The dental school circa 1930
THE STORY OF THE COLUMBIA UNIVERSITY SCHOOL OF DENTAL and Oral Surgery revolves around education, research, and service. These three guiding principles never go out of fashion, although some receive more emphasis from time to time. For example, the current dean, Dr. Ira B. Lamster, is stressing the further development of the research capacities, which parallels some of the ideas of one of the schools founders, Dr. William J. Gies, professor of biochemistry at P&S in the early 1900s.
Columbias dental school, started in 1916, was the fruit of a 25-year effort by a group of influential New York dentists, who formed the Committee for a Columbia University Dental School. Along with Dr. Gies, that group included brothers Henry Sage Dunning and William Bailey Dunning and Arthur H. Merritt, Henry S. Vaughn, Leuman M. Waugh, and William Jarvie.
Most dental schools around the turn of the 20th century were not affiliated with universities. The committee considered the typical dental schools to be low-grade trade schools with weak educational programs. Committee members wanted dental students to be in a university environment where they would study the basic sciences in joint classes with medical students. Columbia, with its College of Physicians & Surgeons, had precisely what they wanted.
Of the group of founders, Dr. Gies is perhaps the most well-known by dentists. He conducted research about biochemistry in relation to dental caries, tooth development, and tooth structure and wrote the 1926 Carnegie Commission Report, Dental Education in the United States and Canada, which has functioned as a blueprint for dental education ever since. The report called for higher pre-professional standards, more and better basic science instruction, greater correlation between clinical medicine and dentistry, more opportunities for structured training in the specialties, and a greater commitment for ongoing research. Dr. Gies said dentistrys goal should be to become the oral equivalent of a medical specialty.
Columbias dental school officially opened as the School of Dentistry on Sept. 27, 1916, at the P&S buildings at 437 W. 59th St. The inaugural class had two students, both in a six-year combined M.D. and D.D.S. program. It was the first dental school to require all incoming students to have completed two years of university education. (In 1931, it was the first to increase the requirement to three years of pre-professional university education.)
Also in the pre-CPMC era, Columbia acquired the New York School of Dental Hygiene, the worlds first university-affiliated school of dental hygiene, and the 1-year-old New York Postgraduate School of Dentistry.
As Columbia University and Presbyterian Hospital developed plans for the worlds first academic medical center, the dental school prepared to be the first dental school physically integrated into an academic medical center.
Before the move to Washington Heights, the dental school outgrew its P&S facilities in midtown as enrollment increased, so the school merged with the 300-student College of Dental and Oral Surgery of New York on July 1, 1923. The new entity, known as the Columbia University School of Dental and Oral Surgery, had two buildings on East 34th and East 35th streets and a 164-chair clinic.
Dr. Alfred Owre, dean of the School of Dentistry at the University of Minnesota for 22 years, became dean in 1927. He energetically mapped out the development of SDOS at CPMC. When CPMC opened, SDOS occupied the top three floors (seven, eight, and nine) of the Vanderbilt Clinic building (more floors were added to Vanderbilt Clinic later).
A proponent of closer ties between dental and medical education, Dr. Owre quickly added a third-year course in medicine in 1928. The course included presentations of patients, given by two P&S physicians. He also emphasized research, preventive dentistry, and a strong bond between technical courses and clinical services.
Some of his ideas were controversial, according to Dr. Irwin D. Mandel, a 1945 SDOS graduate and professor emeritus of the school. Dr. Owre established a fee-for-service dental clinic to provide options for middle class patients. He felt many dentists were unskilled and the middle class could not afford the better practitioners. Dr. Owre had a vision of an SDOS clinic staffed by faculty dentists who would charge low fees and compete directly with private dentists for middle-class patients. Not surprisingly, private dentists were not happy about the proposed clinic and voiced their dissatisfaction as the Great Depression began in 1929.
Dr. Owres efforts to tie dentistry to medicine also created problems. He first viewed dentistry as an independent profession but then began thinking that dental schools should be divisions of medical schools. His views fostered disagreements and were seen as radical by his faculty and by dentists in New York and throughout the country. By 1929, even such former supporters as Dr. Gies had become adversaries.
The resistance to Dr. Owre grew so much that he took a leave of absence as dean in 1933. Columbia gave the deanship to Dr. Willard C. Rappleye, also dean of P&S. The immediate administration of the dental school was in the hands of a series of associate deans, an arrangement that persisted until 1959. The SDOS faculty was part of the Faculty of Medicine from 1945 until 1959.
