Christensen House: A Case Study for Inclusive Decision-making within Professional Associations.

Accounts of dental history in Queensland are few and almost invariably authored by those who either held or hold power. The focus is 'who, what, when' rather than 'why and how'. House-related developments as a case study provide an opportunity to assess aspects of the Australian Dental Association Queensland Branch's (ADAQ) model of administration in the early 1970s. The authors use literature review and historical methods. The ADAQ's articles of association, codes of conduct and memoranda centralized Brisbane-based authority and elite leadership into its management. The ADAQ council's decision to build Christensen House in Brisbane, prompted by the posthumous benevolence of George Christensen, was informed, logical, measured and appeared timely. The advocates for the house were innovative, optimistic, resolute, and well-intentioned, with their design and selected location of the building being appropriate. However, the decision occurred at a time of latent discontent within the membership, many of whom did not support the project financially. Distance in Queensland dictates that provincial members either accept or tolerate Brisbane-based centralized authority within ADAQ administration. Nonetheless, when it comes to policy warranting membership subscription, the Christensen House experience demonstrates that the modus operandi of the ADAQ council should be, as far as possible, inclusive, and representative.

Colin Robertson, Smile A While: Dentistry, History, Theater and Golf.

Many commentators argue that, until the 1980s, Brisbane and Queensland were cultural backwaters within the Australian context. However, with the hosting of the highly successful XII Commonwealth Games (1982) and World Expo 88 (1988) and with the development of the Queensland Cultural (1976-) and South Bank (1974-) Precincts, Brisbane and Queensland cast aside perennial apologism to acquire prominence, maturity, and self-respect. Within these national, state, and municipal settings, the theme, timing, and venue for the 24th Australian Dental Congress (1985) involved risk. Enter a Brisbane dental practitioner, Colin Robertson: a theater critic and a scriptwriter, who possessed competitive and entrepreneurial streaks, a vivid imagination, a steely resolve, and a love of golf. Robertson became an erudite, incisive, and prolific commentator, who penned much of the historical musical Smile A While (aka Smile Awhile) for the abovementioned congress. He contributed to an outstanding Dental Health Week (1980), served on the Australian Dental Association Queensland Branch Council (1981), its Fluoridation Committee (1973) and chaired both its Oral Health Education Committee (1981) and the Congressional Entertainment Division within the Congress Organizing Committee (1982-1985). Accordingly, the authors use historical methods to expose and explore a scarcely acknowledged narrative within dental history in Queensland.

James Meyrick Croker: A Model for Professional Behavior.

The rationale that underpins volunteering has long fascinated behavioral scientists. James Meyrick Croker's personal life, professional career and community engagement conform to the classic twentieth century model for professional behavior. Accordingly, the authors use historical methods of investigation to evaluate the influences on and the legacies from a remarkable contribution to the professions and the community. The narrative demonstrates elements of altruism, collaboration, conviction, compassion, drive, entrepreneurialism, familial and grammar school influence, leadership, pragmatism and vision. Croker's professional and community service was multi-organizational. Concurrent demands on his time warranted discipline, energy and expertise. For the behavioral scientist, achievement, affiliation, nature and nurture appear relevant to the outcome. Available archives provide no evidence of ego-driven motivation. Leadership style was transformational not transactional. Major legacies to the national and state Australian Dental Associations are ADAQ Christensen House (1972-1980), the eventual financial stability for the Australian Dental Association Queensland Branch, formal dental assistant training, policies of the Australian and Queensland Councils of Professions, a notable Goddard Oration and the successful 24th Australian Dental Congress.

Community water fluoridation support and opposition in Australia.

