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Dentistry and the Foundations
DENTISTRY AND THE FOUNDATIONS N. C. Hudson, BBA, Chicago
Unlike medicine, dentistry generally has failed to interest the foundations in helping to solve its problems. However, dentistry in recent years has kept the leading foundations informed of its needs. Recently the American Fund for Dental Educa tion announced receipt of a $177,500 three-year challenge grant from the W. K. Kellogg Founda tion to establish a program of scholarships for Negro dental students. (A challenge grant is a grant based on a matching system.) It may well be that this latest grant is a harbinger o f better recog nition for dentistry from the foundations. But even if dentistry were to be more successful in present ing its case to the foundations, this still would not solve the problems of the dental profession. This article takes a brief look at the world of founda tions, at their role in the United States, and at the support they have given dentistry and medicine.
Who are the foundations? There are an estimated 18,000 to 20,000 founda tions in the United States today. The great surge of US foundation building coincided with the first federal income tax of 1913, a provision of which exempted religious, educational or charitable or ganizations. As the tax bite has grown, so has the foundation birth rate. Edition 3 of The Foundation Directory, pub lished in 1967 by the Russell Sage Foundation for the Foundation Library Center, gives details on the 6,803 foundations that have assets of at least $200,000 or distribute annually $10,000 or more in grants. These 6,803 foundations— the top third— had total assets of $19,927 millions 206
and made grants of $ 1,212 millions in 1966. The “fields of interest” index listed only two foundations concerned with dentistry. One is the giant W. K. Kellogg Foundation, of B attle Creek, Mich, incorporated in 1930 by W. K. Kellogg, with assets (as of August 31, 1967) o f $397 m il lions, and expenditures that year of $13.3 m il lions, including $12.5 millions in grants. The sec ond is The Murry and Leonie Guggenheim Foun dation, incorporated in 1929 in New York City, with assets in 1966 of $19 million and expendi tures that year of $1,145 million, including $1.1 million in grants. This foundation’s principal ac tivity until very recently was the support and main tenance of The Murry and Leonie Guggenheim Dental Clinic in New York City, recently closed because the state’s Medicaid program took over the dental care of needy children. (A third, small, foundation, listed in the directory and interested in dental education, but unlisted in the “ Fields” index, is the Dentists’ Supply Company Founda tion, York, Pa, established in 1955. In 1965 this foundation had assets of $927,903 and made grants o f $54,009. Its stated purpose is “ Prim ari ly local giving, with emphasis on community funds, hospitals, and higher education; support also for dental education.”) In contrast to the paucity o f interest in dentis try, medicine has many foundations catering to it. No fewer than 9 are listed in the directory for medical education, 20 for medical research, 7 for cancer research, 3 for heart disease, 4 for neurol ogy, 5 for ophthalmology, and 15 for medical sciences. All told, health received in 1964 about $160 millions in grants, almost all of it from the 237 largest foundations.
The Charles Stewart M ott Foundation supports a dental c lin ic in its Health Center in F lint, Mich. The dental project provides care fo r the children o f fa m ilie s fo r whom payment for dental services is d iffic u lt. The Foundation also provides fellow ships fo r the graduate tra in in g of pedodontists and prom otes preventive dental services and dental health education in the F lin t area.
Thirteen are worth $ 7 .7 billion
One of the most outstanding facts concerning foundation assets is the degree of their concentra tion in a few large organizations. Thirteen founda tions presently report assets exceeding $200 mil lion each. In order of size, at estimated market value of assets, they are:
A pedodontist at th e M ott Foundation Health Center examines a patient.
F o u n d a t io n
A s s e ts ( m illio n s )
F o rd F o u n d a tio n R o c k e fe lle r F o u n d a t io n D uke E ndow m ent K e llo g g (W. K.) F o u n d a t io n M o tt F o u n d a tio n H a r t f o r d F o u n d a tio n L illy E n d o w m e n t S lo a n ( A lfr e d P.) F o u n d a t io n C a rn e g ie C o r p o r a t io n o f N e w Y o rk P e w M e m o r ia l T r u s t L o n g w o o d F o u n d a t io n M o o d y F o u n d a t io n R o c k e fe lle r B r o t h e r s F u n d
$ 3 ,0 5 0 854 692 492 424 342 320 309 28 9 273 25 1 244 210
These 13 foundations, less than 0.1% of Am eri can foundations by number, hold assets of $7,750 million, or more than a third of the assets of all foundations. O f annual grants totaling $1,212 million made by foundations in 1964, more than $750 million came from the large foundations. O f these total grants, the most (over $400 million) went for edu cation, slightly less than $200 million for welfare, about $175 million for international activities, about $160 million for health, about $115 million for sciences, about $105 million for religion, and about $60 million for the humanities. Grants of $10,000 or more for health totaled $35 million in 1963, $129 million in 1964, $103 million in 1965, and $62 million in 1966.
H ow health gran ts w ere d istrib u ted
As to foundation grants for health, hospitals were the chief beneficiaries, receiving nearly $32 mil 207
A unique fe a ture o f a new program aided by th e W. K. Kellogg Foundation at th e U niversity o f Pittsburgh is th a t the tra in in g o f dental assistants and dental hygienists is com bined. Shown is a dental assistant-hygienist h elping an oral surgeon. Photograph from Kellogg Foundation.
The Kellogg Foundation has aided teacher preparation and inservice tra in in g as means to increase health manpower. Pictured at th e U niversity o f Illin o is College o f D entistry is a group o f postgraduate students and young in stru cto rs discussing problem s in preparation fo r practice teaching. Photograph from Kellogg Foundation. 2 0 8 ■ JADA, Vol. 77, A ugust 1968
The head o f the oral science program at Massachusetts In s titu te o f Technology, together w ith two Fellows in the histology and pathology laboratory. The program, supported by th e Kellogg Foundation, is oriented toward basic science and n u tritio n as they relate to dental health. Photograph from Kellogg Foundation.
lion in 733 grants from 503 foundations in 1966, or 5 1% of the total for health. Medical education profited from a number of substantial specially di rected grants, including nine Commonwealth Fund grants totaling more than $4 million, two Kellogg grants of $1 million or more, and single grants in the $1 million range from two smaller foundations. The Commonwealth Fund recently indicated a shift to medical education from medi cal research, chiefly in view of large government funds now available in the latter area. In 1966, dentistry (according to the directory), received eight grants from five foundations totaling $ 1,399,000 or 2% of the total granted for health. This compared with 30% of the total for medical educa tion ($ 18,000,000). O f the $ 160 million granted for health in 1964, $84 million came from the largest foundations, $42 million came from 1,227 intermediate founda tions (assets from $1 million to $10 million), $37 million came from small foundations (assets be tween $200,000 and $1 million), and $4 million came from very small foundations (assets under $ 2 0 0 ,0 0 0 ).
