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The Value of Dental Organization
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THE VALUE OF DENTAL ORGANIZATION* B y St
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H E v a lu e o f d en ta l o rgan izatio n is best m easu red b y th e a ccom p lish m en ts re co rd ed in its pages o f history, w h ich are im b u e d w ith th e sp irit a n d g ro w th o f the profession. S in ce th e in ce p tio n of the first den ta l so ciety in N e w Y o r k in 1834, organ ized d en tistry has b een th e c ard in al fa c to r
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S T A N L E Y J. R U Z IC K A and m o tiv a tin g fo rc e in th e e th ica l a n d scien tific a d va n ce m e n t o f th e d en ta l profession, fo r “ w ith o u t organ izatio n , th ere w o u ld be no p rofession ” ;1 th ere w o u ld b e no m eans of securing c o lle c tiv e ly benefits w h ich can n o t be ob ta in ed b y in d iv id u a l efforts; th ere w o u ld be no u n ifica tio n o f d en ta l ed u ca tio n , n o law s for th e p u b lic con tro l o f d en ta l p ra ctice ;
From the School of Dentistry, Western R e serve University, Cleveland, Ohio. *Prize essay in the American Dental Asso ciation Junior Membership Contest.
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there w o u ld be n o d en ta l m eetin gs, n o re li a b le p u b licatio n s— n o m eans b y w h ich den tal kn o w le d ge m ig h t b e dissem inated. T h e in flu en ce th a t d en tal o rgan izatio n was to h a v e in th e d e v elo p m e n t o f d en tistry from a trad e to a profession w as fo re to ld in the d e claratio n of purposes and aim s o f th e early societies. T h e fu n ctio n of th e so ciety, as con ceiv ed b y the d en ta l pion eer, w as to p ro m o te union a n d h a rm o n y am on g th e resp ecta b le elem en ts and so d ifferen tia te th e surgeonden tist fro m the “ to o th -ca rp en ter,” th e less com p eten t m e c h a n ic a l dentist; to a d va n ce the scien ce b y in terch a n g e o f th ou gh ts and ideas, eith er w ritten or o ral, am on g the m e m bers o f the so ciety; to re je c t the p re cep to r system o f ed u ca tio n b y en co u ra g in g the fo u n d in g of sp ecialized in stitution s o f le arn ing, n a m e ly th e d en ta l co lle ge , fo r th e e d u ca tion o f the dentist; to giv e c h a ra cte r and re sp ecta b ility to th e profession b y establish ing a lin e betw een the m eritoriou s a n d those w h o p la ce d th e stin t o f e m p iricism u p o n the profession. A n d w h ile these aim s a n d p u r poses w e re n ot fu lly a tta in e d b y a n y o f the e a rly organization s, each d id co n trib u te to the fin a l a cco m p lish m e n t b y p ro v in g th e a d van tages to be ga in ed fro m organization . T o d a y th e a ctiv ities of th e A m e ric a n D e n ta l A sso cia tio n h a v e an u n d en ia b le in fluence on th e progress o f den tistry. B ein g the v o ic e o f m o re th an 50,000 q u alified d en tal p ractitioners, the A ssociation has a
The papers by Eldred L. Arch, Creighton University; Philip S. Loechler, University of Minnesota; Stanley J. Ruzicka, Western R e serve University; and Henry D. Prensky, U n i versity of Pennsylvania, were the prize winning essays in the American Dental Association Junior Membership Contest for 1942 . The authors w ill be invited to attend the annual meeting of the American Dental Asso ciation as guests of the Association. T he papers are published as presented by the authors without material editorial change.— E d i t o r .
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representation second to that of no other similar professional organization. By its ac tivities, it extends its influence to all fields of practice, and, accordingly, these m ay be grouped into a dozen or more categories. Through the meetings of the Association and its components, the highway of postgraduate education is maintained. Through The Jour nal, an evergrowing book of dental knowl edge is added to the library of every member of the Association. Through its Committee on Public Health and Education, and its Bureau of Public Relations, there is con ducted a comprehensive and continuous pro gram of lay education. Through its Dental Educational Council, it seeks high standards for future practitioners. Through its Bureau of Chemistry and its Council on Dental Therapeutics, both the public and the profes sion are informed on those products which are deemed acceptable or undesirable either in practice or for lay use. Through its Relief Fund Commission, security is provided for needy members. Through the Judicial Coun cil, questions of ethics are decided and re viewed, and thus the actions of the men in the profession are controlled, toward one an other and toward their patients. Through its Committee on Dental Economics, data are compiled relative to economic problems that confront the profession and the public. Through the Committee on Legislation, the educational, professional and ethical stand ards of the profession are guarded against unjust legislation. Through its Research Commission, dental materials are constantly being improved, and further research is pro moted by grants. Through its National Health Program Committee, sound policies are sought to improve the dental health of a growing population. These councils, bureaus, committees, com missions and other groups not mentioned here render invaluable services, involving tre mendous expenditures of time and money. T hey furnish benefits which are the out growth of dental organization and which are the direct result of years of intensive plan ning and sound interest in the advancement of dental health for the people of this coun try. The benefits have been three-fold: First, to the individual practitioner, who owes his present position in society and in the profes sion to organization, for with organization the practitioner has continued to gain wider
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knowledge and more expert skill. Second, to the manufacturer of dental items, who has profited by the standards that the American Dental Association has established for certain approved dental products. Third, to- the public, to whom there has accrued the benefits which have first fallen to the dentist and the man who supplies him; for by their enhanced abilities, the practitioner and the manufacturer— through organized dentistry — have served to render an improved service measured in terms of better dental health for the nation. Thus, organized dentistry has proved its value in time of peace. Today, in time of war, organized dentistry continues to carry the banner of the profession. As early as two years ago, the American Dental Associa tion instituted a preparedness program whereby an extensive survey was made of all dental practitioners and their relation to na tional defense. Through this program, the basis for cooperation with the armed forces and the Public Health Service was estab lished, so that, today, most of the respon sibility for securing dental personnel for the armed forces has been placed by the govern ment on the American Dental Association; and, in accepting this responsibility, organ ized dentistry, through its representatives on the Procurement and Assignment Service, has worked effectively to provide for the needs of the armed services and the civilian population by weighing the needs of the services against those of the community. It is recognized then that organized den tistry has been the consolidating influence which has bound together our literature, our education, our heritage. W e may regard it as the guardian angel of a recognized eth ical profession for more than ten decades of social, scientific, and political evolution, for it stands today as the agency by which the future of dentistry can be assured. BIBLIOGRAPHY
1. C a s t o , F. M .: Some Pertinent Facts R e lating to Organized Dentistry. Ohio D. Soc. / . , 9 : i o i , M arch 19 3 5 . a. A n t h o n y , L . P.: Influence o f Organ ization on Development o f Dentistry in United States. Proc. D. Centenary Celebration, 1940 , pp. 870 -874 . 3. D i t t m a r , G. W .: R 6sum6 of Develop ment of Organized Dentistry in America and
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194 1.
