The Evolution of America’s Scientific

Advancements in Dentistry in the Past 150

Years
James L. Gutmann
J Am Dent Assoc 2009;140;8S-15S

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The evolution of America’s scientific
advancements in dentistry in the past
150 years
James L. Gutmann, DDS
ajor advances in dentistry during the past 150
M years include the use of safe and effective local
anesthetic, radiographs, high-speed instru-
mentation, new dental materials and dental
implants. It was not until the last 50 years,
however, that science became a prominent component of
dental education and an integral part of dental practice.
The scientific evolution of America’s contribution to dental
practice and science occurred because of many factors, but
four major events had a significant effect on bringing sci-
ence to dentistry. These included the 1926 Carnegie Foun-
dation for the Advancement of Teaching report1 and the
vision of William J. Gies; the formation of scientific jour-
nals; the role of immigrant dental scientists from Europe
and oral biology as a discipline; and the establishment of
the National Institute of Dental Research in 1948.
THE EARLY YEARS
In the mid-19th century, the United States was viewed
globally as the geographical center of innovation in den-
tistry, but the innovations were based on applied research
as opposed to more basic science, which flourished in
Europe.2 Early examples of innovations in dentistry in
America include the development of the use of general
anesthetic by Horace Wells, who administered nitrous
oxide to patients so that they would experience little or no
pain during tooth extractions, and the subsequent intro-
duction of ether as another way to induce anesthesia, a
development that often has been attributed to William T.G.
Morton.3 Other notable examples of applied research were
the discovery of the welding property of annealed gold foil
by Robert Arthur, the development of innovative oral sur-
gical methods by Simon Hullihen, the characterization of
oral deformities and procedures for their correction by
Norman Kingsley, the classification of malocclusion and
treatment by Edward Angle, surgical procedures for clo-
sure of clefts by Truman Brophy, the use of radiographs to
reveal anatomical and pathological conditions of the teeth
and jaws by C. Edmund Kells, and the major contributions
of Greene Vardiman (G.V.) Black in operative dentistry
8S JADA, Vol. 140 http://jada.ada.org September 2009
Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
AB STRACT
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Background. During the last 150 years,
dentistry in the United States faced many chal-
lenges as it developed its scientific foundation.
In the latter part of the 19th century, clinical
practice was driven by empirical evidence, and
the first few decades of the 20th century set
the stage for America’s scientific evolution of
dentistry.
Conclusions. Seminal developments in
America’s contribution to science in dentistry
and oral health included the 1926 Carnegie
Foundation for the Advancement of Teaching
report and the vision of William J. Gies; the
development of scientific dental journals; the
role of immigrant dental scientists from Europe
and oral biology as a discipline; and the estab-
lishment of the National Institute of Dental
Research in 1948.
Clinical Implications. Due in large part
to America’s contribution to dental science and
practice, we are at the brink of a transforma-
tion that may expand the role of the dental
profession dramatically and improve the oral
health of people throughout the world.
Key Words. Dental science; dental practice;
history of dental science.
JADA 2009;140(9 suppl):8S-15S.
Dr. Gutmann is a professor emeritus, Department of Restorative
Sciences, Baylor College of Dentistry, Texas A&M University Health
Science Center, Dallas, and maintains a private practice limited to
endodontics, Dallas. Address reprint requests to Dr. Gutmann
at 1416 Spenwick Terrace, Dallas, Texas 75204-5529, e-mail
“jlgutmann@earthlink.net”.
and oral pathology.4,5 Even in light of these develop-
ments, however, skeptics such as Alton Howard
Thompson from Topeka, Kan., challenged the empir-
ical basis of dentistry as it was practiced in the
19th century.6
Willoughby D. Miller, who received his Doctor of
Dental Surgery degree from the University of Penn-
sylvania, Philadelphia, in 1879, was one of the first
true American dental scientists. His seminal 1890
publication, “The Micro-Organisms of the Human
Mouth: The Local and General Diseases Which Are
Caused by Them,” 7 reported that when carbohy-
drates are mixed with saliva and incubated at 37°C,
they generated lactic acid that could decalcify an
entire tooth crown. He also identified
several bacteria that created acids
during their metabolism, presented
various proposals regarding the role of
bacteria in oral disease and proposed
that saliva could be used for research.
Perhaps most importantly, he
attempted to reorient the dental pro-
fession from focusing on treatment to
focusing on disease prevention.
Although many people were at the
forefront of dentistry as an evolving
science in the United States, the fol-
lowing deserve special mention: G.V.
Black, Truman Brophy, Edmund Dr. William J. Gies
Noyes, Charles N. Johnson, Thomas
Gilmer, W.G. Skillen, Edgar D. Coolidge, Balint
Orban, Frederick B. Moorehead, Edward H. Hatton
and S.D. Tylman. Many of these people were asso-
ciated with schools in the Chicago area, including
the Chicago College of Dental Surgery at Loyola
University; Northwestern University Dental School;
and the University of Illinois, College of Dentistry.
The development of science that would define the
essence of dentistry as a whole, beyond that of a
technical or empirical profession, had its roots in the