Advice fo r prospective grantees F. Em erson A ndrew s, o f the Foundation Library Center, in his foreword to the directory, states: “ Grant applications are the lifeblood o f founda tions, w hose central purpose is to find good re cipients for their m oney. “ Fund-raisers need to be warned that at least the larger foundations do not usually m ake grants toward the operating budgets o f agencies, whether national or local, or for individual need. Many foundations have accepted the doctrine that their lim ited funds should be used ch iefly as the venture capital o f philanthropy, to be spent in enterprises requiring risk and foresight, not likely to be sup ported by governm ent or private individuals. In their fields o f special interest they prefer to aid research, designed to push forward the frontiers o f know ledge, or p ilot dem onstrations, resulting in im proved procedures apt to be w idely copied. “Support for current programs, if it com es at all from foundations, m ust usually be sought from the sm aller organizations, and especially those located in the area o f the agency, well acquainted with its personnel and its needs. M ost small foundations, and som e larger ones, restrict their grants to the local com m unity or state. Im m ense variety exists; the interests and lim itations o f each foundation need to be exam ined before it is approached. . . . “ W here there is evidence that the applicant has not bothered to find out the field o f interest o f the foundation, or has m ade a general m ailing, the cost o f even a form al declination is scarcely war ranted; w astebaskets are available in any required size.” T h ese elem entary truths m ay seem so obvious as hardly to be worth repeating. Y et, hundreds o f w ould-be grantees overlook them every day.
The dental hygienist teacher tra in in g program at the U niversity o f M ichigan School o f D entistry is supported by the Kellogg Foundation. Photograph from Kellogg Foundation.
Relative weight o f foundations W hen the am ounts granted by the foundations are stacked up against the role o f the federal govern m ent and the state governm ents in education and research, the relative insignificance o f foundation givin g in dollar value becom es apparent.
Dental hygiene teacher education program at the U niversity o f Iowa is supported by the Kellogg Foundation. Here an undergraduate is prepared to apply the p rin cip le s o f oral prophylaxis to a clin ic a l situation. Photograph from Kellogg Foundation. Hudson: DENTISTRY AND FOUNDATIONS ■ 209
For instance, total outlay for research and de velopment in the United States from both public and private sectors rose from $2.9 billion 17 years ago to an estimated $23 billion today (Seymour J. Kreshover, 1967). This expenditure represented about 3% of the estimated gross national product for 1967, and over two thirds of it was supplied by the federal government. National expenditures on biomedical research, which amounted to $160 million in 1950, rose to an estimated $2.3 billion in 1967— a 14-fold in crease, according to Kreshover. O f the $2.3 billion spent for health-related research, 25% came from private industry, 10% from private philanthropy, voluntary health agencies and miscellaneous sources, and the remaining 65 % from the federal government. The federal share was largely funneled through the National Institutes of Health. Foundations, incidentally, are able to spend for all purposes only about 9 cents of the annual dollar of private philanthropy.
T ypically A m erican phenom enon
The modern foundation is a typically American phenomenon. Though almost as old as recorded history (Plato’s Academy, which survived its founder’s death by nine centuries, is considered a precursor), in the main the foundation is an American institution. From only about two dozen in 1900, the number has climbed almost perpen dicularly to more than 19,000 today (according to an essay in the January 19, 1968, issue of Tim e). New foundations are being formed at the rate of 1,500 a year, under the twin whips of family pride and federal taxes.
A dvan tages that fo u n dation s have
Foundations (according to the article in the Ency lo p a ed ia o f th e Social Sciences ) have the ad vantage over government in sponsoring research projects of an international character, and in spon soring protracted and costly pieces of research the outcome of which may be entirely uncertain. “ Similarly, the sponsorship of new social tech niques that are still in the experimental stage and may require years to prove or disprove their value — for example, mental hygiene, adult education and radio education— is undertaken to great ad vantage by private foundations; but here the ques tion arises whether the scope of experimentation 210 ■ JADA, Vol. 77, A ugust 1968
with new social techniques is not limited, by the source and administration of foundation funds, to those techniques which fit into the existing social system rather than change it in any essential way. Successful pioneering work by a private founda tion has, however, in the past encouraged public activity in the same field, particularly where the individualist tradition survives as strongly as in official America. . . .The foundations have also done excellent work for selected individuals. . . . Foundation activities, while by no means justify ing the economic situation out of which they spring, do at least in part wring good out of its defects.”
A cou n terw eigh t to govern m en t
Though foundations have in the past been regard ed by some critics as simply tax-dodging devices established to perpetuate the influence of wealthy individuals and families on the nation’s affairs, and as a means of perpetuating their concepts of capitalism, thinking on the role of the foundation has veered sharply in recent years. For one thing, time and again the foundations have ventured into new ground where government and the politicians have feared to tread because of vested interests and prejudices. For a second point, many of us are glad to see as many counterweights as possible develop to the massive weight of government in the nation’s affairs. Neither the radicals nor Congressman Wright Patman (the most persistent critic of foundations in Washington) find much sympathy for their crit icism of foundations, though Patman has scored some telling points in support of his demand that they could use m ore policing than they now get. T im e in its essay held that “Foundation giving belongs to the best democratic tradition: ruggedly individualistic, proud of its great wealth— and guilty enough about possessing it to consider in vesting it in unselfish ways. In no other country does private philanthropy possess either the wealth or the social conscience that informs its conduct in the U.S. To give money away wisely is a challenge that perhaps only a rich democracy can feel. And it is one that American philanthropy is earnestly striving to elevate into an art.” The principal mission of the private foundation, asserts Tim e, is to take its resources where neither government, which must consider the taxpayer, nor private business, which must account to the stockholder, dare go. Foundations should provide
the risk capital o f philanthropy, acting as the pio neers pushing forward into the future. “ A vast body of evidence in a dozen fields testi fies to their performance in this role,” points out Time. “As early as 1930, the Daniel and Florence Guggenheim Foundation was sponsoring the rock et research of Dr. Robert Goddard— a bit of fore sight so far ahead of its time that it took the gov ernment one World War to catch up. Without steady support from Ford funds, which have totaled some $140 million, educational television might have died of anemia. . . .Ford’s Gray Areas pro grams in five cities have been described as a fore runner of the government’s poverty program. As for science, Geneticist George W. Beadle has said that ‘the remarkable 20th century flowering of ex perimental biology would not have been possible without the support of private foundations in key areas and at critical times.’ “ Where the foundation money goes, govern ment money often follows— as it should. The U.S. government’s overwhelming presence- in such fields as public education, social welfare, medi cine and scientific research was largely prompted by foundation initiative. . . . “ There are countless examples of small sums priming big results. In 1908, for just $14,000 from Andrew Carnegie, an educator named Abra ham Flexner produced a broadside indictment of medical training in the U.S. and Canada that revolutionized and reformed the entire field. Pres ent-day foundation executives still cite it as a textbook example of how much good even a little money, when imaginatively applied, can do. [William Gies’ 1926 report on Dental Educa tion in the United States and Canada was pub lished by, and supported by, the Carnegie Founda tion for the Advancement of Teaching. And The Survey o f Dentistry, published in 1961, was aided by grants o f $280,000 from the Kellogg Founda tion, $25,000 from the Rockefeller Brothers Fund, and $5,000 from the Louis W. and Maud Hill Family Foundation.] “On its 50th anniversary, the Rockefeller Foun dation noted with understandable pride that 34% of all Nobel prizewinners in medicine, physiology, chemistry, and physics had been helped along the road to their achievement by Rockefeller grants . . . .A 1967 Ford grant of $175,000 for a voter registration drive sponsored by the Congress of Racial Equality in Cleveland was instrumental in electing Carl Stokes, the city’s first Negro mayor . . . .Project Head Start, now moving along on gov ernment backing, took inspiration from a pilot
The Kellogg Foundation is aiding a num ber of programs for the preparation o f teachers of dental hygiene. Shown are students in a lib ra ry at Colum bia University. Photograph from Kellogg Foundation.