A .: T ren d s in A m erican D entistry. J .A .D .A ., 2 9 : 7 6 7 , M a y 1942. 6. R ep ort o f C om m ittee on D en tal Pre paredness: Procurem ent and Assignm ent S ervice fo r Physicians, D entists and V e te ri narians. J .A .D .A ., 2 9 : 4 6 6 , M arch 1942. 7. R o b i n s o n , J. B .: Foundations of Pro 5. O liv e r ,
O.
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fessional D entistry. Proc. D . C en ten a ry C e le bration , 1940, pp. 1043-1048. 8. R o b i n s o n , W . H . : A m erican D en tal A ssociation in 1940 -1941, a Y e a r o f Crisis. J .A .D .A ., 28 :2 0 19, D ecem b er 1941. 9. W e l l s , R . C .: R ôle of D en tistry in W ar Effort. J .A .D .A ., 29:8 35, M a y 1942. 10. W h y O rgan ized D entistry J .A .D .A ., 24:969, June 1937.
(ed ito rial).
THE VALUE OF DENTAL ORGANIZATION* B y P h i l i p S. L
\ S T achievements of organized den tistry have more than proved the value of a united effort in the behalf of one of the most eminent professions of the day.
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P H I L I P S. L O E C H L E R
A group is only as staunch as the ethics upon w hich it is founded. Since the year From the U n ive rsity of M innesota, M in n e apolis. *P rize essay in the A m erican D en tal Asso ciation Jun ior M em bership Contest.
oech ler
1834 , organized dentistry has been a bulwark against illegal practices. Q uacks and the more inelegant practitioners have been the chief recipients of censorship. It has con trolled the quality o f dental service offered to the public by exam ination and licensure. T h e license fees w hich the dentist pays pro vide for the enforcement of its ethics and prevent illegal com petition from the labora tories and back room technicians. It is the representative of A m erican dentistry and the only group that can speak w ith authority. A ll the laws enacted by the several states in regard to dental practices have been spon sored by it, and this has given character and respectability to the profession by establish ing a line o f distinction between the truly meritorious and skilful operators and the im pudent and em piric bootleg practitioner. O r ganization is the essence of success of the movement in which the combined effort of several individuals is desired for the promo tion of the dental science. It is the flywheel of progress w hich gives balance to combined efforts, brings up and pushes forw ard the laggard o f conservatism, restrains the erratic flight of the too exuberant enthusiasm of the reformer, gives steadiness of action and makes advancem ent sure. A n association of persons for the promotion of scientific in vestigation for its successful advancement, the professional organization’s value o f today lies not only in the bringing together of the great, the good and the wise to exchange con gratulations on w hat the few know, more than the many, but in the fact that the m any m ay m eet the few and that knowledge, cul ture, refinement and a true professional
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spirit m ay be m ore w idely diffused and bet ter approached. Needless to say, a group o f this type makes for the cultivation of the social qualities of its members by surrounding each mem ber w ith friends to whom he can turn for advice and assistance when needed. It has for its objects the prom otion of union and harmony am ong all respectable and w ell informed dentists. It also uplifts the social standing of its group in the aid and relief of its m em bers. For instance, dental organization allows a low rate of insurance to w hich a member can turn; also a library bureau for purposes of authoritative information. T h e circulation o f a journal in any group whether professional or industrial is a teach ing factor. T h e dental journal is the largest and most influential periodical in the world, having a circulation of m ore than 50,000 copies a month. It finds its w ay into eightytwo foreign countries and is read wherever dentistry is practiced. D ental literature lies at the base of dental organization. This world-wide circulation enables its members to keep in touch w ith each other. In this manner, it maintains the full-tim e practi tioner at a pace consistent w ith that of his fellow men in the various phases of advance ment. T h e profession cannot go forw ard without the two essentials of education: first, the education of the laity; second, the educa tion o f its students. It cannot advance in the full accomplishm ent of its health mission without help from the laity. In the past, it has been depending solely on the dues of its members. T h e curricula of study have been standardized by the controlling factor of organization. T h e dental organization educates the public in all matters pertaining to dental health, w ith benefit to both the public and the profession. C ertainly the least that can be said con cerning the group is that it assists its m em bers in all their laudable undertakings and exerts its influence untiringly for the ad vancem ent in the dental field of methods of teaching, practice, jurisprudence and re search. T h e A m erican D ental Association op poses legislation w hich, if passed, w ould be detrimental to the association; for example, the compulsory health laws which would
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handicap the dentist. B y means of the or ganization, committees can be maintained w hich keep in touch w ith the legislative a c tivities of the federal government and the forty-eight states, w ith a view to preventing the enactm ent o f unwise dental laws. T h e y also m aintain economic committees situated throughout the nation. T h e y keep close con tact w ith the federal government through a national health program committee— a con tact com m ittee between the dental organi zation and the government in matters of public health. T h e y have surveyed the granting of patents, so that collecting of undue royalties could or would not be ex acted from the dentist. H owever, w ith all the progress which has been made, there are a few things yet to be accomplished. These cannot be accom plished w ithout a full and cooperative m em bership of all the men involved who can bring these ideals to reality. W e have yet to see the day when the cause, or the preven tion, of dental ills through subsidized re search m ay com e to light. T h e public, therefore, must accept its responsibility in this endeavor. For the student, w e must, through the organization o f the N ational A s sociation o f D ental Examiners, secure uni form ity of licensure in all the states. T h e dentist is standing, in these troubled times, beside the government, the arm ed forces and the public in anticipation and pre paredness. W hen the need arises, he m ay and w ill step in to again prove to the nation, and even the world, the eminent worth— the value of organized dentistry. B IB L IO G R A P H Y
Northwest Dentistry, 1 6 : 104 , April 1937 . Northwest Dentistry, 1 6 : 1 7 1 , July 19 3 7 . Northwest Dentistry, 1 7 : 103 , April 1938 . J.A .D .A ., 27:33, 122 , 129 , January 1940 . Ibid., 2 7 :i 103 , 114 3 , Ju ly 1940 . Ibid., 2 7 : 1635 , 1638 , 1650 , 1658 , October 1940 . Ibid., 2 7 : 1939 , 19 6 1 , December 1940 . Ibid., 2 8 : 1 6 7 1 , 1674 , October 19 4 1 . Ibid., 2 8 : 1863 , November 19 4 1 . Ibid., 2 8 :2019 , 2031 , December 19 4 1 . Ibid., 2 9 :io o , January 1942 . Ibid., 2 9 :2 13 , 310 , February 1942 . Ibid., 2 9 :835 , M ay 1942 .
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THE VALUE OF DENTAL ORGANIZATION* By H
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is now the prime concern of our citizenry. In every w alk of life, Am ericans are coming face to face w ith the problem of adjusting their lives to an all-em bracing plan, the es sence of organization. T h e awareness is rapidly growing that the heroism of Bataan
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H E N R Y D. PR E N SK Y
alone w ill not bring victory. V icto ry de pends also, and in equal measure, on the ability to transform 130 ,000,000 individual existences into an integrated, united people. O n ly a healthy people can be victorious. A program for the health of the nation is not a m atter of proclamations. A ble leader ship and smooth functioning apparatus are the basic essentials of a program that w ill result in a healthy people. From the U n ive rsity of Pennsylvania, School of D entistry, P h ilad elph ia, Pa. *P rize essay in the A m erican D en tal Asso ciation Junior M em bership Contest.