late 1800s and early 1900s, and major benchmarks
that affected contemporary dentistry in the third to
the fifth decades of the 20th century were set. Before
the late 1800s and early 1900s, dentistry in the
United States was recognized throughout the
Western world for its technical excellence, but it was
not recognized generally as having a scientific basis.
THE CARNEGIE FOUNDATION FOR THE
ADVANCEMENT OF TEACHING REPORT
AND THE VISION OF WILLIAM J. GIES
In 1926, the Carnegie Foundation for the Advance-
ment of Teaching published a report by William J.
Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
Gies, a professor of biological chemistry at Columbia
University, New York City, that encouraged faculty
to conduct research in dental schools and include a
scientific basis for dentistry in the curriculum.1 The
report urged U.S. and Canadian dental schools to
improve their curricula by employing well-trained
and full-time teachers, by encouraging and con-
ducting research and by providing adequate
libraries.1 In 1928, the American Dental Association
(ADA) created the National Board of Dental Exam-
iners, and dental school graduates began taking
examinations in the basic sciences and the mechan-
ical aspects of dentistry.3
Gies proposed that predental and dental educa-
tional requirements should include a
minimum of two years of college before
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entry into dental school; however, it
was not until 1937 that prospective
dental students were required to have
two years of college.3 Furthermore, Gies
called for dentists to receive graduate-
level instruction after graduating from
dental school, for more complete dental
libraries, for better cooperation between
dentistry and medicine, for the elimina-
tion of independent or proprietary
dental schools, and for the affiliation of
dental schools with private or state-
supported universities.8 He also called
for increased financial support for
dental education and for dental educators to have a
greater appreciation for the biological and medical
aspects of dentistry.
Gies envisioned an organization in which all
research-oriented people could promote interest in
dental research. On Dec. 20, 1920—two years after
the formation of the Journal of Dental Research
(JDR)—Gies and 24 colleagues organized the Inter-
national Association for Dental Research (IADR) to
bring together dentists and scientists to enhance
dental research.4,8 The North American Division of
IADR first met in 1952. In 1970, the North Ameri-
can Division had 2,102 members from the United
ABBREVIATION KEY. FDI: Fédération Dentaire Interna-
tionale. IADR: International Association for Dental
Research. JADA: The Journal of the American Dental
Association. JDR: Journal of Dental Research. NDA:
National Dental Association. NIDCR: National Institute
of Dental and Craniofacial Research. NIDR: National
Institute of Dental Research. NIH: National Institutes of
Health. NIST: National Institute of Standards and Tech-
nology. PRC: Paffenbarger Research Center.
JADA, Vol. 140 http://jada.ada.org September 2009 9S
 ADAF Paffenbarger Research Center
Where many new ideas for dentistry start
or more than 80 years, ADA Foundation’s
F Paffenbarger Research Center (PRC) has
played a key role in dentistry—identifying
the needs of dental practitioners and translating
those needs into improved products. Every time
you pick up a front-surface dental mirror or high-
speed handpiece or place a composite restoration
or dental sealant, you are taking advantage of
advances developed by scientists at PRC.
“Technological breakthroughs at PRC have cre-
ated the tools that make modern dentistry pos-
sible,” says Dr. Daniel Meyer, senior
vice president, American Dental
Association (ADA) Science/
Professional Affairs. “Projects that
are currently under way will help
revolutionize how dental diseases
are treated in the future.”
PRC was established in 1928 as
the Research Unit of the ADA to col-
laborate with the National Bureau
of Standards (now called the Na-
tional Institute of Standards and
Technology [NIST]) to develop
science-based specifications for Dr. George Paffenbarger
dental products. In 1929, Dr. George
Paffenbarger joined the scientists at the Research
Unit and rapidly became the unit’s lead scientist.
Under his guidance, the Research Unit continued
developing standards to ensure that products per-
form predictably, safely and effectively. He also
expanded the scope of Research Unit projects to
further advances in dental materials, equipment
and therapies. In 1985, the ADA renamed the
Research Unit in Dr. Paffenbarger’s honor.
Thanks to his vision, PRC research has resulted
in technologies that are hallmarks in dentistry:
dhigh-speed handpieces;
drhodium-coated front-surface dental mirrors;
dpanoramic radiography;
ddental sealants;
dorthodontic bracket bonding;
dtooth-colored resin-based composite restorative
materials;
ddental bonding adhesives;
dcalcium phosphate remineralization.
In addition, scientists at PRC developed the first
10S JADA, Vol. 140 http://jada.ada.org September 2009
Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
calcium-phosphate bone cements whose use in
humans was approved by the U.S. Food and Drug
Administration. More recent developments have
included amorphous calcium phosphate, which is
effective in treating sensitive teeth, and remineral-
izing pulp-capping therapies. More than 200 prod-
ucts on the market are based on PRC patents. Roy-
alties from patents are a significant source of
revenue for the ADA Foundation, amounting to
$5.5 million during the past six years.
Today, the PRC has a staff of 27 people who
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work at the NIST campus in Gaithers-
burg, Md. The scientists at PRC con-
tinue to collaborate with NIST
