A century of influence: part 3. The modern era.

The story of orthodontics during the first 100 years of Journal publication can be told through the people who lived it. As part of the American Journal of Orthodontics and Dentofacial Orthopedics Centennial Celebration, we present 100 people who most influenced the specialty during the last 100 years. Part 3 concludes with "The Modern Era" and describes those born in 1920 or later. They came of age near or after the end of World War II. Proprietary orthodontic schools and preceptorship training were giving way to expanding postgraduate university programs. The graduates of these rigorous programs fanned out across the country, making orthodontic specialty education available to an ever-widening circle of students and orthodontic treatment to new generations of patients.

James M. Clyde, D.D.S., M.S.A.: The Canadian-American who rescued the Chicago Post-Graduate School of Anaesthesia.

The Chicago Post-Graduate School of Anaesthesia (PGSA) commenced with the opening of the Columbian Exposition, eight miles north of that Chicago World's Fair in May of 1893. When PGSA founder Samuel J. Hayes, D.D.S., M.S.A., forsook Chicago to tend to his moribund son back in Pittsburgh, Hayes' fellow professor, James M. Clyde, D.D.S., M.S.A., kept the PGSA from closing.

Henry Goldman and dental education: reflections on the early days at Boston University.

Dental education at Boston University began in 1958 as an outgrowth of Henry M. Goldman's desire to create a university-based center for advanced graduate training in the dental specialties. By 1963, the Boston University School of Graduate Dentistry was established. Henry Goldman (1911-1991), an unwavering visionary, is largely responsible for the solid foundation on which is built the successful present-day Goldman School of Dental Medicine at Boston University.

Preceptorship revisited.

Before the advent of university-based dental education, preceptorship training was the only way one could learn to be a dentist. Even after dental schools became firmly entrenched in the university system, preceptorships were accepted for specialty training. In the 1960s, the American Association of Orthodontists revived the tradition to meet a growing demand for orthodontic specialists. By the time that program concluded a decade later, over 200 specialists had completed their studies; many preceptees went into clinical practice near or with their mentors. The author of this historical review is a practicing orthodontist certified by the American Board of Orthodontics, a faculty member of a university orthodontic department, and a 1961 graduate of the supervised preceptorship program.

Forsyth, Harvard, and endodontic education: 1970-1987.

In 1970, there were few fully-educated endodontists and formalized endodontic programs in the United States. Dr. Alvin Krakow began a teaching/clinical program that combined the best in technical education and research for academically-minded young clinicians. The Forsyth Dental Center hosted the program while the Harvard University School of Dental Medicine (HSDM) offered the prerequisite courses in basic science. The program ended in 1987 and was reinstituted in 1993. Today, the program continues to graduate a small group of diversified and educated clinicians. A number of graduates in the original group have made significant contributions to the specialty. This historical perspective focuses on the early years of the combined program.

Icons of dentistry: Dr Leon Eisenbud.

Dentistry has a long, often well documented history. Evidence of tooth pullings has been discovered in crude carvings on the walls of caves that are over 10,000 years old. The ancient Egyptians, the Athenians, and the early inhabitants of Rome required oral health care; in addition to tooth extractions, they underwent tumor removal, tamponade for hemorrhage, reduction of jaw fractures with gold wire ligatures, cautery using white hot platinum loops, and an additional variety of remedies and nostrums. Pain relief was offered, with courses of treatment as varied as postural change, alteration of ambient temperature, and vegetable and organic medicines in poultices or via oral and rectal routes. Through the centuries, great surgeons and physicians introduced various methods of treatment: Hippocrates codified ethical standards; Maimonides established pragmatic rules for physicians; LeFort categorized facial fractures; Pasteur clarified the need for sterilization; Semmelweis standardized antiseptic conditions in the operating theater; Morton and Wells discovered safer methods of analgesia; Freud explored the theraupeutic uses of narcotics; Roentgen championed X-ray imaging; Curie pioneered the use of chemotherapy; and Barton and Nightingale were models of empathy and patient care. In more recent times, we have profited from the genius of Watson and Crick (DNA); Fleming (penicillin); Venable and Stuck (Chrome-cobalt--molybdenum alloy); Gershkoff and Goldberg (the subperiosteal implant); Chercheve, Branemark, Linkow, Misch, Tatum, and Niznick (innovative root forms, titanium and its alloys, and sinus floor grafting). The 20th century has brought to us phenomenal imaging, breathtaking intrauterine fetal surgery, wildly promising stem cell research, and astonishing CADCAM techniques. We've had great teachers and clinicians who have introduced us to new forms of therapy and advanced methods, including the role of the hemidesmasomes, the essential elements of bone grafting, the importance of microscopic analysis, and the benefits to patients of physical diagnosis by their dentists. To recognize and celebrate some of my heroes' contributions to the health and well-being of humankind, editorials will occasionally appear on these pages that explore their various contributions.