D . Pren sky
T h e health professions, consisting of lim ited trained personnel, . are faced w ith an unlim ited emergency. Leadership, efficiency, organization! T hese are the keynotes. W ith them, our unlim ited em ergency w ill be met and mastered. W ithout them, w e are in the dangerous position of “ m uddling through.” Leadership, efficiency, organization! T h e evidence is abundant that the dental profes sion possesses these attributes. O rganized dentistry has m aintained the integrity of our profession through the years. O ur standards have been raised, our institutions developed to the highest level in the world. A n eth ical code has been firm ly established. T he com m ercialization and promotion of dental pharm aceuticals have been kept within rigid bounds of honesty and scientific a c curacy. T h e public has been consistently impressed w ith the im portance of oral health and prevented from receiving harm ful misinformation. Legislation has been enacted prom oting the best interests of the practitioner and the patient. In conjunction w ith such federal agencies as the Bureau of Standards, the U nited States Public H ealth Service, the Veterans Adm inistration and others, the A m erican D ental Association has been expanding a livin g N ational H ealth Program. T his is a record of concrete achievement. T h e w ar added m ore evidence. H ad there not been a plan, had there not been a fun c tioning apparatus, the w ar would have brought in its w ake disruption of the dental activities of the country and a chaotic threat to the nation’s health. T h ere was a plan; there was an apparatus; there were people, people w ith knowledge and the experience of countless, successful campaigns. T h e w ar brought not chaos, but heightened activity; not disruption, but the greatest integration of the profession ever witnessed. T h e N ational H ealth Program Com m ittee of the A m erican D ental Associa tion could state, after the w ar had begun, “ T o d a y the dental service in the arm y and
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navy corps is much higher than in any other comparable group in the world.” T h e tight knit character of our organization was the key factor in determining the facile manner whereby the enormous demands of the war situation were met. Here was the acid test and the overwhelming proof of the value of dental organization. T he times are such, however, that we can not afford to rest contented with these ac complishments. As rapidly and intensely as we have worked until now to insure our country’s defense, so must we speed up the tempo now to insure an offense for victory. A normal peacetime pace, measured by today’s standards, is a crawl. If we must wait before we charge, the wastage, during the waiting period (in the form of ships sunk and in allied resources and territory lost) will be tremendous. As leading members of the community, we must instil in the American people a passionate desire fer victory, what ever the sacrifice. W e must realize clearly the truth of the words of the President of the American Dental Association, Dr. Oliver, in T h e J o u r n a l of April 1942: Proportionately greater numbers of trained personnel will be needed for the armed serv ices than would ordinarily be required by a numerically equivalent civilian population. Let each dentist show his eagerness to help, and let each one be prompt about it.' It must never be said of the dental profession that it gave too little, and too late. [Emphasis mine. H. D. P.]
These are words that must be heeded. T o our great credit, we can see that they will be heeded. The technics for securing rapid re sponse, the respect for and confidence in leadership, the effective machinery for check ing and rechecking, all guarantee complete, swift mobilization. In this race against time, the more extensive and deep-seated our or ganization is, the greater will be our service. Herein lies the great value of our organiza tion for tomorrow. T he day after tomorrow is important too. Dental organization assumes a qualitatively new value and one of great moment when seen in the light of a victorious, postwar America. Already certain trends can be ob served in the American people. These trends warrant close, critical examination. W e should note, first, a general realization that a great issue in world history is about
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to be resolved. T he issue is between two mutually antagonistic ways of life: the way of life of a free people, based on funda mental principles of justice, equality and personal freedom, and the way of life of Brown Shirt tyranny, “ the rule of the insane.” Unfortunately, the initiative, up to this writing, has been held by the latter. The rea son is not obscure: it has been able to compel cooperation and effort, with everything driven toward the military objective. T hat this has been accomplished through the use of terror and appeal to outworn prej udice is beside the point. It remains for us to find forms within our democratic framework to match the all-pervading organi zation and power of the enemy. In the world of the day after tomorrow, this will very likely be the great popular lesson of the war. That it will be applied specifically to the health field is not open to much doubt. The trend is beginning to take shape as a desire on the part of people for legislation for subsidized dentistry. On the other hand, it is quite manifest that, as a result of the war, much advance planning is being done by various government agencies. O f late, they have been moving over into the field of social welfare and health. In the first instance, it is important that organized dentistry develop a plan whereby these popular desires can be satisfied and still maintain the proven relationships of dental service. It is imperative that those leaders of the profession, in organized dentistry, who have had the most experience be the con trolling factors in these projects. In;the second instance, organized dentistry should plan in a parallel fashion to place the interests of the dentist in its proper perspec tive. This will result in the protection of the best interests of both the dentist and the patieint, with the best utilization of such forms of endeavor as research projects, exper imental institutes and the subsidization of important research at existing institutes of learning. T he value of dental organization can here be seen most clearly, and in this fact lies the main compelling reason for bringing organi zation to an absolute peak. The young men of dentistry, the dental students, those who will assume the responsibilities of the future, must understand this. The problems in-
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v o lv e d re q u ire an e a rly aw areness, and an e a rly a tte m p t m u st be m a d e to g ra p p le w ith th em a n d so lve them . I f w e seize
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THE VALUE OF DENTAL ORGANIZATION* B y E ldred L . A
H E G reek s h a d a w o rd fo r it. T h a t w o rd w as cosm os; and to th e G reeks it m e a n t th e u niverse, an ord ered , an orga n ized sch em e o f things; it m e a n t the op p osite o f chaos. A n d chaos is w h a t you
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B u t w h a t abou t d en ta l organ izatio n ? T o d a y d en tistry itse lf is o n ly p a rt o f a v aster organization , p a rt o f an a ll-o u t m o b iliza tio n of ou r c o u n try ’s to ta l m a n p o w e r in an en d e a vo r to w in th e w a r, and, w h a t is m ore im p o rta n t, to re b u ild a b e tter w o rld . U n d e r th e stress o f the presen t em ergen cy, den tis try, as I see it, can a n d w ill p ro fit b y a b e tter organ izatio n and u tiliza tio n o f d a ta a n d d is coveries m a d e possible b y th at v e r y e m e r gen cy. L im itin g , then, this to p ic of the v a lu e of d en tal organ izatio n to a con sid eration of den tistry u n d er pressure of the grea te r o r gan ization o f the p resen t em ergen cy, le t m e qu ote here a short and v e r y pertin en t passage fro m an address re a d b e fo re th e A m e ric a n D e n ta l T r a d e A ssocia tion in C h i cago on N o v e m b e r 12, 1941. T h a t address, m a d e b y O re n A . O liv e r , D .D .S ., P resid en t of th e A m e ric a n D e n ta l A ssociation , w as p u blish ed in the M a y 1942 issue of T h e Jo u rn al
of
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A sso
c i a t i o n ; and the passage re ferred to reads as
follo w s:
ge t w ith o u t organ izatio n ; fo r in a ll spheres o f h u m a n a c tiv ity fro m ru n nin g w ars and ra ilro ad s d o w n to ru n n in g a h a m b u rger stan d, th ere is no a d va n cem en t w ith o u t organization .
