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A Proud Tradition

Convocation is a ceremony lush with tradition and custom and rich in hope for the future, a day when a university summons up all the pomp and circumstance it can muster. This was particularly true this year on 5 June, the fifth day of the University of Alberta's Spring Convocation, when the University celebrated 75 years of dental education. To Dean Norman Wood of the Faculty of Dentistry fell the honor of making the Report to the University. In his remarks, Wood invoked the importance of tradition to the Faculty and the University with the words of D.W. Gullet, a Canadian dentist and author who wrote: "It is impossible to comprehend the present, much less guess at the future, without knowledge of the past."

A few days after Convocation, on another radiant Alberta summer day, Wood comments that he and his family enjoy Alberta's "cool summers" — cool compared to humid Toronto, where he received his dental degree in 1958, and Chicago, where he spent 27 years at Northwestern and Loyola Universities before coming to Edmonton in 1989.

Discussing the Faculty he has led for the past three years, Wood says its most precious quality is its long heritage, a legacy resonating from every brick and cornice of the historic Dentistry-Pharmacy Centre, and from the portraits of former deans that dignify the approach to Wood's office. In this setting, he elaborates on what makes the U of A a special dental school.

"The quality of the students, absolutely," Wood says. He says that in the United States demand for dentists and dental school enrolment are both low. "It's hard there to fill a class with good students. Here we have applications at a rate of eight or nine to one — good applicants for each position. We have a tremendous selection, both in dentistry and dental hygiene."

He praises his faculty members as worthy successors of a long line of distinguished educators and professionals, and as an excellent mix of teachers from some 33 different universities. He says, "I often tell [students] when they come in on the first day, they have the opportunity to go to some of these 33 universities and spend a few weeks there — without travelling."

The international profile of his Faculty was enhanced this past July, as several U of A professors who are leaders in their fields presented their research at the International Association of Dental Research meeting in Glasgow. In a profession where the scalpel may be replaced by a dental laser, and where titanium implants attached to lifelike dental prostheses are making dentures obsolete, today's students must be grounded in traditional techniques while toeing the line of the future, suggests Wood. "The challenge now with our curriculum is that we have to hold the line — teach pretty well everything we have taught and on top of that we have to cover all kinds of new things," Wood says. That challenge is captured in the theme that his Faculty chose for this year's anniversary: "75 Years and Forward."

Seventy-five years ago these building blocks of tradition — excellence in students, staff, research, and teaching — began to shift into place. In the fall of 1917, all U of A Dentistry could boast of was students. Three of them. At that time, Dentistry was a department in the Faculty of Medicine. "Dents" and "Meds" took lectures and labs together in anatomy, bacteriology, biochemistry, communicable diseases, pharmacology, and physiology; no purely dental subjects were offered until the second year of the course. After completing the two-year course, Alberta students could qualify for the degree of Doctor of Dental Surgery by finishing two more years of study either at the University of Toronto or McGill University. The U of A remained the only dental school in Western Canada until the founding of the dental school at the University of Manitoba in 1957.

The foundation for a strong dental faculty at the U of A was solidified by 1920. That was the first year that Dr. Harry Bulyea's name appeared in the University calendar as an instructor in operative dentistry. Bulyea was a graduate of Harvard Dental School, established in 1867 as the first university dental program and later the model for the U of A dental degree curriculum. A pillar of the Faculty until his retirement in 1942, Bulyea, who came to Edmonton after stops in Saskatchewan, British Columbia, Chicago, and Calgary — he admitted he "couldn't settle down in any place for too long" — was a legend well after his death at age 103 in 1976. When Dentistry was made a School in 1930, he was appointed director.

The Medical Sciences building opened in 1921 and became Dentistry's permanent home — quite an improvement over the previous quarters in the old Engineering building. Yet little more than 20 years later the need for a dentistry building was recognized. In 1942 the Alberta Dental Association suggested that "the school has been handicapped by unsuitable and inadequate quarters, much miserable equipment and an underpaid staff, yet has continued to graduate men whose abilities are the equal at least, of those of any school."