researchers on dental product specifi-
cations, as well as new technologies,
creating a robust research environ-
ment that has an international repu-
tation for excellence. The presence of
well-equipped laboratories and highly
skilled researchers is invaluable to
practicing dentists when they need
timely answers to critical questions.
For example, earlier this year
media reports raised concerns about
lead in crowns. As soon as the issue
emerged, PRC scientists obtained porcelain pow-
ders from standard commercial sources and fin-
ished crowns produced by both domestic and for-
eign dental laboratories. After storing the samples
in an acidic solution, scientists detected no lead in
the solution, indicating that lead does not leach
from fired porcelain-fused-to-metal crowns. During
the process, PRC scientists developed new test
methods that will be useful when questions such
as this arise in the future. PRC researchers also
are looking into other high-profile issues such as
the risk of developing dental erosion from sports
drinks and the bioavailability of any bisphenol A
that might be present in dental materials.
Other PRC projects in the pipeline that promise
important rewards for the dental profession
include
danalysis of aerosol production during restorative
procedures or use of ultrasonic scalers and produc-
tion of ultrafine particles during finishing and pol-
ishing of resin-based composites;
 dcariostatic delivery devices (chewing gum,
cements, fluoride therapies);
damorphous calcium phosphate–containing com-
posites that can remineralize tooth structure;
ddental materials that are indistinguishable from
tooth structure;
States, Canada and Mexico.4 This division consisted
of 37 sections with councilors to IADR. The division
existed only on paper until it was formally activated
in 1972.4 Helmut Zander, an immigrant dental sci-
entist from Germany who was one of the leaders in
the transformation of American dentistry into a sci-
ence, was the first president of the North American
Division. Since its inception, IADR has played a crit-
ical role in the scientific evolution of dentistry in the
United States and has been a staunch advocate for
U.S. governmental funding of oral and craniofacial
research through the National Institute of Dental
and Craniofacial Research (NIDCR).
THE DEVELOPMENT OF SCIENTIFIC DENTAL
JOURNALS
Dental journals had a significant influence on the
advancement of dental science. The first dental peri-
odical, the American Journal of Dental Science, was
introduced in 1839; it was renamed the American
Journal and Library of Dental Science in its second
volume. Other early dental publications were Stock-
ton’s Dental Intelligencer, The New York Dental Re-
corder, The Dental Register of the West, Southern
Dental Journal, The Dental Review, Dental Items of
Interest and the Dental News Letter, which was re-
named Dental Cosmos in 1859.3 Dental Cosmos, un-
der the auspices of the S.S. White Manufacturing
Company, Philadelphia, published a wide range of
subject matter, including historical accounts, practi-
tioners’ techniques and opinions. Much of its content
was empirical.
In 1913, the Official Bulletin of the National
Dental Association (NDA) was introduced, and it
was renamed The Journal of the National Dental
Association in 1915. When the name of the NDA
was changed to the American Dental Association
in 1922, the journal’s name was changed to The
Journal of the American Dental Association
(JADA). In 1932, African American dentists formed
a national association called the National Dental
Association. In 1936, JADA merged with Dental
Cosmos, and the first joint edition was published
in 1937.
Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
dtissue engineering scaffolds for bone repair.
For more information about PRC and its current
research projects, visit “www.ada.org/goto/prc”. ■
Anita Mark, manager, Scientific Information, American Dental
Association Division of Science.
The journals of the New York Institute of Stoma-
tology, American Academy of Dental Science, Har-
vard Odontological Society and Metropolitan Dis-
trict (Massachusetts State Dental Society) combined
in 1906, and in 1912 their quarterly journal became
known as The Journal of the Allied Societies. By late
1918, William J. Gies made plans for publishing
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JDR as a journal for dental investigators, and The
Journal of the Allied Dental Societies was discon-
tinued and replaced in March 1919 by JDR. JDR
was a quarterly publication and “a journal of stoma-
tology; devoted to the advancement and dissemina-
tion of knowledge pertaining to the mouth and teeth,
and to their relation to the body as a whole.”4 Gies
was listed as the executive officer of JDR and was its
editor from 1919 through 1935. His initiative and
vision spearheaded a significant increase in dental
research, which resulted in JDR’s becoming a
bimonthly publication in 1928. In 1934, the journal
became an IADR publication, and, along with many
other journals with a focus on oral health research,
JDR and JADA have served as vehicles for dissemi-
nating research findings and explaining the scien-
tific basis of dentistry to the profession. In the latter
part of the 20th century, major biological and medi-
cal journals began to publish articles that described
the results of dental and craniofacial research, pro-
viding evidence that the science of dentistry had
matured into a discipline that was accepted widely
by the broader scientific community.
THE ROLE OF IMMIGRANT EUROPEAN DENTAL
SCIENTISTS AND ORAL BIOLOGY
American dentistry was recognized widely for its
technical excellence in the first few decades of the
20th century, but it was not known for having a sci-
entific basis. In the early to middle 1920s, a group of
