3.

THE BULLETIN OF THE ANERICAN ASSOCIATION OF PUBLIC HEALTH DEIJTISTS

Pub l i shed Q u a r t e r l y by t h e A s s o c i a t i o n f o r t h o P u b l i c Hea l th Dentists of America

Volume 2 A p r i l , 1942 Moa 2

HOW TO GET TTiE PUBLIC INTERESTED IN DEX'JTAL HEALTH By Randolph G. Bishop*, Yiashington, DOC,

The problem i s n o t on ly how t o g e t t h e p u b l i c i n t e r e s t c d i n d e n t a l h e a l t h , b u t a l s o how t o keep them i n t e r e s t e d . Seekring t o g e t and keep the p u b l i c interested i n dental h e a l t h i s an e d u c a t i o n a l p rocess , a process i n v o l v i n g b o t h inf ormst i o n and o r g a n i z a t i o n ; it a l s o invo lves treatment and leads t o more adequate treatment. One wi thou t t h e o t h e r cannot s o l v e the p u b l i c problern.

Aside from t h e b e n e f i t s o f r o s e a r c h , we are dependent t r e a t m e n t t o c a r r y us toward our goal . Sporadic a c t i v i t i e s will n o t suf'fico. P rogres s n e c e s s i t a t e s t h e development of a sound founda t ion upon which con- t i nuous and ever i n c r e a s i n g programs can g r w a Th i s founda t ion must pro- v i d e a workable b a s i s and one which i s p r a c t i c a l in t h e l i g h t of t h e a v a i l a b l e r e s o u r c e s I

upon e d u c a t i o n and

The program r e q u i r e s lcng- te rm ob- j e c t i v e s which r each far beyond pos- s i b l e achievement of t h e day. A t t h e same t i m e it must have s h o r t - term o b j e c t i v e s roasona3 ly p o s s i b l e of imxiediate Fittainment. O u r p r a c t i -

*Executive S e c r e t a r y , N a t i o n a l Den ta l Hygiene Assoc ia t ion . Rend be fo re t h e American A s s o c i a t i o n of P u b l i c Health Dentists, Houston, Texas, October 26, 1941.

c a l o b j e c t i v e i n d e n t a l h e a l t h edu- c a t i o n i s t o persuade an e v e r increas- inC number of our c i t i z e n s t o seek and p c r i o d i c a l l y t o con t inue t o seek d e n t a l c e r e f o r themselves and f o r t h e i r c h i l d r e n , t o mako dental t r ea t - ment reasormbly a v a i l a b l e t o them, and t o e n c o u r n p t h e h i g h e s t pos- s ible ste.ndard of p r o f e s s i o n a l ser- v i c e f o r a l l . To accomplish t h i s o b j e c t i v e , an e s s e n t i a l requi rement i s t h a t our nppec l be made th rough t h e use of' lnnguage which i s e a s i l y unders tood by t h e type of c i t i z e n we seek t o reach . A t t h e same t i m e our p r e s e n t a t i o n must bo based upon m d r e l a t e d t o a l r e a d y e x i s t i n g i n t e r e s t s of t h e v a r i o u s groups reached. Too o f t e n i n h e a l t h and o t h e r types of e d u c a t i o n a l work t h e m a t e r i a l p re- s e n t e d hRs been impress ive i n i t s ef- f e c t upon p r o f e s s i o n a l co l l eagues b u t e n t i r e l y i n e f f e c t i v e upon t h e p u b l i c a t which it was d i r e c t e d . The t h o u g h t s , b e l i e f s , and a t t i t u d e s of i n d i v i d u a l s a r e t h e r e s u l t o f person- a l e x p e r i e n c e , a s s o c i a t i o n s , and t r a i n i n c . The words we use and t h e channels t h rough which we r e a c h peon le engaged in one type of en- deavor l . ~ y be e n t i r e l y d i f f e r e n t for o the r s .

The d e n t a l h e a l t h problem i s s o v a s t t h a t j u s t t h e thought of t r y i n g to r e a c h a hundred m i l l i o n people might e a s i l y cause onyone t o t h r o w up h i s hands, i f a t the same t ime one cioes n o t v i s u a l i z e such an e f -

4.

HOW TO GET THE PUBLIC INTERESTED IN DENTAL HEALTH - Bishop

f o r t as Q cooperative movement and consider t h e almost numberless ave- nues of approach through t h e u t i l i - za t ion of organized and ind iv idua l support ava i l ab le -- support which, up t o da t e , has hardly been tapped i n t h e cause of dental heal th .