project in Harlem that began with just $80,000 from the Taconic Foundation in 1960.” Harrar on role o f foundations J. George H arrar, president of the prestigious Rockefeller Foundation, in his annual report for 1967, discussed the role of foundations.“Over a period of years, the general-purpose foundations have acquired both experience and a degree of wisdom,” said Harrar. “They have found that to be most useful to society, they must choose their projects in anticipation of the problems of the future and deal with them in a way which will
Dental hygiene graduate students use a sorting m achine at the com puter center o f th e U niversity o f M ichigan. Photograph from Kellogg Foundation. Hudson: DENTISTRY AND FOUNDATIONS ■ 211
bring light rather than heat to bear upon them. Philanthropic funds should be used with fore thought, care, and persistence to support causes, programs, and projects that are clearly demon strable as fundamental to human progress. An element of risk will assuredly appear in all such cases and will take a variety o f forms. These risks cannot be avoided, nor can they be permitted to become deterrents to action. On the contrary, they must be faced squarely with full realization of their implications. “Foundations are, of course, only a minuscule element in the total picture of social institutions. In terms of experience and accomplishment, how ever, their share is proportionately much larger than the sums of money they have expended over the years. Foundations can innovate, catalyze, and stimulate; they can demonstrate the value of ideas, methods, and materials which can work toward the lessening or elimination o f persistent hunger and malnutrition, chronic disease and pestilence, continued ignorance and prejudice, and the other obvious social ills which underlie most human concerns. “ Perhaps the greatest single enemy of mankind is self-interest, which appears in countless forms and many guises in every society, in all inter group and interpersonal relations. . . .Self-interest is a definite symptom of a deep-seated impulse in human nature and can be controlled only through constant improvements in understanding and communication and respect for the rights of others. Man cannot subsist alone and every individual must find significance and self-fulfillment in re lationships with his fellow men. . . .In this area, too, as in others, private philanthropy must cou
rageously continue to take risks in the cause of human welfare.”
Small role in dental research, education Foundations, except for the Kellogg Foundation, have played an insignificant role in dental re search and dental education. Kreshover (North west Univ Bull 67:6 Fall 1967) has pointed out that “whereas industry, foundations, and other organizations contribute substantially to research and graduate education in the general medical field, the National Institute of Dental Research is the overwhelmingly predominant source of sup port for research in oral health. . . .Because oral health problems do not ordinarily involve fatal disease, general recognition of their magnitude has come slowly. Thus, dental research has lacked both visibility and critical mass of trained person nel characteristic of other health-related research. For this reason, the support of research and gradu ate education in the basic and clinical sciences by NIDR. . .may be estimated at over 80% of the total national investment in dental research. . . . “The most important source of dental research workers and teachers has been the graduate train ing and fellowship programs sponsored by NIDR . . . .To meet greatly expanding future needs, how ever, dental schools will also have to utilize, to an increasing extent, support available from the N a tional Institute of General Medical Sciences and such organizations as the National Science Foun dation.”
Grants level o f f in 1967 U niversity of Iowa p ra ctice teachers in dental hygiene discuss a p a tie n t’s history. Photograph from Kellogg Foundation.
212 ■ JADA, Vol. 77, A ugust 1968
In 1967, for the first time in over a decade, the na tion’s philanthropic foundations failed to increase the total amount of their annual grants, according to a story in the April 7, 1968, New York Times. In 1967, their disbursements leveled off at $1.3 billion, about equal to the 1966 total. The Times estimated the foundations’ combined assets last year at $20.3 billion, about double the amount in 1960. In the same period, annual grants also doubled. The Times obtained its figures from the annual report of the Foundation Library Center. The Cen ter attributed the leveling off to “ a shift of empha sis as foundations seek ways of responding to the urban crisis and Negro needs.” Increased govern ment action in education, health, welfare and re-
search was found to have forced the foundations to reexamine their own role. M anning J. Pattillo, Jr., president of the Cen ter, said that, to avoid losing public support, foun dations should be more forthright in their account ing to the public. Only 150 of the nation’s 20,000 foundations publish annual reports, he said. They merely file routine reports with the Internal Rev enue Service to retain their tax exemption. Pattillo praised the diversity of most foundations as an im portant force in a free society. But he pre dicted that as the foundations entered into more sensitive social and political areas of activity, such as social reform in the cities, they might face in creasing controversy over their grants and opera tions. Growing interest in the cities and in television has led to a decline in the foundation support of higher education. In 1967, for instance, the Ford Foundation president, George McBundy, announced that the foundation’s general support of colleges and universities would be discontinued in favor of pinpointed grants, such as a major support program to permit selected universities to improve their graduate education. About 1,800 new foundations were established in 1967, according to the Center. Ten of the 25 largest foundations and one fourth of all founda tions are in New York City. Neither New England nor California has a single major foundation.
U niversity of M ichigan fle d g lin g teachers o f dental hygiene view cu ltu re s under the m icroscope and counsel w ith a professor. Photograph from Kellogg Foundation.
Grants also were made to strengthen professional dental organizations and to train dental auxiliaries. In the United States the Kellogg Foundation made grants in 1967 to help institutions develop experi mental programs for the training of dental teachers, to strengthen various professional organizations, to help graduate programs to prepare teachers of dental hygiene, and to help six educational institu tions develop programs to train dental auxiliaries. One reason the Kellogg Foundation is sensitive to dentistry’s needs may be the fact that Emory W. Morris, chairman o f the board, and Philip E. Blackerby, president, are dentists.
