Dental Public Health
The Faculty of Dentistry at the University of Toronto, as the oldest and largest dental school in Canada, has had a profound impact on Canadian dental public health. Our alumni and faculty members have been involved as advocators, educators, practitioners, policymakers and decision-makers from the very beginning of organized dentistry to today. The book The Politics of Dental Care in Canada by Dr. Carlos Quiñonez, Associate Dean of Schulich Dental School, Western University, tells a more complete history of dental public health in Canada (1). This book provides details of the milestones, policies, key decisions and political influences that make dentistry in Canada what it is today.
Below is a very brief overview of how some of our community members have contributed to Dental Public Health in Canada over the years. Please note, this does not cover all the contributions of our community, just a few highlights.
An Act Respecting Dentistry, 1868
The movement to organize dentistry was initiated by a desire to improve dental public health. In 1867, when Canada passed its constitution, Canadian health providers took it as an opportunity to regulate themselves as professionals in the new country (2). Dentists, especially, saw an opportunity to distinguish themselves from barber surgeons (anyone who extracted teeth without training) at the time. There was a desire by some practitioners to organize the profession in a formal way with legislation that would regulate education, examinations, licensing and practice. The first milestone towards this goal was An Act Respecting Dentistry, passed as law on March 3, 1868 (2). In Ontario, full powers of regulating and licensing the profession were given to the Royal College of Dental Surgeons of Ontario. This became the first legislation in the world to grant self-regulations to dentists (3). Barnabas W. Day, L.S.D., M.D., was a driving force to achieve the passing of this law. In the years before this milestone, he put in many efforts in writing to other dentists, mailing letters to as many Ontario practitioners as possible, collecting signatures supporting the law to convince policymakers of the importance of this step, and creating the Ontario Dental Association (then called the Ontario Dental Society), which held its first meeting on July 2, 1867 (2).
Beginning of dental education in Ontario
In Ontario, there were several failed initiatives to create a private dental school that would oversee the education and preparation for licensing for dentists. Read more about the history of dental education in Ontario in the Dental Programs section of this exhibit. In 1875, the Royal College of Dental Surgeons (the former name of U of T’s dental school) was established by Dean James Wilmott, L.D.S.
The First Children’s Dental Hospital in Canada, 1883
An account of Dr. John C. G. Adams’ struggle and accomplishment in 1883 to establish the first children’s dental Hospital in North America was told by Dr. David Kenny and David Wencer’s History of Dentistry at SickKids (4).
Dr. Adams believed strongly in parental education on caring for children’s teeth. He often wrote about and spoke on educating parents on oral health techniques, to keep their children’s mouths healthy and instill good health practices as they became independent adults. In 2015, a plaque was erected at 57 Elm Street to commemorate Dr. Adams. View Dr. Adams' plaque here.
The Canadian Dental Association, 1902
As the profession grew, dentists across Canada wanted to organize at the national level. It was agreed that one member from each province should join an organization to discuss matters such as licensing, education, and practice. After many years of attempts, the first meeting of the Canadian Dental Assocation (C.D.A.) was held on September 16, 1902 in Montreal. The meeting was chaired by Dr. F. A. Stevenson, the first C.D.A. president. The first agenda item was a nation-wide qualification standard for the practice of dentistry which would be acceptable to all the licensing boards in each province. Another major item on the agenda was dental health for the public (2). The shaping of the C.D.A. was founded on the belief that standardization across the provinces would benefit dentistry and the public.
Canadian Oral Prophylactic Association (C.O.P.A.), 1906
Established in 1906, the Canadian Oral Prophylactic Association (C.O.P.A.) raised money, through sales of toothpaste and toothbrushes, to finance public education and dental research (2). Dr. Andrew J. McDonagh, a professor at U of T Dentistry, established C.O.P.A. with the intention to benefit the patients’ oral health by providing a safe toothpaste and an effective toothbrush. Dr. McDonagh is said to be the first professor of periodontology courses at the school (2). C.O.P.A. created the first safe toothpaste for the public, Hutax. The library has the original recipe for the Hutax toothpaste patented by C.O.P.A.
