International Dentistry

I N T E R N A T I O N A L D E N T I S T R Y

GREAT B RITAIN

■ N ATIONAL HEALTH SER VIC E: An edi­ torial in the O ctober 1972 issue of the B ritis h D e n ta l Jo u rn a l, titled “ Poor Relations in M anagem ent,” contained the following para­ graphs: When viewed as a social experi­ ment, few would deny that the Na­ tional Health Service must be re­ garded as a resounding success. Unfortunately, the public at large seems to be u naware th a tth e stand­ ard of patient care which has been achieved to date often has been made possible only by those em ­ ployed in the National Health Ser­ vice contributing far more than they are contracted to do in order to re­ solve problems resulting from shortages of staff, money, and fa­ cilities. Nevertheless, the Service has shortcomings, and it has been the declared policy of the present gov­ ernm ent— as well as its predeces­ sors— to attempt to resolve them by reorganizing the administrative structure. The latest docum ent to be issued is titled “ Managem ent Arrange­

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ments for the Reorganized National Health Service.” It is couched in the jargon of “ m anagem ent” and con­ tains little to comfort any dentist. Like its predecessors, it places em ­ phasis on the value of good man­ agement, but ignores the fact that this alone cannot compensate for the chronic under-financing which has characterized the NHS to date. The proposed management structure places far more power in the hands of administrators at the ex­ pense of both the professions and the representatives of the public. The reorganization is due to take place in 1974. As there is little evi­ dence of the existence of an ade­ quate pool of enlightened, experi­ enced, and gifted potential appli­ cants for these im portant adminis­ trative posts, it would appear to be probable that the transitional phase is likely to be prolonged. Administrative dental officers are to be appointed, and it is to be hoped that details of the career structure, salary scales, and oppor­ tunities for training in management techniques will be made available to the dental profession at an early date. Dentists must heed the lessons

learned from past experience, for it has been rightly said that those who fail to learn from history are con­ demned to relive it. Those employed in both hospitals and universities know only too well what happens when decisions on dental matters are taken by others. The proposed arrangements at regional level will cause them justifiable anxiety con­ cerning the future of dental teach­ ing hospitals and the development of hospital dental services. Public dental officers have good reason to know how status, career prospects, and job satisfaction are imperiled when dentists are subor­ dinate to members of another pro­ fession. They will need to consider whether right of access is really an adequate substitute for genuine participation in management. Every dental practitioner must re­ member that integration is one of the stated aims of the reorganiza­ tion. The W hite Paper presented to Parliament by the Secretary of State for Social Services on Aug 1 opens with the words: “The National Health Service should be a single Service.” All should realize that, within the reorganized Service as it is described in that docum ent, it is

possible— in theory at least—that their clinical freedom can be affect­ ed, albeit indirectly, by policy de­ cisions made without reference to them or to their representatives. Decisions of importance to den­ tistry will be made at every level and the profession should endeavor to insure that its views are given the consideration they merit. Surely, a representative dentist should serve as a member of every district man­ agement team, and an appointed dental officer should be a full mem­ ber of the team of officers at both area and regional levels. Unless such minimal objectives are se­ cured, it is to be feared that dentists are likely both to experience and to be poor relations in management. ■ GENERAL DENTAL COUNCIL: In his

President’s Address at the opening of the 36th session in November, Sir Robert Brad law included the follow­ ing remarks: The theme of my address to you today is the need for communica­ tion. It is a need which is being in­ creasingly emphasized by percep­ tive observers of the contemporary scene. Today it is axiomatic that auth­ oritarianism is out; and it follows that successful administration is de­ pendent on meaningful discussion between the administrators and those who will be most affected by their actions.

The need to carry with us the gen­ eral agreement of those whose will­ ing cooperation is essential to the success of our policies seems to me to concern this Council very much on three different levels. First, there is a need for communication be­ tween the practitioner and his pa­ tient; second, there is a need for communication between the dental profession and the public; and third, there is a need for communication between the General Dental Coun­ cil and the profession. I have been made increasingly aware during my period- of office that all three needs remain to some extent unsatisfied. P ra c titio n e r and p a tie n t Of the letters of complaint which reach the Council, a very high pro­ portion— perhaps, more than half— have, I believe, originated in afailure of communication between practi­ tioner and patient. Has not the practitioner, as an educated and experienced profes­ sional man, a moral duty to insure that the uninformed layman under­ stands precisely what service he needs and how this is to be carried out? Should he not insure that each and every one of his patients is told clearly and unequivocally whether he is being treated under the Na­ tional Health Service regulations or as a private patient? I am convinced that there can be

few of the dentists against whom complaints are made to the Council who had any intention of deceiving their patients; it is simply that there has been a failure to get the mes­ sage across. P rofession a n d p u b lic Then there is, as it seems to me, a lack of communication between the dental profession in general and the public we serve. A disgruntled journalist recently wrote in a leading article in his newspaper: “ I am getting a trifle weary of our so-called professional people. I think it is time all their professional bodies looked at their images: looked at what they seem to be do­ ing to themselves, and looked at what they are doing to the public trust.” He illustrated ways in which, according to him, the taint of com­ mercialism had crept into medicine, dentistry, and the law. Others have written in the same strain. The professions are not accus­ tomed to speak out for themselves. By tradition they have been relative­ ly privileged and they have on the whole taken great care to provide a quality of service which has more than justified their position. Now, under economic pressure and sub­ ject to public criticism, they should continue to give exemplary service. M ostdoso, butthey should no long­ er be hesitant to make it known and to explain, simply and often, the rea­ sons for any actions which are found to provoke criticism. C o u n c il a n d p ro fe ssio n

During his recent visit to the Hebrew University-Hadassah School of Den­ tal Medicine, Louis A. Saporito (left), ADA president, reviews the school's training and research program with Jack Lewin-Epstein, dean of the Jerusalem dental school. Dr. Sapo­ rito was in Israel as guest of honor of the international convention of the Alpha Omega Fraternity.