Dentistry immediately began lobbying for a new building, but the government's only response was an equipment grant of $40,000. In the late '60s when plans were prepared for what would become, in 1984, the Walter Mackenzie Health Sciences Centre, they originally included a separate dental building. This part of the plan never came to fruition, however, and today the dentistry and pharmacy schools share the old Medical Sciences building, which has now been renamed to reflect their tenancy.

Starting in 1923 students could complete a full four-year dental degree at the U of A, with the first class of seven graduating in 1927. During the Depression the maximum number of third-Year dental students was limited to seven. "This was probably the first quota to be established at the University!" wrote the late Hector MacLean, a 1928 U of A DDS graduate and later dean of the dental school, in his history of Alberta dentistry.

Things got worse in 1932-33, when the graduating class hit an all-time low of one student: the late Dr. Harold Turner. When Dr. William Scott Hamilton took over as director in 1942, the maximum had increased to 15 students. By the time he was appointed dean of the newly-constituted Faculty of Dentistry in 1944, the dental program was accelerated to year-round instruction and students were given a sustenance allowance and enlisted in the Canadian Dental Corps in support of the war effort. A more normal course resumed after the war, with one enviable difficulty for the Faculty: too many qualified applicants. Ex-servicemen were given preferred acceptance, and many qualified civilians were turned down.

A surplus of qualified applicants has persisted over the years, despite the high entrance standards that have always been maintained for dental students. In the '30s the University of Toronto admitted dental students with Grade 11 matriculation, but the U of A insisted on not only Grade 12 but a pre-dental year in Arts. Medicine was turning away such numbers of students by the '40s that it was suggested that some should be selected for Dentistry — a suggestion that was flatly refused. Nor would the U of A give credit in the post-war years for courses completed at the Canadian Dental Corps School. Today, the Faculty requires two years of university education prior to enrolment in the four-year dentistry program.

Change came to the Faculty in the '60s, with the addition of the new dental auxiliary program in 1961. The next year this program was formed into the School of Dental Hygiene, and a graduate studies program was added.

A sign of the times: yellowed newspaper clippings from 1968 complete with dated photographs report that the Faculty had adopted the use of lap covers for mini-skirted female patients. The company that supplied the covers claimed that the dental students' grades had "shown a marked improvement." Despite the fact that the first woman entered the profession in 1899, and the Class of '43 included Yachiyo Yoneyama, the first woman dental graduate at the U of A, as late as the '60s dentistry was still a predominantly male profession. A sign of modern times: two women tied for the Faculty's top honors in the Class of '92, a graduating class approximately one-third women.

While the bulk of the Faculty's dental graduates went on to establish private practices, others pursued careers in dental education. William Scott Hamilton, a student at the U of A in 1920-21; Hector MacLean, '28 DDS; Donald Collinson, '58 DDS; and Gordon Thompson, '65 DDS; all later became deans at their alma mater. John Neilson, '41 DDS, was the first dean of Dentistry at the University of Manitoba, and U of A dental graduates now hold teaching and administrative positions at many North American schools of dentistry.

After other Canadian dental schools appeared in the '60s at the Universities of British Columbia, Western Ontario and Saskatchewan, some of the weight of dental education was taken off the U of A, and more resources were devoted to building up research. Between 1977 and 1982 the faculty firmed its academic structure of departments and divisions. Under the leadership of Gordon Thompson, who served as dean from 1978 to 1989, a greater number and variety of research projects were pursued, and increasingly faculty members were able to travel to national and international conventions to give exposure to their work.

A dental faculty must equally balance the academic and research demands of the university, and the community mandate to train health professionals, says the current dean of Dentistry. While some might take a negative view of the recent cut in enrolment that the dentistry program has implemented, Wood holds the positive view that the Faculty must respond to community needs. "We're pretty well balanced at the moment. We went down from 50 to 30 [dentistry students], and I think that's about where we should be." He adds that the government and the university will do a survey of the dental profession in 1994-95 to determine the demographics and the future needs of dentistry and dental education.