Despite the dissent his opinions created, Dr. Owre strengthened the school by bringing from Minnesota 17 professors, many of whom became leaders. Dr. Arthur Rowe joined Columbia as director of prosthetics and became associate dean in 1933. Dr. Houghton Holliday, who taught periodontics and radiology, followed Dr. Rowe as associate dean from 1935 to 1945. Dr. Gilbert P. Smith was instructor and later head of the crown and bridge division before becoming associate dean in 1956 and dean in 1959. Dr. Ewing C. McBeath, a dentist, pediatrician, and nutrition researcher, created the childrens dentistry division, one of the earliest in the country. Dr. Daniel Ziskin formed the oral diagnosis division in 1930 and then led the clinical research laboratory and graduate studies.
On July 1, 1959, Columbia made SDOS a separate dental faculty again after its administrative position within the medical faculty threatened the dental schools continued accreditation. Dr. Smith, who had been associate dean reporting to the medical school dean, became dean when the school was made a separate faculty. He got off to a good start as the dental faculty warmly welcomed the return of an independent dean for SDOS. But his term was soon beset by budget, space, resource, and equipment problems in the 1960s. It was difficult to find resources for full-time faculty or facility renovation. These drawbacks were cited in the American Dental Association accreditation report at the time, which gave the school only a provisional accreditation.
In reaction to the accreditation action, Dr. Smith asked Dr. Melvin L. Moss to create a plan to build up the schools oral biology program. When Dr. Smith retired in 1968, Dr. Moss became dean. Dr. Moss was able to procure more resources from the university and the medical center, enabling new investment in facilities and faculty hiring. He also made significant changes to the curriculum, creating a basic science core in the first year, dental science in the second year, clinical training in the third, and electives in the fourth and final year.
In 1973, Dr. Moss was followed in the deans office by SDOS faculty member Dr. Edward V. Zegarelli, SDOS37, who had been active in clinical research stretching back to his time as a student when he collaborated with Dr. Daniel Ziskin. Dr. Zegarelli oversaw a fund-raising campaign that attracted $9 million in federal and private funds, enabling improvements to all three SDOS floors on VC 7, 8, and 9.
Dr. Zegarelli retired in 1978 and, after a national search, was succeeded by Dr. Allan J. Formicola from the New Jersey College of Dentistry. Dr. Formicola became the schools longest serving dean in a term that stretched to 2001. In that 23-year period, SDOS reached out to other health science disciplines at the university and what is now New York-Presbyterian Hospital. We started new programs that reached to the hospital that opened up opportunities for SDOS faculty and students, says Dr. Formicola.
In hospital dentistry, the school instituted the oral and maxillofacial surgery M.D. residency program, which is a joint P&S and SDOS program. We hired faculty who could work closely with P&S colleagues in otolaryngology, medicine, and surgery, Dr. Formicola says.
The dental school also worked with Columbias School of Public Health now the Mailman School of Public Health encouraging the recruitment of SDOS faculty with master of public health degrees. By 2000, SDOS had about a dozen faculty members with D.D.S. and M.P.H. degrees. The interest in public health furthered the dental schools involvement in public health research and community-based programs. Students also participated; during the 1980s and 1990s, 25 students graduated with D.D.S. and M.P.H. degrees.
In the D.D.S. programs, the school increased the number of electives, enabled students to cross-register in programs at other schools, and developed a combined D.D.S./M.B.A. program with the Columbia Business School.
Further broadening its focus, SDOS formed more affiliations with New York area metropolitan hospitals, pushing the total to about 30. Two major affiliates are Harlem Hospital and the Bronx Veterans Administration Medical Center. New residency and dental assistant training programs at the hospitals provided more education options for students and service programs for the communities.
In the 1980s, SDOS started the Community DentCare program, a partnership involving SDOS, the Mailman School, Presbyterian Hospital, and the northern Manhattan community, to prevent oral disease in children by creating school-based dental clinics and to improve access to dental care for residents in off-site neighborhood locations. Seven public school clinics now offer prevention services provided by Columbia dentists, hygienists, and dental assistants. SDOS staffs four dental clinics in community health centers and a mobile dental van in collaboration with the Childrens Aid Society.
|Killings Mar History
Achievements in dental education, research, and patient care illustrate SDOS history best. But the schools early years at the medical center are also remembered for a tragedy. On Dec. 12, 1935, a handyman at the school killed the schools highest administrator at the time, Dr. Arthur Rowe, associate dean of SDOS, in his office. The handyman also shot two other SDOS faculty, killing one, Dr. Paul Wiberg, before killing himself.
The new programs also provided additional revenue streams, which became necessary when state aid to dental schools was cut in the late 1980s and early 1990s. We were able to apply for and receive more foundation grants and more federal government support for the school as we built more programs, Dr. Formicola says. The additional funding also made it possible to expand the faculty from about 29 full-time members to 70 most of whom were recruited from other national and international universities.
We moved into the modern era, Dr. Formicola adds. We were able to keep all that was good about Columbia and move into a modern environment.
