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Even in later years the American Dental Association has itself done little constructive educational work, but it has financially supported the Dental Educational Council and thus by proxy has done a great educational service.
2. NATIONAL ASSOCIATION OF DENTAL EXAMINERS
In 1883 the members of the licensing boards of several States formed the National Association of Dental Examiners. This later came to include the licensing boards of nearly every State. Its problems of licensure involve a consideration of education, and throughout its career it has shown a real interest in betterment of dental education. In 1891 it appointed a committee for conference with the National Association of Dental Faculties and frequently met in the same city as did that association, in order to facilitate adjudication of differences, for it early came into conflict with the schools, especially with those proprietary schools which graduated deficiently trained men.
3. THE NATIONAL ASSOCIATION OF DENTAL FACULTIES
In 1884 there were 23 dental schools in operation in the United States. Seven of the 30 that had been established had already succumbed.
On August 4, 1884, 10 of these 23 schools united in the establishment of the National Association of Dental Faculties. Of these 10 schools, 7 were independent and proprietary.
The National Association of Dental Faculties was a potent factor in dental education from its organization in 1884 until its fusion into the Association of American Dental Colleges in 1923. In these 40 years it did much, but it also failed to avail itself of the opportunities to do more. The accomplishments of its earlier history are more to its credit than those of its later years. Throughout its existence the independent schools dominated its policies. Some of them were, in name, affiliated with universities but in operation were proprietary. Initially, proprietary schools in the professions were necessary and served a real pioneer purpose at the time when dental education was ignored by most of the universities, but when in later years the independent schools have resisted advance in dental education they have become a hindrance.
The primary interest of the proprietary schools, with a few mitigating exceptions, has been to secure a large number of students. Since quality of graduates is nearly in inverse ratio to number of students, the improvement of quality has never been the primary object of proprietary schools.
In its initial year the National Association of Dental Faculties recommended an increase in entrance requirements to include the elements of a good English education, which, from later developments, was seen to mean less than the completion of the grammar school. It also recommended that the number of sessions be increased from two to three and that a graded curriculum be adopted to replace the repetitive curriculum, in which a student attended in his second year upon the same instruction that was given to newcomers and which he had attended the previous year.
None of these recommendations was enforced upon the members of the association, and their value was academic rather than regulatory, for more than a decade. Gradually this association made recommendations and finally regulations to govern its member schools, and with great travail moderate advances were made, but its ideals were so moderate that after some 20 years many of the schools controlled by universities withdrew from it, and left the independent schools with slight opposition in the association, with little contact with universities.
Too large a part of the time and effort of the association was taken with regulations about the transfer of students from one school to another, based on the theory that the student was an asset of the school in which he had enrolled, and with discussions about accepting students who did not meet the avowed entrance requirements.
For 25 years this association gave its attention to matters of administration rather than to problems of teaching. Its name was a misnomer. It was not an association of faculties, but an association of deans and owners, and it gradually became decadent as the broad functions of dental education were fulfilled by other agencies. Historically, it is important in the first half of its existence but can claim little credit for the advances in dental education that have taken place in the past 20 years.
4. AMERICAN INSTITUTE OF DENTAL TEACHERS
The policy of the National Association of Dental Faculties of ignoring all matters concerning pedagogy gave an invitation for formation of an association to consider such problems. In 1893, in connection with the Dental Congress at the Columbian Exposition in Chicago, 15 teachers, representing 11 dental schools, organized the National School of Dental Technics. The name was unfortunate. It was not a school, and it soon found that there were many other problems confronting dental teachers beside those in technics. In. 1898 its name was changed to the Institute of Dental Pedagogics, and in 1914 to the yet more descriptive name of American Institute of Dental Teachers.
This group of teachers gradually supplanted the National Association of Dental Faculties as the leading agency for the advance of dental teaching. It was purely advisory, tried to enforce no rules, and abjured the question of finding some excuse for accepting deficient students. Also, since it was an association of dental teachers, rather than an association of owners of dental schools, it had no property rights to protect. This association of teachers received the support of all the schools, including the university dental schools.
The consideration of teaching problems for the period from 1893 to 1908 was entirely taken over by the Institute of Dental Pedagogics, where, from year to year, appeared very creditable papers usually freely discussed. At first these were confined to the teaching of dental technology, but gradually the field was widened until, in later years, the discussion of the curriculum as a whole began to appear, and finally those administrative problems which affect instruction.
With the Institute of Dental Pedagogics, later known as the American Institute of Dental Teachers, lies nearly all, if not all, the credit for whatever concerted effort there was, up to 1908, to improve the quality of teaching in the dental schools.
