A History of Dental Public Health in North Carolina Jean Spratt, DDS, MPH John Pendill, DDS July 16, NC Statewide Dental Public Health Conference

NCOHS 2008 Early 1800s Early 1800s Anyone could Anyone could provide dental provide dental care care Dentistry Dentistry a “trade” a “trade”

NCOHS 2008 Early 1800s Period of Period of the traveling dentist the traveling dentist Dentistry working to become a profession Dentistry working to become a profession

NCOHS Dr. Chapin A. Harris founded the first dental school, Baltimore College of Dental Surgery Dr. Chapin A. Harris founded the first dental school, Baltimore College of Dental Surgery Dr. W. R. Scott, first graduate of a dental school to practice in North Carolina Dr. W. R. Scott, first graduate of a dental school to practice in North Carolina

NCOHS The North CarolinaDentalSocietyorganized

NCOHS North Carolina Board of Health established North Carolina Board of Health established 50 county boards of health established by county boards of health established by 1879

NCOHS North Carolina State Legislature passed: “An Act to Regulate the Practice of Dentistry and to Protect the People Against Quackery in Relation Thereto in the State of North Carolina, and Providing Penalties for the Violation of the Same”

NCOHS Dr. J. M. Parker recommended appointing dentists to examine the mouths of all North Carolina school children

NCOHS Dr. J. C. Watkins recommended a permanent committee on oral health Dr. J. C. Watkins recommended a permanent committee on oral health to educate all people in North Carolina to educate all people in North Carolina Oral Hygiene Committee Oral Hygiene Committee established established

NCOHS Oral Hygiene Committee educating students in Gastonia Oral Hygiene Committee educating students in Gastonia Dentists examine elementary students in Wilmington Dentists examine elementary students in Wilmington Raleigh Women’s Club endorses dental inspections in the schools Raleigh Women’s Club endorses dental inspections in the schools Dr. R. M. Squires of Wake Forest recognizes value of education Dr. R. M. Squires of Wake Forest recognizes value of education

NCOHS “And we dentists…may yet find our greatest calling by acting in the humble role of teacher for our patients, our friends, and our neighbors who are in such dire need of our instruction” Dr. R. M Squires Dr. R. M Squires

NCOHS NC schools providing “at least some” dental education 17 NC schools providing “at least some” dental education Some of these schools providing dental care for underprivileged children Some of these schools providing dental care for underprivileged children

NCOHS Dr. George M. Cooper presents “Preventive Dentistry” for NC Dental Society Dr. George M. Cooper presents “Preventive Dentistry” for NC Dental Society Society endorses dental prevention program in the schools Society endorses dental prevention program in the schools

NCOHS Six dentists hired by Dr. Cooper Six dentists hired by Dr. Cooper to begin providing a to begin providing a coordinated dental care coordinated dental care program program North Carolina first state board to have a dental program North Carolina first state board to have a dental program NASH COUNTY

NCOHS Dr. E. J. Tucker first dentist on the North Carolina State Board of Health Dr. E. J. Tucker first dentist on the North Carolina State Board of Health

NCOHS Dr. J. C. Johnson appointed Supervisor of Oral Hygiene to oversee the dental program: Dr. J. C. Johnson appointed Supervisor of Oral Hygiene to oversee the dental program: Relief of pain and suffering Relief of pain and suffering Education Education

NCOHS Dr. Ernest Branch succeeded Dr. Johnson as the Supervisor of Oral Hygiene Dr. Ernest Branch succeeded Dr. Johnson as the Supervisor of Oral Hygiene Believed in education Believed in education Worked for local: Worked for local: Interest Interest Participation Participation Financial Support Financial Support

NCOHS Dr. Branch appointed Director of the new North Carolina Division of Oral Health

NCOHS full-time 4 full-time and 12 and 12 part-time part-time dentists dentists Each spent Each spent 3 months in 3 months in a county a county

NCOHS Volunteer dentists did Mouth Health Survey 54.3% children had never 54.3% children had never had dental treatment had dental treatment 85% of these same 85% of these same children needed dental children needed dental care care

