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Absenteeism and Dental Diseases
THE JOURNAL o f the AMERICAN DENTAL ASSOCIATION H arold Hillenbrand, D .D .S., Editor L . Pierce Anthony, D.D .S., Editor Emeritus Published by the American D ental Association 222 East Superior St., Chicago n , 111.
SEPTEM BER 1, 1946 •
EDITORIALS
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• V O LU M E 33
CONGRESS GOES HOME Congress has gone home. One-third of the members of the Senate and all of the members of the House of Representatives w ill face their constituencies in elections before Congress convenes again. Unless a special session is called during the last months of the year, there will be no further legislative activity until the new Congress meets in January 1947. A ll bills introduced in the current 79th Congress die autom atically arid must be reintroduced in the next session to receive further consideration. T h e last days of the session were hectic as usual, and many bills failed in being called up for consideration because of conditions created by the crisis on O P A and other measures. Wagner-Murray-Dingell B ill.— T h e W agner-M urray-Dingell bill (S. 1606) did not make much progress toward enactment in its present form even though ex tended hearings were held from April 2 to July 10 before the Senate Committee on Education and Labor. A subcommittee of this group did issue an interim report1 on health insurance but did not give approval to the W agner-M urray-Dingell measure. T h e report, which limited itself to an advocacy of a system of national health insurance, was signed by Senators Claude Pepper, Florida; Elbert D . Thomas, U ta h ; James E. M urray, M ontana; and George D. A iken, Verm ont. Senators R ob ert A . T a ft, Ohio, and H. Alexander Smith, N ew Jersey, dissented from some of the findings and conclusions; Senators Lister H ill, Alabam a, James M . Tunnell, Delaware, and W ayne L . Morse, Oregon, indicated that they had not completed their study of the report. T h e proponents of the W agner-M urray-Dingell bill were successful during this term of Congress in focusing public attention on national health needs and pro grams. T h ey were not successful, however, in getting the measure closer to enact ment because the methods proposed met with such forthright opposition on the 1. Interim R eport from the Subcommittee on H ealth an d Education to the Committee on E ducation and Labor. W ashington: U . S. Government P rin tin g Office, 1946 . Jour. A .D .A ., V o l. 33, September 1, 1946
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part of so many groups and individuals. Legislation of this type is not dead, and the new Congress may well witness a flood of new health measures early next year. T h e Senate hearings revealed a rather sharp difference in philosophy on health legislation among members of the committee. O ne group advocated a national system of health insurance while the other countered with a program of grantsin-aid to the states. Unless this basic difference is compromised, it will be diffi cult for any comprehensive health legislation to get early and favorable consid eration from the Senate. Taft-Ball-Smith Bill.— This measure (S. 2143),2 which also lapses with the close of the session, did not proceed to hearings before a Senate committee. It is interesting because it embodies the grants-in-aid principle as contrasted with a federal system of health insurance. It is quite likely that a revised bill on the same general pattern will be introduced early in the next session. M aternal and Child Health Bill.— T h e M aternal and Child Health bill, also known as the Pepper bill (H. R . 3922) ,3 received strong support in the closing days of the session. Opposition prevented the bill from being reported favorably, but there was general agreement that funds for maternal and child health should be enlarged. Congress subsequently provided additional funds for an expanded pro gram of maternal and child health services, for crippled children’s services and for child welfare services. This bill, in amended form, is a candidate for réin troduction in the new session. A .D .A . Bills.— T h e two bills sponsored by the American Dental Association were not enacted and will be reintroduced in the next session. T h e Dental Research Bill (S. 190) was favorably reported by the Senate Committee on Education and Labor and passed. It was not acted upon by the House committee, owing to the “ press of other legislation.” S. 1099, the dental health education and dental care bill, met some difference of opinion in the Senate subcommittee and was not reported to the Senate before the end of the session. Army Dental Corps Bill.— T h e Arm y Dental Corps bill (H . R . 6750),4 intro duced at the request of the Am erican Dental Association to “ provide more effi cient dental care for the personnel of the United States Arm y,” was not enacted. It was introduced late in the session, and time did not permit hearings by a House committee. It will be reintroduced early in the next session. O ther Legislation.— President Trum an’s reorganization plan for the health and security agencies of the federal government was opposed by the House of Repre sentatives but won approval in the Senate. The reorganization plan, therefore, became effective July 14. It is expected in many quarters that efforts will be ipade in the next session to give this agency cabinet status. T h e full import of the reor ganization plan, however, will not become entirely clear until staff organization, changes and personnel are announced. T h e number of health measures introduced in Congress during this session, the support given by the special message of the President on health problems and the wide popular discussion of the subject mean that the issue of health legislation will, continue to be a prominent one. T h e present need isnot for a smug satisfac2. See page 1187 for a discussion of this bill. 3. Testimony of the American Dental Association onMaternal and Child Health Bill (H. R. 3922). J.A.D.A. 3 3 :io i2 , August 1, 1946. 4. House Gets A .D .A. Bill Calling for Greater Autonomy for Army Dental Service. J.A.D.A. 33:949, July 15, 1946.