. . . defense preparations and w ars tend to force advances in techn ology, advan ces in health service fields, and, in m an y respects, also tend to accelerate preexisting social trends. T h erefo re . . . w e m ay also, w ith some justification, anticip ate th at dentistry w ill be confronted b y as m uch social pressure for change as w as the case after the First W orld W ar. T h is pressure cannot be avo id ed ; how ever, it can, in the pu blic interest, and in the interest o f the dental practitioner, be con trolled b y judicious, cooperative study and plann in g now and a fter the em ergency.
From the C reigh to n U n iversity, School of D entistry, O m ah a, N ebr. *P rize essay in the A m erican D en tal Asso ciation Junior M em bership Contest.
W h a t D r. O liv e r foresees a n d calls fo r is a g rea te r o rgan izatio n of d en tistry, b o th n ow and d u rin g the em e rg e n cy a n d in the p o st w a r p eriod . H e foresees an o rgan izatio n th at w ill shape u p in answ er to so cial pressure;
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he calls for an organization controlled by cooperative study and long range planning, and from this kind of organization he expects and predicts valuable results both for the dental practitioner and for the public whom the dentist serves. For the sake o£ clarification and to adopt some rather large and general principles of division, I w ould envision that im provem ent in dental organization under the follow ing three headings or interrelated phases of den tistry: ( 1 ) the organization of new knowl edge as regards the prevalence and frequency o f oral diseases, disorders ahd deficiencies; ( 2 ) the organization o f dentistry as a health service, and ( 3 ) the organization of the den tal profession as regards its personnel. First, the draft of men into our armed forces provides, as it were, a vast laboratory for the findings of dentistry. A lready we know that m ore than 20 per cent of the rejected Selective Service registrants are re jected because of dental defects. O u t of this great turn-over and check-over of men from all parts o f our country, there should issue accurate reports and records as to the prevalence and frequency o f oral diseases, disorders and deficiencies. T h ere should be, as we expect there w ill be, a clearing house or some central agency for the breakdown of these reports into tabulations and statis tics that w ill show the regional, occupational and nutritional influences on the dental dis orders of the nation. From the dentists in the armed services, we m ay expect m any valuable and interesting reports in the fields of operative dentistry, oral surgery and orthodontics. Advances w ill be m ade in technology. Theories as to diagnosis and treatment w ill be rejected or fu lly verified and validated. In short, under the pressure of war, m any discoveries, contributions and improvements m ay be expected in the whole field o f pathology. But all these findings w ill need systema tizing and publicizing. O n ly in that w ay w ill they be of any value to the practitioner and to the public. For this systematization and correlation, w e have our institutes, our learned societies, our learned journals and publications. B y the cooperative efforts of all these agencies, w e m ay m ake available the new knowledge, the new data. T hus we shall be better able to know and to combat the dental ills of the nation; thus we shall
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have more efficiency and system in our pro fession, and all this w ill work out to the benefit o f the public whom the dentist serves. Secondly, out of this present emergency, w e m ay expect an im provem ent in the or ganization of dentistry as regards its place and function in public health work. It is evident that the dental profession w ill be called upon in the future to p la y an in creasingly im portant role in service organ ized under public and governm ental aus pices. In the past, dental health activities have grown in m an y instances without advice or encouragement, without plan or in telli gent cooperation between the m'edical and dental professions. T h e dental, public health, and m edical professions are not yet utilizing fu lly and econom ically the avail able scientific knowledge for the preven tion, am elioration and cure of disease. T o reduce the gap between such knowledge and its application in health service; to bring the physician and the dentist into closer co operative endeavor for the solution of a common problem should be one of the good results of the present mobilization o f both professions that is taking place today in both the m ilitary and the civilian spheres of our country as it girds itself for victory and for the w elfare o f its people in the postwar world. Dentistry has a distinct place in public health work, local, state and national. T h e im portance of this fact should be recognized b y the organized professions of dentistry, public health and medicine, all of w hich should lend their support and influence to guide this developm ent along proper chan nels. O rganized dentistry, organized m edi cine and organized public health work w ill have to pull together in closer harmonious cooperation to solve the problem s o f dis ease prevention, especially among industrial workers. Com prehensive planning and inter related activity w ill be called for. Som e de gree of leadership in these matters w ill fall to the dentist. I f he uses it successfully, his usefulness to the com m unity w ill be m ate ria lly increased and his standing m arkedly benefited both socially and professionally. T h ird ly, as one of the results of the pres ent m obilization, we m ay expect an ap praisal, a verd ict to be passed upon the per sonnel o f our profession who are now com
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missioned officers am ong the men in the service. T h is judgm ent w ill be passed, of course, m ostly upon the younger members of the dental profession; in m any cases, upon those who have just finished school and who have gone therefrom into various branches o f the service. From these reports and ap praisals, w hich could be assembled and or ganized by means o f questionnaires sent to the com m anding officers, conclusions can be arrived at as to w hat makes up the ideal dentist, both in the m atter o f personal en dowments and in the m atter o f his training and education. T hus a clearer and m ore ob jective standard could be fixed b y w hich to accept candidates for the dental profession; thus, too, the whole m atter o f an adequate curriculum could be gone over w ith em pha sis not only upon certain specialized prob lems of dentistry, but most o f all upon a liberal, cultural training that w ill fit the dentist to contribute directly to the social and civic w elfare of his community. For, as D r. O liv er warns, dentistry w ill be confronted by great social pressure for change. H o w that social pressure w ill be
met, how dentistry w ill organize to meet the new challenges and the new responsibilities, w ill depend, o f course, prim arily upon the dental profession itself. B ut ultim ately it w ill depend upon the individual dentist, upon the m en w ho m ake up the profession. W hat o f our rank and file? W hat of their training? A re they personally and profes sionally equipped to take their proper place in the new and better order that w e hope is coming? W ill they reflect credit upon their profession and bring it to a higher status in the service o f their country and o f all hu manity? T h e answer, I believe, lies in better, more efficient organization; in the utilization of the present em ergency; in taking stock and inventory right now; in judicious coopera tive study o f all phases o f dentistry; in long range planning for the future; in coopera tion w ith the trends o f our time. W ith such organization, dentistry w ill advance w ith profit both to the practitioner and to the public; w ithout it, dentistry w ill be wasteful in effort and w eak in isolation in a w orld reorganized.
( Continued from page 2303) not p ay their share, only 10 per cent o f the few entitled to dental benefits claim them. Analysis of the type of care received under this program testifies to its gross inadequacy. It was found from a sam ple study of dental care paid fo r by the approved societies that for every filling placed, there was more than one full denture constructed and more than six extractions performed. It is recom m ended that dental • benefits under the insurance plan be m ade statutory. W hen this is achieved, a dental representative should be appointed on each local insurance
committee. D ental service subcommittees should be set up and dental panels or ganized. U nder the present system, the den tist cannot proceed w ith treatment of a patient covered by insurance until a letter giving an estim ate o f costs has been for w arded to the approved society and ap proved by them. T h e B r i t i s h D e n t a l A s s o c i a t i o n complains that this affects adversely the dentist-patient relationship and recommends that this procedure be aban doned and that some other means of control be instituted.