Hospital dentistry and GPRs. A relationship with a past.

Dental programs have evolved from an occasional component of hospitals to fully recognized departments within the structure of most institutions. A review is presented of some of these developments, including the initiation of general practice residency (GPR) programs and training in a residency program as a substitute for the standard licensing examination.

History of federal legislation in health professions educational assistance in dental public health, 1956-97.

Health professions education assistance in dental public health has been congressionally authorized in one form or another during the last four decades. The US Department of Health and Human Services (and its predecessor, the Department of Health, Education, and Welfare) has been a focal point for managing these federal programs. This report tracks the history of relevant national legislation, beginning in the 1950s with the Health Amendment Acts of 1956 and continuing most recently with the Health Professions Education Extension Amendments of 1992. The number of dental public health professionals trained and available to provide expertise and leadership to improve community oral health status has been tied to the presence and intensity of federal programming in this area.

The first orthodontic diploma.

The advent of the Inter-Collegiate Membership in Orthodontics in the year 2000 will mark the end of an orthodontic diploma specific to the Royal College of Physicians and Surgeons of Glasgow. The Diploma in Dental Orthopaedics (RCPS) was the first orthodontic diploma in the United Kingdom. The fact that such a diploma has existed first as a DDO and latterly as the MDO (Membership) for some 50 years is remarkable in view of the relative infancy of most dental specialties and the fact that the General Dental Council has instigated a specialist register in orthodontics as recently as 1998. It was 1965, before other specialty diplomas became available in the British Isles, with the introduction of the FFD by the Royal College of Surgeons in Ireland.

The changing role of the dentist.

This paper considers some of the specific factors which have changed the role of the dentist in a historical context. The impact of post-war developments on postgraduate education, the Nuffield Inquiry of 1980 and the Dental Strategy Review Group are examined. The broader scope of the dentist and dental auxiliaries in general dental practice in the light of changes in disease patterns is described. The benefits to patient care of involving the general dental practitioner and the dental team in primary care services are emphasised. There is a need to educate and train all health care professionals together to promote multidisciplinary teamwork in clinical practice. Change is inevitable but is to be welcomed more than feared.

Postdoctoral education in dentistry: preparing dental practitioners to meet the oral health needs of America in the 21st century.

There has been increasing interest in the organization and accreditation of Postdoctoral General Dentistry Programs (PGD). In addition, numerous national organizations have called for increases in the number of first postdoctoral year (PGY-1) positions and programs. At the same time there has been a movement to incorporate concepts of competency-based education into dental education programs in order to stress the outcomes of education rather then the process. These movements have coincided with an increased recognition that dental education will be affected by the changing demographics of our population, the emerging trends in health care delivery and financing, and the need for an increase in the number of primary care providers in dentistry, trained at an advanced level, who are capable of caring for an increasingly socially diverse and medically complex population in our country in the next century. This paper reviews the history of postdoctoral education programs in dentistry and medicine with a focus on PGD education, describes the changing health care environment in which future dental professionals will practice, and relates the dental postdoctoral experience to that in medicine. A strategy is presented for the dental profession to prepare dental practitioners with the competencies needed for the future and to create enough training opportunities to prepare these practitioners to care for the oral health needs of the nation. This proposal calls for a "National Consensus Development Conference on the Future of Postdoctoral Primary Care Education in Dentistry". This conference would define the strategies necessary to prepare dental practitioners with the competencies needed for the future and develop approaches to create enough training opportunities to prepare these practitioners to care for the oral health needs of the nation.

The scope, goals, and objectives of graduate dental education--II.

This position paper on the "Scope, Goals, and Objectives of Graduate Dental Education" provides a discussion of basic working definitions and an attenuated historical review of graduate dental education, with special emphasis on the evolution of goals and objectives of graduate dental education. The goals and objectives are presented in a general context, and the following factors affecting them are discussed: (1) type of program (postgraduate or graduate) and desired end-product; (2) the specific discipline or specialty (including commentary on goals and objectives of each existing dental specialty and general practice residency program), and the suggestion for the creation of one additional specialty (dental anesthesiology); and (3) the institutional setting, with special emphasis on the role of the hospital in dental education. Suggestions or recommendations for further consideration or possible action are shown in italics throughout the paper.