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ournal of t h e
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tion that legislative efforts have been halted. T he need is for a better under standing of the basic problems by both the public and the profession so that a more informed attention can be given to providing better health care for all of the people.
THE ANNUAL MEETING AT MIAMI T h e first postwar session of the House of Delegates of the Am erican Dental Association will be held in M iam i, October 14-16. Because of wartime stringencies in hotel accommodations and railroad reservations, no annual meeting of the House of Delegates was held last year. Officers were held over for another year and essential business was transacted by the House of Delegates. A ll of the many practical limitations on large conventions have not yet disappeared, so no scien tific program has been scheduled for M iami. T he House of Delegates, however, will complete plans for a full-scale meeting in 1947. I f crowded convention cities continue to be the rule rather than the exception, the House, of Delegates might well consider selecting its meeting place two or three years in advance, a practice that has worked successfully for other organizations. T h e eighty-seventh annual session of the House of Delegates will be confronted by many problems and the need to legislate on matters that w ere necessarily de ferred during the war. It is important, therefore, that each constituent society have a full delegation at M iam i so that all of these issues can be resolved demo cratically.
ABSENTEEISM AND DENTAL DISEASES Absenteeism, which became an acute problem during the war when man-hours were needed for production, has many causes. In its chronic state, absenteeism is related in large degree to ill health. This has led to the widespread development of industrial medical programs and, in a much smaller degree, to industrial dental programs. In the past few years, under initiative provided by the Committee on Economics and the Industrial Dental Committee of the Council on Dental Health of the Am erican Dental Association and the American Association of Industrial Dentists, the subject has been explored and some advances have been made. These advances could be made more rapidly if there were more comprehensive studies on the relation between dental diseases and industrial absenteeism. In this issue,1 Puffer and Sebelius report on absenteeism in Tennessee industrial plants caused by diseases of the teeth and gums. Their findings are of interest and point to the need for considering dental problems in industry more seriously. Puffer and Sebelius found that in one year, in a group of 5,988 employees in industry, there were 283 absences as a result of diseases of the teeth and gums. T h e average length of these absences was 4.4 days, making a total loss of more than 1,200 employee-days for the entire group. Tw elve per cent of the 283 absences were eight days or longer in duration, with an average severity rate of 18.9 days. Absenteeism of this order has a high cost both to the individual and to industry when compared to the cost of effective dental prevention and treatment. T h e I. See page 1 1 22.
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authors quote H eacock2 as noting that “ the rate for dental disability was almost on a parity w ith that for tuberculosis, and this being the case, it seemed odd that we should spend thousands of dollars for the prevention of tuberculosis and pennies for dental prophylaxis.” As a result of their study, the authors recommend (1) that more fact-finding surveys be m ade to demonstrate graphically the need for dental service in many plants; (2) that a better understanding of the role and purpose of industrial dental service is needed; (3) that the findings and treatment of the dental service in industry should be closely integrated with the other services affecting the general health of the individual. 2. Heacock, L. D .: T he Place of D entistry in Industrial H ealth Program. 1 2 : 672 , O ctober 1943 .
