JACD 71-4 - American College of Dentists

Cohesive gold became available. Amalgam
started to be developed. What is now the
American Dental Association was started
in the 1850s. There were other dental
education programs beginning, but most
of the education in the U.S. in the 1800s
was still by apprenticeship. There was
no scientific approach to operative
procedures or restorative materials. The
first dental school in a university was
founded at Harvard University.
G. V. Black
The first case study in audacious leadership
I will present is someone whom all
of us in dentistry know—Dr. G. V. Black,
a dentist-physician who began as an
apprentice dentist in the late 1800s but
laid the foundations for dentistry as a
profession. He was recognized as an
inquisitive man, a person who was interested
in creating a scientific approach to
his profession. He joined the Chicago
College of Dental Surgery in 1883 on a
full-time basis and began to develop an
understanding of operative dentistry. He
became dean of Northwestern University
School of Dentistry and served from
1897 until 1915. During that time, he
refined dental amalgam as a cost-effective
alternative to extraction or gold. His
published work on operative dentistry
in 1908 was essentially the textbook of
operative dentistry for more than fifty
years. To better understand restorative
treatment he probed the etiology of the
dental caries. He worked with others in
helping define what we now know as
the plaque concept and the biochemical
changes that subsequently occur in the
caries process. G. V. Black was recognized
within the profession of his time
as an audacious leader. His leadership
resulted in major changes; he redefined
dentistry as a profession and not a trade.
William J. Gies
Journal of the American College of Dentists
The needs of the
practicing profession
have outgrown the
capacity of our
educational programs.
The dental profession faced new
challenges at the turn of last century.
Dental education was still principally
provided in proprietary schools—
essentially a grouped and economically
superior form of apprenticeship. Dental
students had little or no exposure to
basic and clinical sciences or anything
else that was not directly billable. Their
education was primarily focused on
cavity preparation and restoration,
placement of dentures, and extractions.
(Remember, it was also at this time
that vulcanite was invented, and it
was becoming a readily available and
worthwhile material to use as a base
for complete dentures.) Essentially no
scientific research was being conducted
in dentistry.
The times were right for another
audacious leader, William J. Gies.
Gies was not a dentist; he was a PhD
biochemist who taught at Columbia
University in New York. Local dentists
stimulated his interest in developing a
scientific foundation for practice. He
was one of the founders, in 1916, of the
Columbia University School of Dental &
Oral Surgery. He was the founding editor
of the Journal of Dental Research in 1919
and continued in that capacity into the
mid-1930s. He was one of the founders
in 1923 of both the International
Association for Dental Research and the
American Association of Dental Schools,
now the American Dental Education
Association. But perhaps he is best
known for the “Gies Report,” released in
1926. Abraham Flexner, an educator, had
been hired by the Carnegie Foundation
in the early 1900s to evaluate medical
education in the United States. The
National Leadership Symposium
result of that report was a recommendation
that medical education should
include basic, clinical, and behavioral
sciences and two years of clinical
experience. Gies was also hired by the
Carnegie Foundation to undertake a
similar comprehensive investigation in
dentistry. He visited every dental school
in the United States and Canada. His
report to the Carnegie Foundation
essentially paralleled Flexner’s work,
arguing for a three-year curriculum, an
increase in research, and strengthening
the foundations of professional education
so that dentistry, although a distinct profession,
would be the equal of medicine.
Gies had the audacity to make recommendations
to provide leadership and
again was very well recognized within
our profession during his time.
Arthur A. Dugoni
Now let’s move to the middle and late
1900s. What were some of the challenges
facing dental educators at the end of the
last century? Our profession was polarized
in the 1960s through the 1990s and
there was dissatisfaction among people
attempting to work together. Another
feature of our profession at this time was
that teaching methods in dental school
during this time were often militaristic
or draconian. In my dental school
experience, we did not refer to faculty
members as “doctor,” but by their
military rank. Still another feature of our
profession at this time was curriculum
overload. We added content to an
already heavily loaded program, and
there were concerns about the relevance
of certain portions of the curriculum.
There were new procedures and new
biomedical knowledge, and patients
were become more complex. The needs of
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