What a re t h e groups we need t o re= ‘ T C i t i z e n s of a l l economic and

( 2 ) Profess iona l workers, board

-- - -- age l eve l s .

members, vo lunteers , and o thers concerned wi th t h e need for den ta l se rv ice .

nursing, and a l l i e d professions; hosp i t a l board members; hospi- t a l s e rv i ce groups; auxiliary members ; and o thers

( 3 ) Members of t h e den ta l , medical,

‘Ahat are the kinds of educat ion needed? ‘ 7 i J T d u c a t i o n t o i n t e r e s t agencies

and organizat ions i n t h e prob- lem of den ta l h e a l t h , includ- ing chi ld-car ing i n s t i t u t i o n s and f o s t e r homes.

( 2 ) Education t o s t imula te ind i - v idua ls t o e s t a S l i s h good per- sonal d e n t a l h e a l t h hab i t s and t o seek adequate den ta l c a r e f o r chi ldren. Health educat ion f o r t h e ind iv idua l should be designed f o r t he spec ia l group t o which it i s d i rec ted . A pop- u l a r program should be cont in- uously aimed at t h e por t ion of t he populet ian t h a t can pay normal den ta l f e e s but does not soek denta l care . Spec ia l groups include t h e f ollowingr a. Adolescents and young a d u l t s

--through schools, chnrac- te r -bui ld ing agencies,church and social groups, indus t ry , Camp F i r e Girls, G i r l Scouts, Boy Scouts , and similar or- gmiza t ions .

’0. School children-through co- opera t ion with public and

parochia l , elementary, jun- i o r and sen ior high schools , and t r a d e schools.

C. I n d u s t r i a l workers--through cooperntion wi th i n d u s t r i a l p l a n t s and commercial and i n d u s t r i a l unions.

d. C l i e n t s of maternr.1 and c h i l d vrelfnre agencies-- through cooperation wi th h o s p i t a l s , clinics , p r ena ta l c l n s s e s , nurs ing orgcniza- t i o n s , nnd o thers d e d i n g wi th this group.

e. Adults-through c i v i c , soc- i a l , f r a t e r n a l , and o ther lay groups. These o r p n i z a - t i o r i s c m a l s o a i d i n reach- ing t h e other groups.

(3) Education needed t o prepnre leaders and professionfil work- ers t o promote nnd p a r t i c i p a t e i n d e n t d h e a l t h programs.

(4 ) Education needed t o encourage &if%s and bequests f o r oducc.- tiontzl cnd study p rogrms , om- p loymnt of d e n t a l personnel , purchase of suppl ies a d equip- ment, p rovis ion of s e rv i ce fnc- i l i t i e s , m d more ndcquate pub- l i c funds f o r r e h n b i l i t a t i o n of t h o indigent .

7Nhnt tire the methods of reaching - 7 - various g r o u x *(1)ethods of reaching agencies

and o rgmizn t ions should in- clude p r in t ed mtoricl, r a d i o brondcnsts, news s tor ies on s i g n i f i c u n t phnses of d e n t a l cRre, qur. l if ied speakers f o r profossionnl m d lay groups, v i s u a l educntion of t imely s i g n i f i c m c e by populw means, s c r i p t s , and t r a n s c r i p t i o n s f o r use i n s m l l e r communities. Iitethods of reaching individuals . C. Adolescents and young ndul t s

should be rertched by the same methods used t o roach agcnc i e s and o r g m i z n t ions .

b. School ch i ld ren should be

5.

HOW TO GET TW3 PUBLIC INTERESTED IN DENTAL HEALTH - Bishop

C.

d,

reached by school hea l th programs, a c t i v i t i e s of school physician and publ ie heal th nurse, school d e n t i s t and hygienist , n u t r i t i o n i s t s , su i t ab le motion pictures and dental l i t e r a t u r e , poster- making, p lay le t s , e tc . Pre- school children should also be reached by encouraging the inclusion of dental ex- aminations, education, and follow-up in connection w i t h the sumrnsr round-up and well chi ld conferences. Indus t r i a l workers should be reached through such media as educational l i t e r - ature, posters , motion pic- t u re s , and speeches. Employ- ers should help develop programs f o r dental hea l th education and care f o r t h e i r employees and families. Clients of maternal and c h i l d welfare agencies should be reached by pre- n a t a l dental supervision, postnatal dental supervis- ion, qual i f ied speakers f o r worker s groups , parent classes , and educational mater ia l for mothers pre- pared in collaboration w i t h and under the advice of ob- s t o t r i c ians and pe d i n t r i- c ians 0

