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A History ofA History of Dental Public Dental Public
Health in Health in North CarolinaNorth Carolina
Jean Spratt, DDS, MPHJean Spratt, DDS, MPHJohn Pendill, DDSJohn Pendill, DDS
July 16, 2008July 16, 2008
2008 NC Statewide Dental Public Health 2008 NC Statewide Dental Public Health ConferenceConference
NCOHS 2008NCOHS 2008
Early 1800sEarly 1800s Anyone could Anyone could
provide dental provide dental
carecare
Dentistry Dentistry
a “trade”a “trade”
NCOHS 2008NCOHS 2008
Early 1800sEarly 1800s
Period of Period of
the traveling the traveling dentistdentist
Dentistry working to become a Dentistry working to become a professionprofession
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1820 - 18451820 - 1845
1839 - Dr. Chapin A. 1839 - Dr. Chapin A. Harris founded the Harris founded the first dental school, first dental school, Baltimore College of Baltimore College of Dental SurgeryDental Surgery
1842 - Dr. W. R. Scott, 1842 - Dr. W. R. Scott, first graduate of a first graduate of a dental school to dental school to practice in North practice in North CarolinaCarolina
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18561856
The NorthThe North
CarolinaCarolina
Dental Dental
SocietySociety
organizedorganized
NCOHS 2008NCOHS 2008
18771877
North Carolina Board of Health North Carolina Board of Health establishedestablished
50 county boards of health 50 county boards of health established by 1879established by 1879
NCOHS 2008NCOHS 2008
18791879
North Carolina State Legislature passed:North Carolina State Legislature passed:
““An Act to Regulate the Practice of An Act to Regulate the Practice of
Dentistry and to Protect the People Dentistry and to Protect the People
Against Quackery in Relation Thereto in Against Quackery in Relation Thereto in
the State of North Carolina, and the State of North Carolina, and
Providing Penalties for the Violation of Providing Penalties for the Violation of
the Same”the Same”
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18961896
Dr. J. M. Parker Dr. J. M. Parker
recommended recommended
appointing dentists appointing dentists
to examine the to examine the
mouths of all mouths of all
North Carolina North Carolina
school childrenschool children
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19101910 Dr. J. C. Watkins recommended a Dr. J. C. Watkins recommended a
permanent committee on oral health permanent committee on oral health
to educate all people in North to educate all people in North CarolinaCarolina
Oral Hygiene Committee Oral Hygiene Committee
establishedestablished
NCOHS 2008NCOHS 2008
19121912 Oral Hygiene Committee educating Oral Hygiene Committee educating
students in Gastonia students in Gastonia Dentists examine elementary Dentists examine elementary
students in Wilmingtonstudents in Wilmington Raleigh Women’s Club endorses Raleigh Women’s Club endorses
dental inspections in the schoolsdental inspections in the schools Dr. R. M. Squires of Wake Forest Dr. R. M. Squires of Wake Forest
recognizes value of education recognizes value of education
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19121912
““And we dentists…may yet find our And we dentists…may yet find our greatest calling by acting in the greatest calling by acting in the humble role of teacher for our humble role of teacher for our patients, our friends, and our patients, our friends, and our neighbors who are in such dire need neighbors who are in such dire need of our instruction”of our instruction”
Dr. R. M Dr. R. M SquiresSquires
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19141914 17 NC schools 17 NC schools
providing “at least providing “at least some” dental some” dental educationeducation
Some of these Some of these schools providing schools providing dental care for dental care for underprivileged underprivileged childrenchildren
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19181918 Dr. George M. Cooper presents Dr. George M. Cooper presents
“Preventive Dentistry” for NC Dental “Preventive Dentistry” for NC Dental Society Society
Society endorses dental prevention Society endorses dental prevention program in the schoolsprogram in the schools
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19181918
Six dentists hired by Dr. Cooper Six dentists hired by Dr. Cooper
to begin providing ato begin providing a
coordinated dental care coordinated dental care
programprogram
North Carolina first state board to North Carolina first state board to have a dental programhave a dental program
NASH COUNTY
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19191919
Dr. E. J. Tucker first dentist on the Dr. E. J. Tucker first dentist on the North Carolina State Board of HealthNorth Carolina State Board of Health
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19211921
Dr. J. C. Johnson Dr. J. C. Johnson appointed appointed Supervisor of Oral Supervisor of Oral Hygiene to Hygiene to oversee the dental oversee the dental program:program:
Relief of pain and Relief of pain and sufferingsuffering
EducationEducation
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19291929
Dr. Ernest Branch succeeded Dr. Dr. Ernest Branch succeeded Dr. Johnson as the Supervisor of Oral Johnson as the Supervisor of Oral HygieneHygiene Believed in educationBelieved in education Worked for local:Worked for local:
InterestInterest ParticipationParticipation Financial SupportFinancial Support
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19311931Dr. Branch Dr. Branch
appointed appointed
Director of Director of
the new the new
North Carolina North Carolina
Division of Oral Division of Oral
HealthHealth
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19311931 4 full-time 4 full-time and 12 and 12 part-time part-time dentists dentists Each spentEach spent 3 months in 3 months in a countya county
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19341934
Volunteer dentists did Mouth Health Volunteer dentists did Mouth Health SurveySurvey
54.3% children had never 54.3% children had never
had dental treatmenthad dental treatment
85% of these same 85% of these same
children needed dentalchildren needed dental
carecare
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19351935 ““Little Jack” puppet Little Jack” puppet
show hits the road show hits the road across NCacross NC
““The Goodest Story”The Goodest Story”
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19351935
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19361936
Institute of Public Institute of Public
Health Dentistry Health Dentistry
established in established in
Chapel Hill to train Chapel Hill to train
dentists working dentists working
in public healthin public health
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19491949
Charlotte Charlotte becomes becomes first city in first city in North North Carolina to Carolina to fluoridate fluoridate its waterits water
NCOHS 2008NCOHS 2008
19501950
UNC School of UNC School of Dentistry established Dentistry established in Chapel Hillin Chapel Hill
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19591959
Dr. Ernest A. Pearson, Jr. Dr. Ernest A. Pearson, Jr.
succeeded Dr. Branch as succeeded Dr. Branch as
North Carolina State North Carolina State
Dental DirectorDental Director
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1960-19631960-1963 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 DiseasesNatural History of Dental Diseases First trained Health Educator, First trained Health Educator,
Becky Bowden, was hired Becky Bowden, was hired
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19691969 The North Carolina Citizens The North Carolina Citizens
Committee for Dental Health was Committee for Dental Health was established to help expand established to help expand community water fluoridationcommunity water fluoridation
Fluoridators placedFluoridators placed
in rural schoolsin rural schools
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19711971 Role played by plaque in Role played by plaque in
dental disease identifieddental disease identified
Task Force for Community Preventive Task Force for Community Preventive Dental Health established by the Dental Health established by the North Carolina Dental SocietyNorth Carolina Dental Society
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19721972 Division of Oral Health hired first four Division of Oral Health hired first four
dental hygienists to teach preventive dental hygienists to teach preventive dental health in the countiesdental health in the counties
First fluoride First fluoride mouthrinse mouthrinse program started program started in Robeson Countyin Robeson County
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19731973
10 year plan10 year plan 25% reduction in dental caries in the 25% reduction in dental caries in the
population 20 years of age and underpopulation 20 years of age and under 40% reduction in dental caries in the 40% reduction in dental caries in the
population 10 years of age and underpopulation 10 years of age and under 15% reduction in periodontal disease in 15% reduction in periodontal disease in
the population 20 years of age and the population 20 years of age and underunder
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19741974 Teachers Guide to aTeachers Guide to a Preventive Dental Health Preventive Dental Health Program in NC distributedProgram in NC distributed
Dental Public Health Dental Public Health providing teacher providing teacher workshops across theworkshops across the statestate
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19761976
Kellogg Foundation funded the 2Kellogg Foundation funded the 2nd nd statewide comprehensive dental survey statewide comprehensive dental survey
in NCin NC
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19791979
Dr. George Dudney Dr. George Dudney
succeeded Dr. Pearson succeeded Dr. Pearson
as Chief of the North as Chief of the North
Carolina Dental Health Carolina Dental Health
SectionSection
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19801980
The Framework for The Framework for
Dental EducationDental Education
Published and Published and
DistributedDistributed
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19851985
Kate B. Reynolds Healthcare Trust Kate B. Reynolds Healthcare Trust funded the 3funded the 3rdrd statewide dental statewide dental
survey in NCsurvey in NC
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19891989
Dr. C. Jean SprattDr. C. Jean Spratt
succeeded Dr.succeeded Dr.