Research under Dean Formicola moved forward in fits and starts but generated momentum in the 1980s. The research mission was helped by the hiring of Dr. Lamster as professor and director of the periodontics division, in 1988. Dr. Lamster built a strong research program that continues today.
In 2001, Dr. Formicola ended his term as dean to become vice dean at Health Sciences for Columbias Center for Community Health Partnerships, a 1-year-old Health Sciences initiative to foster partnerships among institutions, schools, and community-based organizations to improve the general and oral health of the Washington Heights/Inwood and Harlem communities.
Since Dr. Lamster was named dean in 2001, he has moved quickly to augment the research capacities of the school. Like Dr. Formicola, Dr. Lamster seeks to increase collaborations among SDOS and the other Health Sciences faculty but with an emphasis on research revolving around thematic areas. The first area is the relationship of oral infection to systemic inflammation and such multifactorial and multisymptom diseases as diabetes and cardio- and cerebrovascular diseases. A second focus is determinants of dental disease in patients at risk. A third area under development focuses on the interplay of dental research and biomedical engineering. This research will focus on the development and evaluation of new materials and new approaches to care, Dr. Lamster says, such as the use of growth factors to aid wound healing and foster the regeneration of tissues in the oral cavity.
But Dr. Lamster does not stray far from the other missions of the school. His administration also is working to improve the quality of its patient care and educational programs. Evaluations of the school, including a university review in 2000 and the American Dental Association full accreditation in 2002, plus an administrative reorganization and a new strategic plan indicate that the school continues to move in the right direction.
Matthew Dougherty is a staff writer in the Office of External Relations at Columbia Health Sciences.
Modern dental school facilities
|SDOS Research Contributions
The schools research legacy stems largely from founder William J. Gies, who wanted research to be a powerful part of Columbias dental school. He led the way in his own studies of the relationship of saliva components to cavities and how diet and hormones affect tooth development. He also helped found the Journal of Dental Research in 1919 and the International Association for Dental Research in 1920, both still influential.
Through the efforts of Dr. Gies and others, Columbia became a hub of dental research. Dr. Charles Francis Bodecker, who became chairman of oral histology and director of research in 1923, is known for his histological studies of the 1920s and 1930s that include descriptions of enamel lamellae or layers, rod sheaths and tufts, the nature of the odontoblastic process, and changes in tooth structure in aging.
Another SDOS founder, Dr. Leuman Waugh, a professor of histology and embryology and later chairman of orthodontia, collaborated in the 1920s and 1930s with Dr. Theodore Rosebury, professor of bacteriology, and other SDOS colleagues to conduct studies now considered to be classics on the relationship of diet to oral health in Eskimo populations in Canada and Alaska.
|Dentists still quote from their analysis of what happens to teeth when a Western diet high in fermentable carbohydrates replaces an indigenous one.
During World War II, Dr. Rosebury put his Columbia research on hold, taking a position as head of the Air-Borne Infection Unit of the Biological Warfare Program at Camp Detrick, Md., where he studied bacterial warfare methods and how to defend against them.
After the war, Melvin Moss, a 1946 SDOS graduate who became dean, followed in the footsteps of two SDOS dental anatomists, Drs. Moses Diamond and Milo Hellman, who in the 1920s and 1930s studied the evolution of human dentition. In 1962, Dr. Moss, now professor emeritus at SDOS and in anatomy at P&S, published his functional matrix hypothesis, a renowned theory of facial growth that shows how the growth of soft tissues causes the growth of bones.
During the early 1960s, Dr. Irwin Mandel formed a salivary chemistry laboratory and started what became the longest continuous National Institute of Dental and Craniofacial Research R-01 grant. His lab focused on studies in saliva and its relationship to oral and systemic disease, and his
|teaching and research inspired many students to develop research careers.
The research program has expanded even more in recent years. Dr. Ira Lamster, SDOS dean, is principal investigator of a $2 million, five-year NIH grant to study the connection in young people between diabetes and periodontal disease. The project, which involves researchers at SDOS and Columbias Naomi Berrie Diabetes Center, is the first large study to assess periodontal disease, which causes bone loss near the teeth, as a complication of diabetes in children and adolescents.
Dr. Panos N. Papapanou, associate professor of dentistry and director of the periodontics division at SDOS, is leading the Columbia component of a large, multicenter clinical trial to study whether the treatment of periodontal infections reduces the incidence of pre-term birth and low birth-weight babies. Columbias part of the University of Minnesota-led study, which has a $7 million NIDCR grant, will enroll 204 women at Harlem Hospital. If the study shows that treating periodontal disease reduces the risk of pre-term birth, the next step would be to include periodontal care in the standard package of prenatal care for women when indicated.