scientists from the University of Vienna were linked
to dentistry in the United States through their par-
ticipation in Fédération Dentaire Internationale
(FDI) World Dental Federation. They were wel-
comed into academia in the United States despite
the Great Depression and the resistance of the
National Association of Dental Examiners and most
JADA, Vol. 140 http://jada.ada.org September 2009 11S
state dental boards. During this time, dentistry in
the United States was attempting to rise to the chal-
lenges and dictates set forth by the Gies report of
1926. The scientists in the Vienna group had bio-
logical expertise that complemented the U.S. den-
tists’ technical expertise in restorative dentistry,
which helped give the struggling, yet emerging,
dental research effort in the United States a sound
and credible foundation that enabled the profession
to take advantage of the development of IADR and
federal funding of research that would take place
after World War II. Among these immigrants were
Bernhard Gottlieb, Balint Orban, Rudolf Kronfeld,
Harry D. Sicher and Joseph Peter Weinmann.
A turning point occurred in the mid-1920s when
the dean of dentistry at Chicago College of Dental
Surgery at Loyola University, William H.G. Logan,
sought the advice of Bernhard Gottlieb2,9 on how to
establish a research endeavor in an academic envi-
ronment.9 Gottlieb moved to the United States in
1940. He was associated briefly with Columbia Uni-
versity and the University of Michigan, Ann Arbor,
before moving to Baylor University, Dallas, where
he was a professor and the chair of the Department
of Pathology and Research in the School of Dentistry
until his death in 1950.10,11 During his career, Got-
tlieb wrote numerous scientific articles and four
textbooks and is responsible for founding the study
of oral histology. He has been acknowledged as
being the first dentist to integrate basic science
information with clinical treatment.12
Balint Orban, a protégé of Bernhard Gottlieb,
came to the United States from Vienna in 1927 to
establish a research program at the Chicago College
of Dental Surgery at Loyola University. He later
joined the faculty at the University of Illinois Col-
lege of Dentistry, Chicago. Rudolf Kronfeld was
another protégé of Bernhard Gottlieb. His short
career at Loyola University was marked by many
research advancements that helped place science
into the practice of dentistry. His message to clinical
dentists was expressed in an article in which he
delineated the crucial connection between the tech-
niques of restorative dentistry and the biological
foundation on which those techniques rested.13 In
1939, one month before he was to become president
of IADR, Kronfeld died, as his colleague Edgar D.
Coolidge put it, “surrounded by his library, his histo-
logical material and his work in progress for the
coming season.”14
Harry D. Sicher began his career in the United
States at the Chicago Medical College, and then he
moved to the Chicago College of Dental Surgery at
12S JADA, Vol. 140 http://jada.ada.org September 2009
Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
Loyola University. Joseph Peter Weinmann began
his U.S. career in 1938 at the University of Illinois
College of Dentistry, followed by one year at
Columbia University. He then joined the faculty at
the Chicago College of Dental Surgery at Loyola
University. In 1946, he returned to the University of
Illinois. Both scientists undertook significant
research endeavors in oral anatomy, histology, bone
physiology and oral pathology; Weinmann received
significant grant funding from the National Insti-
tutes of Health (NIH).9
A tremendous debt is owed to the dentists and
dental scientists who emigrated from Europe to the
United States in the 1930s and 1940s; they were
instrumental in nourishing dental research and
incorporating it into the dental school curriculum.
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During this period, Europe was experiencing polit-
ical upheaval, anti-Semitism and war. Under these
conditions, many dentists and medical scientists—
primarily from the University of Vienna—sought
refuge in the United States. This created a struggle
between the members of the dental profession in the
United States who viewed the emigration of foreign-
trained scientists as an opportunity for the dental
profession and as a moral responsibility, and those
who viewed it as an economic threat. Some prac-
ticing dentists in Austria and Germany were able to
emigrate to the United States, and some who had
lost their academic positions in Europe received help
from their U.S. colleagues.9 Russell W. Bunting,
then dean of the University of Michigan School of
Dentistry stated that the dental schools making up
the American Association of Dental Schools “are
faced with a decision as to what they will do to
orient the stranger dentists within our gates to be-
come useful citizens and respected practitioners.”15
The development of oral biology as a discipline
has been an integral factor in America’s contribution
to dental science and practice. Its origins can be
traced back to 1928, when the University of Roch-
ester Medical Center, Rochester, N.Y., established
the first oral biology research and training program
in the United States. The program eventually be-
came the Department of Dental Research in the
School of Medicine and Dentistry. In 1998, the De-
partment of Dental Research (renamed the Center
for Oral Biology) joined five other research centers to
form the Aab Institute of Biomedical Sciences.16
The American Institute of Oral Biology was
founded in 1943 to encourage basic and clinical re-
search for the prevention and treatment of oral dis-
ease. It offered practitioners the opportunity to ac-
quire knowledge in allied clinical fields, as well as in
TABLE