OBJECTIVE: To estimate the level of support for water fluoridation across Australia and examine the association between water fluoridation stance and demographic and socioeconomic characteristics, commitment to the stance, and opinions, beliefs and knowledge regarding water fluoridation. METHODS: Cross-sectional questionnaire data were obtained from 510 Australian adults (response rate = 34%) in 2008. Data were weighted by age, gender and state and territory estimated resident population. MAIN OUTCOME MEASURES: Participants were asked to rate the strength of their support for or opposition to water fluoridation on a 7-point scale. RESULTS: Approximately 70% of survey respondents supported water fluoridation, 15.4% were opposed, and 14.5% were neutral. Those strongly opposed were most resistant to altering their opinion on the basis of new information or research. However, approximately 90% of people who were neutral, slightly supportive or moderately supportive would "maybe" or "definitely" change their stance. Fluoridation opposition was associated with lower income and educational attainment, more self-rated knowledge, and with beliefs about reduced benefits and greater harms. Opinions about who should be responsible for the introduction of water fluoridation and sources of information on fluoridation varied significantly by water fluoridation opinion. CONCLUSIONS: While this survey lends further weight to the evidence confirming extensive support for water fluoridation in Australia, a large percentage of the public may be open to changing their stance if presented with new information or research. To maintain the widespread acceptance of water fluoridation, it is important that the public are provided with unbiased and accurate interpretations of the continual stream of research related to fluorides and water fluoridation.

Does poverty cause dental caries?

Dental caries generates significant health, financial and social costs to individuals and communities, but risk factors are not spread randomly and evenly throughout populations. People from lower socio-economic status (SES) and disadvantaged groups suffer a disproportionately greater disease burden. Clinicians and public health experts view this problem through a different lens. Dentists at the clinical coalface consider individual risk factors and behaviours, for example sugar consumption, cariogenic bacteria and poor oral hygiene, as major causes of dental caries. However, considerable evidence suggests that low SES, via traditional individual risk factors as mediators and through additional independent pathways, is another significant cause. Progressive clinical practice uses education, prevention and treatment to reduce the impact of individual risk factors. Policy-makers and health administrators use population-based approaches to improve the health of societies. The authors use literature review to argue for both a greater awareness of the upstream socio-economic causes of dental caries, and action from key community sectors to redress the societal inequalities contributing to dental health inequalities.

Collaboration, vision and reality: water fluoridation in New Zealand (1952-1968).

In comparison with that of other nations in the British Commonwealth, New Zealand's early and comparatively high adoption of water fluoridation was a distinctive health policy. National concerns about the caries epidemic and the legacies of TR Hunter, F Truby King, HP Pickerill and JP Walsh engendered a spirit of cooperation between the Department of Health, the New Zealand School Dental Service, the Medical Research Council (of New Zealand), the New Zealand Dental Association and the University of Otago's dental and medical schools. The consequence was a contagious culture of multidisciplinary research and institutional liaisons that produced exceptional dental epidemiology. The government's involvement in children's public dentistry harmonised with fluoride advocates' radical vision of community caries reduction. New Zealand assumed not only a leading international role in immediate post-World War cariology, but also the dominant position in the fluoride politics of the British Commonwealth. The incomplete fulfilment of Fuller's "Dreams Pursued" presents a case study that confirms the roles of both scientific evidence and centralised political authority in public health administration. Paradoxically, political scientists have largely ignored New Zealand's early adoption of water fluoridation. This paper addresses this deficiency.

An historical perspective on early progress of Queensland water fluoridation 1945-1954: sheep, climate and sugar.

BACKGROUND: Queensland's virtual rejection of artificial water fluoridation sets it apart from other Australian states, yet the early fluoride environs has been scantily recorded. METHODS: This paper used archives, literature review, personal interview and the traditional historic method. RESULTS: The connection between Queensland artesian bore water and caries resistance was postulated as early as 1912. Four decades later, two Queensland-specific factors influenced the planning to fluoridate community water supplies. The first (1945-1950) was confusion between the high levels of fluoride in artesian water supplying the pastoral industry and the scientific concept of artificial water fluoridation of communal supplies. The second (1952-1954) involved further scientific investigation involving water consumption patterns, occupational dehydration and fluid homeostasis within a sub-tropical climate. The role of the Australian Dental Association Queensland Branch (ADAQ) in early fluoride politics was minimal. Four early protagonists are identified--two dentists, an engineer and the sugar industry. CONCLUSIONS: Queensland had its advocates for artificial water fluoridation of communal supply as a means of caries prevention. Interest came from the dental, medical and engineering professions, and from the sugar industry. However, these efforts met with indifference based on confused extrapolation of the artesian experience (1945-1952) and hesitancy (1952-1954) due to contemporaneous concerns about human fluid homeostasis in Queensland's sub-tropical climate.