5. DENTAL FACULTIES ASSOCIATION OF AMERICAN UNIVERSITIES
The university dental schools began to withdraw from the National Association of Dental Faculties about 1900. Following its decision in 1903 to keep preliminary requirements below high-school graduation, still more of the university dental schools withdrew from that association. By 1908 the number of such schools had become enough to warrant organized effort, and in Boston on July 31, 1908, representatives of 6 of the dental schools that were integral parts of universities launched the Dental Faculties Association of American Universities, which gradually increased its membership to 13 in 1923. This new association disavowed any effort at mandatory control by rules as to accepting students and devoted itself to the real educational problems influencing betterment of the instruction within the dental school. In this it supplemented the work of the Institute of Dental Pedagogics, but since its members were more nearly in sympathy than in the varied membership of the institute, this new association was able to agree upon a concrete program of educational advance; and freed from financial interests and largely from dental politics, its accomplishments, though not widely heralded, were very substantial. The stimulus to the striking progress made by dental education in the past 10 years is largely due to the Association of Dental Faculties of American Universities.
When the beneficent results of publicity of conditions regarding medical education came from the 1910 report on medical education by the Carnegie Foundation for the Advancement of Teaching, the university association of dental schools sought a similar survey and similar publicity regarding dental education by some outside agency. This was undertaken 10 years later.
6. THE DENTAL EDUCATIONAL COUNCIL OF AMERICA
The National Association of Dental Examiners had been formed in 1883, a year before the National Association of Dental Faculties. Its purpose was to approach uniformity of procedure in the determination of fitness to enter the practice of dentistry. Since each member of a State examining board is a public official, this association was supported by the power of the people as expressed through the statutes, and therefore had a status lacking in the voluntary association of schools.
Besides this association and the National Association of Dental Faculties, there was the more inclusive association of dental practitioners, which, existing since 1859, came to include in its membership the large majority of dentists of the country. It was, and is, the most powerful body in dentistry. Its attention was given to organization, to the problems connected with practice, and to advance in knowledge, technique, and methods in the various fields of dentistry. It later gave very definite help to the promotion of research. Somewhat incidentally it also gave attention to dental education through standing committees that furnished annual reports, often merely perfunctory, but sometimes with creditable recommendations.
There were thus three associations each interested in dental education from a different viewpoint; one, that of the schools, interested in the details of carrying on such education; another, that of the examiners, interested in the graduates produced by such education in so far as they could or could not, with safety to the public, be licensed to practice; and the third, that of the dental practitioners, as such interested in the capability of the men who were to become their professional colleagues and competitors.
For several years there had been suggestions of combined educational effort by those three groups, and as a result, at Old Point Comfort, Va., on August 3, 1909, two committees of five each, one from the National Association of Dental Examiners, the other from the National Association of Dental Faculties, organized the Dental Educational Council of America. They invited the National Dental Association also to appoint 5 representatives, these three groups to form a joint committee of 15.
The organization of this tripartite joint educational council marks the establishment of a powerful agency to advance dental education in this country. Potentially it was in position to bring early order out of the chaos in that field.
The council organized for its work into three committees. One of these was on legislation; another committee was that on curriculum, charged with preparing a model course of study. Not until eight years later did this committee publish its first suggested standard course of study, and this with no indication as to sequence of subjects. It has not yet taken up any really adequate study of the curriculum, which is a purely educational matter. In fact, the council has never seized the opportunities offered it to study and work out the questions relating to teaching and courses of instruction; that is, the constructive educational aspects apart from the administrative phases. The committee which proved to be most active was that on colleges, the duties of which were to make visits to the dental schools, to ascertain their equipment and the character of their work, including the enforcement of their avowed preliminary educational requirements. The initial program included the making of an early survey of all dental schools of the United States in order to get a comparative knowledge of what was done and upon this information to organize a suggestive standardization as to administration, facilities, and instruction. No idea of classification of schools appears in its earlier statements.
From the annual reports of the council to its parent bodies one can trace its activities. Initially there was an effort to learn something about the relative situation in the schools by questionnaires. This was but partially successful. In 1911 a definite attack was made upon the indifference in administrative enforcement of the preliminary entrance requirements, which had in 1910 been advanced nominally to high-school graduation. In 1912 this same effort was continued, but practically nothing had been done yet on curriculum or inspection of schools, and there appeared little interest in the council by a majority of its membership, only a few valiant members being responsible for keeping it alive.
In 1913 the council announced its purpose to inspect all the schools and then to classify them into grades A, B, C, following the plan adopted for medical schools.
The council was favorable to the extension of the dental course from three to four years. In 1911 an effort in the National Association of Dental Faculties to secure such an advance, to begin in 1912, was defeated, but the plan continued to gain adherents. Some of the university schools announced it as a definite program; and finally in 1915, after strenuous debate, the National Association of Dental Faculties adopted the four-year dental curriculum, to