Columbia University School of Dental and Oral Surgery - Dental Columbian Yearbook (New York, NY)

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The Bicentennial, the Medical Center and Dentistry L. Laszlo Schwartz, D.D.S. An anniversary is not only a time for evaluat- ing the record of the past. It serves a greater pur- pose if it is a time for stocktaking with a view to the future. Institutions, whether small or great, never stand still for any length of time. They move forward or they slip backward. Such a mo- tion may at times seem imperceptible but it is present nonetheless. It is, therefore, most impor- tant that we try at times such as this to estimate what we would hope to accomplish in the next twenty-five years, to assess our obstacles and diffi- culties and to take inventory of our assets. A ship seldom reaches its harbor by drifting. These words, spoken by President Kirk at the twenty-fifth anniversary of the founding of the Columbia-Presbyterian Medical Center, apply to the School of Dental and Oral Surgery and the profession of dentistry. Even a cursory examination of dentistry today shows that, in principle, its practices are ancient in origin. They arose from two sources during antiquity: one technical, the other scientific. The first had its beginnings among the Phoenician and Etruscan craftsmen. The second began with the birth of Greek science. There are many valid reasons why dentistry has developed more fully along the technical rather than the scientific lines. The most common dental disorders— caries and periodontal disease— are older than civiliza- tion itself. They have been essentially universal afflictions to which nature offered little resistance. Although these diseases were not fatal they were a cause of great human unhappiness because they hampered the diverse functions of the complex physiological system we call the mouth. An art had to develop to cope with these dis- eases because neither nature nor science was able to. This dental art, developing slowly during the past 2000 years, reached a level of full effective- ness only in our own century. It is to America that the world owes most of the achievements of modern dentistry: the effec- tive restoration of carious teeth and replacement of those lost, the successful treatment of diseased teeth and the structures which support them and perhaps the most dramatic of all— the gift of anes- thesia. American dentistry, of all the branches of med- icine, has led the world from the beginning. For this the reasons are many and complex. Man ' s Right to Knowledge and the Free Use Thereof has been primarily responsible for the fact that, in dentistry, the words excellence and American have become practically synony- mous throughout the world. We owe this distinction also to the diversity of the sources from which dentistry drew its nour- ishment: Colonial craftsmen with their mechani- cal ingenuity, enterprising practitioners who brought to our shores the fruits of French dental art and English biological science, American physicians and engineers with their special tal- ents. All were drawn to dentistry in this country by its many challenges and opportunities. These diverse groups found in the new world an at- mosphere of freedom. They could work unfet- tered by guild or other restrictions which had hindered dental progress in the old world. American dentistry was bom and progressed in an atmosphere which held sacred the right to knowledge and its free use. An important use of this freedom occurred in 1840, when it became evident that the knowl- edge necessary for further growth in dentistry

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MAURICE J. HICKEY, D.M.D., M.D. Associate Dean of the Faculty of Medicine for Dental and Oral Surgery; Executive Officer, Department of Dentistry; Professor of Oral Surgery

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was not to be found within the framework of the medicine of the time. Medical thought of that dav was characterized bv philosophical theorizing. Medical treatment consisted for the most part of bleeding, purging and leeching. Excisions and amputation composed the main- stays of surgical practice. Dentistry went its own wav to seek the knowledge and develop the procedures it required. So successful was dentistry that within sev- enty-five years its art had outstripped its science. In 1910. William Hunter, an English physician, charged American dentistry with the responsi- bility for building a veritable mausoleum of gold over a mass of sepsis . . . without parallel in the whole realm of medicine or surgery. American dentistry world famous for its dex- terity, now faced the task of becoming more sci- entific. The researches of W. D. Miller in dental caries had already shown that the scientific knowledge necessary for the growth of dentistry was to be found in the great research and teach- ing centers of medicine. In less than a century medicine had progressed more than it had in the previous thousand years. In 1840 dentistry left medicine to develop the technical skills necessary for effective dental treatment. By 1911 it be- came evident that if dentistry was to flower and ultimately to minimize or eliminate the need for its complicated and costly techniques, it had to develop a biological basis for its therapy. Into this world of shifting emphasis Colum- bia ' s dental school was born. The new school— with the same entrance requirements as those of the College of Physicians and Surgeons— was unique. The first years were difficult, but by 1928, with funds provided by the University, the School became part of the new Medical Center. Subsequent steps taken by the University to weld dentistry with medicine were not always received with enthusiasm. Some individuals and groups in dentistry even called for a halt in Co- lumbia ' s experiments in dental education. But Columbia had not carried the tradition of a great university for two hundred years for naught. Because we are free, stated President Kirk recently, because no man and no group of men may limit us in the process of honest inquiry and expression, our responsibility is great. Co- lumbia ' s is a tradition of leadership. There have been instances in which that leadership was not ' .mmediately popular. This is not important. The university which is timorous, which fears to es- pouse an unpopular view that is the product of honest, sound, qualified scholarship and research, is a university in name only. Acting on these principles the University merged the Dental and Medical Faculties in 1945 and dentistry took its place as a full mem- ber of Columbia ' s medical family. By this action the University reaffirmed the conviction upon which it founded the Dental School— dentistry is logically a branch of general medicine. This step did not achieve, even at Columbia, the full integration of dentistry with medicine. In a free society, individuals do not shed their attitudes and alter their behavior over-night. For some the change was recklessly rapid; for others it appeared hopelessly slow. The type of change envisioned by the University was expressed by Dean Rappleye when he wrote, It is often dif- ficult to steer a course in the middle of the road, particularly because that requires a high order of judgment and courage. Our progress must be by evolution, but it also must be progress. The integration, like the founding of the School and the move to the Medical Center, provided the soil necessary for the further growth of dentistry. For a good harvest, fertilizing and tilling are also needed. To look at dentistry at the Medical Center to- day, it is evident that it has come a long way to- ward becoming a part of general medicine. In research, teaching and practice dentists have as- sumed responsibilities and won recognition as specialists of the mouth. Yet the obstacles that remain are many. The necessity for training the student in the complicated techniques demanded by dental practice today makes it difficult to relate these procedures to the basic sciences. At Columbia, the schism between the science of dentistry and its art has been narrowed, but it is still much too wide. With specialization, the art it- self is unduly fragmented and the need for better communication is great. In spite of formidable obstacles, not the least of which is the need for financial support, the University is continuing its pioneering efforts in the fields of dental education. As a result, the graduates of this Bicentennial year at Columbia are unquestionably better educated and trained than were their predecessors. But the success of the University in dentistry will also be measured by the extent to which its graduates, as profes- sional men and as citizens, adhere to the prin- ciple expressed in the theme of the Bicenten- nial.