A brief history of the National Institute of Dental Research/National

Institute of Dental and Craniofacial Research and its directors.
DIRECTOR DATES SIGNIFICANT FOCUS/ACCOMPLISHMENTS

H. Trendley Dean
1948-1953 Provided first leadership for dental research at the National Institutes of Health (NIH)
(1931); appointed director of Dental Research Section (1945); became first director of the
National Institute of Dental Research (NIDR) (1948); provided for oversight by the National
Advisory Dental Research Council; awarded first extramural dental research grants and fel-
lowships; supported research on mottled enamel and fluoride, fluorosis, prevention of
dental caries by fluoride and water fluoridation; established intramural research units for
basic and clinical science, created an intramural section for epidemiology and biometry;
advocated for integration of dental health into mainstream medical research.

Francis A. Arnold Jr.
1953-1966 With H. Trendley Dean, led Grand Rapids, Mich., fluoridation study that established water
fluoridation as a safe, effective and economical way to prevent dental caries; established
the first Board of Scientific Counselors to provide advice to the director for intramural
research program; established intramural Laboratory of Biochemistry; provided oversight
for intramural building and laboratory facilities of intramural research program; encour-
aged dental faculty in the United States to apply for research grants; expanded NIDR
research to dental materials, human genetics and oral medicine; funded first multidiscipli-

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Seymour J. Kreshover
David B. Scott
nary cleft palate study.
1966-1975 Previously served as the scientific director of the NIDR’s intramural research program;
enhanced grants in the neurosciences, pain research, caries prevention through the
National Caries Program (a merger of both intramural and extramural programs) and
craniofacial research and cleft palate reconstruction; enabled the formation of the intra-
mural Laboratory of Oral Medicine, the Laboratory of Microbiology, and expanded
research investments in periodontal diseases, autoimmune diseases and allergic disorders;
expanded intramural research and grants to include pain research and anesthesiology, as
well as the behavioral sciences.
1976-1981 Expanded extramurally supported research in periodontal diseases, oral and pharyngeal
cancer, and enhanced both intramural and extramural capacity to conduct clinical studies;
stimulated expansion of grants in the behavioral and social sciences; established an intra-
mural Diagnostic Systems Branch to study noninvasive diagnostic techniques; established
an intramural Clinical Investigations and Patient Care Branch to coordinate and integrate
patient treatment with clinical research conducted elsewhere in NIDR and NIH; supported
first consensus development conference on dental implants.