R eco rd o f K ellogg Foundation A m erican Fund f o r D en tal Education
The foundation most aware of, and most re sponsive to, dentistry’s needs, and whose name has cropped up several times in this report, is one of the largest, the W. K. Kellogg Foundation. Its annual report for some years has been studied by dental leaders. In 1967, a typical year, the Foun dation made grants of $546,834 to dentistry, of which $25,201 went to dental needs in Canada, $210,919 to dental institutions in Latin America, and $310,714 to dental institutions in the United States. In Canada the University of Toronto re ceived payments of $25,201 toward a larger long term grant to assist in developing a program to teach dental students the effective use of auxiliary personnel. In Latin America, the Kellogg Foun dation made large grants to the Pan American Sanitary Bureau for community water fluoridation, and financed fellowships in many Latin American dental schools to permit faculty members to obtain specialized preparation in the United States.
Joseph Dickinson, executive vice-president of the American Fund for Dental Education, is knowl edgeable about the foundation field. There are about 1,600 foundations interested in higher education or health projects, he said. In 1963, the A FDE wrote these foundations, giving them general information about the dental field. In 1965 the AFD E approached about 800 founda tions specifically for support of graduate students in dentistry. Not one responded to an appeal for $6,000 fellowships. The A FD E sends its annual report to 800 foundations, two or three of which have given token amounts. The largest grant was $5,500 from the Sears Roebuck Foundation to publish career guidance material, said Dickinson. As noted earlier, the A FD E recently received a grant for help in establishing a scholarship pro gram for Negro dental students from Kellogg. “To succeed with the foundations, one must Hudson: DENTISTRY AND FOUNDATIONS ■ 213
have a program tailored to fit a particular need which falls within the Foundation’s area of inter est” said Dickinson. The Ford Foundation to date has omitted dentistry from its fields of interest, he said. “The foundations generally are interested in investing money in individuals and institutions who are going to use the money,” he said. “ We have a third-party relation to the foundations.” Some dental schools have had sizable grants from foundations, he said. New York University has had foundation support, chiefly from local or regional foundations. The Kellogg challenge grant will help to provide 40 five-year scholarships of up to $12,500 each over the next three years. Total cost of the program, including administration and recruitment, will be $560,500. Scholarship support, as determined by individual need, will begin in the final year of predental school and continue throughout the four years of dental school. For the initial three years the Kellogg Foundation will provide $150,000 for 12 scholarships and $ 15,000 for administration. Raymond J. Nagle, outgoing president of AFDE, termed this the first challenge grant given to dentistry by the Kellogg Foundation. He termed the grant as “ a very satisfying one which will allow dentistry to compete more effectively with other professions and with industry for the qualified Negro student.” Though Negroes comprise over ! 1% of the nation’s population, only 2% of the nation’s more than 1 10,000 dentists are Negroes, said Doctor Nagle. Under terms of the challenge grant, the A FDE must match dollar for dollar the $27,500 for scholarships and administration awarded by the Kellogg Foundation the first year.
The Fund has agreed to guarantee that amount and has begun to seek the necessary matching funds for all three years from foundations and other sources. AFDE officials expressed the hope that ultimately funds can be obtained for at least 250 scholarships per year. Four scholarships will be offered for the 1968-1969 school year, Dickin son said. Provided the necessary matching funds are raised, 12 scholarships will be offered in 1969 and 24 in 1970. Other than the dental schools at Howard Uni versity and Meharry Medical College, only 21 of the nation’s dental schools have any Negro stu dents. None has more than four and most have only one. Howard and Meharry used to have sizable Negro enrollments in their dental schools but now are experiencing increasing difficulty in enrolling Negro students; other fields offer more immediate financial returns and fewer years of study.
A n a lysis b y on e den tal a d m in istra to r
Several dental spokesmen were asked why' more foundations have not contributed to dentistry. Typical was the well-formulated response by Viron L. Diefenbach, assistant surgeon general of the United States, and director of the Division of Den tal Health, Public Health Service. “I think the dental profession has been re miss in ‘not attempting to whet the interest of the foundations with creative proposals,” said Diefen bach. “There are many challenges in developing dental manpower, in organizing better services
In an experim ental program at th e U niversity o f M anitoba in Canada, fu n c tio n s th a t have been perform ed only by the d e n tist have been delegated to auxiliary workers. Photograph from Kellogg Foundation.
for disadvantaged groups, in testing new schemes to finance dental care, in supporting much-needed dental programs in international health— surely good proposals in these areas could spark founda tion interest. “By contrast, I surmise that proposals sub m itted to the foundations have been pleas for financial assistance to remodel and expand dental clinics and teaching facilities. Such unglamorpus undertakings, important as they may be, are not usually the kind of projects that fit the philosophies and purposes of foundation programs. “Perhaps the dental profession should first fix the responsibility for serious planning and soli citing of foundation support. To begin with, we must know what major areas o f interest founda tions have and what emphases are currently holding their attention. An attempt to see dentistry from the perspective of the foundations is what is needed. “The American Fund for Dental Education might be an initial source to plan what should be done regarding foundations and dentistry and be gin to carry that plan out. Under its auspices, a small, full-time staff could put together the neces sary documents and determine the dental'interest of the foundations. I believe that proposals then could be developed and carried out but it will be up to us to gain the know-how and to go after their support.” If dentistry now intensifies its appeals for foun dation support, such appeals will come at a time when some of the major foundations appear to be turning away from the health and research fields. Also, we are probably entering a period when researchers in many fields will be desperately seeking foundation support because it seems likely that the federal government, under extreme pressure to set its own financial house in order, is
going to cut drastically its support for health re search and health education. Research workers and institutions who have been living on govern ment funds are going to have to look elsewhere for support. Finally, we are entering a period when the nation’s dental schools themselves are in desperate need of support. H arold Hillenbrand, secretary of the American Dental Association, has reported that the country’s dental school's are faced by an unparalleled financial crisis. Unless there is a ’’substantial increase in the amounts of federal support for dental education, 10% of the nation’s dental schools may have to close their doors,” said Doctor Hillenbrand. “We may lose another four to six dental schools unless Congress takes swift action to increase federal assistance to dental schools.” The financial crisis is particularly severe for the dental schools in private universities which constitute half of the nation’s 50 dental schools, he said. “The closing o f any dental school is a crippling blow to our hopes of increasing dental manpower.” he concluded. “The retention of an existing school, its faculty and student body, is at least as impor tant to the future as the funding of a completely new school that will require eight or ten years before graduating its first practitioner.” If the nation’s major foundations can now be induced to scrutinize dentistry and its needs, they may be intrigued at the opportunities that exist for promising grants in this field.
Mr. Hudson isassistant editor, Am erican Dental Association.