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Finally, I must come to the com­ munication between the Council and the dental profession. It has not, I think, always been as adequate as it might have been. There is an inevitable tendency toward divergence of purpose be­ tween the state, which must seek to satisfy as best as it can a widespread need for routine dental treatment, and the dental profession, which would cease to justify its position as a learned profession if it did not continuously strive to grow up­ wards in increased knowledge and

improved techniques as well as seeking to serve greater numbers. The Council, as a body composed mainly of dentists— both teachers and practitioners and supported by fees paid by a dentist— but respon­ sible for the public welfare, is in a position to overcome this tendency and to insure that the community obtains the best of both worlds with­ in the limits of the available means. This is the C ouncil’s principal function and, incidentally, its great­ est service to the dental profession in this country. But the Council benefits the den­ tal profession in another way. If we examine the C ouncil’s statutory functions in education and discip­ line, it is clear that they all are in­ tended to serve to improve and maintain the public’s confidence in the dental profession. Holders of dental degrees and diplomas awarded in this country are auto­ matically entitled to registration, but the standard of education provided in each dental school is subject to regular supervision by the Council, as are their examinations, by means of visitations. Supervision of asim ilarkin d is ex­ ercised over the standard of those overseas dental schools whose de­ grees are generally recognized as admitting the holders to the R egis­ ter. The holders of other overseas degrees wishing to practice here have to show that they as individuals possess the requisite knowledge and skill for the practice of dentist­ ry in the United Kingdom, and this they can do only by passing the stat­ utory examination prescribed by the Council. Thus, because the Council has controlled the standard required for entry to the R egiste r, people may confidently believe that any dentist from whom they seek treatment has attained an approved level of com­ petence. They need have no fear of harm at the hands of an untrained person. Now that our entry into the Euro­ pean Economic Community is immi­ nent (Great Britain entered the Common Market in January), it is well that I should give reassurance

that it is still the duty of this Council to satisfy itself that those who are permitted to practice dentistry here are fit to do so, although the mech­ anism by which this is to be done within the EEC has yet to be de­ signed. ■

DENTAL SU R G E O N 'S LIB EL ACTION:

Last June 12, a hearing began in the High Court before JusticeAckner on the libel action brought by S. L. Drummond-Jackson against the British Medical Association as pub­ lishers of th e B ritis h M e d ic a l J o u rn a l and four members of the staff of the University of Birmingham. Dr. Drummond-Jackson com­ plained about an article written by the four members of the staffs of the departments of anesthesia or of conservative dentistry at the Univer­ sity of Birmingham. In his statement of claims, the plaintiff alleged that the effect of the article on his reputation was that, in te r alia, he was understood to be using and advocating a technique for conservative dentistry which was likely to cause death and/or which had several deaths associ­ ated with it, and that he was acting with irresponsibility in continuing to use and advocate the technique after a governm ent committee had expressed disquiet about its safety in 1967. The defendants alleged in their defense that the words did not bear or were not understood to bear any meaning defam atory of the plaintiff. They pleaded that the words were true and they relied on the alleged results of the experiments at Bir­ mingham as being the basis of their case. They also claimed that what they wrote was fair comment on a mat­ ter of public interest— namely, the use and effects of the drug methohexitone as an anesthetic agent and the plaintiff’s advocacy and teach­ ing of such use. A further defense that the defen­ dants relied on was that the words were published on an occasion of qualified privilege. They argued that because the B ritis h M e d ic a l J o u rn a l was the official journal of the British

Medical Association, because it cir­ culated almost entirely among the medical profession, and was gen­ erally recognized as a principal me­ dium for the com m unication and discussion of matter concerning the profession, they had a duty to pub­ lish what they did and their readers had a common and corresponding interest to receive the information contained in the article. On the 38th day of the hearing, discontinuance of the action was announced by counsel fo r Dr. Drum­ mond-Jackson, who said: “We are all grateful to Your Lord­ ship for giving us tim e for further discussions. It has becom e increas­ ingly clear as this case has proceed­ ed that a full exam ination of the is­ sue would require many months of further evidence, and the atten­ dance of a large num ber of medical and academ ic witnesses to express their opinions on the difficult sci­ entific questions which arise for de­ cision. “Against this background, the parties are happy to tell Your Lord­ ship that they have settled this ac­ tion on the terms that it is discon­ tinued with all parties bearing their own costs, and this agreed state­ ment is made in open court with the concurrence of all concerned. “The defendants all recognize and acknowledge that the plaintiff is a man of the highest integrity and skill, and of outstanding ability as a dentist. “The plaintiff, for his part, with­ draws any allegation against the de­ fendants or any of them of dishon­ esty or impropriety. Further, he rec­ ognizes and acknowledges that the B ritis h M e d ic a l J o u rn a l has a right and duty to its readers and to the medical profession generally to publish articles such as that sub­ mitted to them by the individual de­ fendants and to com m ent on th em .” ■ p a r l i a m e n t a r y n e w s : The Secre­ tary of State for Social Services was asked about the num ber of dentists practicing in Wales, Scotland, and England. He noted that as of March 1972, there were 445 in Wales, 1,105 in

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Scotland, and 10,687 in England providing general dental services. This was a total of 12,237. G. H. LEATHERMAN, FDS, RCS, DMD, DSC

AUSTRALIA

■ S y d n e y : Dental training in Aus­ tralia— where the Federation Dentaire Internationale meeting will be held July 14-20— was incorporated into university curriculums here in 1901. The first graduating class at Syd­ ney University in 1906— members of which acquired the degree of Bachelor of Dental Surgery— was made up of 11 men and two women. Students graduated from the dental department in the medical school, but in 1920 a dental school was established with Richard Fairfax Reading accepting the appointment as dean of the Faculty of Dentistry. At the present time, with the ex­ ception of Tasmania and the Aus­ tralian Capital Territory, there is a dental school in each state. Stu­ dents graduate with the degrees of either Bachelor of Dental Surgery or Bachelor of Dental Science. The de­ gree consists of five years training, and higher degrees of Master of Dental Science and Doctor of Den­ tal Science are available to success­ ful students after further study and research.

