Dental Research History of the Faculty of Dentistry

Introduction

The Faculty of Dentistry at the University of Toronto (U of T) was established in 1875. The history of its research is unique in Canada, as the oldest and largest dental school. An Act Respecting Dentistry was passed in 1868, which encouraged the profession to become standardized and distance itself from barber surgeons. Some years later, in 1875, a formal school was established in Ontario: the Royal College of Dental Surgeons (R.C.D.S.), whose focus was to turn dentistry into a regulated, licensed health profession.  

Below is a very brief overview of how some of our members have contributed to Dental Research in Canada over the years. Please note, this does not cover all the contributions of our community, just a few highlights.  

It is difficult to trace the very beginning of dental research in Canada, but the first landmark, as noted by Dr. Gullett in his book A History of Dentistry in Canada, is the awarding of the first Ph.D. in dentistry at U of T in 1920. It was received by Dr. Harold Keith Box in periodontal pathology (1).  

Dr. Box graduated from the R.C.D.S. in 1914, and shortly after became part of the teaching staff, first in pathology and then in periodontology (1). In addition, he was editor of the Bulletin of the Canadian Dental Research Foundation for twelve years (1). Find Dr. Box's thesis here.

Before Dr. Box achieved his Ph.D., there were others that paved the way for dental research in Toronto and Canada.

In 1906, Dr. Harold Clark, a well-respected dentist in Toronto for nearly 50 years, delivered a paper to the Ontario Dental Society about dentifrices and toothbrushes on the market at the time, and how they were doing more harm than good to patients (1). In the audience of this talk was U of T Dentistry lecturer, Dr. Andrew J. McDonagh (D.D.S. 1887). He became very interested in this topic, and within the year, he pulled together a group of dentists to establish the Canadian Oral Prophylactic Association (C.O.P.A.) (1). C.O.P.A. was to investigate dentifrices that would work to cleanse the teeth but not cause harm to the user (1). Dr. McDonagh was a lecturer at the R.C.D.S. for years, and was the first in Canada to lecture on pyorrhea alveolaris and the tissues surrounding the teeth (1). C.O.P.A. included many members of the U of T school, who together created the product called "Hutax" in the early 1940s (from Greek words meaning health and mouth), which was to be used in cleansing the teeth without harm (1). Dr. Andrew J. McDonagh travelled to the U.S. and was part of a group who established the American Academy of Periodontology in 1914. This group was lead by two women dentists, Drs. Gillette Hayden and Grace Roger Spalding (2).

World War I: 1915-1919

In 1904, W. T. Hackett of Oakville, Ontario was the first dentist to join the armed forces with the official designation of Dental Surgeon (1). At first, dental surgeons did not have a very big role in militia. However, by 1915 requests came from England to establish dental units at every base hospital (1). Thus the demand for dentists increased dramatically. McGill University was the first to offer a medical unit (including dentistry) for overseas service (1). The first military dental clinic in Canada was opened in March 1915 at the Canadian National Exhibition grounds in Toronto, and a separate Dental Corps was appointed with J. Alex Armstrong as Director of Dental Services shortly afterwards (1). On June 24, 1915, the first contingent left for England, composed of 151 men. Fifty-three of these men were graduated dentists while the rest were undergraduate dental students and men with experience in dental laboratories (1). It is important to note that other dentists not part of the Dental Corps also served in the war (1). While serving, the men and women in the Dental Corps collected data and noticed that more research was necessary to advance the profession — but even more importantly, dental education needed to have a research focus to attract funds for that necessary research.

After World War I (1920-1939)

In 1920, another important development for dental research occurred: the Canadian Dental Association, recognizing advances in the discipline and the lack of research resources at schools to attract researchers, formed the Canadian Dental Research Foundation. This foundation, led by U of T Dentistry Dean Wallace Seccombe and a board with a representative from each province, established a fund in honour and recognition of the service and sacrifice of Canadian dentists during the war (1). They also published a research bulletin for about 20 years, which was edited by Dr. Box, among others.