Hudson: DENTISTRY AND FOUNDATIONS ■ 215
Unlike medicine, dentistry generally has failed to interest the foundations in helping to solve its problems. However, dentistry in recent years has kept the leading foundations informed of its needs. Recently the American Fund for Dental Educa tion announced receipt of a $177,500 three-year challenge grant from the W. K. Kellogg Founda tion to establish a program of scholarships for Negro dental students. (A challenge grant is a grant based on a matching system.) It may well be that this latest grant is a harbinger o f better recog nition for dentistry from the foundations. But even if dentistry were to be more successful in present ing its case to the foundations, this still would not solve the problems of the dental profession. This article takes a brief look at the world of founda tions, at their role in the United States, and at the support they have given dentistry and medicine.
Who are the foundations? There are an estimated 18,000 to 20,000 founda tions in the United States today. The great surge of US foundation building coincided with the first federal income tax of 1913, a provision of which exempted religious, educational or charitable or ganizations. As the tax bite has grown, so has the foundation birth rate. Edition 3 of The Foundation Directory, pub lished in 1967 by the Russell Sage Foundation for the Foundation Library Center, gives details on the 6,803 foundations that have assets of at least $200,000 or distribute annually $10,000 or more in grants. These 6,803 foundations— the top third— had total assets of $19,927 millions 206
and made grants of $ 1,212 millions in 1966. The “fields of interest” index listed only two foundations concerned with dentistry. One is the giant W. K. Kellogg Foundation, of B attle Creek, Mich, incorporated in 1930 by W. K. Kellogg, with assets (as of August 31, 1967) o f $397 m il lions, and expenditures that year of $13.3 m il lions, including $12.5 millions in grants. The sec ond is The Murry and Leonie Guggenheim Foun dation, incorporated in 1929 in New York City, with assets in 1966 of $19 million and expendi tures that year of $1,145 million, including $1.1 million in grants. This foundation’s principal ac tivity until very recently was the support and main tenance of The Murry and Leonie Guggenheim Dental Clinic in New York City, recently closed because the state’s Medicaid program took over the dental care of needy children. (A third, small, foundation, listed in the directory and interested in dental education, but unlisted in the “ Fields” index, is the Dentists’ Supply Company Founda tion, York, Pa, established in 1955. In 1965 this foundation had assets of $927,903 and made grants o f $54,009. Its stated purpose is “ Prim ari ly local giving, with emphasis on community funds, hospitals, and higher education; support also for dental education.”) In contrast to the paucity o f interest in dentis try, medicine has many foundations catering to it. No fewer than 9 are listed in the directory for medical education, 20 for medical research, 7 for cancer research, 3 for heart disease, 4 for neurol ogy, 5 for ophthalmology, and 15 for medical sciences. All told, health received in 1964 about $160 millions in grants, almost all of it from the 237 largest foundations.
The Charles Stewart M ott Foundation supports a dental c lin ic in its Health Center in F lint, Mich. The dental project provides care fo r the children o f fa m ilie s fo r whom payment for dental services is d iffic u lt. The Foundation also provides fellow ships fo r the graduate tra in in g of pedodontists and prom otes preventive dental services and dental health education in the F lin t area.
Thirteen are worth $ 7 .7 billion
One of the most outstanding facts concerning foundation assets is the degree of their concentra tion in a few large organizations. Thirteen founda tions presently report assets exceeding $200 mil lion each. In order of size, at estimated market value of assets, they are:
A pedodontist at th e M ott Foundation Health Center examines a patient.
F o u n d a t io n
A s s e ts ( m illio n s )
F o rd F o u n d a tio n R o c k e fe lle r F o u n d a t io n D uke E ndow m ent K e llo g g (W. K.) F o u n d a t io n M o tt F o u n d a tio n H a r t f o r d F o u n d a tio n L illy E n d o w m e n t S lo a n ( A lfr e d P.) F o u n d a t io n C a rn e g ie C o r p o r a t io n o f N e w Y o rk P e w M e m o r ia l T r u s t L o n g w o o d F o u n d a t io n M o o d y F o u n d a t io n R o c k e fe lle r B r o t h e r s F u n d
$ 3 ,0 5 0 854 692 492 424 342 320 309 28 9 273 25 1 244 210
These 13 foundations, less than 0.1% of Am eri can foundations by number, hold assets of $7,750 million, or more than a third of the assets of all foundations. O f annual grants totaling $1,212 million made by foundations in 1964, more than $750 million came from the large foundations. O f these total grants, the most (over $400 million) went for edu cation, slightly less than $200 million for welfare, about $175 million for international activities, about $160 million for health, about $115 million for sciences, about $105 million for religion, and about $60 million for the humanities. Grants of $10,000 or more for health totaled $35 million in 1963, $129 million in 1964, $103 million in 1965, and $62 million in 1966.
H ow health gran ts w ere d istrib u ted
As to foundation grants for health, hospitals were the chief beneficiaries, receiving nearly $32 mil 207
A unique fe a ture o f a new program aided by th e W. K. Kellogg Foundation at th e U niversity o f Pittsburgh is th a t the tra in in g o f dental assistants and dental hygienists is com bined. Shown is a dental assistant-hygienist h elping an oral surgeon. Photograph from Kellogg Foundation.
The Kellogg Foundation has aided teacher preparation and inservice tra in in g as means to increase health manpower. Pictured at th e U niversity o f Illin o is College o f D entistry is a group o f postgraduate students and young in stru cto rs discussing problem s in preparation fo r practice teaching. Photograph from Kellogg Foundation. 2 0 8 ■ JADA, Vol. 77, A ugust 1968
The head o f the oral science program at Massachusetts In s titu te o f Technology, together w ith two Fellows in the histology and pathology laboratory. The program, supported by th e Kellogg Foundation, is oriented toward basic science and n u tritio n as they relate to dental health. Photograph from Kellogg Foundation.
lion in 733 grants from 503 foundations in 1966, or 5 1% of the total for health. Medical education profited from a number of substantial specially di rected grants, including nine Commonwealth Fund grants totaling more than $4 million, two Kellogg grants of $1 million or more, and single grants in the $1 million range from two smaller foundations. The Commonwealth Fund recently indicated a shift to medical education from medi cal research, chiefly in view of large government funds now available in the latter area. In 1966, dentistry (according to the directory), received eight grants from five foundations totaling $ 1,399,000 or 2% of the total granted for health. This compared with 30% of the total for medical educa tion ($ 18,000,000). O f the $ 160 million granted for health in 1964, $84 million came from the largest foundations, $42 million came from 1,227 intermediate founda tions (assets from $1 million to $10 million), $37 million came from small foundations (assets be tween $200,000 and $1 million), and $4 million came from very small foundations (assets under $ 2 0 0 ,0 0 0 ).