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H E v a lu e o f d en ta l o rgan izatio n is best m easu red b y th e a ccom p lish m en ts re co rd ed in its pages o f history, w h ich are im b u e d w ith th e sp irit a n d g ro w th o f the profession. S in ce th e in ce p tio n of the first den ta l so ciety in N e w Y o r k in 1834, organ ized d en tistry has b een th e c ard in al fa c to r
T
S T A N L E Y J. R U Z IC K A and m o tiv a tin g fo rc e in th e e th ica l a n d scien tific a d va n ce m e n t o f th e d en ta l profession, fo r “ w ith o u t organ izatio n , th ere w o u ld be no p rofession ” ;1 th ere w o u ld b e no m eans of securing c o lle c tiv e ly benefits w h ich can n o t be ob ta in ed b y in d iv id u a l efforts; th ere w o u ld be no u n ifica tio n o f d en ta l ed u ca tio n , n o law s for th e p u b lic con tro l o f d en ta l p ra ctice ;
From the School of Dentistry, Western R e serve University, Cleveland, Ohio. *Prize essay in the American Dental Asso ciation Junior Membership Contest.
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there w o u ld be n o d en ta l m eetin gs, n o re li a b le p u b licatio n s— n o m eans b y w h ich den tal kn o w le d ge m ig h t b e dissem inated. T h e in flu en ce th a t d en tal o rgan izatio n was to h a v e in th e d e v elo p m e n t o f d en tistry from a trad e to a profession w as fo re to ld in the d e claratio n of purposes and aim s o f th e early societies. T h e fu n ctio n of th e so ciety, as con ceiv ed b y the d en ta l pion eer, w as to p ro m o te union a n d h a rm o n y am on g th e resp ecta b le elem en ts and so d ifferen tia te th e surgeonden tist fro m the “ to o th -ca rp en ter,” th e less com p eten t m e c h a n ic a l dentist; to a d va n ce the scien ce b y in terch a n g e o f th ou gh ts and ideas, eith er w ritten or o ral, am on g the m e m bers o f the so ciety; to re je c t the p re cep to r system o f ed u ca tio n b y en co u ra g in g the fo u n d in g of sp ecialized in stitution s o f le arn ing, n a m e ly th e d en ta l co lle ge , fo r th e e d u ca tion o f the dentist; to giv e c h a ra cte r and re sp ecta b ility to th e profession b y establish ing a lin e betw een the m eritoriou s a n d those w h o p la ce d th e stin t o f e m p iricism u p o n the profession. A n d w h ile these aim s a n d p u r poses w e re n ot fu lly a tta in e d b y a n y o f the e a rly organization s, each d id co n trib u te to the fin a l a cco m p lish m e n t b y p ro v in g th e a d van tages to be ga in ed fro m organization . T o d a y th e a ctiv ities of th e A m e ric a n D e n ta l A sso cia tio n h a v e an u n d en ia b le in fluence on th e progress o f den tistry. B ein g the v o ic e o f m o re th an 50,000 q u alified d en tal p ractitioners, the A ssociation has a
The papers by Eldred L. Arch, Creighton University; Philip S. Loechler, University of Minnesota; Stanley J. Ruzicka, Western R e serve University; and Henry D. Prensky, U n i versity of Pennsylvania, were the prize winning essays in the American Dental Association Junior Membership Contest for 1942 . The authors w ill be invited to attend the annual meeting of the American Dental Asso ciation as guests of the Association. T he papers are published as presented by the authors without material editorial change.— E d i t o r .
M id - M o n t h l y I s s u e
representation second to that of no other similar professional organization. By its ac tivities, it extends its influence to all fields of practice, and, accordingly, these m ay be grouped into a dozen or more categories. Through the meetings of the Association and its components, the highway of postgraduate education is maintained. Through The Jour nal, an evergrowing book of dental knowl edge is added to the library of every member of the Association. Through its Committee on Public Health and Education, and its Bureau of Public Relations, there is con ducted a comprehensive and continuous pro gram of lay education. Through its Dental Educational Council, it seeks high standards for future practitioners. Through its Bureau of Chemistry and its Council on Dental Therapeutics, both the public and the profes sion are informed on those products which are deemed acceptable or undesirable either in practice or for lay use. Through its Relief Fund Commission, security is provided for needy members. Through the Judicial Coun cil, questions of ethics are decided and re viewed, and thus the actions of the men in the profession are controlled, toward one an other and toward their patients. Through its Committee on Dental Economics, data are compiled relative to economic problems that confront the profession and the public. Through the Committee on Legislation, the educational, professional and ethical stand ards of the profession are guarded against unjust legislation. Through its Research Commission, dental materials are constantly being improved, and further research is pro moted by grants. Through its National Health Program Committee, sound policies are sought to improve the dental health of a growing population. These councils, bureaus, committees, com missions and other groups not mentioned here render invaluable services, involving tre mendous expenditures of time and money. T hey furnish benefits which are the out growth of dental organization and which are the direct result of years of intensive plan ning and sound interest in the advancement of dental health for the people of this coun try. The benefits have been three-fold: First, to the individual practitioner, who owes his present position in society and in the profes sion to organization, for with organization the practitioner has continued to gain wider
2305
knowledge and more expert skill. Second, to the manufacturer of dental items, who has profited by the standards that the American Dental Association has established for certain approved dental products. Third, to- the public, to whom there has accrued the benefits which have first fallen to the dentist and the man who supplies him; for by their enhanced abilities, the practitioner and the manufacturer— through organized dentistry — have served to render an improved service measured in terms of better dental health for the nation. Thus, organized dentistry has proved its value in time of peace. Today, in time of war, organized dentistry continues to carry the banner of the profession. As early as two years ago, the American Dental Associa tion instituted a preparedness program whereby an extensive survey was made of all dental practitioners and their relation to na tional defense. Through this program, the basis for cooperation with the armed forces and the Public Health Service was estab lished, so that, today, most of the respon sibility for securing dental personnel for the armed forces has been placed by the govern ment on the American Dental Association; and, in accepting this responsibility, organ ized dentistry, through its representatives on the Procurement and Assignment Service, has worked effectively to provide for the needs of the armed services and the civilian population by weighing the needs of the services against those of the community. It is recognized then that organized den tistry has been the consolidating influence which has bound together our literature, our education, our heritage. W e may regard it as the guardian angel of a recognized eth ical profession for more than ten decades of social, scientific, and political evolution, for it stands today as the agency by which the future of dentistry can be assured. BIBLIOGRAPHY
1. C a s t o , F. M .: Some Pertinent Facts R e lating to Organized Dentistry. Ohio D. Soc. / . , 9 : i o i , M arch 19 3 5 . a. A n t h o n y , L . P.: Influence o f Organ ization on Development o f Dentistry in United States. Proc. D. Centenary Celebration, 1940 , pp. 870 -874 . 3. D i t t m a r , G. W .: R 6sum6 of Develop ment of Organized Dentistry in America and
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194 1.
A .: T ren d s in A m erican D entistry. J .A .D .A ., 2 9 : 7 6 7 , M a y 1942. 6. R ep ort o f C om m ittee on D en tal Pre paredness: Procurem ent and Assignm ent S ervice fo r Physicians, D entists and V e te ri narians. J .A .D .A ., 2 9 : 4 6 6 , M arch 1942. 7. R o b i n s o n , J. B .: Foundations of Pro 5. O liv e r ,
O.
