Dentistry: Old School, New Style

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For the doctors and dentists assembled to celebrate the 125th anniversary of the Baltimore College of Dental Surgery, one of the most promising aspects of the school's proud plans for the future was a reflection of its past. Contemporary dentistry's most urgent need, said Baltimore Dean John J. Salley, is to reinforce its intimate partnership with the science of medicine.

Back in 1840, when four Baltimore physicians got a state charter for the world's first dental college, dentistry was still largely concerned with replacement of defective or missing teeth. One of its most impressive achievements was the ill-fitting sets of artificial teeth that had been carved from hippopotamus bone and mounted in gold by Boston-born John Greenwood more than 40 years before for George Washington.

Two Years to Four. The Baltimore doctors insisted that dentistry was properly a specialized branch of medicine, requiring knowledge of anatomy, physiology and pathology. For their school, which has long since become part of the University of Maryland, they decided on the revolutionary step of setting up educational standards similar to those already existing for medical training: either two years in the dental college or one year of dental training after a year in medical school.

That well-laid foundation remains in the curricula of most dental colleges. But over the years, while the medical aspects of mouth care have come to include whole new sciences such as microbiology, radiology and histology, dentistry itself has developed from a crude craft into a highly respected and technical profession.

Modern dentistry has come to demand so many and varied skills that the average dentist has little time to stay abreast of medical science after his first years in dental school. Traditionally, explains Dean Salley, "the student spends his first two years learning the basic sciences, such as anatomy and physiology. Only in his third and fourth years does he begin to meet and treat patients and apply those basic sciences." What is needed, says the dean, is better continuity.

In the Baltimore school's huge main clinic, with its array of 64 dental chairs, advanced students now treat hundreds' of patients (at nominal fees) every day under the guidance of their teachers. When the new $9,000,000 building is completed in 1968, says Dr. Salley, "we plan to have freshmen deal with patients, learn to apply their basic knowledge before the end of their first year. They will continue to have basic science courses through all four years, so that clinic and classroom will always be meshed together."

There will also be a "multi-science" department, in which a student will learn that a cleft palate, for example, involves anatomy, speech pathology and social work as well as plastic surgery.

To foster rapport with patients, and also because so many dental ills are at least partly psychogenic the school will be teaching its students some psychology and psychiatry.