Its ow n college Australia recently established its own College of Dental Surgeons, and some dentists achieve fellow­ ship in the Royal Australian Col­ lege of Dental Surgeons. Australia’s dental schools are among the first in the world to rec­ ognize the changing demands of dentistry. In the words of Sydney’s Prof. Noel D. Martin, “20,oreven 15, years from now could see a move­ ment from practice to public health dentistry.” The World Health Organization’s ideal dentist-patient ratio of one to every 1,000 head of population long has been recognized as an unob­

Four buildings will be involved in most o f the activity during the 61st annual session o f th e Fed­ eration Dentaire Internationale to be held in Sydney, Australia, July 14-20. The structures are the Stage III Building (right foreground) which will house the FDI offices and com m ittee rooms; the Round House (just above Stage III) which will contain the trade exhibitions and eating facil­ ities; and the Applied S cience Building (top right with clock) and the Science Hall (top left) w here the lectures will be held.

tainable object, butthe problem still has to be tackled. The reorienta­ tion of the dental schools in Aus­ tralia toward the posture of preven­ tive dentistry and public health den­ tistry now are recognized as the most practical approach. New ground first was broken in Australia in 1962 when Prof. P. Barbard was appointed lecturer in pub­ lic health dentistry, as a reinforce­ ment to the existing department of preventive dentistry. Prof. Martin has been the personal driving force behind Australia’s fluoridation pro­ gram. Fluoride had been recog­ nized as an important weapon against tooth decay, but it was not until Prof. Martin took the question of fluoridation out of the university

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into open public debate that results were achieved. 80% e n jo y flu o rid a tio n Government action and legisla­ tion in various states have made it possible for 80% of the population to have fluoridated drinking water. Clinical prevention techniques de­ veloped by the profession have brought about marvellous results in the onslaught against dental car­ ies. Clinicians employing preven­ tive procedures and operating in a fluoride environment have recorded results which can be computed to represent a reduction of more than 90% in the incidence of caries in their areas. While the population of Australia

(13 million) has a m anpow erof 5,300 dentists at its service, the national result of demonstrable caries pre­ vention in relation to this manpower is approaching the best in the world. The establishment of the Dental Health Education and Research Foundation of the University of Syd­ ney was the w ork of the profession. Concerned with the high rate of dental decay and difficulty of chang­ ing patient attitudes to treatment, the Dental Alumni Society of the University of Sydney and the Aus­ tralian Dental Association sought fi­ nance from within the profession to establish thefoundation. Im mediate pledges of support totaled more than $A100,000. The senate of the University of Sydney accepted the foundation as a function of the uni­ versity, and the first council was named and approved by the senate in May 1962. F o u n d a tio n 's aim s The stated aims of the founda­ tion were to cooperate with the uni­ versity and the Faculty of Dentistry to improve the dental health of the community by communications, postgraduate work, and research. The activities of the foundation have embraced the direct communica­ tion with the general public and spread to the financing of research scholars. A three-year study into patientdental relationship was completed by the psychology department of the University of New South Wales. This project did much to direct the attention of the foundation in its work of direct communications with the general public. At present, the foundation is em­ ploying two school dental health educators, who have the coopera­ tion of the Department of Health and Education in their regular visits to primary schools. Children are thereby introduced to the basic causes of decay and instructed in home oral hygiene by professional staff at the earliest optimum age. D e ntal e p id e m io lo g y At the same time as dentistry in Australia has been accenting pre­

ventive procedures, the study of dental epidemiology has been ad­ vancing. Australia’s David Barmes, in his position with the World Health Organization, is a leader in dental epidemiology. A field study in the Territory of Papua, New Guinea, led by Dr. Barmes under the sponsor­ ship of the World Health Organiza­ tion, employed several other em i­ nent Australian Epidemiologists and research workers. Among them were R. G. Schamschula, B. L. Ad­ kins, and Prof. G. Charlton. Material and information from this field subsequently were made available to departments in Austra­ lian universities and the Institute of Dental Research where new in­ sights have been gained into the eti­ ology of dental caries and periodon­ tal disease. A highlight of this work has been the demonstration by Dr. Schamschula of the strong positive associations between the preva­ lence of caries and the prevalence and relative proportion of total streptococcal counts in plaque. In the institute, particularly im­ portant w ork has been done on the biochemistry of caries and peri­ odontal breakdown. The Institute of Dental Research, under the direc­ torship of Robert Harris, is an inde­ pendent institute working within the Dental Hospital of Sydney. Although the institute was modeled along the lines of the National Institute of Den­ tal Research at Bethesda, there is no other quite like the institute in Sydney for its independence and freedom to cooperate with whatever available personnel pursue parallel interests. G o ve rn m e n t c o o p e ra tio n Government departments of pub­ lic health cooperate with the dental profession in Australia, where den­ tists are less inclined to practice in remote areas or underdeveloped centers. Shortly after the com­ mencement of the present century, the Australian Dental Association carried out an extensive exam ina­ tion of schoolchildren. As a direct result, the Department of Public In­ struction initiated a school dental service. The government care was extend­

ed to include the poor and under­ privileged, aged pensioners, and settlers in Outback areas and the Aborigines. The dental treatm ent of patients in the Outback is attended to by the Flying Dental Service, a branch of the famous flying physi­ cian service. The patients are the settlers and workers in the Northern Territory and the rem oter parts of neighboring states. In the Northern Territory there are about 23,500 Aborigines, employed in the rural industry or engaged on mission stations, and the mobile dental units endeavor to visit these centers twice annually.