The Canadian Dental Research Foundation bulletins were foundational papers written by many leaders in Canadian dental research, such as Dr. Roy G. Ellis, Dr. Cummer, Dr. Box and Dr. G. R. Anderson, in orthodontics, periodontics, prosthodontics, public health and policy. As an example, find the Canadian Dental Reserach Foundation bulletin on periodontal pathology here.

Dental education was changing after the First World War. The curriculum needed to be changed from a simply technical one, to one with a balance between biomedical and clinical research. In 1926, the American Association of Dental Schools, which consisted of representatives from all dental schools in the U.S. and Canada, created a curriculum survey committee sponsored by the Carnegie Foundation (1). The resulting 1935 report on a course of study in dentistry set the minimum standards for all dental schools, which included a robust curriculum of dental research.

In the early 1920s, there was a theory for disease that became dominant – that bacteria could collect in one area of the body and, if left untreated, would spread through the circulation system (1, 3). This prompted infection in the mouth to get more attention from the medical profession. At this time, many medical professionals were prescribing extraction of non-vital teeth to prevent infection, and thus, many sound teeth were pulled (1). The development of x-ray and root restorations become essential during this time.

The development of research programs in the schools was accompanied by continued advocacy for dental hygiene for the public to prevent oral diseases. The Canadian Dental Hygiene Council was formed in 1924, as an offshoot of the C.O.P.A. This council was responsible for a campaign to educate and advocate for dental public health (1).

In 1925, under the leadership of Dean Wallace Seccombe (D.D.S. 1900; Dean of U of T Dentistry 1923-1936), the school became part of the University of Toronto. In 1927 it established the Bachelor of Science in Dentistry and the Master of Science in Dentistry to encourage dental research (1). During this time, Dr. Seccombe researched and published in topics of dental public health and preventive dentistry (1). Find Dr. Seccombe's papers here.

Dr. W. E. Cummer, a graduate of the R.C.D.S.O. dental school, published on prosthetic dentistry and introduced engineering principles to the speciality at the Toronto school (1). Dr. Cummer graduated in 1902, was appointed professor in 1907, and became Dean of the dental school in Detroit from 1931 to 1938 (1). Find Dr. Cummer's articles here.

In 1932, the prestigious William Jarvie Fellowship for research was awarded to Dr. Albert Edward Webster by the State of New York (4).

By 1933, it was evident that a space for dental research was warranted, where faculty, staff and students could dedicate time away from the clinics to study the science of dentistry. The department of dental pathology, headed by Dr. Box, was thus created (5).

World War II (1940-1944)

Another war called for more enlistments and overseas service, leaving Canada with few dentists to take care of the population. Dentists in leadership positions in the associations and at the schools focused on dental insurance and how this impacted the philosophy of dentistry. Leaders did not want dentistry to become merely a profession to restore teeth, but one that would control dental diseases and prevent them (6). At this time, resources were scarce and output in terms of scientific articles from Canada was halted.

In 1943, the Department of Paedodontics was established by Dr. Stewart A. MacGregor (D.D.S. 1931) (7).

After World War II (1945-1949)

During the war, the dental schools saw a significant increase in enrollment to meet the heightened demand for dentists. After the war, enrollment dropped to a number that could more easily be sustained by the schools (1). In the U.S., dental specialists emerged, specializing in orthodontics, periodontics and oral surgery. Canada followed this trend by adding specialty training at the Faculty of Dentistry. The following individuals limited their practice to one specialty:

Oral surgery: Edgar W. Paul, Thomas Henderson

Periodontics: Andrew J. McDonagh

Orthodontics: George W. Grieve, Arthur Roberts

Pediatric dentistry courses, focusing on prevention of oral disease in children, began to be important in Canada as well. At U of T Dentistry, S. A. MacGregor was one of the first to teach courses on prevention of oral disease in children (1).