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fessional D entistry. Proc. D . C en ten a ry C e le bration , 1940, pp. 1043-1048. 8. R o b i n s o n , W . H . : A m erican D en tal A ssociation in 1940 -1941, a Y e a r o f Crisis. J .A .D .A ., 28 :2 0 19, D ecem b er 1941. 9. W e l l s , R . C .: R ôle of D en tistry in W ar Effort. J .A .D .A ., 29:8 35, M a y 1942. 10. W h y O rgan ized D entistry J .A .D .A ., 24:969, June 1937.
(ed ito rial).
THE VALUE OF DENTAL ORGANIZATION* B y P h i l i p S. L
\ S T achievements of organized den tistry have more than proved the value of a united effort in the behalf of one of the most eminent professions of the day.
P
P H I L I P S. L O E C H L E R
A group is only as staunch as the ethics upon w hich it is founded. Since the year From the U n ive rsity of M innesota, M in n e apolis. *P rize essay in the A m erican D en tal Asso ciation Jun ior M em bership Contest.
oech ler
1834 , organized dentistry has been a bulwark against illegal practices. Q uacks and the more inelegant practitioners have been the chief recipients of censorship. It has con trolled the quality o f dental service offered to the public by exam ination and licensure. T h e license fees w hich the dentist pays pro vide for the enforcement of its ethics and prevent illegal com petition from the labora tories and back room technicians. It is the representative of A m erican dentistry and the only group that can speak w ith authority. A ll the laws enacted by the several states in regard to dental practices have been spon sored by it, and this has given character and respectability to the profession by establish ing a line o f distinction between the truly meritorious and skilful operators and the im pudent and em piric bootleg practitioner. O r ganization is the essence of success of the movement in which the combined effort of several individuals is desired for the promo tion of the dental science. It is the flywheel of progress w hich gives balance to combined efforts, brings up and pushes forw ard the laggard o f conservatism, restrains the erratic flight of the too exuberant enthusiasm of the reformer, gives steadiness of action and makes advancem ent sure. A n association of persons for the promotion of scientific in vestigation for its successful advancement, the professional organization’s value o f today lies not only in the bringing together of the great, the good and the wise to exchange con gratulations on w hat the few know, more than the many, but in the fact that the m any m ay m eet the few and that knowledge, cul ture, refinement and a true professional
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spirit m ay be m ore w idely diffused and bet ter approached. Needless to say, a group o f this type makes for the cultivation of the social qualities of its members by surrounding each mem ber w ith friends to whom he can turn for advice and assistance when needed. It has for its objects the prom otion of union and harmony am ong all respectable and w ell informed dentists. It also uplifts the social standing of its group in the aid and relief of its m em bers. For instance, dental organization allows a low rate of insurance to w hich a member can turn; also a library bureau for purposes of authoritative information. T h e circulation o f a journal in any group whether professional or industrial is a teach ing factor. T h e dental journal is the largest and most influential periodical in the world, having a circulation of m ore than 50,000 copies a month. It finds its w ay into eightytwo foreign countries and is read wherever dentistry is practiced. D ental literature lies at the base of dental organization. This world-wide circulation enables its members to keep in touch w ith each other. In this manner, it maintains the full-tim e practi tioner at a pace consistent w ith that of his fellow men in the various phases of advance ment. T h e profession cannot go forw ard without the two essentials of education: first, the education of the laity; second, the educa tion o f its students. It cannot advance in the full accomplishm ent of its health mission without help from the laity. In the past, it has been depending solely on the dues of its members. T h e curricula of study have been standardized by the controlling factor of organization. T h e dental organization educates the public in all matters pertaining to dental health, w ith benefit to both the public and the profession. C ertainly the least that can be said con cerning the group is that it assists its m em bers in all their laudable undertakings and exerts its influence untiringly for the ad vancem ent in the dental field of methods of teaching, practice, jurisprudence and re search. T h e A m erican D ental Association op poses legislation w hich, if passed, w ould be detrimental to the association; for example, the compulsory health laws which would
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handicap the dentist. B y means of the or ganization, committees can be maintained w hich keep in touch w ith the legislative a c tivities of the federal government and the forty-eight states, w ith a view to preventing the enactm ent o f unwise dental laws. T h e y also m aintain economic committees situated throughout the nation. T h e y keep close con tact w ith the federal government through a national health program committee— a con tact com m ittee between the dental organi zation and the government in matters of public health. T h e y have surveyed the granting of patents, so that collecting of undue royalties could or would not be ex acted from the dentist. H owever, w ith all the progress which has been made, there are a few things yet to be accomplished. These cannot be accom plished w ithout a full and cooperative m em bership of all the men involved who can bring these ideals to reality. W e have yet to see the day when the cause, or the preven tion, of dental ills through subsidized re search m ay com e to light. T h e public, therefore, must accept its responsibility in this endeavor. For the student, w e must, through the organization o f the N ational A s sociation o f D ental Examiners, secure uni form ity of licensure in all the states. T h e dentist is standing, in these troubled times, beside the government, the arm ed forces and the public in anticipation and pre paredness. W hen the need arises, he m ay and w ill step in to again prove to the nation, and even the world, the eminent worth— the value of organized dentistry. B IB L IO G R A P H Y
Northwest Dentistry, 1 6 : 104 , April 1937 . Northwest Dentistry, 1 6 : 1 7 1 , July 19 3 7 . Northwest Dentistry, 1 7 : 103 , April 1938 . J.A .D .A ., 27:33, 122 , 129 , January 1940 . Ibid., 2 7 :i 103 , 114 3 , Ju ly 1940 . Ibid., 2 7 : 1635 , 1638 , 1650 , 1658 , October 1940 . Ibid., 2 7 : 1939 , 19 6 1 , December 1940 . Ibid., 2 8 : 1 6 7 1 , 1674 , October 19 4 1 . Ibid., 2 8 : 1863 , November 19 4 1 . Ibid., 2 8 :2019 , 2031 , December 19 4 1 . Ibid., 2 9 :io o , January 1942 . Ibid., 2 9 :2 13 , 310 , February 1942 . Ibid., 2 9 :835 , M ay 1942 .
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THE VALUE OF DENTAL ORGANIZATION* By H
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is now the prime concern of our citizenry. In every w alk of life, Am ericans are coming face to face w ith the problem of adjusting their lives to an all-em bracing plan, the es sence of organization. T h e awareness is rapidly growing that the heroism of Bataan
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H E N R Y D. PR E N SK Y
alone w ill not bring victory. V icto ry de pends also, and in equal measure, on the ability to transform 130 ,000,000 individual existences into an integrated, united people. O n ly a healthy people can be victorious. A program for the health of the nation is not a m atter of proclamations. A ble leader ship and smooth functioning apparatus are the basic essentials of a program that w ill result in a healthy people. From the U n ive rsity of Pennsylvania, School of D entistry, P h ilad elph ia, Pa. *P rize essay in the A m erican D en tal Asso ciation Junior M em bership Contest.