In 1914, Dr. McDonagh, with other leading American dentists, helped establish the American Academy of Periodontology (A.A.P.) (5). In addition to practicing in Toronto for many years, he was very active in Canadian and American organized dentistry and an inspiring teacher and researcher here at U of T Dentistry. Some of the positions he held through his career include: Chair of the Committee on Research and Nomenclature of the A.A.P.; President of the Toronto Dental Association; member of Senate at U of T; representative for dentists in the Ontario Cancer Committee of the Ontario Government; and honorary life member of the O.D.A., Toronto Academy of Dentistry. He was also the first President of the Canadian Section of the International Association of Dental Research (5).
The War Years/Military Dentistry
The importance of oral health was prominent in the recruitment of soldiers for World War One and World War Two, for which everyone had to have a dental screening before being enlisted to serve in the Canadian Forces. The establishment of the Canadian Dental Corps in 1914 was necessary to support troops abroad and the community back home. The work and data gathered by the Corps overseas led to those who came back producing evidence for the need of more studies on epidemiology in Canada (2), as they traced patterns of disease and trauma abroad. The shortage of dentists in Canada at the time was alarming, and this encouraged advocacy for dental public health funding as well as the expansion of dental schools in each province, including the expansion of the Toronto school.
Dental Nurses Program, 1919
Dental nurses would often speak to patients about oral hygiene and dental care techniques to maintain healthy brushing habits. The dental nurse would also train mothers to keep children’s mouths healthy. The role of dental auxiliaries in WWI, and their contribution to serving patients back home, while many dentists were serving abroad, was a catalyst in improving training for dental nurses (2). The Dean of the Faculty, Dr. Webster, recommended to the Ontario Board that a course for dental nurses should start in 1919 (2). The faculty established the first Dental Nursing Program in Canada in 1919 and it ran until 1961 (7). Enrollment in the program was limited to women (7). For more information on the U of T dental nursing program, see the Dental Programs section of this site.
Dental hygiene as a public health concern
The Canadian Dental Hygiene Council was incorporated by federal charter in 1924, and included oral health professionals and members of the public. Its goal was “to undertake such measures as may be necessary to prevent, reduce or assist in the control of dental disease, thus establishing a higher standard of public health” (2). The role of the dental hygienist was established to fill this need.
The role of dental hygienists versus dentists has been subject to much dispute throughout the history of dental public health. The Canadian Dental Association passed a resolution in 1966 establishing the Auxiliary Services Committee to define duties for the dental hygienist, so that the curriculum of the training program could be adjusted accordingly (8). Dental auxiliaries were able to provide much needed oral health services to underserved populations.
Dental services expansion
In 1932 to 1933, the Faculty of Dentistry organized the Johnston Dental Clinic for the Blind. This clinic was supported by the Canadian National Institute for the Blind. The Johnston Clinic serviced hundreds of visually impaired individuals at the time (9).
In 1932, in co-operation with the Department of Health of the City of Toronto, a central orthodontia clinic for school children was started. Dr. C. A. Corrigan was appointed by the Department of Health for half-time service to take charge of the clinic which was to be developed as a Preventive Orthodontia Service. This clinic supplied a much-needed dental service to children whose parents were unable to pay regular dental fees (9).
In 1933, a dental clinic was established at the request of the Academy of Dentistry of Toronto for Toronto citizens who needed social assistance, in order to provide better access to care for low-income families (9).