It was evident that support for research at the graduate level was necessary to meet the requirements of a graduate degree. Thus, the deans of the dental schools took leadership via the National Research Council of Canada (N.R.C.) and formed the Associate Committee on Dental Research in 1945, with the first meeting held on June 1 of that year (8). Find the first meeting minutes of the Associate Committee on Dental Research here.

A list of those present:  

Dean C. J. Mackenzie (N.R.C.) 

Dr. H. K. Box (U of T; D.D.S. 1914; Ph.D. 1920) 

Dr. E. Charron 

Dr. R. G. Ellis (D.D.S. 1929; B.Sc. 1930; M.Sc. 1942) 

Dr. M. H. Garvin (Manitoba) 

Dr. H. R. MacLean (Alberta) 

Dr. G. D. Stibbs 

Brig. F. M. Lott (D.D.S. 1923; M.Sc., Ph.D.) 

Col. D. S. Coons (D.D.S. 1923) 

Major W. J. Linghorne (D.D.S. 1923) 

Dr. E. F. Burton (Professor of Physics and Head of Department of McLennan Laboratory, U of T) 

Dr. J. B. Collip  

Dr. A. R. Gordon (Professor of Chemistry and Head of Department, U of T) 

Dr. O. W. Ellis 

W/C J. W. K. Ferguson (Associate Professor of Pharmacy and Pharmacology, U of T) 

Dr. D. Mainland 

Dr. D. L. Thomson 

S/Capt. C. H. Best (Professor of Physiology, Director and Professor in the Banting and Best Medical Research Department, U of T) 

Mr. S. P. Eagleton (Secretary) 

In 1946, Dr. Ellis was appointed Chairman of the Dental Section of the National Research Council (9). The research projects that were successfully awarded funds in the first few meetings included studies on prosthodontic resins and plastics (U.S./Canada), water fluoridation, nitrous oxide studies, and tooth movement and associated tissues. The committee would place a call for applications, review the applications and award funds for the projects to be carried out.

The National Institute of Dental Research was established in the United States in 1948 as a need grew for consistency in teaching and research throughout the dental schools, as well as in reinforcing accreditation standards of the time (9). Funding for research projects was an important component for attracting interested researchers and improving evidence.

Still, funding remained hard to come by. The Faculty Newsletter, a publication distributed to all staff, listed the following sources for funding for dental research in 1947 (10):

Associate Committee for Dental Reseach, National Research Council

Advisory Committee for Scientific Research, U of T

Research Committee, Faculty of Dentistry, U of T

1952

The faculty expanded the research section and formally established the Division of Dental Research. This was accompanied by funds from U of T to renovate the 5th floor into a modern space with laboratories. They also received funding from the O’Keefe Foundation and the W. E. Mason Foundation for the purchase of lab equipment and instruments (11).

1953

The faculty began to ask for donations from the dental community to fund research projects. The response was great. They were able to pledge $300,000 as an objective. Contributions were also made by 100% of the student body (12). The Burlington Orthodontic Research Study was launched during this time. This was part of a larger study led by Dr. Robert Moyers, Chairman of the Department of Orthodontics and Dr. Margaret Hutton, a Ph.D. in Human Genetics (13). The study was done in Burlington, and the leading orthodontist was Dr. Frank Popovich (D.D.S. 1951, Diploma in Orthodontics 1953) (13). Dr. Popovich and a team of orthodontists and other health professionals gathered data on growth and development from 1,380 children and 312 parents from 1952 to 1971. Dr. Moyers left the faculty in 1953, and other faculty members who helped lead the study were Drs. Harvey Jenkins, Egil Harvold, and Donald Woodside (13). Other orthodontists who contributed to the data gathering were Wilf Feasby, Alan Fendman, Stuart Hunter, Bert Jarvis, Bruce Marrow, Lorne Scott, and many others (13). The findings contributed to the understanding of normal and abnormal growth, benefitting education and practice in dentistry and beyond (14).

1960s onwards

Dental research grew during this period to include more scientific studies on the dental specialities. As more literature was being produced in each specialty, programs tailored to the specialities started to grow. A list of dental programs at U of T and how they developed is available in the Dental Programs section of this exhibit.