■ P R E V EN TIV E D E N T IS TR Y S U ITE ': A specially designed “ Ideal Preven­ tive Dentistry Suite” is to be estab­ lished at the 20th Australian Dental Congress— to be held in conjunc­ tion with the FDI meeting— by the Dental Health Education Com m it­ tee. It will be in the same building as the international equipm ent exhibi­ tion. The suite will consist of open booths arranged for easy access to visitors, and also to maintain the collective continuity of the suite. The suite will demonstrate how waiting rooms, consultation rooms, operatories, and diagnostic labora­ tories can be adapted and designed for use in the practice of preventive dentistry. A most important function of the preventive dentistry suite will be the provision of a forum where the tech­ niques of plaque control, dental car­ ies examinations and susceptibility tests, treatm ent planning, and the practical aspects of such a program can be discussed and dem onstrat­ ed. In order both to help the visitors and to provide experience for those present, a number of patients will use the suite and will be used to demonstrate preventive proce­ dures, treatment planning, and the various special bacteriological tests of plaque. An opportunity will be provided to see bacteriological tests and plaque examination in the labora­ tory as a real and practical aid to

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the control of dental disease. The opportunity will be taken to present to the profession plans of the Dental Health Education Com mittee to pre­ vent dental disease and, in effect, to eliminate dental caries as an en­ demic disease in Australia in the near future. With more than 50% of the reticu­ lated water supplies in Australia fluoridated and 80% of these sup­ plies in New South Wales fluoridat­ ed, the committee feels it has a won­ derful foundation fo rth e prevention of dental disease. The preventive dentistry suite will be a focal point of activity and interest for all those interested in the preventive aspects of dental care. ■

IN TR A VENO US SED ATIO N IN D EN TISTR Y:

The National Health and Medical Research Council approved the fo l­ lowing recommendations at its 75th session in November: “The Council recognized that in­ travenous sedation in conjunction with local anesthesia by an ade­ quately trained dentist and on se­ lected patients has its place in den­ tistry. However, the Council con­ sidered the routine use of intraven­ ous sedation by dental practitioners undesirable because of the respira­ tory and circulatory problems which may arise, its prolonged action which could be a serious danger to an ambulant patient leaving the dentist’s premises, and also be­ cause of the possible problem of drug dependence with repeated dosage.” The above statement by the Na­ tional Health and Medical Research Council is in no way contrary to any aspect of the policy of the Australian Dental Association. ■

DENTAL TEC H N IC IA N S AND TH E PU BLIC :

The State of Victoria recently passed legislation to enable dental technicians to deal directly with the public. The introduction of this con­ cept was vigorously opposed by the dentists, and as usual caused argu­ ments by the opponents on political philosophies other than on preser­ vation of health standards. After more than two years of con­

sideration by the government, the Technicians Act finally passed through both houses of the Victor­ ian State Parliament by Dec 13, 1972. At all times, dentists have been adamant in their endeavor to main­ tain standards and to safeguard public health. When it became quite evident that the government intend­ ed to proceed with the legislation to create a new paradental person, then dentists’ efforts were directed at the protection of standards. All future graduates in advanced den­ tal technology must be as well trained in their work as are other paramedical personnel. The Technicians Act provides for the licensing of technicians and the registering of advanced dental tech­ nicians. Under the act, a committee called the Dental Technicians Li­ censing Com mittee will be respon­ sible for supervising the conduct of dental technicians and the practice of dental mechanics by dental tech­ nicians. By law, the committee must main­ tain a roll of licensed technicians. Those employed bona fide as tech­ nicians on the passing of the act will automatically be licensed on pay­ ment of a fee, provided that this is done within 12 months after the act becomes law. After 12 months, a technician must have satisfactorily completed an apprenticeship or a full-time course to be able to be li­ censed. The act provides for the setting up of an Advanced Dental Techni­ cians Qualifications Board to be re­ sponsible for the conduct and prac­ tice of advanced dental technicians who will be allowed to construct and fit in the mouth full upper and full lower dentures, or a full denture in one jaw. They will be allowed to repair full dentures and fit same. Partial den­ tures of any type are definitely not allowed, n orare technicians perm it­ ted to work on a jaw in which natural teeth exist. Dentists always will be adamant in this respect. A person who applies for a license as an advanced dental technician must satisfy the board that he:

— has attained the age of 21 years; — is or is entitled to be licensed as a dental technician; and — has completed an approved course of training for advanced den­ tal technician. The board will determ ine the edu­ cational standard for entry to the course, the subjects to be studied, the length of the course, and the ex­ aminations to be set. However, any person who has practiced as a dental technician for a period of not less than ten years and is licensed, may— at any time prior to Dec 31, 1975— apply to the board for registration as an ad­ vanced dental technician. The board shall require such an appli­ cant to take “such exam inations, written, oral, and practical as it thinks fit” (quote from the act). Som ewhat sim ilar to the Dentists Act 1972, th is act provides for a pen­ alty of up to $500, or up to six months imprisonment— or both— for the first offense, and of $1,000 or up to one year’s im prisonm ent— or both—for the second offense. This will apply to any person whether he is a licensed technician or an advanced dental technician if he moves outsidethe provisions of the Act. R O B E R T Y. N O R TO N