The First Dental Public Health Program in Canada, 1944
The faculty, as a constant advocator for dental public health, established the first Dental Public Health diploma (to be completed after the D.D.S.) in 1944. It was the first program of its kind in Canada. The goal of the program was to equip dentists with research opportunities to study epidemiology, and, just as important, to advocate to policymakers and decision-makers about the importance of oral health to overall health. The first 10 years of the program had ten graduates. The R.C.D.S.O. lists all graduates from the beginning of organized dentistry, and in the Members lists of the 1955-1956 issue, lists the following individuals as having completed both the D.D.S. and the Diploma of Dental Public Health (D.D.P.H.) (10):
George Kerner Clarke (D.D.S. 1935, D.D.P.H.),
Cecil Irwin Coburg (D.D.S. 1925, D.D.P.H.),
Frank Howard Compton (D.D.S. 1949, D.D.P.H.),
Ralph Aubrey Connor (D.D.S. 1933, D.D.P.H.),
Grainger, Robert Moore (D.D.S. 1943, D.D.P.H., M.Sc.D.),
Samuel Lee Honey (D.D.S. 1923, D.D.P.H.),
Arthur Murray Hunt (D.D.S. 1943, D.D.P.H.),
Kohli Frank Albert (D.D.S. 1928, D.D.P.H.),
Thomas Leslie Marsh (D.D.S. 1932, D.D.P.H.),
Glen Thompson Mitton (D.D.S. 1923, D.D.P.H.),
Ontario Society of Public Health Dentistry
The Ontario Dental Association created a committee on Dental Public Health shortly after its inception. This committee eventually became the Ontario Society of Public Health. The Committee had a regular section in the Ontario Dental Assocation journal that would discuss dental public health topics, such as children’s oral health, promotion of oral health to parents and adults, proper toothbrushing, and the responsibility of people to learn how to take care of their mouths (11).
Canadian Association of Public Health Dentistry/Association canadienne de la santé dentaire publique, 1966
The Canadian Society of Public Health Dentistry was established as a section of the Canadian Dental Association in 1966 (12). It was the goal of the society to “advance the art and science of Dental Public Health... and maintain and improve the dental health of the public” (12). They held their first meeting on May 17, 1967 at the Royal York Hotel in Toronto, in conjunction with the O.D.A./C.D.A. Centennial meeting (13). The first President was Dr. Ralph Aubrey Connor (D.D.S., 1933; D.D.P.H.), an alumnus of U of T Dentistry, who advocated for water fluoridation and dental care for all members of society. Before establishing the C.A.P.H.D., Dr. Connor was a member of the Canadian Public Health Association for many years.
In 1995, the society changed name to what it is known as today: the Canadian Association of Public Health Dentistry (14). Today, the C.A.P.H.D. is the “voice of dental public health in Canada and advocates on behalf of its members and the public to decision makers within government on dental public health matters” (14).
Dental Public Health Faculty Members
In the years following the creation of the Dental Public Health program at U of T Dentistry, its graduates and faculty have continued to contribute to the discussion of oral health policy at all levels of government, including federal. Here are just a few of the many faculty members who have contributed to the shaping of dental public health:
Dr. Donald Wayne Lewis
Dr. Donald W. Lewis (D.D.S. 1962; D.D.P.H. 1965) was professor of preventive dentistry at the Faculty for many years. Dr. Lewis was a leader in many research studies on water fluoridation, dental care coverage in Canada, knowledge assessment of dental practitioners on clinical practice guidelines, and many other areas of public health dentistry. A selection of his works can be viewed in PubMed. Dr. Lewis was internationally known as an advocator for studying knowledge gaps in practitioners and trying to reduce this gap in education. Upon his retirement in 1997, a scholarship was established in his honour for any graduate student in the Dental Public Health Program (15). He received the Award of Distinction from the C.D.A. in 1998 for his long career in public health dentistry.
