it h a c u t e d is e a s e , m a in ly w it h a c u t e i n f e c t i o n in e p id e m ic s . D e n t a l diseases, lik e o t h e r c h r o n ic d is o rd e r s , a r o u s e d n o in te r e s t a m o n g th e e a r ly e p id e m io lo g is ts . A s s o o n , h o w e v e r , as it b e c a m e a p p a r e n t th a t th e e p id e m io lo g is t m u s t e x t e n d h is in te r e s t t o th e e n d e m ic b e h a v io r o f a ll fo r m s o f d ise a s e, d e n t is t r y r e c o g n iz e d its o p p o r t u n it y a n d b e g a n t o e n c o u r a g e th e d e v e l o p m e n t o f d e n t a l in te r e s t in t h a t fie ld . A m o n g th e firs t o f th e d e n t a l e p id e m io lo g is t s w e r e th o s e w h o p io n e e r e d in th e fie ld o f flu o r id a t io n . “The
a c c o m p lis h m e n t s o f
d e n ta l
G o r d o n in a r e c e n t issu e o f th e g a tio n s o n m o t t l e d am ong
e p id e m io lo g y
e n a m e l o r d e n t a l flu o ro s is in
e p id e m io lo g ic
are
im p r e s s iv e ,”
s ta tes J o h n
American Journal of Public Health.1
classics, a lo n g
w it h
th o s e
th e w e s te r n of
Panum
U n it e d
on
E.
“ T h e in v e s t i S ta te s
m e a s les ,
ra n k
Snow
on
c h o le r a , a n d G o l d b e r g e r o n p e l l a g r a . ” T h e b a s ic fu n c t io n o f e p i d e m i o l o g y is to d e t e r m in e th e f r e q u e n c y a n d d is t r ib u tio n s
of
m a ss
d ise a s e,
th u s
p r o v id in g
th e
i n fo r m a t io n
g u id a n c e a n d e v a lu a t io n o f p u b lic h e a lt h p r o g r a m s . A
n eeded
fo r
o r g a n iz a t io n ,
s e c o n d fu n c t io n is t o o b t a in
a n a n s w e r to a s p e c ific q u e s tio n a b o u t a n is o la t e d v a r ia b le o r c o m b in a t io n o f v a r ia b le s . A t h ir d f u n c t io n is t o h o l d f i e l d tr ia ls w h e r e a g e n ts o r m e th o d s f o r c o n t r o llin g d ise a s e m a y b e e v a lu a t e d . A l l t h r e e uses o f th e e p i d e m i o lo g ic m e t h o d h a v e f o u n d a p p lic a t io n in d e n tis tr y — f o r in s ta n c e , in th e s tu d ie s o f c a rie s a n d d e n t a l flu o ro s is , in
th e d e
te r m in a t io n o f f lu o r in e as t h e a n t i- c a r ie s a g e n t , a n d in th e c o n t r o lle d N e w b u r g h K in g s t o n s tu d ie s o f f lu o r id a t io n .
EDITORIALS . . . VOLUME 60, J A N U A R Y I960 • 101/87
P e r io d o n t a l d is e a s e is th e e p i d e m i o l o g i c p r o b le m o c c lu s io n
in its m a ss r e la t io n s h ip s a ls o is a n
in v e s tig a tio n .