Advice fo r prospective grantees F. Em erson A ndrew s, o f the Foundation Library Center, in his foreword to the directory, states: “ Grant applications are the lifeblood o f founda tions, w hose central purpose is to find good re cipients for their m oney. “ Fund-raisers need to be warned that at least the larger foundations do not usually m ake grants toward the operating budgets o f agencies, whether national or local, or for individual need. Many foundations have accepted the doctrine that their lim ited funds should be used ch iefly as the venture capital o f philanthropy, to be spent in enterprises requiring risk and foresight, not likely to be sup ported by governm ent or private individuals. In their fields o f special interest they prefer to aid research, designed to push forward the frontiers o f know ledge, or p ilot dem onstrations, resulting in im proved procedures apt to be w idely copied. “Support for current programs, if it com es at all from foundations, m ust usually be sought from the sm aller organizations, and especially those located in the area o f the agency, well acquainted with its personnel and its needs. M ost small foundations, and som e larger ones, restrict their grants to the local com m unity or state. Im m ense variety exists; the interests and lim itations o f each foundation need to be exam ined before it is approached. . . . “ W here there is evidence that the applicant has not bothered to find out the field o f interest o f the foundation, or has m ade a general m ailing, the cost o f even a form al declination is scarcely war ranted; w astebaskets are available in any required size.” T h ese elem entary truths m ay seem so obvious as hardly to be worth repeating. Y et, hundreds o f w ould-be grantees overlook them every day.
The dental hygienist teacher tra in in g program at the U niversity o f M ichigan School o f D entistry is supported by the Kellogg Foundation. Photograph from Kellogg Foundation.
Relative weight o f foundations W hen the am ounts granted by the foundations are stacked up against the role o f the federal govern m ent and the state governm ents in education and research, the relative insignificance o f foundation givin g in dollar value becom es apparent.
Dental hygiene teacher education program at the U niversity o f Iowa is supported by the Kellogg Foundation. Here an undergraduate is prepared to apply the p rin cip le s o f oral prophylaxis to a clin ic a l situation. Photograph from Kellogg Foundation. Hudson: DENTISTRY AND FOUNDATIONS ■ 209
For instance, total outlay for research and de velopment in the United States from both public and private sectors rose from $2.9 billion 17 years ago to an estimated $23 billion today (Seymour J. Kreshover, 1967). This expenditure represented about 3% of the estimated gross national product for 1967, and over two thirds of it was supplied by the federal government. National expenditures on biomedical research, which amounted to $160 million in 1950, rose to an estimated $2.3 billion in 1967— a 14-fold in crease, according to Kreshover. O f the $2.3 billion spent for health-related research, 25% came from private industry, 10% from private philanthropy, voluntary health agencies and miscellaneous sources, and the remaining 65 % from the federal government. The federal share was largely funneled through the National Institutes of Health. Foundations, incidentally, are able to spend for all purposes only about 9 cents of the annual dollar of private philanthropy.
T ypically A m erican phenom enon
The modern foundation is a typically American phenomenon. Though almost as old as recorded history (Plato’s Academy, which survived its founder’s death by nine centuries, is considered a precursor), in the main the foundation is an American institution. From only about two dozen in 1900, the number has climbed almost perpen dicularly to more than 19,000 today (according to an essay in the January 19, 1968, issue of Tim e). New foundations are being formed at the rate of 1,500 a year, under the twin whips of family pride and federal taxes.
A dvan tages that fo u n dation s have
Foundations (according to the article in the Ency lo p a ed ia o f th e Social Sciences ) have the ad vantage over government in sponsoring research projects of an international character, and in spon soring protracted and costly pieces of research the outcome of which may be entirely uncertain. “ Similarly, the sponsorship of new social tech niques that are still in the experimental stage and may require years to prove or disprove their value — for example, mental hygiene, adult education and radio education— is undertaken to great ad vantage by private foundations; but here the ques tion arises whether the scope of experimentation 210 ■ JADA, Vol. 77, A ugust 1968
with new social techniques is not limited, by the source and administration of foundation funds, to those techniques which fit into the existing social system rather than change it in any essential way. Successful pioneering work by a private founda tion has, however, in the past encouraged public activity in the same field, particularly where the individualist tradition survives as strongly as in official America. . . .The foundations have also done excellent work for selected individuals. . . . Foundation activities, while by no means justify ing the economic situation out of which they spring, do at least in part wring good out of its defects.”
A cou n terw eigh t to govern m en t
Though foundations have in the past been regard ed by some critics as simply tax-dodging devices established to perpetuate the influence of wealthy individuals and families on the nation’s affairs, and as a means of perpetuating their concepts of capitalism, thinking on the role of the foundation has veered sharply in recent years. For one thing, time and again the foundations have ventured into new ground where government and the politicians have feared to tread because of vested interests and prejudices. For a second point, many of us are glad to see as many counterweights as possible develop to the massive weight of government in the nation’s affairs. Neither the radicals nor Congressman Wright Patman (the most persistent critic of foundations in Washington) find much sympathy for their crit icism of foundations, though Patman has scored some telling points in support of his demand that they could use m ore policing than they now get. T im e in its essay held that “Foundation giving belongs to the best democratic tradition: ruggedly individualistic, proud of its great wealth— and guilty enough about possessing it to consider in vesting it in unselfish ways. In no other country does private philanthropy possess either the wealth or the social conscience that informs its conduct in the U.S. To give money away wisely is a challenge that perhaps only a rich democracy can feel. And it is one that American philanthropy is earnestly striving to elevate into an art.” The principal mission of the private foundation, asserts Tim e, is to take its resources where neither government, which must consider the taxpayer, nor private business, which must account to the stockholder, dare go. Foundations should provide
the risk capital o f philanthropy, acting as the pio neers pushing forward into the future. “ A vast body of evidence in a dozen fields testi fies to their performance in this role,” points out Time. “As early as 1930, the Daniel and Florence Guggenheim Foundation was sponsoring the rock et research of Dr. Robert Goddard— a bit of fore sight so far ahead of its time that it took the gov ernment one World War to catch up. Without steady support from Ford funds, which have totaled some $140 million, educational television might have died of anemia. . . .Ford’s Gray Areas pro grams in five cities have been described as a fore runner of the government’s poverty program. As for science, Geneticist George W. Beadle has said that ‘the remarkable 20th century flowering of ex perimental biology would not have been possible without the support of private foundations in key areas and at critical times.’ “ Where the foundation money goes, govern ment money often follows— as it should. The U.S. government’s overwhelming presence- in such fields as public education, social welfare, medi cine and scientific research was largely prompted by foundation initiative. . . . “ There are countless examples of small sums priming big results. In 1908, for just $14,000 from Andrew Carnegie, an educator named Abra ham Flexner produced a broadside indictment of medical training in the U.S. and Canada that revolutionized and reformed the entire field. Pres ent-day foundation executives still cite it as a textbook example of how much good even a little money, when imaginatively applied, can do. [William Gies’ 1926 report on Dental Educa tion in the United States and Canada was pub lished by, and supported by, the Carnegie Founda tion for the Advancement of Teaching. And The Survey o f Dentistry, published in 1961, was aided by grants o f $280,000 from the Kellogg Founda tion, $25,000 from the Rockefeller Brothers Fund, and $5,000 from the Louis W. and Maud Hill Family Foundation.] “On its 50th anniversary, the Rockefeller Foun dation noted with understandable pride that 34% of all Nobel prizewinners in medicine, physiology, chemistry, and physics had been helped along the road to their achievement by Rockefeller grants . . . .A 1967 Ford grant of $175,000 for a voter registration drive sponsored by the Congress of Racial Equality in Cleveland was instrumental in electing Carl Stokes, the city’s first Negro mayor . . . .Project Head Start, now moving along on gov ernment backing, took inspiration from a pilot
The Kellogg Foundation is aiding a num ber of programs for the preparation o f teachers of dental hygiene. Shown are students in a lib ra ry at Colum bia University. Photograph from Kellogg Foundation.