Dudney as Chief Dudney as Chief ofof
the North Carolinathe North Carolina
Dental HealthDental Health
SectionSection
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19901990
Stopped providing Stopped providing surgical/restorative clinical services surgical/restorative clinical services
to become 100% preventive programto become 100% preventive program
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19921992
Developed a series of traveling Developed a series of traveling dental health education exhibitsdental health education exhibits
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19941994 Five Part sealant initiativeFive Part sealant initiative
School based sealant projectsSchool based sealant projects Sealant ExhibitsSealant Exhibits Media CampaignMedia Campaign Public-Private sealant projectsPublic-Private sealant projects ““Ask Us About Sealants” campaignAsk Us About Sealants” campaign
Discontinue school water fluoridatorsDiscontinue school water fluoridators
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19951995
Standardized Standardized assessment assessment technique technique developeddeveloped
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19961996
Dr. Steven J. Cline Dr. Steven J. Cline
succeeded Dr. Spratt succeeded Dr. Spratt
as Chief of the as Chief of the
North CarolinaNorth Carolina
Dental Health SectionDental Health Section
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19981998
Dental Public Health 80Dental Public Health 80thth Anniversary: Anniversary: “Seal the State in ’98”“Seal the State in ’98”
A statewide sealant initiativeA statewide sealant initiative
Community based sealant projects Community based sealant projects conducted in every county in North conducted in every county in North CarolinaCarolina
NCOHS 2008NCOHS 2008
19991999
““Smart Smiles” became Smart Smiles” became
““Into the Mouths of Babes”Into the Mouths of Babes” Pediatricians:Pediatricians:
Screen for dental diseaseScreen for dental disease Apply fluoride varnishApply fluoride varnish Educate parents about dental diseaseEducate parents about dental disease
NCOHS 2008NCOHS 2008
20002000
Dr. Rick G. Mumford Dr. Rick G. Mumford succeeded Dr. Cline succeeded Dr. Cline as Chief of the North as Chief of the North Carolina Dental Carolina Dental Health SectionHealth Section
NCOHS 2008NCOHS 2008
20022002 Discontinue the fluoride mouthrinse Discontinue the fluoride mouthrinse
program in the schoolsprogram in the schools
Focus on sealants and community Focus on sealants and community water fluoridationwater fluoridation
NCOHS 2008NCOHS 2008
20032003
The Centers for Disease Control & The Centers for Disease Control & Prevention funded the 4Prevention funded the 4thth statewide statewide
dental survey in NCdental survey in NC
NCOHS 2008NCOHS 2008
20052005
Dr. Rebecca S. King Dr. Rebecca S. King
succeeded Dr. Mumfordsucceeded Dr. Mumford
as Chief of the North as Chief of the North
Carolina Oral Health Carolina Oral Health
SectionSection
NCOHS 2008NCOHS 2008
20052005
“ “Into the Mouths of Babes” became a Into the Mouths of Babes” became a part of the North Carolina Oral Health part of the North Carolina Oral Health
Section programSection program
NCOHS 2008NCOHS 2008
20062006 Developed Early HeadDeveloped Early Head
Start Oral Health Start Oral Health
CurriculumCurriculum
Reestablish fluorideReestablish fluoride
mouthrinse program mouthrinse program
in the schoolsin the schools
NCOHS 2008NCOHS 2008
20072007
Carolina Dental HomeCarolina 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 diseasedental disease
Grant funded by Health Resources and Grant funded by Health Resources and Services AdministrationServices Administration
NCOHS 2008NCOHS 2008
20082008
PORRTPORRT
PPriority riority OOral ral RRisk isk
AAssessment and ssessment and
RReferral eferral TToolool
Goal is to develop a risk assessment tool to Goal is to develop a risk assessment tool to
assist medical providers with dental referrals.assist medical providers with dental referrals.
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SummarySummary Developed to help meet the need for dental Developed to help meet the need for dental
carecare Began as a surgical, restorative treatment Began as a surgical, restorative treatment
programprogram Progress followed and adjustments made as Progress followed and adjustments made as
a result of scientific investigationsa result of scientific investigations Over time became 100% prevention Over time became 100% prevention
programprogram
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Trends in Dental Caries (DMFT)Trends in Dental Caries (DMFT) in 12-17-Year-Old Children in 12-17-Year-Old Children
0
1
2
3
4
5
6
7
8
1960-62 1976-77 1986-87 2003-04
Blacks
Whites
NCOHS 2008NCOHS 2008
F
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