The
m o u th
and
o f th e im m e d ia t e fu t u r e . M a l
a p p e a lin g
its a d ja c e n t s tru c tu re s
s u b je c t f o r
s h o u ld
e p id e m io lo g ic
p r o v id e
e x c e p t io n a l
o p p o r t u n it y f o r t h e in v e s t ig a t io n o f c o n g e n it a l a n o m a lie s . I n v i e w o f t h e ir i m p o r t a n c e , p u b lic h e a lt h h as f a r t o o f e w d e n t a l e p id e m io lo g is ts . U n d e r g r a d u a t e in s t r u c t io n in p r e v e n t i v e d e n tis tr y , su ggests G o r d o n , s h o u ld b e b u ilt a r o u n d a f r a m e w o r k o f e p id e m i o l o g y , as is th e t r e n d in m e d ic a l e d u c a t io n . D e n t is t r y th r o u g h
g ra d u a te
in s t r u c t io n
m u st
ta k e
r e s p o n s ib ility
fo r
d e v e lo p in g
its
ow n
e p id e m io lo g is ts . T h e s ta r t w h i c h h as b e e n m a d e b y a f e w s c h o o ls m u s t b e e x t e n d e d b y o th e rs . T h e success a t t a in e d b y e p id e m io lo g is t s in t h e f i e l d o f f lu o r id a t io n p r o m p t s th e p r e d ic t io n t h a t t h e i r s e r v ic e s c a n b e e q u a lly p r o d u c t i v e in o t h e r d e n t a l fie ld s . I n fa c t , it w o u ld s e e m t h a t t h e d a y is n o t f a r d is t a n t w h e n , in t h e in te r e s t o f p u b lic h e a lth , d e n t a l e p id e m i o l o g y w i l l b e c o m e a n in t e g r a l p a r t o f t h e n a t io n ’ s g e n e r a l e p id e m io l o g ic e ffo r t . I.
G ord on , John E. Dental problem s in an e p id e m io lo g ic perspective. A m . J. Pub. Health. 49:1041 A u g .
1959.
A ir Force expands its mass casualty training program to include dental officers
A m a j o r b r e a k t h r o u g h r in th e w a l l o f re s is ta n c e t o th e t r a in in g o f d e n tis ts a n d o th e r n o n m e d ic a l m e m b e r s
of
th e
h e a lt h
p r o fe s s io n
in
th e
p r in c ip le s
and
te c h n ic s
of
d is a s te r m e d ic a l c a r e h a s ju s t b e e n a n n o u n c e d . T h e S u r g e o n G e n e r a l o f t h e U n i t e d S ta te s A i r F o r c e , O l i v e r K .
N ie s s , h as r e c o m m e n d e d
t h e im m e d ia t e
s e r v ic e - w id e
in s t itu tio n in th e A i r F o r c e o f c ro s s - d is c ip lin e t r a i n i n g p r o g r a m s f o r a ll p r o fe s s io n a l a n d a llie d -s c ie n c e s p e r s o n n e l in e m e r g e n c y m e d ic a l a n d s u r g ic a l p r o c e d u r e s e s s e n tia l f o r e f f e c t i v e m a n a g e m e n t o f m ass ca s u a lties . T h i s is th e fir s t a c t i v e r e c o g n it io n b y a n im p o r t a n t s e g m e n t o f th e m e d ic a l p r o fe s s io n o f th e n e e d f o r s u c h t r a in in g as e n u n c ia t e d in th e r e p o r t o f t h e A m e r ic a n M e d i c a l A s s o c ia t io n ’ s N a t i o n a l C o m m is s io n o n E m e r g e n c y M e d i c a l
C a r e re le a s e d
e a r lie r th is y e a r . T h e d e n t a l o ff i c e r t r a i n i n g p h a s e o f th e A i r F o r c e p r o g r a m w i l l in c lu d e in s t r u c tio n a n d e x e rc is e s in s u c h s u b je c ts as r e s u s c ita tio n , s h o c k , t r e a t m e n t o f c o n tu s io n s a n d la c e r a t io n s , t r e a t m e n t o f fr a c tu r e s a n d b u rn s a n d th e r e c o g n it io n a n d h a n d lin g o f r a d ia t io n sickn ess. D e n t a l o ffic e r s w i l l s c ru b -u p as m e m b e r s o f s u r g ic a l te a m s in A i r F o r c e h o s p ita ls a n d w i l l fu n c t io n as a c t iv e p a r t ic ip a n t s o r o b s e rv e rs in t h e s u r g ic a l and
m e d ic a l
m anagem en t
of
a ll
ty p e s
of
em ergen cy
a d m is s io n s ,
not
e x c lu d in g
o b s te tric s . T h e a s s im ila t io n o f s u c h c o m p r e h e n s iv e t r a in in g w i l l m a k e e v e r y d e n t a l o ff ic e r a n e f f e c t i v e m e m b e r o f t h e d is a s te r m e d ic a l c a r e te a m , c a p a b le o f f u n c t io n in g e ff ic ie n t ly a n d , i f n e c e s s a ry , in d e p e n d e n t ly in a m a ss m e d i c a l e m e r g e n c y . T h e p r o g r a m a n n o u n c e d b y th e S u r g e o n G e n e r a l s h o u ld h a v e a b e n e fic ia l e f f e c t . o n th e a t t it u d e o f th o s e m e m b e r s o f s o m e lo c a l m e d i c a l s o c ie tie s w h o
h a v e been
102/88 • THE J O U R N A L OF THE AME RI CA N DENTAL ASS O CI A TIO N
r e lu c t a n t t o c o o p e r a t e in th e d e v e lo p m e n t a n d o p e r a t io n o f r e a lis tic t r a in in g p r o g r a m s f o r d e n tis ts in t h e fie ld o f d is a s te r m e d ic in e . O n l y in t h e m i l i t a r y d o e s c o m m a n d p rogra m
a u t h o r it y
e x is t f o r
o f th is t y p e . It s a d o p t io n o n a n a t io n a l s c a le in
th e e s t a b lis h m e n t o f a c iv ilia n
life
can b e ac
c o m p lis h e d o n ly w i t h a p p r o v a l a n d p o s it iv e s u p p o r t o f m e d ic a l s o c ie tie s in e a c h c o m m u n it y .
