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Australian Dental Journal, February, I970 55 FEBRUARY, 1970 ROBEB~ 1. alia r H n A .RBIs, M.D.S., Volume 15 Editor :: Number 1 JournaI Published by the Australian Dental Association 68 Martin Place, Sydney, N.S.W. DENTISTRY AT THE CROSSROADS In 1946 Henry Sigerist of the Johns Hopkins Institute of the History of Medicine published in one book a series of essays he had presented in lecture form to a variety of audiences, and since they were mainly concerned with the development of university education he gave it the title The University at the Crossroads.(l) The title and the timing were important j firstly because of changing concepts of the role of universities, and secondly because the world had been thrown into an upheaval which not only disturbed the way of life of millions but which would do SO for millions then unborn. Sigerist saw the importance of society’s problems reflected upon the practice of medicine, the provision of medical services and consequently the teaching of medicine. Shortly after the termination of World War I1 the Government of Prime Minister Chifley, well aware of contemporaneous plans in other countries for the improvement of the social well-being of their people, set about planning improvements in Social Services and Health Services in Australia. Included was the recognition of the problems of providing dental treatment. During the deliberations between representatives of the profession and the Minister for Health, Senator L. McKenna, the offer of the Government was accepted for a delegation to visit New Zealand and study the well-established service provided by Department of Health, Division of Dental Hygiene, school dental nurses. The service had been in existence for about thirty years, had the support of the profession, and subsequently had been used as a pattern, with modifications for local conditions, for a number of countries with limited dental resources but anxious to provide treatment at least for as many children as possible. The defeat of the Australian Labour Party at the general elections in 1949 was the beginning of an almost twenty-year delay j now three States of Australia and the Australian Capital Territory are making use of these auxiliaries and Tasmania and South Australia have also established schools for training them. In 1950 leaders of the American dental profession reached the conclusion that there was a need for a survey of dentistry, and after a preliminary study the American Council on Education appointed a Commission on the Survey of Dentistry in the United States ‘‘ to assess the achievement, resources and potentialities of dentistry with a view to determining the desirable areas of future growth and development for the purpose of describing and recommending improved approaches, techniques, and methods for the provision of an essential health service to the American people ”. The Commission consisted of four dentists and ten laymen, and it had section committees whose tasks were to submit expert knowledge and guidance on dental health, dent,alpractice, dental education, and dental research. The cost of the survey was heavy 11) Sew York, Henry Schuman, 1946.

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Page 1: DENTISTRY AT THE CROSSROADS

Australian Dental Journal, February, I970 55

FEBRUARY, 1970 ROBEB~

1. alia

r H

n

A .RBIs, M.D.S.,

Volume 15

Editor

:: Number 1

JournaI Published by the Australian Dental Association

68 Martin Place, Sydney, N.S.W.

DENTISTRY AT THE CROSSROADS

I n 1946 Henry Sigerist of the Johns Hopkins Institute of the History of Medicine published in one book a series of essays he had presented in lecture form to a variety of audiences, and since they were mainly concerned with the development of university education he gave it the title The University at the Crossroads.(l) The title and the timing were important j firstly because of changing concepts of the role of universities, and secondly because the world had been thrown into an upheaval which not only disturbed the way of life of millions but which would do SO for millions then unborn.

Sigerist saw the importance of society’s problems reflected upon the practice of medicine, the provision of medical services and consequently the teaching of medicine. Shortly after the termination of World War I1 the Government of Prime Minister Chifley, well aware of contemporaneous plans in other countries for the improvement of the social well-being of their people, set about planning improvements in Social Services and Health Services in Australia. Included was the recognition of the problems of providing dental treatment. During the deliberations between representatives of the profession and the Minister for Health, Senator L. McKenna, the offer of the Government was accepted for a delegation to visit New Zealand and study the well-established service provided by Department of Health, Division of Dental Hygiene, school dental nurses.

The service had been in existence for about thirty years, had the support of the profession, and subsequently had been used as a pattern, with modifications for local conditions, for a number of countries with limited dental resources but anxious to provide treatment at least for as many children as possible. The defeat of the Australian Labour Party a t the general elections in 1949 was the beginning of an almost twenty-year delay j now three States of Australia and the Australian Capital Territory are making use of these auxiliaries and Tasmania and South Australia have also established schools for training them.

In 1950 leaders of the American dental profession reached the conclusion that there was a need for a survey of dentistry, and after a preliminary study the American Council on Education appointed a Commission on the Survey of Dentistry in the United States ‘‘ to assess the achievement, resources and potentialities of dentistry with a view to determining the desirable areas of future growth and development ” for the purpose of “ describing and recommending improved approaches, techniques, and methods for the provision of an essential health service to the American people ”.

The Commission consisted of four dentists and ten laymen, and it had section committees whose tasks were to submit expert knowledge and guidance on dental health, dent,al practice, dental education, and dental research. The cost of the survey was heavy

11) Sew York, Henry Schuman, 1946.

Page 2: DENTISTRY AT THE CROSSROADS

56 Australian Dental Journal, February, 1970

and the expenditure of labour and intellectual resources was considerable, but the reasons were many and justified. The deliberations of the Commission were published in 1961.(2) (Prior to this William J. Gies in 1926, Lloyd E. Blanch in 1934 and 1935, and John T. O’Rourke and Leroy S. Miner in 1941, had published studies on dentistry and its problems.)

It is worth while noting the areas to which the Commission devoted its major efforts :

First were those questions requiring group action, such as fluoridation of community water supplies, dental health education for children and adults, the dental care of school- children, group payment plans, the role of government assistance, and the problem of educating enough people to provide the professional services.