(3) Methods of reaching leaders and professional workers should in- clude j o i n t medical-dental meet- ings which w i l l bring out t he re la t ionship of denta l carc t o general hea l th , addresses be- fore selected groups or dental soc i e t i e s in explanation of rury proposed dental progrnm, improved dental education of nurses i n t ra in ing , addresses before dental hygienists and before open mct ings of hospi- t a l s m d other groups organized for the care o f the s i ck t o

s h m need 04 gdngralieid ddnka3 care. When dental or teachers ' colleges e x i s t i n t h e community, e f f o r t s should be mde t o in- terest them i n dental hea l th in s t ruc t ion.

should include dramatic graphic material f o r l a y groups con- cerned w i t h c iv i c and soc ia l problems, f o r o f f i c i a l bodie s such as health departments, welfare departments and boards of education; f o r hosp i t a l t ru s t ees and f o r any groups o r individuals who m y be in Q po- s i t i o n t o c rea te and sus t a in i n t e r e s t i n providing or in- creasing f a c i l i t i e s . I k t e r i a l must be authent ic and presen- t ed i n a convincing manner. It may include char t s , sl ides, o r motion p ic tures , used by e f -

(4) Methods of procuring funds

- f ec t ive speakers.

Dental h e a l t h is of concern t o both o f f i c i a l and unoff ic ia l heal th , welfare, and character-building agen- c i e s working pti th all age levels . It is of concern t o our school systems. I t i s of concern t o 8, wide var ie ty of lay organizations, It i s of concern t o c i t i z e n s generally great American arqy of volunteer hea l th and welfare workers. And, of course, it is o f i n t e r e s t t o the den- t a l and medical professions. A large, but unknown, number of those agencies and organi ta t ions include dental heal th in t h e i r program, although dental hea l th i s seldom a major item in these program. thora are numberless c i v i c , soc i a l , and f r n t c r n a l organizations, as well as lay individuals , wi l l ing t o put t h e i r shoulders t o the wheel once they understand the importance of denta l hea l th act ion and a r e provided w i t h concrete suggestions as t o what t o do and are guided in t h e i r efforts. Therefore, if we seek t o progress in an effective long-range ac t ion pro-

who make up the

On t h e other hmd,

6 .

HOW TO GET THE PUBLIC INTERESTED

gram, our e f f o r t s must be directed toward the development of mutual un- derstanding and cooperation on the pa r t of a l l groups. No phase of hea l th work has ever had a be t t e r opportunity than has dental heal th t o accomplish these things,

I t i s a t t h e community l eve l t h a t the major features of dental heal th education proGrams must operate. The a c t i v i t i e s on the s t a t e and nat iona l l eve l s a re a s s i s t i n g and stimulating aids t o community programs. A logi- ca l f i r s t s tep is t h e formation of community dental committees made up of representat ives o f health, w e l - f a re , school, l ay , professional, and other groups and t i e d i n with some agency permanently s e t up and f i n - anced, l i k e t h e cornunity chest , council o f social agencies, county health department, schools, etch

This w i l l make dental heal th a community project. It w i l l provide proper pro- fess iona l and management guid- ance t o dental hea l th programs. It will aid i n avoiding dupl i - catiofi of e f f o r t . It w i l l broaden the dental pro- gram t o community-wide propor- t ions . It w i l l be an i n f l u e n t i a l fac- t o r i n preventing i l l -advised progrms on the p a r t of any one group. It w i l l be an invaluable aid i n securing appropriations of public f u n d s f o r dental pro- grams . I t w i l l stimulate and a i d the individual programs of the or - g m i z at i ons part i c ipat ing . It w i l l enhance the pres t ige and importance o f dental hea l th in the eyes of the community.

I do not i n any way mean t o imply t h a t t h e f o r m t i o n of community den- t a l committees i s a so lu t ion of t he dental health education problem, but

I N DENTAL HEALTH - Bishop I do point t o them as an e s s e n t i a l f i r s t s t o p i n ge t t i ng our houses in order, i n securing necessary cooper- a t i o n i n the community and in devel- oping the necessary f inanc ia l and moral suppor t without which we can- not hope to carry our educntional a c t i v i t i e s into t h e homes of a l l c i t i z e n s .