In
th e
in te r e s t o f
n a t io n a l d e fe n s e
p e o p le i t is s in c e r e ly h o p e d
and
t h a t th e v ig o r o u s
fo r
and
th e
p r o t e c t io n
t im e ly
a c t io n
of
A m e r ic a n
o f th e
S u rgeo n
G e n e r a l w i l l set a n e x a m p le f o r h is c iv i l i a n b r e t h r e n : M a j o r G e n e r a l O l i v e r K . N ie s s , S u r g e o n G e n e r a l o f th e A i r F o r c e , is t o b e c o n g r a t u la t e d f o r h is f a r s ig h t e d e ffo r t s o n b e h a l f o f c iv ilia n d e fe n s e .
Tooth cleanser claim s to be cleaned up, promises Federal T rad e Commission
A s th e w o r l d e n te r s a n o t h e r N e w
Y e a r , r e s p o n s ib le m e n in b o t h business a n d th e
p r o fe s s io n s a r e d e e p l y c o n c e r n e d — c o n c e r n e d o v e r t h e in c r e a s in g te n d e n c y t o w a r d u n tr u th fu ln e s s w h i c h h as c r e p t in t o a ll fo r m s o f s a le p r o m o t io n , p r im a r ily in a d v e r tis in g , r u in in g its r e p u t a t io n , le s s e n in g its e ffe c tiv e n e s s a n d c a u s in g u n t o ld h a r m to th o u s a n d s o f
u n s u s p e c tin g ,
n a ïv e
p e o p le .
C on cern
over
th e
past
and
p resen t
is
m a t c h e d b y c o n c e r n o v e r th e fu t u r e . W i l l s u c h a r t f u l d e c e p t io n b e a llo w e d t o c o n tin u e ? F o r t u n a t e l y a t le a s t t w o i m p o r t a n t a c tio n s w e r e ta k e r f la t e la s t y e a r w h ic h s h o u ld le s s e n t h e l a t t e r c o n c e r n :
(1 )
a n n o u n c em e n t b y th e F e d e ra l T r a d e
Com
m is s io n o f its in t e n t io n t o re q u e s t m o r e fu n d s t o s te p u p its in v e s t ig a t io n o f f r a u d u le n t a d v e r t is in g a n d a g a in s t
th e
(2 )
th e is su a n ce o f a c o m p la in t b y th e F e d e r a l T r a d e C o m m is s io n
C o l g a t e - P a l m o l iv e
Com pany
a l l e g in g
u n s u p p o rted
c la im s
m ade
fo r
C o l g a t e D e n t a l C r e a m w i t h G a r d o l , o n e o f its h ig h ly t o u t e d t o o t h p astes. A r o u s e d b y th e p u b lic ’ s r e a c t io n t o th e r e c e n t e x p o s é o f c e r t a in m o r e o r less c o m m o n a n d a c c e p t e d p r a c t ic e s a n d p o lic ie s in th e a d v e r t is in g w o r ld , th e c h a ir m a n o f th e F e d e r a l T r a d e
C o m m is s io n , E a r l W .