Harald Löe
Harold C. Slavkin
Lawrence A. Tabak
* Source: U.S. Department of Health and Human Services.19
1983-1994 Established the Epidemiology and Oral Disease Prevention Program to include periodontal
and other diseases of the oral cavity; established the Dentist Scientist Award program to
enhance clinical research; expanded extramural dental research to include research centers
in the collective fields of oral biology, oral and craniofacial diseases and disorders, and
minority oral health; initiated first national surveys of U.S. adult oral health and children’s
caries; initiated programs of continuing dental education and public information to trans-
late research findings; established World Health Organization Collaborating Center for
Dental Research and Training.
1995-2000 Engineered renaming NIDR as National Institute of Dental and Craniofacial Research
(NIDCR) to reflect expanded research mission; promoted research in developmental
biology, genetics, oral complications of HIV/AIDS, and oral health needs of minority and
vulnerable populations; encouraged scientists outside of dentistry to focus on the struc-
ture and function of the oral and craniofacial area; reached out to the dental profession,
patient groups and the public to promote communication of NIDCR research findings;
facilitated NIDCR leadership in Oral Health in America: A Report of the Surgeon General*–
the first of its kind dedicated solely to oral health.
2000-present Increased support for research on oral health disparities, neuroscience of chronic pain,
head and neck cancer, Phase III clinical trials, genomics (including genome-wide associa-
tion studies), systems biology of salivary glands and diagnostic potential of saliva; sup-
ported creation of a dental practice-based research network and a formal Dentist Scientist
Training Program for concomitant Doctor of Dental Surgery/Doctor of Philosophy degree
training; fostered interdisciplinary research as cochair of the NIH Roadmap program on
Research Teams of the Future; helped lead NIH initiative to enhance peer review; served as
acting deputy director of NIH (November 2008-spring 2009).

fields traditionally associated with dentistry. It also
served as a meeting ground for academically orient-
ed researchers and clinicians. In 1959, IADR and the
ADA sponsored the First International Conference
on Oral Biology (with a grant from the Colgate-
Palmolive Company, New York City) and the pro-
ceedings were published in JDR.17 The journal
Archives of Oral Biology began publication the same
year. In 1988, the first step was taken to form a
society of oral biologists as part of a section of the

JADA, Vol. 140 http://jada.ada.org September 2009 13S

Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
 highlights the directors and his-
tory of NIDCR.
The U.S. government’s funding
of oral health research can be
traced back many years. In 1916,
President Woodrow Wilson cre-
ated the National Research
Council of the National Academy
of Sciences to coordinate the
nation’s scientific research facili-
ties for defense work. It was one
of the first federal governmental
bodies to promote dental biologi-
cal research.3 In 1918, a division
of medical sciences was created,
and, in 1919, a committee chaired