D . Pren sky
T h e health professions, consisting of lim ited trained personnel, . are faced w ith an unlim ited emergency. Leadership, efficiency, organization! T hese are the keynotes. W ith them, our unlim ited em ergency w ill be met and mastered. W ithout them, w e are in the dangerous position of “ m uddling through.” Leadership, efficiency, organization! T h e evidence is abundant that the dental profes sion possesses these attributes. O rganized dentistry has m aintained the integrity of our profession through the years. O ur standards have been raised, our institutions developed to the highest level in the world. A n eth ical code has been firm ly established. T he com m ercialization and promotion of dental pharm aceuticals have been kept within rigid bounds of honesty and scientific a c curacy. T h e public has been consistently impressed w ith the im portance of oral health and prevented from receiving harm ful misinformation. Legislation has been enacted prom oting the best interests of the practitioner and the patient. In conjunction w ith such federal agencies as the Bureau of Standards, the U nited States Public H ealth Service, the Veterans Adm inistration and others, the A m erican D ental Association has been expanding a livin g N ational H ealth Program. T his is a record of concrete achievement. T h e w ar added m ore evidence. H ad there not been a plan, had there not been a fun c tioning apparatus, the w ar would have brought in its w ake disruption of the dental activities of the country and a chaotic threat to the nation’s health. T h ere was a plan; there was an apparatus; there were people, people w ith knowledge and the experience of countless, successful campaigns. T h e w ar brought not chaos, but heightened activity; not disruption, but the greatest integration of the profession ever witnessed. T h e N ational H ealth Program Com m ittee of the A m erican D ental Associa tion could state, after the w ar had begun, “ T o d a y the dental service in the arm y and
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navy corps is much higher than in any other comparable group in the world.” T h e tight knit character of our organization was the key factor in determining the facile manner whereby the enormous demands of the war situation were met. Here was the acid test and the overwhelming proof of the value of dental organization. T he times are such, however, that we can not afford to rest contented with these ac complishments. As rapidly and intensely as we have worked until now to insure our country’s defense, so must we speed up the tempo now to insure an offense for victory. A normal peacetime pace, measured by today’s standards, is a crawl. If we must wait before we charge, the wastage, during the waiting period (in the form of ships sunk and in allied resources and territory lost) will be tremendous. As leading members of the community, we must instil in the American people a passionate desire fer victory, what ever the sacrifice. W e must realize clearly the truth of the words of the President of the American Dental Association, Dr. Oliver, in T h e J o u r n a l of April 1942: Proportionately greater numbers of trained personnel will be needed for the armed serv ices than would ordinarily be required by a numerically equivalent civilian population. Let each dentist show his eagerness to help, and let each one be prompt about it.' It must never be said of the dental profession that it gave too little, and too late. [Emphasis mine. H. D. P.]
These are words that must be heeded. T o our great credit, we can see that they will be heeded. The technics for securing rapid re sponse, the respect for and confidence in leadership, the effective machinery for check ing and rechecking, all guarantee complete, swift mobilization. In this race against time, the more extensive and deep-seated our or ganization is, the greater will be our service. Herein lies the great value of our organiza tion for tomorrow. T he day after tomorrow is important too. Dental organization assumes a qualitatively new value and one of great moment when seen in the light of a victorious, postwar America. Already certain trends can be ob served in the American people. These trends warrant close, critical examination. W e should note, first, a general realization that a great issue in world history is about
Issue
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to be resolved. T he issue is between two mutually antagonistic ways of life: the way of life of a free people, based on funda mental principles of justice, equality and personal freedom, and the way of life of Brown Shirt tyranny, “ the rule of the insane.” Unfortunately, the initiative, up to this writing, has been held by the latter. The rea son is not obscure: it has been able to compel cooperation and effort, with everything driven toward the military objective. T hat this has been accomplished through the use of terror and appeal to outworn prej udice is beside the point. It remains for us to find forms within our democratic framework to match the all-pervading organi zation and power of the enemy. In the world of the day after tomorrow, this will very likely be the great popular lesson of the war. That it will be applied specifically to the health field is not open to much doubt. The trend is beginning to take shape as a desire on the part of people for legislation for subsidized dentistry. On the other hand, it is quite manifest that, as a result of the war, much advance planning is being done by various government agencies. O f late, they have been moving over into the field of social welfare and health. In the first instance, it is important that organized dentistry develop a plan whereby these popular desires can be satisfied and still maintain the proven relationships of dental service. It is imperative that those leaders of the profession, in organized dentistry, who have had the most experience be the con trolling factors in these projects. In;the second instance, organized dentistry should plan in a parallel fashion to place the interests of the dentist in its proper perspec tive. This will result in the protection of the best interests of both the dentist and the patieint, with the best utilization of such forms of endeavor as research projects, exper imental institutes and the subsidization of important research at existing institutes of learning. T he value of dental organization can here be seen most clearly, and in this fact lies the main compelling reason for bringing organi zation to an absolute peak. The young men of dentistry, the dental students, those who will assume the responsibilities of the future, must understand this. The problems in-
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v o lv e d re q u ire an e a rly aw areness, and an e a rly a tte m p t m u st be m a d e to g ra p p le w ith th em a n d so lve them . I f w e seize
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we th e
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THE VALUE OF DENTAL ORGANIZATION* B y E ldred L . A
H E G reek s h a d a w o rd fo r it. T h a t w o rd w as cosm os; and to th e G reeks it m e a n t th e u niverse, an ord ered , an orga n ized sch em e o f things; it m e a n t the op p osite o f chaos. A n d chaos is w h a t you
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B u t w h a t abou t d en ta l organ izatio n ? T o d a y d en tistry itse lf is o n ly p a rt o f a v aster organization , p a rt o f an a ll-o u t m o b iliza tio n of ou r c o u n try ’s to ta l m a n p o w e r in an en d e a vo r to w in th e w a r, and, w h a t is m ore im p o rta n t, to re b u ild a b e tter w o rld . U n d e r th e stress o f the presen t em ergen cy, den tis try, as I see it, can a n d w ill p ro fit b y a b e tter organ izatio n and u tiliza tio n o f d a ta a n d d is coveries m a d e possible b y th at v e r y e m e r gen cy. L im itin g , then, this to p ic of the v a lu e of d en tal organ izatio n to a con sid eration of den tistry u n d er pressure of the grea te r o r gan ization o f the p resen t em ergen cy, le t m e qu ote here a short and v e r y pertin en t passage fro m an address re a d b e fo re th e A m e ric a n D e n ta l T r a d e A ssocia tion in C h i cago on N o v e m b e r 12, 1941. T h a t address, m a d e b y O re n A . O liv e r , D .D .S ., P resid en t of th e A m e ric a n D e n ta l A ssociation , w as p u blish ed in the M a y 1942 issue of T h e Jo u rn al
of
th e
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A sso
c i a t i o n ; and the passage re ferred to reads as
follo w s:
ge t w ith o u t organ izatio n ; fo r in a ll spheres o f h u m a n a c tiv ity fro m ru n nin g w ars and ra ilro ad s d o w n to ru n n in g a h a m b u rger stan d, th ere is no a d va n cem en t w ith o u t organization .