Indust. Med.
SEPTEM BER 1, 1946 •
EDITORIALS
vm w ññññññññññí
• V O LU M E 33
CONGRESS GOES HOME Congress has gone home. One-third of the members of the Senate and all of the members of the House of Representatives w ill face their constituencies in elections before Congress convenes again. Unless a special session is called during the last months of the year, there will be no further legislative activity until the new Congress meets in January 1947. A ll bills introduced in the current 79th Congress die autom atically arid must be reintroduced in the next session to receive further consideration. T h e last days of the session were hectic as usual, and many bills failed in being called up for consideration because of conditions created by the crisis on O P A and other measures. Wagner-Murray-Dingell B ill.— T h e W agner-M urray-Dingell bill (S. 1606) did not make much progress toward enactment in its present form even though ex tended hearings were held from April 2 to July 10 before the Senate Committee on Education and Labor. A subcommittee of this group did issue an interim report1 on health insurance but did not give approval to the W agner-M urray-Dingell measure. T h e report, which limited itself to an advocacy of a system of national health insurance, was signed by Senators Claude Pepper, Florida; Elbert D . Thomas, U ta h ; James E. M urray, M ontana; and George D. A iken, Verm ont. Senators R ob ert A . T a ft, Ohio, and H. Alexander Smith, N ew Jersey, dissented from some of the findings and conclusions; Senators Lister H ill, Alabam a, James M . Tunnell, Delaware, and W ayne L . Morse, Oregon, indicated that they had not completed their study of the report. T h e proponents of the W agner-M urray-Dingell bill were successful during this term of Congress in focusing public attention on national health needs and pro grams. T h ey were not successful, however, in getting the measure closer to enact ment because the methods proposed met with such forthright opposition on the 1. Interim R eport from the Subcommittee on H ealth an d Education to the Committee on E ducation and Labor. W ashington: U . S. Government P rin tin g Office, 1946 . Jour. A .D .A ., V o l. 33, September 1, 1946
1 152
E
d it o r ia l s
1153
part of so many groups and individuals. Legislation of this type is not dead, and the new Congress may well witness a flood of new health measures early next year. T h e Senate hearings revealed a rather sharp difference in philosophy on health legislation among members of the committee. O ne group advocated a national system of health insurance while the other countered with a program of grantsin-aid to the states. Unless this basic difference is compromised, it will be diffi cult for any comprehensive health legislation to get early and favorable consid eration from the Senate. Taft-Ball-Smith Bill.— This measure (S. 2143),2 which also lapses with the close of the session, did not proceed to hearings before a Senate committee. It is interesting because it embodies the grants-in-aid principle as contrasted with a federal system of health insurance. It is quite likely that a revised bill on the same general pattern will be introduced early in the next session. M aternal and Child Health Bill.— T h e M aternal and Child Health bill, also known as the Pepper bill (H. R . 3922) ,3 received strong support in the closing days of the session. Opposition prevented the bill from being reported favorably, but there was general agreement that funds for maternal and child health should be enlarged. Congress subsequently provided additional funds for an expanded pro gram of maternal and child health services, for crippled children’s services and for child welfare services. This bill, in amended form, is a candidate for réin troduction in the new session. A .D .A . Bills.— T h e two bills sponsored by the American Dental Association were not enacted and will be reintroduced in the next session. T h e Dental Research Bill (S. 190) was favorably reported by the Senate Committee on Education and Labor and passed. It was not acted upon by the House committee, owing to the “ press of other legislation.” S. 1099, the dental health education and dental care bill, met some difference of opinion in the Senate subcommittee and was not reported to the Senate before the end of the session. Army Dental Corps Bill.— T h e Arm y Dental Corps bill (H . R . 6750),4 intro duced at the request of the Am erican Dental Association to “ provide more effi cient dental care for the personnel of the United States Arm y,” was not enacted. It was introduced late in the session, and time did not permit hearings by a House committee. It will be reintroduced early in the next session. O ther Legislation.— President Trum an’s reorganization plan for the health and security agencies of the federal government was opposed by the House of Repre sentatives but won approval in the Senate. The reorganization plan, therefore, became effective July 14. It is expected in many quarters that efforts will be ipade in the next session to give this agency cabinet status. T h e full import of the reor ganization plan, however, will not become entirely clear until staff organization, changes and personnel are announced. T h e number of health measures introduced in Congress during this session, the support given by the special message of the President on health problems and the wide popular discussion of the subject mean that the issue of health legislation will, continue to be a prominent one. T h e present need isnot for a smug satisfac2. See page 1187 for a discussion of this bill. 3. Testimony of the American Dental Association onMaternal and Child Health Bill (H. R. 3922). J.A.D.A. 3 3 :io i2 , August 1, 1946. 4. House Gets A .D .A. Bill Calling for Greater Autonomy for Army Dental Service. J.A.D.A. 33:949, July 15, 1946.