Dr. James Leake
A graduate of U of T Dentistry (D.D.S. 1966, D.D.P.H. 1969, M.Sc.D. 1978), Dr. James Leake spent over 30 years dedicating his research to dental public health, specifically water fluoridation and access to care. Dr. Leake was a researcher and educator, and cared deeply about oral health care access for the most vulnerable members of society. During his career, he published over 70 peer-reviewed articles and reports that influenced oral health policy in Canada. His collection of statistics and data measuring oral health in Ontario was crucial in informing policy at the time and was a major contributor to the Community Dental Health Services Research Unit (C.D.H.S.R.U.) collection. He received an Award of Distinction from the faculty in 2018 (16). In 2001, Dr. Leake, with a small team of individuals, wrote a submission to the national Royal Commission on the Future of Health Care, led by Commissioner Roy Romanov. Dr. Leake advocated for the introduction of a chief dental officer for Canada and contributed to the questions designed for the dentistry component of the Canadian Health Measures Survey, delivered in 2007. He was instrumental in initiating the Healthy Smiles Ontario Program, which covers some dental care services for children 17 years of age or younger from low-income families (16).
Dr. David Locker
Dr. David Locker was a professor at the faculty from 1985 to 2010. Dr. Locker dedicated his career to dental public health, his contributions being many. He was interested in psychology and behavioural theories and how they applied to oral health. During his career, he published 5 books, 19 book chapters, and over 250 peer-reviewed journal articles. In 1991, he obtained funding from the Ontario Ministry of Health and Long-Term Care to establish the Community Dental Health Services Research Unit (C.D.H.S.R.U.) (17). The Unit’s goal was to measure the oral health related quality of life of children and adults by assessing population oral health and evaluating dental programs and interventions. The many reports published by this unit from 1991 to 2008 informed public policy at the provincial, federal and international levels, becoming a base for international standards for assessing outcomes of oral disorders in children (18). Upon his passing, he left a bequest for a scholarship to the University of Sheffield, his alma mater, for any student in the Masters of Dental Public Health who is eligible to apply (19). In addition, he left a bequest for the David Locker Doctoral Scholarship in Dental Public Health at the University of Toronto (20).
Our Dental Public Health Community Today
This year (2024-2025) marks the first year of the Canadian Dental Care Plan (C.D.C.P.) launched by the Government of Canada to make the cost of dental care more affordable for Canadians (21). Many U of T alumni are advocators for access to dental care. One of these is alumna Dr. Lynn Tomkins (D.D.S. 1984). Dr. Tomkins’ career spans four decades and includes some distinguished roles; she was the third woman to serve as O.D.A. president, and the second woman to hold the position of C.D.A. president (22). Under her leadership, the C.D.A. released a roadmap of how the historic federal funding (C.D.C.P.) should be implemented. Bridging the financial gap in dental care (23) makes clear recommendations to the government about what the goals of the programs should be (access to dental care), who should deliver the services (existing dental offices, supplemented by public clinics); the human resources requirements to ensure the programs run smoothly; and recommendations to ensure full reimbursement is provided to the patient and oral health provider (23). A study by our faculty members identified vulnerable populations who currently are ineligible for the Plan but could benefit from coverage (24).
In 2024, Dr. Ganss and Dr. Singhal received a $75,000 grant from Cannaught to study molar hypomineralisation (MH), also known as “chalky teeth”. The study, called the Chalky Teeth Check-Durham, is the first of its kind in Canada and will entail screening about 5,000 students, from junior kindergarten, grade 2 and grade 7 in the Durham public school system as part of an ongoing dental health screening program (25). Results will be used to inform diagnosis and treatment, but also inform education and outreach initiatives (25). This study was modelled after a national public health initiative in New Zealand by The 3D Group and its partners (25).
The Dental Public Health team at U of T Dentistry continues to find ways to support patients who experience barriers to oral health. There are many initiatives to support patients, one of which is One Smile Research Program. Operated through the Green Shield Clinic, it is made up of different research studies aimed at improving access to dental care in Canada. Patients will receive cost-free basic dental care over the course of five years. At the same time, a diverse group of researchers at the University of Toronto will study the long-term effect of having regular dental care on oral health, stress, inflammation, wellness and chronic disease – as well as the impact on the economy and health care system (26).
Other notable recent studies from our faculty include work on dental antimicrobial resistance (27, 28) and the oral health of Canadian First Nations (29). Dr. Herenia Lawrence has researched and written on the oral health of Canada’s First Nations and community partnerships to improve oral health.