Beyond Mere Mouthfuls of Teeth...

In 1940 President Conant dismissed 120 of the 125-man staff at the Harvard Dental School and closed the 73-year-old institution. In its place he later opened the Harvard School of Dental Medicine and caused the greatest row in professional education since the Law School switched to the case system of study under Dean Langdell.

Conant sent dental students to the Medical School for basic science in struction because 1) it is better there than it was at the old Dental School and 2) it makes the dentist aware that he is dealing with a part of medicine and of the human body, not a unit in itself. Furthermore, the new School of Dental Medicine was to emphasize research as a means to preventive dentistry. Theory was to become of much more importance in the training of a practicing dentist.

Complaints

The furor burst because Conant turned a 73-year-old trend into a revolution and left some 2000 dentists "without heritage." He made the Dental School a satellite of the Medical School, which caused such a storm of protest across the country that the new ste-up wasn't recognized by any dental association for seven years. And to cap it all, at a time when only 34 per cent of the American people are receiving adequate dental care, Conant cut Harvard's yearly dentist output from 40 to 15.

All but those involved in the revolution thought Harvard had gone haywire again, and all were most out spoken in saying so. Now, of a random 12 dentists contacted in Boston--seven of them graduates of the defunct Dental School--only one would go on record with his opinion. The rest refused to be quoted by name, not because they were any less opposed to Harvard, but because they were afraid that, from the way things are progressing, they just might be wrong.

Controversy Old

The controversy began in July, 1867, when the Corporation approved the establishment of the first university dental school in the United States. It admitted its initial class in 1869 and graduated it in one year. All its members were previously physicians. By 1870 the same Corporation was already making changes. It abolished the custom, then universal among dental schools, of allowing five years of practice without a degree as the equivalent of the first year of study.

"The Harvard School was the first, and for many years the only dental school, to maintain and adhere to this principle, but it was not accomplished without disastrous effects upon the school from a pecuniary point of view," an historian wrote.

President Eliot commented in his first annual report that the Dental School was one of the "worst equipped departments in the University," mainly because it could receive no revenue from students whom Harvard policy drove elsewhere. But he was quick to comment:

"By following the example of many other dental schools and making its degree easy of acquisition, the School could undoubtedly be made to succeed as a commercial venture; but it is no object to the profession or the community that another school of low grade should be maintained, since there are more than enough of that kind already; and Harvard University may properly refuse to carry on such a school."

Thus Harvard Dental began early in bucking tradition, making changes, and adhering to them despite all odds. The controversy, in fact, which arose over the 1940-41 changes over, dates back to Eliot's report of 1873-74. He mentioned at that early date "a division of opinion in the dental profession as to the expedience of having a separate degree for dentists, some persons maintaining that every dentist should be, like an oculist or acurist, a doctor of medicine."

Eliot raised the issue even more exactly in his report of 1880-81 and actually started the upheaval which Conant carried out. "Some dentists maintain," wrote Eliot, "that a dentist, like an oculist, is a physician with a speciality, and that nothing short of the full course for the degree of Doctor of Medicine can be satisfactory; others say that a dentist is simply a fine craftsman, and that there is little use of any training except that of the eye and hand. The Harvard Dental School occupies an intermediate position, which satisfies neither of these extreme parties."

But in the same report Eliot noted, "The very instruction which the Dental Faculty now provides might be given under the direction of the Medical Faculty, and the degree of D.M.D. still be conferred upon conditions very similar to those which now obtain." In 1899, the Dental Faculty became part of the Medical Faculty.

Steady Change

The School continued on an even keel for 30 years, still leading the field in making changes, but making no change so radical that it was not soon followed by other institutions. In 1917, Harvard boosted to four years the course for the Doctor of Dental Medicine Degree, and in 1925 the Dental School established two years of college study as a prerequisite for admission.

In 1932 less than one quarter of the Dental School was made up of college graduates. In 1936 half of its students has their Bachelor of Arts degree, and although the last two year man was admitted in 1950, today only 75 per cent of the student body is made up of college graduates. The newness of the concept of dental study on the graduate plan thus becomes apparent.

Furthermore, the Dental School faculty served gratis until 1929. A bequest of Charles A. Brackett D.M.D. '73, who taught without pay at the School for half a century, and a gift of John T. Morse, Jr. '60 led to the endowment fund which began to pay the institution's teachers in that year. Serious dental study is plainly, then, a recent development, but the field's trend, as shown by Eliot's words and climaxed by Conant's action, is no sudden offshoot. It grew with dentistry.

Dr. C. Sidney Burwell M.D. '91, writing in 1941 as Dean of the Harvard Medical School, stated: "The present tendency of medical organization is centripetal rather than centrifugal... The deevlopment of special interests, special knowledge, and special expertness has been extremely valuable in the improvement of medical practice, the effectiveness of teaching, and the success of investigation. It is equally true, however, that special fields cannot exist by themselves, but that they must remain, if they are to service, in an appropriate relation to the general fields, of medicine...

"Because the teeth are part of the body and exposed to the traumas, the disorders of growth, the intoxications, the infections, the dietary deficiencies, and all the other influences that cause disease of other parts of the body, the study, understanding, and management of dental and oral disease require a biologic and medical preparation not inferior to, and indeed not essentially different from, the preparation required for the study, understanding and management of disease of other parts of the body."