1154
T
h e
J
ournal of t h e
A
m e r ic a n
D
ental
A
s s o c ia t io n
tion that legislative efforts have been halted. T he need is for a better under standing of the basic problems by both the public and the profession so that a more informed attention can be given to providing better health care for all of the people.
THE ANNUAL MEETING AT MIAMI T h e first postwar session of the House of Delegates of the Am erican Dental Association will be held in M iam i, October 14-16. Because of wartime stringencies in hotel accommodations and railroad reservations, no annual meeting of the House of Delegates was held last year. Officers were held over for another year and essential business was transacted by the House of Delegates. A ll of the many practical limitations on large conventions have not yet disappeared, so no scien tific program has been scheduled for M iami. T he House of Delegates, however, will complete plans for a full-scale meeting in 1947. I f crowded convention cities continue to be the rule rather than the exception, the House, of Delegates might well consider selecting its meeting place two or three years in advance, a practice that has worked successfully for other organizations. T h e eighty-seventh annual session of the House of Delegates will be confronted by many problems and the need to legislate on matters that w ere necessarily de ferred during the war. It is important, therefore, that each constituent society have a full delegation at M iam i so that all of these issues can be resolved demo cratically.
ABSENTEEISM AND DENTAL DISEASES Absenteeism, which became an acute problem during the war when man-hours were needed for production, has many causes. In its chronic state, absenteeism is related in large degree to ill health. This has led to the widespread development of industrial medical programs and, in a much smaller degree, to industrial dental programs. In the past few years, under initiative provided by the Committee on Economics and the Industrial Dental Committee of the Council on Dental Health of the Am erican Dental Association and the American Association of Industrial Dentists, the subject has been explored and some advances have been made. These advances could be made more rapidly if there were more comprehensive studies on the relation between dental diseases and industrial absenteeism. In this issue,1 Puffer and Sebelius report on absenteeism in Tennessee industrial plants caused by diseases of the teeth and gums. Their findings are of interest and point to the need for considering dental problems in industry more seriously. Puffer and Sebelius found that in one year, in a group of 5,988 employees in industry, there were 283 absences as a result of diseases of the teeth and gums. T h e average length of these absences was 4.4 days, making a total loss of more than 1,200 employee-days for the entire group. Tw elve per cent of the 283 absences were eight days or longer in duration, with an average severity rate of 18.9 days. Absenteeism of this order has a high cost both to the individual and to industry when compared to the cost of effective dental prevention and treatment. T h e I. See page 1 1 22.
E
d it o r ia l s
i i 55
authors quote H eacock2 as noting that “ the rate for dental disability was almost on a parity w ith that for tuberculosis, and this being the case, it seemed odd that we should spend thousands of dollars for the prevention of tuberculosis and pennies for dental prophylaxis.” As a result of their study, the authors recommend (1) that more fact-finding surveys be m ade to demonstrate graphically the need for dental service in many plants; (2) that a better understanding of the role and purpose of industrial dental service is needed; (3) that the findings and treatment of the dental service in industry should be closely integrated with the other services affecting the general health of the individual. 2. Heacock, L. D .: T he Place of D entistry in Industrial H ealth Program. 1 2 : 672 , O ctober 1943 .
Indust. Med.