NCOHS “Little Jack” puppet show hits the road across NC “Little Jack” puppet show hits the road across NC “The Goodest Story” “The Goodest Story”

NCOHS

1936 Institute of Public Health Dentistry established in Chapel Hill to train dentists working in public health

NCOHS Charlotte becomes first city in North Carolina to fluoridate its water Charlotte becomes first city in North Carolina to fluoridate its water

NCOHS UNC School of Dentistry established in Chapel Hill

NCOHS Dr. Ernest A. Pearson, Jr. succeeded Dr. Branch as North Carolina State Dental Director

NCOHS 2008

Drs. John T. Fulton and Drs. John T. Fulton and John T. Hughes – organized John T. Hughes – organized first comprehensive dental first comprehensive dental survey in the nation: survey in the nation: Natural History of Dental Diseases Natural History of Dental Diseases First trained Health Educator, First trained Health Educator, Becky Bowden, was hired Becky Bowden, was hired

NCOHS The North Carolina Citizens Committee for Dental Health was established to help expand community water fluoridation The North Carolina Citizens Committee for Dental Health was established to help expand community water fluoridation Fluoridators placed Fluoridators placed in rural schools in rural schools

NCOHS Role played by plaque in Role played by plaque in dental disease identified dental disease identified Task Force for Community Preventive Dental Health established by the North Carolina Dental Society Task Force for Community Preventive Dental Health established by the North Carolina Dental Society

NCOHS Division of Oral Health hired first four dental hygienists to teach preventive dental health in the counties Division of Oral Health hired first four dental hygienists to teach preventive dental health in the counties First fluoride First fluoride mouthrinse mouthrinse program started program started in Robeson County in Robeson County

NCOHS year plan 25% reduction in dental caries in the population 20 years of age and under 25% reduction in dental caries in the population 20 years of age and under 40% reduction in dental caries in the population 10 years of age and under 40% reduction in dental caries in the population 10 years of age and under 15% reduction in periodontal disease in the population 20 years of age and under 15% reduction in periodontal disease in the population 20 years of age and under

NCOHS Teachers Guide to a Teachers Guide to a Preventive Dental Health Preventive Dental Health Program in NC distributed Program in NC distributed Dental Public Health Dental Public Health providing teacher providing teacher workshops across the workshops across the state state

NCOHS Kellogg Foundation funded the 2 nd statewide comprehensive dental survey in NC Kellogg Foundation funded the 2 nd statewide comprehensive dental survey in NC

NCOHS Dr. George Dudney succeeded Dr. Pearson as Chief of the North Carolina Dental Health Section

NCOHS The Framework for Dental Education Published and Distributed

NCOHS Kate B. Reynolds Healthcare Trust funded the 3 rd statewide dental survey in NC Kate B. Reynolds Healthcare Trust funded the 3 rd statewide dental survey in NC

NCOHS Dr. C. Jean Spratt succeeded Dr. Dudney as Chief of the North Carolina Dental Health Section

NCOHS Stopped providing surgical/restorative clinical services to become 100% preventive program Stopped providing surgical/restorative clinical services to become 100% preventive program

NCOHS Developed a series of traveling dental health education exhibits Developed a series of traveling dental health education exhibits

NCOHS Five Part sealant initiative Five Part sealant initiative School based sealant projects School based sealant projects Sealant Exhibits Sealant Exhibits Media Campaign Media Campaign Public-Private sealant projects Public-Private sealant projects “Ask Us About Sealants” campaign “Ask Us About Sealants” campaign Discontinue school water fluoridators Discontinue school water fluoridators

NCOHS Standardized assessment technique developed Standardized assessment technique developed

NCOHS Dr. Steven J. Cline succeeded Dr. Spratt as Chief of the North Carolina Dental Health Section

NCOHS Dental Public Health 80 th Anniversary: “Seal the State in ’98” Dental Public Health 80 th Anniversary: “Seal the State in ’98” A statewide sealant initiative A statewide sealant initiative Community based sealant projects conducted in every county in North Carolina Community based sealant projects conducted in every county in North Carolina