project in Harlem that began with just $80,000 from the Taconic Foundation in 1960.” Harrar on role o f foundations J. George H arrar, president of the prestigious Rockefeller Foundation, in his annual report for 1967, discussed the role of foundations.“Over a period of years, the general-purpose foundations have acquired both experience and a degree of wisdom,” said Harrar. “They have found that to be most useful to society, they must choose their projects in anticipation of the problems of the future and deal with them in a way which will
Dental hygiene graduate students use a sorting m achine at the com puter center o f th e U niversity o f M ichigan. Photograph from Kellogg Foundation. Hudson: DENTISTRY AND FOUNDATIONS ■ 211
bring light rather than heat to bear upon them. Philanthropic funds should be used with fore thought, care, and persistence to support causes, programs, and projects that are clearly demon strable as fundamental to human progress. An element of risk will assuredly appear in all such cases and will take a variety o f forms. These risks cannot be avoided, nor can they be permitted to become deterrents to action. On the contrary, they must be faced squarely with full realization of their implications. “Foundations are, of course, only a minuscule element in the total picture of social institutions. In terms of experience and accomplishment, how ever, their share is proportionately much larger than the sums of money they have expended over the years. Foundations can innovate, catalyze, and stimulate; they can demonstrate the value of ideas, methods, and materials which can work toward the lessening or elimination o f persistent hunger and malnutrition, chronic disease and pestilence, continued ignorance and prejudice, and the other obvious social ills which underlie most human concerns. “ Perhaps the greatest single enemy of mankind is self-interest, which appears in countless forms and many guises in every society, in all inter group and interpersonal relations. . . .Self-interest is a definite symptom of a deep-seated impulse in human nature and can be controlled only through constant improvements in understanding and communication and respect for the rights of others. Man cannot subsist alone and every individual must find significance and self-fulfillment in re lationships with his fellow men. . . .In this area, too, as in others, private philanthropy must cou
rageously continue to take risks in the cause of human welfare.”
Small role in dental research, education Foundations, except for the Kellogg Foundation, have played an insignificant role in dental re search and dental education. Kreshover (North west Univ Bull 67:6 Fall 1967) has pointed out that “whereas industry, foundations, and other organizations contribute substantially to research and graduate education in the general medical field, the National Institute of Dental Research is the overwhelmingly predominant source of sup port for research in oral health. . . .Because oral health problems do not ordinarily involve fatal disease, general recognition of their magnitude has come slowly. Thus, dental research has lacked both visibility and critical mass of trained person nel characteristic of other health-related research. For this reason, the support of research and gradu ate education in the basic and clinical sciences by NIDR. . .may be estimated at over 80% of the total national investment in dental research. . . . “The most important source of dental research workers and teachers has been the graduate train ing and fellowship programs sponsored by NIDR . . . .To meet greatly expanding future needs, how ever, dental schools will also have to utilize, to an increasing extent, support available from the N a tional Institute of General Medical Sciences and such organizations as the National Science Foun dation.”
Grants level o f f in 1967 U niversity of Iowa p ra ctice teachers in dental hygiene discuss a p a tie n t’s history. Photograph from Kellogg Foundation.
212 ■ JADA, Vol. 77, A ugust 1968
In 1967, for the first time in over a decade, the na tion’s philanthropic foundations failed to increase the total amount of their annual grants, according to a story in the April 7, 1968, New York Times. In 1967, their disbursements leveled off at $1.3 billion, about equal to the 1966 total. The Times estimated the foundations’ combined assets last year at $20.3 billion, about double the amount in 1960. In the same period, annual grants also doubled. The Times obtained its figures from the annual report of the Foundation Library Center. The Cen ter attributed the leveling off to “ a shift of empha sis as foundations seek ways of responding to the urban crisis and Negro needs.” Increased govern ment action in education, health, welfare and re-
search was found to have forced the foundations to reexamine their own role. M anning J. Pattillo, Jr., president of the Cen ter, said that, to avoid losing public support, foun dations should be more forthright in their account ing to the public. Only 150 of the nation’s 20,000 foundations publish annual reports, he said. They merely file routine reports with the Internal Rev enue Service to retain their tax exemption. Pattillo praised the diversity of most foundations as an im portant force in a free society. But he pre dicted that as the foundations entered into more sensitive social and political areas of activity, such as social reform in the cities, they might face in creasing controversy over their grants and opera tions. Growing interest in the cities and in television has led to a decline in the foundation support of higher education. In 1967, for instance, the Ford Foundation president, George McBundy, announced that the foundation’s general support of colleges and universities would be discontinued in favor of pinpointed grants, such as a major support program to permit selected universities to improve their graduate education. About 1,800 new foundations were established in 1967, according to the Center. Ten of the 25 largest foundations and one fourth of all founda tions are in New York City. Neither New England nor California has a single major foundation.
U niversity of M ichigan fle d g lin g teachers o f dental hygiene view cu ltu re s under the m icroscope and counsel w ith a professor. Photograph from Kellogg Foundation.
Grants also were made to strengthen professional dental organizations and to train dental auxiliaries. In the United States the Kellogg Foundation made grants in 1967 to help institutions develop experi mental programs for the training of dental teachers, to strengthen various professional organizations, to help graduate programs to prepare teachers of dental hygiene, and to help six educational institu tions develop programs to train dental auxiliaries. One reason the Kellogg Foundation is sensitive to dentistry’s needs may be the fact that Emory W. Morris, chairman o f the board, and Philip E. Blackerby, president, are dentists.