Master Dentists

People spoke, but no one took any action. Dr. Milton C. Winternitz stood up at Yale and tried to organize a "master dentist" plan. He proposed that a dentist who also held a medical degree be placed in charge of clinics of regular dentist, and that the dentists consult the master dentist on all cases in order to be sure that every complication was take care of. He was laughed down.

Yale did accept a plan, however, which the Rockfeller Foundation sponsored, to invite two outstanding young dental teachers to take their M.D. at New Haven. Dr. David Weisberger D.M.D. '30 of the Harvard Dental School staff was selected for the program and emerged from it "more informed, grateful, but much older." He had to take the full fouryear course for his M.D. although he had taken courses in the first and second-year subjects when he attended Harvard Dental. The difference was that at the Dental School, the courses had the same names but only half the material.

Separate, Unequal

"There is a great deal of difference between a similar course and an identical course," Weisberger says. "The pay-off is, can you get credit for it? I came to Harvard Dental because of the great names listed in the catalogue as teaching the basic science courses. But I never saw the great names as people. I saw the tenth assistant. And I was never given the same course as the fellow over at the Medical School."

Meanwhile Conant determined to reorganize dental education at Harvard. Conant formed a committee chaired by Dean Burwell of the Medical School and told it to bring its recommendations to the Medical Faculty. This immediately drew protest from dentists, who didn't want to be "railroaded by their big brother" and who forgot that the Dental and Medical Faculties had been combined under the Dean of the Medical Faculty in 1899.

In 1939 the group brought in its recommendations. It proposed a five-year plan, whereby a student would receive both his M.D. and D.M.D. simultaneously at the end of five years of study. Three and a half years were to be spent in medicine and one and a half in dentistry.

Somehow the report leaked to the Boston Globe in May, 1939, and when the story was printed, it was a severe jolt to many people. No dentist felt that his learning could be matched in one and a half years of clinical study. And no dentist liked seeing his profession given second billing to medicine.

The University, in addition, was having trouble in getting the funds to support its new idea. The Dental School had planned to carry on a two and a half million dollar campaign itself, but the University asked for the School's list of prospective donors for its own $30,000,000 drive. In return, the Dental School was promised five million. The University campaign failed miserable, and the Dental School got nothing.

At the end of 1939, however, the Carnegie Corporation, the Rockfeller Foundation, and the Markle Foundation gave the money required for putting the plan into operation. It was at this same time that Conant announced that the Dental School would operate under a new name, the Harvard School of Dental Medicine.

Official in '40

Canant made the new program official in 1940 and established an administration committee to put it into effect. Once a curriculum and plan of study was draw up--one sheet of paper with four typewritten lines on it--the new school had to gain recognition by the American Dental Association and the Association of American Dental Schools. Arthur M. Maloney D.M.D. '23, associate professor of Clinical Dentistry, went to New York to present the School's application.

But the friends of the then Dean, Leroy M.S. Miner D.M.D. '40, who saw him going out with the old School, rallied to save him. "You're at the wrong meeting," the chairman told Maloney. "You should be at the Association of Medical Schools meeting." Maloney discovered that a special session was scheduled specifically to turn down Harvard, and he withdrew the application.

Then came Pearl Harbor and a military speed up as the government took over the University. The Navy was willing and prepared to accept the point degree system but the Army absolutely refused, perhaps because the general in charge "hated everything about Harvard." The medical degree had to be dropped, and the five-year planned never revived.

In 1941, the School admitted nine men. Six were thrown out after six months, and the remaining three dropped by the year's end. NO first-year class was taken in 1942.

The old school was still functioning, however, matriculating its last classes still in course. These were gone by the Spring of 1945, and with them went 120 members of the faculty, who were simply thanked and released. This number included all the part-time instructors and thereby antagonized practicing dentists.

Five Carry On

The five men retained were Dr. A.M. Jazowski D.M.D. '29, assistant professor of Prosthetic Dentistry; Dr. Paul K. Losch, associate professor of Pediatric Dentistry; Maloney; Dr.G. Earl Thompson D.M.D. '29, associate Clinical Professor of Dentistry; and Weisberger. During 1945-46, these few kept up the clinical work so patients could continue their treatment and, more important, so that the School wouldn't close completely. Contact with future patients was maintained for the time when the new School would open. Meanwhile the building was being renovated, and the six-year plan was established.

The 1945 remodeling cost $175,000 for revamping the old building and establishing five new laboratories. The equipment installed in this new space has cost approximately $100,000. In 1948 an animal house costing $110,000 was constructed; three years later $120,000 went for an additional floor of labs over the animal house.

The six-year plan also cost 25 students a year.

Year Added

The new program is an expanded version of the five-year system, but it still drew the challenge of practicing dentists. Instead of giving three and a half years to medicine and one and a half to dentistry, all dental students were to take their first two years of basic study at the Medical school and then switch over to the school of Dental Medicine's own building for two years of clinical dentistry. The student would receive his D.M.D. degree upon the completion of this four-year course. He then had the option of returning to the Medical School for his final two years towards an M.D.

Observers couldn't rationalize the middle two years as being adequate for the making of a practicing dentist. Furthermore, limited Medical