A RG EN TIN A

DEATH OF A SC HO LA R: Juan Chaneles died last June. Even those who didn’t have the good fortune of knowing him personally will regret his death— for he was a com plete man, an excellent practitioner (graduated in 1918), a well-known professor of pharmacology and therapeutics, an equitable dean, a graduate in literature (1921), an ear­ nest researcher, and a good friend of the American Dental Association. As a researcher, he received sev­ eral prizes— among which should be mentioned those awarded by the School of Medicine in 1928, 1931, and 1934. The last two meant a rec­ ognition of his work in the field of fluoridation in which he became an ■

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expert. In this area, he worked for the World Health Organization from 1957 to 1967. Dr. Chaneles was a scholar, more in love with the peace of study and culture than with the din of work and struggle in professional organiza­ tions. Thus, he never accepted a job in the Argentine Odontological As­ sociation other than that of editor of its journal. Up to his last mo­ ments, he tried to keep the world in­ formed of dental life and science in Argentina through his work as for­ eign correspondent for t h e j o u r ­ n a l and abstractor for Oral Re­ search A bstracts. His death will not pass unnoticed in the international dental world. ■ im p o r t a n t 1972 e v e n ts : The year

1972 was a busy one. It would be almost impossible to try to give credit to all the meetings, courses, and lectures held last year. Some will be rescued here from oblivion, although all of them deserve to be. The most important event to be mentioned was the Ninth Interna­ tional Meeting of the Center of the Republic, which was held in Cor­ doba Oct 1-4 with Rodolfo Camardo as its president. Dentists from throughout Argentina as well as sev­ eral American and European coun­ tries met there and exchanged in­ formation. Other meetings should be men­ tioned here. The Circulo Argentino de Odontologia organized a dental meeting at the School of Dentistry, with Hec­ tor L. Schweizer as its president. The oral surgeons of the Argen­ tine Society of Oral Surgeons held their fifth meeting in October at the headquarters of the Argentine Odontological Association. Presid­ ing was Juan C. Jaitt. The Argentine Society of Endodontics held its first seminar with a limited number of participants (150). The seminar, presided over by Enrique Basrani, was held early in September at the Argentine Odontological Association head­ quarters. Juan R. Castro presided at the Second International Meeting of

Prosthodontics last June at the AOA headquarters. The purpose of the meeting was to honor Pedro Saizar, of whom Fermin Carranza said: “ Few men have done so much for Argentine dentistry.” Thefirst Meeting forlm provem ent in Pedodontics took place last Sep­ tem ber, with dentists from the Unit­ ed States, Europe, Brazil, and Ar­ gentina participating. The American teachers were Robert G. Andrews and Louis Ripa. The presiding of­ ficer was Horacio Martinez. ■ e v e n ts t o co m e : With the magnifi­ cent sight of the waterfalls of Iguazu, in the province of Misiones, serv­ ing as a background, the Argentine Odontological Association will hold its 15th Inland Meeting this year. Dentists from the nearby prov­ inces of Corrientes, Chaco, and For­ mosa, as well as from more distant places will attend, plus others from Uruguay, Brazil, Chile, and Para­ guay. Three short courses on sur­ gery, pharmacology, and operative dentistry will be given by Enrique Muller, Pablo Bazerque, and Fer­ nando Pinto. The Sheraton Hotel in Buenos Aires will be the site for the Argentine-Brazilian-Uruguayan Odontol­ ogical Congress Oct 18-31, which is expected to attract the largest num­ ber of dentists ever summoned to Argentina. The Congress is being organized by the Argentine Odon­ tological Association, in coopera­ tion with the Brazilian and Uruguay­ an associations. For information about the meet­ ing, contact Ricardo H. Canzani, President, Junin 959, Buenos Aires, Argentina. HORACIO MARTINEZ

CANADA

■ ADVERSE DRUG REACTIONS: During the 1972 annual meeting of the Con­ sumers’ Association of Canada, the delegate body passed a resolution calling for action from a number of professional associations in urging

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their members to report all adverse drug reactions. The resolution reflects the con­ cern of CAC members with regard to the need for a full-scale thera­ peutic monitoring system in Can­ ada. The three main areas of con­ cern set forth by the CAC as the ba­ sis on which the resolution was drafted are as follows: — There is evidence that adverse reactions in humans to therapeutic drugs are a serious problem of which the full content is concealed by the absence of a large-scale re­ porting system for such reactions. — There is concern among inter­ national medical bodies about the appropriate use of drug treatm ent, of long-term effects of drugs, of the identification of a predisposition to drug reactions, and of the need for thorough pharmacological study of the effects of drugs. — The seriousness of the problem of adverse drug reaction has been acknowledged by eminent medical authorities in several other coun­ tries, and strong recommendations have been made by them for the establishment of national drug monitoring systems. The resolution presented by the CAC delegates reads: “ Be it resolved that CAC support in every possible way the therapeu­ tic drug monitoring program estab­ lished by the Department of Nation­ al Health and Welfare; that it request the Canadian Medical Association, the Canadian Society of Hospital Pharmacists, the Canadian Phar­ maceutical Association, th e Cana­ dian Dental Association, and the Canadian Veterinarian Association to cooperate with the Department of National Health and W elfare by im­ mediate reporting of all adverse drug reactions in order to facilitate the collating, analyzing, and prompt feedback of this inform ation; and that it urge the publicizing of find­ ings among all those responsible for the prescribing of therapeutic drugs so that the harmful effects of these drugs may be reduced as much as possible.” Dentists across Canada are urged to cooperate in this im portant pro-

gram. Comments or information should be forwarded to Clive Good­ win, Chairman, Resolutions Imple­ mentation, Consumers’ Association of Canada, 100 Gloucester St, Ot­ tawa, Ont K2P OA3. ■ M ERCURY A B SO RPTIO N : The July 1972 issue of The J o u rn a l carried a report on a pilot study on mercury absorption by dental personnel con­ ducted in Ontario. This investiga­ tion demonstrated that 10% of those tested showed elevated mercury levels. The Department of National Health and W elfare now has ap­ proved a grant to cover further in­ vestigation. At least 1,000 volun­ teers from the dental profession in Ontario are needed to participate in this project. The principal investigators, J. H. Hibberd and D. C. Smith of the Uni­ versity of Toronto’s Faculty of Den­ tistry, are sending information, ap­ plication forms, and kits to all den­ tists in the province and would ap­ preciate their cooperation and that of their assistants. No charge will be made for the tests and all results will be communicated in confi­ dence. Ontario dentists and dental assis­ tants are urged strongly to partici­ pate in this important study.