R eco rd o f K ellogg Foundation A m erican Fund f o r D en tal Education
The foundation most aware of, and most re sponsive to, dentistry’s needs, and whose name has cropped up several times in this report, is one of the largest, the W. K. Kellogg Foundation. Its annual report for some years has been studied by dental leaders. In 1967, a typical year, the Foun dation made grants of $546,834 to dentistry, of which $25,201 went to dental needs in Canada, $210,919 to dental institutions in Latin America, and $310,714 to dental institutions in the United States. In Canada the University of Toronto re ceived payments of $25,201 toward a larger long term grant to assist in developing a program to teach dental students the effective use of auxiliary personnel. In Latin America, the Kellogg Foun dation made large grants to the Pan American Sanitary Bureau for community water fluoridation, and financed fellowships in many Latin American dental schools to permit faculty members to obtain specialized preparation in the United States.
Joseph Dickinson, executive vice-president of the American Fund for Dental Education, is knowl edgeable about the foundation field. There are about 1,600 foundations interested in higher education or health projects, he said. In 1963, the A FDE wrote these foundations, giving them general information about the dental field. In 1965 the AFD E approached about 800 founda tions specifically for support of graduate students in dentistry. Not one responded to an appeal for $6,000 fellowships. The A FD E sends its annual report to 800 foundations, two or three of which have given token amounts. The largest grant was $5,500 from the Sears Roebuck Foundation to publish career guidance material, said Dickinson. As noted earlier, the A FD E recently received a grant for help in establishing a scholarship pro gram for Negro dental students from Kellogg. “To succeed with the foundations, one must Hudson: DENTISTRY AND FOUNDATIONS ■ 213
have a program tailored to fit a particular need which falls within the Foundation’s area of inter est” said Dickinson. The Ford Foundation to date has omitted dentistry from its fields of interest, he said. “The foundations generally are interested in investing money in individuals and institutions who are going to use the money,” he said. “ We have a third-party relation to the foundations.” Some dental schools have had sizable grants from foundations, he said. New York University has had foundation support, chiefly from local or regional foundations. The Kellogg challenge grant will help to provide 40 five-year scholarships of up to $12,500 each over the next three years. Total cost of the program, including administration and recruitment, will be $560,500. Scholarship support, as determined by individual need, will begin in the final year of predental school and continue throughout the four years of dental school. For the initial three years the Kellogg Foundation will provide $150,000 for 12 scholarships and $ 15,000 for administration. Raymond J. Nagle, outgoing president of AFDE, termed this the first challenge grant given to dentistry by the Kellogg Foundation. He termed the grant as “ a very satisfying one which will allow dentistry to compete more effectively with other professions and with industry for the qualified Negro student.” Though Negroes comprise over ! 1% of the nation’s population, only 2% of the nation’s more than 1 10,000 dentists are Negroes, said Doctor Nagle. Under terms of the challenge grant, the A FDE must match dollar for dollar the $27,500 for scholarships and administration awarded by the Kellogg Foundation the first year.
The Fund has agreed to guarantee that amount and has begun to seek the necessary matching funds for all three years from foundations and other sources. AFDE officials expressed the hope that ultimately funds can be obtained for at least 250 scholarships per year. Four scholarships will be offered for the 1968-1969 school year, Dickin son said. Provided the necessary matching funds are raised, 12 scholarships will be offered in 1969 and 24 in 1970. Other than the dental schools at Howard Uni versity and Meharry Medical College, only 21 of the nation’s dental schools have any Negro stu dents. None has more than four and most have only one. Howard and Meharry used to have sizable Negro enrollments in their dental schools but now are experiencing increasing difficulty in enrolling Negro students; other fields offer more immediate financial returns and fewer years of study.
A n a lysis b y on e den tal a d m in istra to r
Several dental spokesmen were asked why' more foundations have not contributed to dentistry. Typical was the well-formulated response by Viron L. Diefenbach, assistant surgeon general of the United States, and director of the Division of Den tal Health, Public Health Service. “I think the dental profession has been re miss in ‘not attempting to whet the interest of the foundations with creative proposals,” said Diefen bach. “There are many challenges in developing dental manpower, in organizing better services
In an experim ental program at th e U niversity o f M anitoba in Canada, fu n c tio n s th a t have been perform ed only by the d e n tist have been delegated to auxiliary workers. Photograph from Kellogg Foundation.
for disadvantaged groups, in testing new schemes to finance dental care, in supporting much-needed dental programs in international health— surely good proposals in these areas could spark founda tion interest. “By contrast, I surmise that proposals sub m itted to the foundations have been pleas for financial assistance to remodel and expand dental clinics and teaching facilities. Such unglamorpus undertakings, important as they may be, are not usually the kind of projects that fit the philosophies and purposes of foundation programs. “Perhaps the dental profession should first fix the responsibility for serious planning and soli citing of foundation support. To begin with, we must know what major areas o f interest founda tions have and what emphases are currently holding their attention. An attempt to see dentistry from the perspective of the foundations is what is needed. “The American Fund for Dental Education might be an initial source to plan what should be done regarding foundations and dentistry and be gin to carry that plan out. Under its auspices, a small, full-time staff could put together the neces sary documents and determine the dental'interest of the foundations. I believe that proposals then could be developed and carried out but it will be up to us to gain the know-how and to go after their support.” If dentistry now intensifies its appeals for foun dation support, such appeals will come at a time when some of the major foundations appear to be turning away from the health and research fields. Also, we are probably entering a period when researchers in many fields will be desperately seeking foundation support because it seems likely that the federal government, under extreme pressure to set its own financial house in order, is
going to cut drastically its support for health re search and health education. Research workers and institutions who have been living on govern ment funds are going to have to look elsewhere for support. Finally, we are entering a period when the nation’s dental schools themselves are in desperate need of support. H arold Hillenbrand, secretary of the American Dental Association, has reported that the country’s dental school's are faced by an unparalleled financial crisis. Unless there is a ’’substantial increase in the amounts of federal support for dental education, 10% of the nation’s dental schools may have to close their doors,” said Doctor Hillenbrand. “We may lose another four to six dental schools unless Congress takes swift action to increase federal assistance to dental schools.” The financial crisis is particularly severe for the dental schools in private universities which constitute half of the nation’s 50 dental schools, he said. “The closing o f any dental school is a crippling blow to our hopes of increasing dental manpower.” he concluded. “The retention of an existing school, its faculty and student body, is at least as impor tant to the future as the funding of a completely new school that will require eight or ten years before graduating its first practitioner.” If the nation’s major foundations can now be induced to scrutinize dentistry and its needs, they may be intrigued at the opportunities that exist for promising grants in this field.
Mr. Hudson isassistant editor, Am erican Dental Association.
Hudson: DENTISTRY AND FOUNDATIONS ■ 215