. . . defense preparations and w ars tend to force advances in techn ology, advan ces in health service fields, and, in m an y respects, also tend to accelerate preexisting social trends. T h erefo re . . . w e m ay also, w ith some justification, anticip ate th at dentistry w ill be confronted b y as m uch social pressure for change as w as the case after the First W orld W ar. T h is pressure cannot be avo id ed ; how ever, it can, in the pu blic interest, and in the interest o f the dental practitioner, be con trolled b y judicious, cooperative study and plann in g now and a fter the em ergency.
From the C reigh to n U n iversity, School of D entistry, O m ah a, N ebr. *P rize essay in the A m erican D en tal Asso ciation Junior M em bership Contest.
W h a t D r. O liv e r foresees a n d calls fo r is a g rea te r o rgan izatio n of d en tistry, b o th n ow and d u rin g the em e rg e n cy a n d in the p o st w a r p eriod . H e foresees an o rgan izatio n th at w ill shape u p in answ er to so cial pressure;
E L D R E D L. A R C H
M
id - M o n t h l y
he calls for an organization controlled by cooperative study and long range planning, and from this kind of organization he expects and predicts valuable results both for the dental practitioner and for the public whom the dentist serves. For the sake o£ clarification and to adopt some rather large and general principles of division, I w ould envision that im provem ent in dental organization under the follow ing three headings or interrelated phases of den tistry: ( 1 ) the organization of new knowl edge as regards the prevalence and frequency o f oral diseases, disorders ahd deficiencies; ( 2 ) the organization o f dentistry as a health service, and ( 3 ) the organization of the den tal profession as regards its personnel. First, the draft of men into our armed forces provides, as it were, a vast laboratory for the findings of dentistry. A lready we know that m ore than 20 per cent of the rejected Selective Service registrants are re jected because of dental defects. O u t of this great turn-over and check-over of men from all parts o f our country, there should issue accurate reports and records as to the prevalence and frequency o f oral diseases, disorders and deficiencies. T h ere should be, as we expect there w ill be, a clearing house or some central agency for the breakdown of these reports into tabulations and statis tics that w ill show the regional, occupational and nutritional influences on the dental dis orders of the nation. From the dentists in the armed services, we m ay expect m any valuable and interesting reports in the fields of operative dentistry, oral surgery and orthodontics. Advances w ill be m ade in technology. Theories as to diagnosis and treatment w ill be rejected or fu lly verified and validated. In short, under the pressure of war, m any discoveries, contributions and improvements m ay be expected in the whole field o f pathology. But all these findings w ill need systema tizing and publicizing. O n ly in that w ay w ill they be of any value to the practitioner and to the public. For this systematization and correlation, w e have our institutes, our learned societies, our learned journals and publications. B y the cooperative efforts of all these agencies, w e m ay m ake available the new knowledge, the new data. T hus we shall be better able to know and to combat the dental ills of the nation; thus we shall
I ssue
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have more efficiency and system in our pro fession, and all this w ill work out to the benefit o f the public whom the dentist serves. Secondly, out of this present emergency, w e m ay expect an im provem ent in the or ganization of dentistry as regards its place and function in public health work. It is evident that the dental profession w ill be called upon in the future to p la y an in creasingly im portant role in service organ ized under public and governm ental aus pices. In the past, dental health activities have grown in m an y instances without advice or encouragement, without plan or in telli gent cooperation between the m'edical and dental professions. T h e dental, public health, and m edical professions are not yet utilizing fu lly and econom ically the avail able scientific knowledge for the preven tion, am elioration and cure of disease. T o reduce the gap between such knowledge and its application in health service; to bring the physician and the dentist into closer co operative endeavor for the solution of a common problem should be one of the good results of the present mobilization o f both professions that is taking place today in both the m ilitary and the civilian spheres of our country as it girds itself for victory and for the w elfare o f its people in the postwar world. Dentistry has a distinct place in public health work, local, state and national. T h e im portance of this fact should be recognized b y the organized professions of dentistry, public health and medicine, all of w hich should lend their support and influence to guide this developm ent along proper chan nels. O rganized dentistry, organized m edi cine and organized public health work w ill have to pull together in closer harmonious cooperation to solve the problem s o f dis ease prevention, especially among industrial workers. Com prehensive planning and inter related activity w ill be called for. Som e de gree of leadership in these matters w ill fall to the dentist. I f he uses it successfully, his usefulness to the com m unity w ill be m ate ria lly increased and his standing m arkedly benefited both socially and professionally. T h ird ly, as one of the results of the pres ent m obilization, we m ay expect an ap praisal, a verd ict to be passed upon the per sonnel o f our profession who are now com
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missioned officers am ong the men in the service. T h is judgm ent w ill be passed, of course, m ostly upon the younger members of the dental profession; in m any cases, upon those who have just finished school and who have gone therefrom into various branches o f the service. From these reports and ap praisals, w hich could be assembled and or ganized by means o f questionnaires sent to the com m anding officers, conclusions can be arrived at as to w hat makes up the ideal dentist, both in the m atter o f personal en dowments and in the m atter o f his training and education. T hus a clearer and m ore ob jective standard could be fixed b y w hich to accept candidates for the dental profession; thus, too, the whole m atter o f an adequate curriculum could be gone over w ith em pha sis not only upon certain specialized prob lems of dentistry, but most o f all upon a liberal, cultural training that w ill fit the dentist to contribute directly to the social and civic w elfare of his community. For, as D r. O liv er warns, dentistry w ill be confronted by great social pressure for change. H o w that social pressure w ill be
met, how dentistry w ill organize to meet the new challenges and the new responsibilities, w ill depend, o f course, prim arily upon the dental profession itself. B ut ultim ately it w ill depend upon the individual dentist, upon the m en w ho m ake up the profession. W hat o f our rank and file? W hat of their training? A re they personally and profes sionally equipped to take their proper place in the new and better order that w e hope is coming? W ill they reflect credit upon their profession and bring it to a higher status in the service o f their country and o f all hu manity? T h e answer, I believe, lies in better, more efficient organization; in the utilization of the present em ergency; in taking stock and inventory right now; in judicious coopera tive study o f all phases o f dentistry; in long range planning for the future; in coopera tion w ith the trends o f our time. W ith such organization, dentistry w ill advance w ith profit both to the practitioner and to the public; w ithout it, dentistry w ill be wasteful in effort and w eak in isolation in a w orld reorganized.
( Continued from page 2303) not p ay their share, only 10 per cent o f the few entitled to dental benefits claim them. Analysis of the type of care received under this program testifies to its gross inadequacy. It was found from a sam ple study of dental care paid fo r by the approved societies that for every filling placed, there was more than one full denture constructed and more than six extractions performed. It is recom m ended that dental • benefits under the insurance plan be m ade statutory. W hen this is achieved, a dental representative should be appointed on each local insurance
committee. D ental service subcommittees should be set up and dental panels or ganized. U nder the present system, the den tist cannot proceed w ith treatment of a patient covered by insurance until a letter giving an estim ate o f costs has been for w arded to the approved society and ap proved by them. T h e B r i t i s h D e n t a l A s s o c i a t i o n complains that this affects adversely the dentist-patient relationship and recommends that this procedure be aban doned and that some other means of control be instituted.