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by Thomas B. Hartzell from the
University of Minnesota was
President Harry S. Truman signs the bill establishing the National Institute of Dental Research, formed to encourage scientific
June 24, 1948. Also present (from left): Dr. C. Willard Camalier, director, Washington office of research in dentistry; however, it
the American Dental Association; Congressman Walter E. Brehm (Ohio), author of the bill; Dr.
H.B. Washburn, ADA president; Dr. Bruce D. Forsyth, chief dental officer, Public Health Service; faced many roadblocks including
Dr. Carl O. Flagstad, chairman, ADA Committee on Legislation; Dr. Daniel F. Lynch, past presi- lack of financial support. A break-
dent, District of Columbia Dental Society; and Dr. H. Trendley Dean, dental director, National
Institutes of Health. through occurred in 1924, how-
ever, when the Carnegie Corpora-
American Association for Dental Research. This tion, New York City, a member of the National
organization became the American Association of Research Council of the National Academy of Sci-
Oral Biologists, and its first annual meeting was ences, awarded $85,000 to the University of Cali-
in 1989. fornia College of Dentistry in San Francisco “to
undertake, through cooperation of a number of men
THE NATIONAL INSTITUTES OF HEALTH, in different fields of science, a joint study of pyorrhea
THE NATIONAL INSTITUTE OF DENTAL
AND CRANIOFACIAL RESEARCH AND U.S. and its possible relation to other human maladies.” 20
FUNDING OF ORAL HEALTH RESEARCH The ADA Scientific Foundation and Research Com-
mission helped plan the project, and the award
Overall, the major driver of America’s contribution marked the first large dental research grant in the
to the science of dental practice and oral health has United States from a foundation outside the dental
been the National Institute of Dental and Craniofa- community.21
cial Research (NIDCR)—known as the National In- The NIH originated in 1887 in Staten Island,
stitute of Dental Research (NIDR) until Oct. 21, N.Y., as a small laboratory called the Laboratory of
1998. The institute was founded in 1948 and has Hygiene in the Marine Hospital Service, a precursor
stimulated and funded many of the scientific ad- to the U.S. Public Health Service. In 1891, the Hy-
vances in dentistry and dental practice. Directed by gienic Laboratory, as the small laboratory became
visionary dental scientists, NIDCR has been instru- known as, moved to Washington, and, in 1930, the
mental in transforming dentistry from a technical Ransdell Act changed the name of the Hygienic Lab-
profession to one that is based firmly in prevention oratory to the National Institute of Health and
and technological innovation.18 NIDCR-supported established research fellowships to investigate basic
research has had a major impact on public health, biological and medical problems. In July 1930, the
dental practice and our understanding of dental and ADA passed a resolution that requested the U.S.
craniofacial function and disorders. It has played a surgeon general to conduct dental research.22
critical role in many areas of public health and den- In 1948, largely through the efforts of the ADA
tal practice, such as caries and water fluoridation, with support from IADR, President Harry S. Tru-
dental sealants, composite restorations, acid-etch man signed legislation that established NIDR, now
bonding, periodontal disease and therapy, oral can- NIDCR.20 NIDR was one of the first of the 27 NIH
18 19
cer, pain control, and salivary function. The table institutes and centers to be established. Much of the

14S JADA, Vol. 140 http://jada.ada.org September 2009

Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
impetus for this legislation was that during World
War II many young American men could not serve
in the military because they did not have the min-
imum number of six opposing teeth required to
qualify for combat.20 Fluoridation was the first chal-
lenge faced by the leaders of the fledgling institute,
and the need to train dental researchers was critical.
By 1972, NIDR had supported more than 1,600
trainees and fellows, most of whom were involved in
teaching and research and more than one-half of
whom were involved in providing patient care.20
RECENT TRENDS IN DENTAL SCIENCE
AND PRACTICE
In the late 20th century, and continuing now,
evidence-based practice, bioinformatics and bio-
mimetics emerged and promise to have a major
impact on the future of dental practice. Evidence-
based practice is the process of integrating clinically
relevant scientific evidence with the patient’s oral
and medical conditions and histories, the dentist’s
clinical expertise, and the patient’s treatment needs
and preferences.23 Dental bioinformatics has been
defined as the “application of computer and informa-
tional sciences to improve dental practice, research,
education and professional management,”24 and it
will play an increasingly important role in the way
dentistry is practiced in the future. For example,
bioinformatics will facilitate the discovery of more
sensitive and specific drugs for the treatment and
management of diseases and disorders, and it will
enable dental and medical records to be accessed
readily anywhere in the world. Biomimetics is the
study of the structure and function of biological sys-
tems as models for the design and engineering of
materials and machines. While biomimetics has had
a place in dentistry for many years in developing
dental materials, it promises to take on new impor-
tance in terms of tissue engineering and the devel-
opment of true biological biomaterials to replace
body parts such as teeth, salivary glands, muscle,
cartilage, bones and joints.25 Taken together, these
relatively new disciplines hold great promise for the
future of dental education and clinical practice and,
ultimately, for the improvement of oral and craniofa-
cial health.
CONCLUSIONS
In the last 150 years, dentistry has faced many chal-
lenges as it has moved from a purely technical pro-
fession to one that is increasingly science-based. The
Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.
future must be driven by a global vision for the pro-
vision of science-driven oral health care and the com-
mitment of dental educators and practitioners to em-
brace science as an integral part of our profession. ■
Disclosure. Dr. Gutmann did not report any relevant disclosures.
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