NCOHS “Smart Smiles” became “Into the Mouths of Babes” Pediatricians: Pediatricians: Screen for dental disease Screen for dental disease Apply fluoride varnish Apply fluoride varnish Educate parents about dental disease Educate parents about dental disease

NCOHS Dr. Rick G. Mumford succeeded Dr. Cline as Chief of the North Carolina Dental Health Section

NCOHS Discontinue the fluoride mouthrinse program in the schools Discontinue the fluoride mouthrinse program in the schools Focus on sealants and community water fluoridation Focus on sealants and community water fluoridation

NCOHS The Centers for Disease Control & Prevention funded the 4 th statewide dental survey in NC

NCOHS Dr. Rebecca S. King succeeded Dr. Mumford as Chief of the North Carolina Oral Health Section

NCOHS “Into the Mouths of Babes” became a part of the North Carolina Oral Health Section program “Into the Mouths of Babes” became a part of the North Carolina Oral Health Section program

NCOHS Developed Early Head Developed Early Head Start Oral Health Start Oral Health Curriculum Curriculum Reestablish fluoride Reestablish fluoride mouthrinse program mouthrinse program in the schools in the schools

NCOHS Carolina Dental Home Effort to develop a more Effort to develop a more comprehensive system of comprehensive system of dental care for very young dental care for very young children at high risk for children at high risk for dental disease dental disease Grant funded by Health Resources and Services Administration Grant funded by Health Resources and Services Administration

NCOHS PORRT Priority Oral Risk Assessment and Referral Tool Goal is to develop a risk assessment tool to assist medical providers with dental referrals.

NCOHS 2008 Summary Developed to help meet the need for dental care Developed to help meet the need for dental care Began as a surgical, restorative treatment program Began as a surgical, restorative treatment program Progress followed and adjustments made as a result of scientific investigations Progress followed and adjustments made as a result of scientific investigations Over time became 100% prevention program Over time became 100% prevention program

NCOHS 2008 Trends in Dental Caries (DMFT) in Year-Old Children

NCOHS 2008 F

1912 “There is nothing that moves the heart and at the same time excites righteous indignation so much as the patient suffering of a child under the agonizing pains of toothache while the ignorant parent carelessly says, ‘It is only a toothache’.” Dr. R. M. Squires Dr. R. M. Squires

NCOHS “…the reason for this unhappy plight, neglect; and the reason for neglect; ignorance. …ignorance could be remedied only through faithful and earnest ministrations of teaching.” Dr. R. M. Squires Dr. R. M. Squires

NCOHS Dr. John Harris, M.D. offered training to those entering medical college Dr. John Harris, M.D. offered training to those entering medical college

NCOHS Dr. George M. Cooper, M.D. – Director of Medical Inspections of Schools of the State Board of Health Dr. George M. Cooper, M.D. – Director of Medical Inspections of Schools of the State Board of Health North Carolina first state board to include dentistry North Carolina first state board to include dentistry Six dentists hired to begin providing a coordinated dental care program Six dentists hired to begin providing a coordinated dental care program

NCOHS North Carolina General North Carolina General Assembly approved monies Assembly approved monies to hire more staff to work to hire more staff to work in the field in the field Continued to develop Continued to develop teacher training materials teacher training materials

NCOHS UNC School of UNC School of Dentistry established Dentistry established in Chapel Hill in Chapel Hill Matching federal grant monies used to hire more dentists for the Division of Oral Health Matching federal grant monies used to hire more dentists for the Division of Oral Health

NCOHS North Carolina General Assembly approved monies to hire more staff to work in the field North Carolina General Assembly approved monies to hire more staff to work in the field

NCOHS North Carolina General Assembly approved monies to hire more staff to work in the field North Carolina General Assembly approved monies to hire more staff to work in the field

NCOHS 2008

1912 Dentists educating about need for healthy mouth Press not interested Press not interested Many schools not interested Many schools not interested Public skeptical Public skeptical

NCOHS Institute of Public Health Dentistry established in Chapel Hill to train dentists working in public health