■ OFFIC E OF STU D ENT AFFAIRS: Bev­ erly Nicholl has been appointed seccretary of the Association’s newly formed Office of Student Affairs. The creation of this new office, centralizing headquarters’ student activities under one head, was un­ dertaken to better meet the needs of a growing number of students in­ volved and interested in the affairs of the Canadian Dental Association and to provide the increased ad­ ministrative assistance needed by the various committees serving in this rapidly developing field. The Office of Student Affairs is designed to improve the liaison be­ tween students and headquarters staff; to encourage involvement of student members in the affairs of the Association; and to actively strive for total enrollment of all den­

tal students in the CDA. Student membership at present stands at 841. In addition to her new responsi­ bilities as secretary of the student affairs office, Miss Nicholl is the ad­ ministrator of the Dental Aptitude Test Program. Before joining the staff at CDA, she was employed by the Ontario Institute for Studies in Education, where she worked di­ rectly with graduate students of the University of Toronto.

criticisms on Health Minister Rich­ ard Potter, who had the bill altered to exclude the right of denturists to deal directly with the public instead of under a dentist’s supervision. By the end of the meeting, 12 peo­ ple had volunteered to serve as di­ rectors of the committee, including Mayor Garnett Williams of Vaughan and two dentists— Charles Peterson of London and Angus Blair of Bowmanville, which is Minister Potter’s hometown.

G O V E R N O R S ' LETTER CANADIAN DENTAL ASSOCIATIO N

■ t o r o n t o : A citizen’s committee was formed at a public meeting to support O ntario’s denturists in their struggle for the legal right to sell ar­ tificial teeth directly to the public. It was the first step in a renewed campaign by denturists against a hastily-approved bill— no pro­ claimed law as yet by the provincial government— which would outlaw their businesses and raise existing penalties, including a possible sixmonth jail sentence. Gordon Smith, spokesman fo rth e Denturist Society of Ontario, told the meeting that denturists will go to jail rather than abide by the bill, which he termed “ a colossal fraud . . . a hoax.” It was approved by the legislature on seven days’ notice last month. He said the bill was inconsistent. “ It says we should not be allowed to practice, but says to go ahead until we are ready to put you out of busi­ ness.” He was referring to comments by government spokesmen that den­ turists were free to carry on until the bill is proclaimed— which they said could take a year. The New Democratic Party health critic, Jan Dukszta, of Parkdale Rid­ ing, told the audience of about 225 people at St. M ichael’s School that the bill protected the vested inter­ ests of dentists without providing extra services to the public. He pointed out that “there is an obvi­ ous need for extra dental man­ power.” Both he and Smith focused their

FEDERATION DENTAIRE INTERNATIONALE

■ M e x ic o c it y : Several United States dentists were chosen for po­ sitions as chairmen or members of the council or commissions at the 15th World Dental Congress and 60th annual session of the Federa­ tion Dentaire Internationale in Mex­ ico City. John W. Stanford, secretary of the ADA Council on Dental Materials and Devices, was appointed for one year as chairman of the standing commission for dental materials, in­ struments, equipment, and ther­ apeutics, while Leland C. Hendershot, ADA editor, was reappointed chairman of the publications com­ mittee. Gordon H. Schrotenboer, secre­ tary of the ADA Council on Dental Therapeutics, was made a member of the standing commission for den­ tal materials, instruments, equip­ ment, and therapeutics. Other United States selections were: — Adm Anthony Kaires, member, commission on armed forces dental services; — H. S. Horowitz, member, com­ mission on classification and sta­ tistics for oral conditions; — Donald J. Galagan, member, commission on dental education; and — H. M. Fullmer, member, com­ mission on dental research. Harold Hillenbrand, ADA exec­ utive director emeritus, started his second year as FDI president, and

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J. M. Knutson was reelected as one of four vice-presidents. The meeting attracted a total reg­ istration of 10,400, with 71 countries represented (902 attended from the United States). The exec­ utive committee of the FDI studied 63 designs from 18 countries last April in seeking to select an inter­ national symbol of dentistry. Of these, three were chosen for submission to the General Assem­ bly. After a secret ballot, the design submitted byJ. H. Albers of Bremen, Germany, was chosen. He received a $500 cash prize. ■ S Y M B O L OF DENTISTRY:

■ 19 74 a n n u a l s e s s io n : T he1974an nual session of the FDI will be held in London Sept 8-14, with the over­ all theme to be “the dentists’ role in a changing society.” This year’s meeting will be held in Sydney, Aus­ tralia. ■ p r i n c i p l e s o f e t h ic s : A revised version of the International Prin­ ciples of Ethics for the Dental Pro­ fession, approved in Paris in 1967, was adopted in Mexico City. The principles, divided into three sec­ tions— the patient, the community, and the profession— are as follows:

The p a tie n t 1. The primary duty of the den­ tist is to safeguard the health of pa­ tients irrespective of their nation­ ality, sex, race, creed, political views, or social and economic standing. 2. The dentist should bear in mind that for the benefit of patients all possible treatment should be made available with, if necessary, the assistance of another qualified dental or medical colleague. 3. Professional secrecy is abso­ lute, except where the laws of the country dictate otherwise. It is also the obligation of the dentist to see that his auxiliary personnel observe this rule. 4. The dentist, when delegating any service or operation to an oper­ ating or nonoperating assistant, shall assume the complete respon-

A symbol for international dentistry was se­ lected by th e General Assembly of the FDI at the 1972 meeting in M exico City. Th e winning design (above), one of the 63 exam ined by the Executive C om m ittee, was subm itted by J. Heinrich Albers of Brem en, Germ any, who re­ ceived a prize of $500.

sibility for such clinical service or operation. The dentist shall not delegate any service or operation to an individual who is not within their competence nor permitted by the laws governing the practice of den­ tistry within the country. The c o m m u n ity 1. Accepted measuresto improve the general and dental health of the public should be promoted by the dentist. 2. The dentist should participate in health education and, in particu­ lar, dental health education of the public by promoting generally ac­ cepted measures which improve the general and dental health of both the individual and the community. 3. Dentists may only advance their professional reputation through professional servicesto pa­ tients and to society. 4. The dentist should assume a responsible role in the life of his community.

3. Dentists have an obligation to assist each other professionally. 4. When consulted by the patient of another dentist, the dentist should attend to any condition con­ stituting an emergency and referthe patient back to his or her regular dentist who should be informed of the conditions found when treated. 5. The dentist should not refer disparagingly to the services of anotherdentist in the presence of a pa­ tient. If the welfare of the patient de­ mands that corrective treatment be instituted, this should be carried out in such a way as to avoid reflection on the previous dentist or on the dental profession. 6. Dentists have the obligation to support the advancement of their profession through membership in scientific and professional organi­ zations and to observe their rules of ethics. 7. Dentists have the obligation to make the fruits of their discoveries and labors availableto all when they are useful in safeguarding or pro­ moting the health of the public. Pa­ tents and copyrights may be se­ cured by the dentist, provided that they are not used to restrict re­ search, practice, or the benefits of the patented or copyrighted mater­ ial. ■ ADM ISSIO N TO M E M B E R SH IP : The General Assembly approved appli­ cations for regular membership in the FDI from the Bahama Islands Dental Association and the Indian Dental Association. It also approved applications for affiliate member­ ship in the FDI from the Interna­ tional Association of Dentistry for Children, the International Associ­ ation for Dental Research, and the Behavioral Scientists in Dental Re­ search.

The pro fe ssio n 1. Dentists should maintain the honor, morality, and integrity of the profession, and avoid any conduct which might lower its esteem in the eyes of the public. 2. Dentists should maintain their professional knowledge and skill by continuing education.

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BRAZIL

■

THR EE-NA TION

DENTAL C O NVENTION:

The new Sheraton Hotel in Buenos Aires will be the site for the Argentinian-Brazilian-Uruguayan Dental Convention which will be held Oct

28-31 in conjunction with the 18th international meeting of the Argen­ tine Dental Association. The nine round-table discussions will include specialists from various nations. The program also will con­ sist of conferences, table clinics, in­ formal meetings, scientific films, and industrial exhibits. Leading members of the Brazilian organizing com m ittee are Edmundo Nejm, president; Luiz Goncalves Neto, secretary; Newton Hucke, treasurer; and Edy Sa Carneiro, as­ sessor. ■ N E W DEAN IN SAO PAULO: AraO Rumel, who took office last December, is the new dean of the School of Dentistry, University of Sao Paulo. Dr. Rumel said that among his aims are the establishment of a univer­ sity hospital and completion of mov­ ing the entire school to the new campus in Butanta. Dr. Rumel has been president of the Brazilian Association of Dental Radiology and head of the depart­ ment of radiology at the Sao Paulo dental school. He also took a post­ graduate course in dental radiology at the University of Pennsylvania. D EN TA L S C H O O L IN M ANAUS: The School of Dentistry, University of Amazonas in Manaus, is now an autonom ous entity and no longer affiliated with the School of Phar­ macy. It will later become part of the new School of Health Sciences at that university. A coordinator, Airton Costa, and a substitute coordinator, Sergio Eduardo Feitosa Henriques— both nominated by the head of the Uni­ versity of Amazonas— now direct the dental school. ■

■ s c h o l a r s h i p s in j a p a n : Seven Bra­ zilian dentists of Japanese extrac­ tion— Minoru Massaoka, Paulo Tone, Satoru Hannes, Satoru Tominaga, Tetsuo Saito, Toshihico Tan, and B. Shibayama— have re­ ceived scholarships to study in Ja­ pan. They will take a two-month course in prosthesis at the Kasumigaseki Institute of Postgraduate Dentistry in Tokyo.

■ PR O F BADRA H O N O R E D : Prof Alvaro Badra, well known authority in the use of hypnosis in dentistry and for­ mer president of the Sao Paulo State Dental Association (APCD), was honored recently by several or­ ganizations. He received a commendation and medal from the Brazilian Academy of Military Dentistry, and became honorary m em ber of the Mexican Society of Medical Hypnology “ in recognition of his scientific knowlege and his collaboration in the con­ ferences organized by this society for the professional improvement of its mem bers.” He also became a correspondent m em ber of the latter group. Prof Badra received additional honors from a society in Brazil and another in Barcelona, Spain. ■ h o s p i t a l s h ip ss h o p e : The famed American hospital ship, SS HOPE, left the city of Natal last December after a stay of about ten months. Nearly 6,200 patients were exam­ ined by the ship’s physicians and dentists. Many Brazilian dentists and physicians had an opportunity to benefit from service on the SS HOPE, and their American col­ leagues had a chance to study trop­ ical diseases which do not occur in the United States. The SS HOPE recently returned to Brazil, this tim e to the city of Maceio, State of Sergipe. ■ n e w s f r o m p a r a i b a : Nancy Alves, the coordinator of dental services in Paraiba, stated to the newspapers that in the State of Paraiba the 170 dentists were adequate to attend to the needs of the population. How­ ever, the scarcity of materials and equipment is being remedied by re­ cent purchases from the local health secretary. The National Institute of Social Previdence (INPS) has an efficient dental night service for its members in the State of Paraiba. Modern equipm ent in its 14 dental offices as well as surgery and radiology sec­ tions makes this service an out­ standing feature. Amir Gaudencio, superintendent of these services,