K in tn e r ,
p ro m is e s
t h a t th e
C o m m is s io n
“ m e a n s b u sin ess” a n d t h a t i t is d e t e r m in e d t o “ f u l l y d is c h a r g e its d u tie s ” t o p r o t e c t th e p u b lic f r o m f a ls e a n d m is le a d in g a d v e r t is in g c la im s . A s e v id e n c e t h a t C h a ir m a n K i n t n e r ’ s w o r d s a r e n o t m e r e p r o m is e s a n d t h a t h is C o m m is s io n r e a lly “ m e a n s b u s i ness” is t h e a c t io n ta k e n b y th e C o m m is s io n a g a in s t th e C o l g a t e - P a l m o l iv e C o m p a n y c h a r g in g s p e c if ic a lly t h a t th e c la im s m a d e f o r G a r d o l a r e “ fa ls e , m is le a d in g a n d d e c e p t iv e . ”
F o llo w in g
are
th e
m ore
p e r t in e n t
p ara grap h s
fro m
th e
C o m m is s io n ’ s
c o m p la in t :
P A R A G R A P H F O U R : In the course and conduct of its business and for the purpose of inducing the purchase of C olgate D en tal C ream with G ardol, respondent has advertised said product by m eans of advertisem ents in m agazines of national circulation, and newspapers and by television com m ercials broadcast over nationwide networks. P A R A G R A P H F I V E : Respondent, by m eans of the aforesaid advertisem ents and television com m ercials, has represented, directly or by im plication, that C olgate D en tal C ream with
EDITORIALS . . . VOLUME 60, JA N U A R Y I960 • 103/8»
G ard ol form s a “ protective shield” aroun d teeth, thereby affording the users thereof com plete protection against tooth decay or the developm ent of cavities in their teeth. P A R A G R A P H S I X : T h e aforesaid representations are false, m isleading an d deceptive. In truth and in fact, the said C olgate D en tal C ream with G ardol does not afford the users thereof with com plete protection against tooth decay or the developm ent of cavities in their teeth by form ing a “ protective shield” or otherwise. P A R A G R A P H S E V E N : In the conduct of its business, at all times m entioned herein, respondent has been in substantial com petition, in commerce, with corporations, firms and individuals in the sale of dental cream. P A R A G R A P H E I G H T : T h e use by respondent of the aforesaid false, m isleading and deceptive representations and practices has h ad, and now has, the capacity an d tendency to m islead m embers of the purchasing public into the erroneous and m istaken belief th at said representations were, and are, true and into the purchase of substantial quantities of re spondent’s product by reason of said erroneous and m istaken belief. As a consequence thereof, substantial trade in com m erce has been, and is being, unfairly diverted to respondent from its com petitors and substantial injury has thereby been, and is being, done to com petition in commerce. P A R A G R A P H N I N E : T h e aforesaid acts and practices of respondent, as herein alleged, were and are all to the prejud ice and injury of the public and of respondent’s com petitors and constituted, and now constitute, un fair an d deceptive acts and practices and un fair m ethods of com petition, in com m erce, within the intent and m eaning of the Federal T rad e Com m ission Act. D e n t is t s a n d a ll o th e r s in t h e h e a lt h p r o fe s s io n s w i l l w a t c h t h e o u t c o m e o f th is a c t io n b y t h e F e d e r a l T r a d e C o m m is s io n w i t h t h e h o p e t h a t i t w i l l b r e a k n o t o n ly th e s h ie ld t h a t h a s p r o t e c t e d th e u n f o u n d e d c la im s o f C o l g a t e D e n t a l C r e a m G a r d o l b u t a ls o th e
e q u a lly f a n t a s t ic
c la im s
m ade
by m any
of
th a t
w it h
d e n t if r ic e ’ s
c o m p e tit o r s . Y e a r s o f e x p e r ie n c e h a v e p r o v e d t h a t a g o o d d e n t i f r i c e is a n h o n e s t, h a r d - w o r k in g m e m b e r o f th e c o s m e tic f a m ily . N o
g lib - t o n g u e d h u c k s te r s h o u ld b e p e r m it t e d
ta rn is h its r e p u t a t io n b y c l a im in g f o r it v ir tu e s i t d o e s n o t possess.
to