Second were problems involved in the relationships of dentists and patients, the types of practice, the question of fees, the use of auxiliary personnel, licensure regulations, and the relationship of the dentist to health institutions such as hospitals and to social organizations.

Third was the vitally important question of how to educate enough people of high ethics and intelligence to perform the public and private professional tasks in the field of dental health.

Fourth was the necessity to discover whether enough time and energy were devoted to experimentation with new methods and materials which might alleviate some of man’s age-old dental suffering.

The Commission was well aware that not all of its recommendations could or should be implemented at once, that the formula for action might extend over a period of fifteen years, that to carry out such a programme required persistent public effort as well as concerted action by many local and State dental groups, and in many instances the study could only “ erect guideposts with signs which may need changing as conditions change ”.

Arthur 5. Adams, President of the American Council on Education, said, ‘‘ The willingness of dentistry t o expose itself to inspection indicates a maturity and con- scientiousness deserving of high praise ”.

There is general agreement in the profession that nearly everyone in Australia suffers from some form of dental disease, although some methods of relieving individual dental troubles can be achieved by public action. Nevertheless, there remains a large proportion of the population who still do not receive adequate dental care. The community is certainly aware of this.

The Australian, December 17, 1969, announced an extreme shortage of dentists in Australia and mentioned the worst affected States. Despite this, graduates from the University of Adelaide were still seeking employment in October 1969, and it was reported in that month’s issue of the Newsletter of the South Australian Branch of the Australian Dental Association that a number of final year students required appointments in 1970. The Australian quoted from the Report of the Dental Advisory Committee to the Honourable the Minister of Health, Victoria.(3) The Committee, consisting of fourteen (ten dentists), was set up primarily to inquire into the affairs of the Royal Dental Hospital and the Dental School as they affect a number of matters, such as admission of students, numbers of dentists for Victoria’s needs, use of facilities, relationships between the two bodies and the profession, costs, and anything else which the Committee considered relevant.

In New South Wales, the Honourable the Minister for Health has announced the appointment of an Advisory Committee to study a document prepared by the Australian Dental Association, New South Wales Branch, A long-term policy for the provision of dental services i n New South Wales.(4) This Committee consists of ten members, seven of whom represent the dental profession or are dentists.

It met on forty-one occasions.

( 2 ) American Council on Education, 1961. (3) Melbourne, September 1969. ( 4 ) Sydney, March 1969.

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Australian Dental Journal, February, I970 5 7

With the American example as a guide, it seems that a wonderful opportunity has been lost, in these two instances, to widen the representation with much more variation in skill and knowledge. In such a manner the community as a whole becomes involved and more informed through leaders in medicine, nursing, commerce, industry, adminis- tration, institutions, and education, and let it not be forgotten that it is the community that provides the finance for dental treatment ! In fact, something like sixty million dollars were spent in the year ended June 1967,(6) and added to this is the sum required by universities for the training of dentists. It should be self-evident that the community has a large and important stake in dental affairs.

Less than half of one per cent of the money involved in dentistry for one year, if used wisely, would go a long way towards supporting a survey of dentistry in Australia ; not to survey dental disease, but to survey the way we are going about treating it. Let it not be forgotten that the profession opposed the introduction of auxiliaries until now, when the cost of dental treatment is placing severe burdens on many families.

A perusal of the Victorian report and the New South Wales proposals shows the limitations of both-when dentistry is at the crossroads in the latter part of the twentieth century.

t 5 l Awrtralian Dental Journal, December 1969.

William John Tuckfield,

LL.D., D.D.Sc.(Melb.), Sc.D.(N’western), F.D.S.R.C.S.(Eng.), F.A.C.D.

Dr. William John Tuckfield, Editor Emeritus of the Journal, died recently in Brisbane at the age of eighty-eight.

During his long professional career he rendered outstanding service i n many aspects of dentistry. The son of a Methodist minister, he was born at Port Fairy in the Western District of Victoria. He graduated from the Australian College of Dentistry i n 1902 and was registered on his twenty-first birthday in December of that year.

I t was as Editor of the Australian Journal of Dentistry, a post he held for more than forty years, that Dr. Tuckfield made what is generally regarded as his most valuable contri- bution to the profession. Under his leadership that journal achieved world-wide recognition for its standard of publication and scientific content. In his editorial comment he displayed a unique degree of professional insight, a kindly tolerance of opinions other than his own, and above all a n unfailing common sense. His publications were numerous and he was the author of a standard textbook which passed through several editions.

In 1956, on the establishment of the Australian Dental Journal, he accepted a seat on the Journal Board and his experience and advice proved invaluable.

As a teacher Dr. Tuckfield excelled, and from his earliest days as a dentist he was associated

E

with teaching-as a demonstrator, clinician and lecturer-and in 1934 he relinquished a very successful private practice to accept a full time appointment as Head of the Depart- ment of Prosthesis at the Dental School of the University of Melbourne; ultimately he became Acting Professor, and was the first occupant of the Chair of Dental Prosthesis when i t was established i n 1949.

He occupied the highest posts in practically every sphere of dental activity in Australia. He was active in the establishment of the Australian Dental Association; was a Federal Councillor for many years and Federal President between 1939 and 1941. He also played an active part in the administration of the 2nd, 6th and 10th Australian Dental Congresses and waa President of the 1927 Congress in Melbourne. In 1966, in recognition of his outstanding services, the Australian Dental Association conferred on him the rare distinction of Honorary Life Membership.

William Tuckfield was a man of simple tastes and great humility. He had the ability to make friends among all age-groups, and few dentists have been able to command the same degree of respect, admiration and affection from their colleagues. He will always be remembered by those who were privileged to know and work with him.-J.M.W.