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has become an honorary member of the Paraiba Dental Association. ■ O F FIC IA L D ELEG A TE IN LO NDON: Amedeo Bobbio was the official delegate from Brazil and represented the American Academy of the History of Dentistry at the 23rd International Congress of the History of Medicine. This meeting, organized by the Brit­ ish Society fo r the History of M ed­ icine, was held last September in London. A special session was dedicated to the history of dentistry, and Dr. Bobbio spoke on odontologic char­ acteristics of the so-called “ Sambaquis m an” and “ Lagoa Santa m an” of Brazilian history. This original presentation was of great interest, and prompted many questions from both physicians and dentists. Although this convention was at­ tended by more than 800 people from 42 countries, few dentists were present and only Dr. Bobbio came from Latin America. ■ s e c o n d e d i t i o n : The second edi­ tion of D e n ta l M o n o g ra p h s No 2— a well known book in Brazil— is now available. Francisco de Paula Azzi rewrote and updated all chapters from his first edition. The seven portions of the book explain pain in dentistry, facial paralysis, tem porom andibular dis­ orders, affections of the salivary glands, local anesthesia and post­ anesthesia accidents, neoplasms and biopsy, and psychology applied to dentistry.

The Sixth Sao Paulo convention of Dentistry will be held in the city of Sao Paulo Jan 19-25, 1974, and not in 1975 as listed in the January j a d a . ■ c o r r e c tio n :

HANS FR EU DEN TH A L, CD

FRANCE

■ DENTAL PR O FE S SIO N IN FRANCE: The art of dentistry was form ally separat­ ed from surgery in 1699 by a royal decree requiring dentists to obtain the title of expert.

At about the same time, Pierre Fauchard, considered by many the father of modern dentistry, dealt with parodontology and numerous dental prosthetic techniques, in­ cluding the dowel crown, in his well known book, The D o c to r o f D ental S urgery or D e ntal Treatise. However, after the French Revo­ lution which proclaimed free access to all professions and abolished de­ gree requirements, the dental pro­ fession again was open to charla­ tans. Although the first degrees of doctor of dental surgery were be­ stowed in the United States as early as the mid-nineteenth century, the dental degree was not created in France until Nov 30, 1892. It must be mentioned, however, that well before that date, French practitioners had created associ­ ations, journals, and even dental schools in Paris (dating from 1880). Over a period of several decades, the profession developed and or­ ganized on a regional basis. Finally, in July 1935, the National Confed­ eration of Dental Syndicates was established. Around this strong, representative organization devel­ oped numerous scientifc groups and— after World W ar II— young practitioner movements. In 1968, by general agreement, the French Dental Association was founded in order to coordinate all the various professional activities. This association, federal in nature, is designed on the one hand to act as sole representative on the inter­ national level (Federation Dentaire Internationale) and, at the same time, act as sole representative for practitioners in dealing with the government and parliament for all

problems of national scope. However, the National Confedera­ tion of Dental Syndicates remains the only strong and structured body at every level nationwide, and it has exclusive legal responsibility in so­ cial matters. Each of the 95 French metropolitan departments (as well as three overseas departments in Re'union island, Martinique, and Guadeloupe) has its dental surgeon syndicate— with membership on a voluntary basis that includes about threefourths of private practitioners — and it is these syndicates that make up the NCDS. The Maison Dentaire in Paris be­ longs to the NCDS, but the latter rents a certain number of offices to other organizations of the French Dental Association, which all have their headquarters there. The NCDS has a budget of approximately 3 mil­ lion francs ($600,000). It publishes a weekly journal, L e C h iru rg ie n -D e n tiste de France, with a circulation of 17,000. The NCDS is directed by an 11member executive board, by a 35member administrative council (which makes most of the deci­ sions), and by a sovereign general assembly which each year decides the general political lines to be fol­ lowed during the months to come. After World War II, a National Or­ der of Dental Surgeons was estab­ lished (with sections for regional jurisdiction and departmental exec­ ution). Its role is to defend the mor­ ality, honor, and independence of the profession, and it ensures re­ spect of theodontological code and requires registration with the de­ partmental section of the NODS as a prerequisite to practice.

Finally, since 1949 it has been mandatory to adhere to the Autono­ mous Retirement Fund for Dental Surgeons, which guarantees monthly retirement payments to every practitioner 65 years of age and over. ja c q u e s c h a r o n ■ n ic e : G. Conrad Hornbuckle of Cedar Rapids, Iowa, will address the annual meeting of the Centre de Perfectionnement en Odonto-Sto-

G .C O N R A D H O R NB U CK LE

I matalogie of France, which will be held at the Hotel Splendid in Nice March 17-19. He also will give a lecture in Bonn, Germany, and in Paris the following week on the various phases of peri­ odontal therapy. Dr. Hornbuckle, who is on the oral diagnosis staff at the University of Iowa College of Dentistry and in pri­ vate practice in Cedar Rapids, for­ merly was director of undergrad­ uate periodontics at Loma Linda University in California and main­ tained a private practice in San Ber­ nardino. He received his dental degree from the University of Iowa and a certificate in periodontics at the Boston University School of Dentist­ ry.

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