In each of four years, U of A dental students spend an average of over 1000 hours in lecture, lab, and clinical time; dental hygiene students average nearly the same number of hours in each of two years of their program. Subjects such as anatomy, bacteriology, and medicine are offered by other faculties, and clinical experience, dental subjects, and courses in practice management are run by the faculty. Because the Faculty is approved by the Canadian Dental Association, dental graduates are automatically eligible for registration in Alberta and with the National Dental Examining Board, without further examination.

The Faculty is also distinguished by a graduate program in orthodontics, which normally requires an additional three years of study beyond the DDS degree in order to obtain a Master of Science with specialization in orthodontics. Over its entire 75-year history, the faculty has produced 40 such specialists, 886 hygienists, and 2,238 dentists.

Wood is proud of the fact that the Faculty has excellent relations with the professional and greater community. Each academic year more than 100 practising dental professionals return to the faculty as part-time clinical instructors, and Dentistry's continuing education division offers many courses for practising dentists. This year, in response to public concerns over the transmission of communicable diseases, the Faculty will launch a community sterilization-monitoring program. Sterilization strips will be available to every dental practice in the province, to check how the effectiveness of each office's sterilization equipment.

Wood says the profession must take dental care to segments of the population that aren't receiving it. "The joke used to be that dentists had their offices on the second or third floor of a building with no elevator. If the patients could walk up the stairs, they were well enough to be worked on. But those days are gone," he says. Academically, Wood would like to see the concentration of research into a few centres of excellence, and development of more graduate programs. "Graduate students are able to teach in undergraduate programs, and they could handle some of our tougher (clinical) cases," he says. During his tenure as dean he says he has put more emphasis on the clinical component of the program: "I really felt very strongly when I came here that there was not enough emphasis put on clinical teaching." More interdisciplinary work with Medicine, Nursing, and Pharmacy would also benefit the students and the Faculty, he says.

What else would he do if the University handed him a blank cheque? "A new building would be nice," Wood says with a smile. The more some things change˜.

The profession is changing rapidly, without a doubt. A paper called "Dentistry Looks Ahead," prepared by Wood and colleague Dr. Ken Hinkelman, predicts that in another 75 years "there will be a drastic change in the things that a practitioner does during an average day." Increased public awareness of dental health, and new technology will bring about this change, Wood says.

He is particularly enthusiastic about new technological applications, such as the hand-held dental laser, which the Faculty of Dentistry helped develop in conjunction with John Tulip of the Faculty of Engineering at the U of A. Computers also have their place in the future of dentistry, for uses such as producing and enhancing the images collected by a television camera the size of a dental mirror, and imaging the results of cosmetic dentistry or orthodontics. CAD-CAM technology, currently in use by only handful of dentists, can be used to optically scan and measure a prepared tooth, design a crown or inlay, and relay instructions to a milling machine which creates the restoration.

The future of the dental profession may lie in sophisticated technology, but Wood knows that a good dental education is much more than mere technical training. "I count dental education as probably one of the hardest disciplines, because you have to conquer both the academic aspect of it, as well as develop tremendous manual dexterity," he says.

In addition, students have to cope with the various stresses of dental education and practice. First, many patients are scared of dentists; second, dentists are always watching the clock because technical difficulties frequently prolong procedures; third, dentistry as a business has a high overhead — and a high responsibility — for two or three other staff members. "All these thing push dentists very hard," says Wood.

As a qualified dentist, Wood can appreciate the pressures faced by practitioners and students. "I think the dean of a dental school should have a dental degree˜ so that he's aware of all the heartaches and pitfalls and everything else that goes with a dental education. It gives you some compassion for the students and what they are going through." He says one of his primary goals is to make concern about students and teaching a top priority of the Faculty of Dentistry.

Based on the impression he got from the graduating students at this year's convocation, Wood thinks that significant progress has been made towards this goal. "They are very positive. A very good class, and very interested in dentistry and in treating human beings."

Published Autumn 1992.

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