Those of us who arc today working f o r dental hea l th must become the salesmen who persuade a l l possible organizations t o mke dental health a fea ture of t h e i r programs, at t he s,me time t e l l i n g them how to go about it and provide the working tools . Pcoplc- i n p n e r n l do not l i k e t o be lectured, they do not l i k e being t 'talked down t o , " and they d b not l i k e t o feel that some- one i s t rying t o educate them. Don- t a l heal th is E. very personal m d often sens i t i ve matter. On the other hand, everyone cnjoys t ry ing t o educate the other f e l l o w , and tho peoplc who receive t h e bes t ed- ucation are those whom we e n l i s t t o help educate others, although they seldom r e a l i z e what is happening t o them.

No iridividual can hope t o reach an appreciable number of people per- sonally. Therefore, the dental h e a l t h educator who is charged w i t h responsibility f o r ac t ion programs depends i n large measure upon per- suading the o f f i c e r s of organiza- t i ons t o t r a n s l a t e the. message of dental hea l th requirements t o t h e i r members and e n l i s t t h e i r members in carrying it t o others.

In every community there a re lay organizations concerned with c iv i c , health, and welfare problems. The membership of these organizations runs in to many mill ions, They take an ac t ive i n t e r e s t in various phases of hea l th work. They mus t be per- suaded t o include dental hea l th edu-

7.

HOW TO GET TIE PITBLIC INTERESTED IN DENTAL, mALTB - Bishop

cation i n t h e i r programs and, where possible , t o fea ture dental heal th education. G o o m e n t must guide our requests .to l ay organizations. Each organization has a spec i f ic contribution t o make t o the cause; there a t e c e r t a i n things it can do and others for which it i s e n t i r e l y unsuitable.

I n addi t ion t o h i s other profes- s iona l a c t i v i t i e s , the public health d e n t i s t , pa r t i cu ln r ly one who is d i rec t ing state a c t i v i t i e s , is pro- vided today with nn unusual oppor- t u n i t y t o be the organizer and leader of s ta te and community corn- mittoes for the advancement of den- t a l health.

DENTAL SERVICES IN INDUSTRY* By Harold A. Hoaper**, D.D.S.,

Chicago, Illinois

Non-occupational i l l nes ses are a constant drain on industry; a bur- den on the employee i n reduced earn- ings, an imposition on the employer i n added expense. But nore impor- t a n t than e i t h e r of these nmr is t h e i r cos t i n time i t s e l f . The ec- onomics of eiyloyee absenteeism must be studied in t e r m of the nat ional war e f fo r t .

-

There i s au thor i ty f o r t he s t a t e - ment t h a t absentee ism f rom illnesses i s d i r ec t ly t raceable - to ora l conditions.

I. In 2,469 employment medical ex- aminations i n 1928, Sappington d i s - covered 15,491 defects o f a l l kinds --an average of 6.3 per person.

2. Another large i n d u s t r i a l con- cern found t h a t more than 95% of i t s employees had defective t e e t h and diseased gums. 3. In three s to re c l i n i c s i n Bos-

ton, w i t h a t o t a l of 2,605 cases

a t l e a s t 25% of employee non- oc cupat i onal

diagnosed and recorded, clean mouths were found i n 19,s; f a i r mouths i n 53%; and neglected mouths in as many as 27.1%. 4. Black, i n h i s invest igat ion of'

the prevalence of dental in fec t ions , found t h a t 78 of' every 100 persons averaging 35 years of age had infec- t e d teeth. 5. Kammer extmined 10,000 men in rr

s t e e l plant. The most common type of defect among t h e o ld employees was dental impairment (42%)

Further evidence of the prevalence of dental defec ts in workcrs i s being developed by indus t r i a l physicians.

A subs tan t ia l and growing number of companies have es tab l i shed d e n t r l services as a fea ture of t h e i r rnedi- cal departmnts. But, i n the main, t o o l i t t l e i s bciry; done. The avercgc medical examination does not include x-rsys of t h e t e e t h , which is t h e only wry a r e a l diagnosis o r progno- sis con be made. And the nverage follow-up is more desul tory than in- sistent.

*Abstract f rom an a r t i c l e i n Indus- - t r ia l Hedicine, 11:157-162 (April , -19421.

**Dental consultant , Chicago, St. Paul , and Pac i f ic Railroad.

#

The r e l a t i o n of oral sepsis t o d i s - ease conditions throughout the body is t o o w e l l h o v n t o medical men t o be more than menhioned here. It is s o well hmovm t h a t , i n EL manner of