The Faculty of Dentistry’s Staff Letter, which would inform all staff about research and other activities in the school, started to report on research projects that the faculty members were conducting, as well as their speaking engagements and publications.

In clinical practice, the roles of the Dental Assistants and Dental Hygienists became a topic of interest. Educational programs were shaped based on the roles of each oral health professional. Four-handed dentistry (the dentist working together with the dental assistant to make the dental visit easier on the patient) became common (15), as did considering the ergonomics of dentistry.

1961: The first Canadian conference on Dental Research was held at the Dental Building, University of Toronto, in October 1961. It was organized under the auspices of the Canadian Dental Research Foundation and the Canadian Dental Association. A total of twenty papers were submitted by research workers representing the six Canadian Dental Schools and the Royal Canadian Dental Corps (16). 

1966: Dr. K. J. Paynter was appointed to membership on the Public Health Research Advisory Committee of the Dominion Council on Health, the first dentist to serve in this capacity (17). 

1967: The faculty, lead by Dr. R. M. Grainger, received the first computer, an IBM 1130 II computer. It was purchased with funds from the Associate Committee on Dental Research of the N.R.C., and was thought to be the largest computer anywhere devoted completely to dental research problems (18). 

1971: Dr. Dennis Smith, together with researchers from dentistry, medicine, chemistry and engineering, formed the Canadian Biomaterials Society. This is the first national society focusing on biomaterials and bioengineering (19).

1974: The Health Disciplines Act was passed on July 1974. This act was concerned with dentistry, medicine, nursing, optometry, and pharmacy. It ensured that residents’ rights were protected and that each discipline had its own council with four committees: executive, registration, complaint and discipline. These councils would ensure fair treatment of residents in each discipline (20). 

1975: The U of T Dental Faculty celebrated 100 years of dental education. Celebrations of its history and events were planned and enjoyed by all. At this time, dentistry continued to seek funding for both clinical and basic science research. There were many changes to the research conducted at the school.  

1978: A booklet by Dean Gordon Nikiforuk was published, summarizing all the dental research and major education changes from 1970 to 1976. Among these was listed the establishment of dental departments in the Toronto Teaching Hospitals, thus creating a partnership with the faculty to provide undergraduate students in 3rd and 4th year experience in the Emergency Services department and with patients requiring complex treatment. Another note of interest from this booklet that impacts dental research is the reported value of research grants, $750,000 per year, which came from the federal government, the Department of National Health & Welfare, the Ontario government and private funding agencies. This funding supported the following research areas at the faculty, which ultimately were the foundation of future research units: Morphological Sciences, Plaque Biology, Neurophysiology, Periodontal Physiology, Materials Sciences, Growth and Development, and Delivery of Health Care (21).  

1982: In 1982, Dr. George Zarb introduced osseointegration in Canada. Dr. Zarb taught in the department of prosthodontics from 1966 to his retirement in 2004, 38 years (22). He was instrumental in the establishment of the Prosthodontics Speciality at U of T Dentistry. He served as head of prosthodontics department from 1971 to 2004, when he retired. In 1973, he was also co-founder of the Association of Prosthodontics of Canada (23) and served as its president. For his work in clinical prosthodontic research, he received the order of Canada in 2004 (24). He was a recipient of the Alpha Omega International Dental Society’s Achievement Medal Award in 2023 (25). 

1986: Dr. Dennis Smith became Director of the Institute of Biomaterials, Faculty of Dentistry from 1986 to 1992. His position firmed the Faculty of Dentistry’s seat at the discussion of biomaterials in the University of Toronto. The Faculty of Dentistry was an important, active collaborator in this multidisciplinary collaboration. You can find Dr. Smith's article "The Genesis and Evolution of Acrylic Bone Cement" here.

1989: Drs. Douglas A. Deporter (D.D.S. 1970, Diploma in Periodontics, Ph.D.), Robert M. Pilliar (B.A.Sc., Ph.D.), Philip Watson (D.D.S. 1967, M.Sc.D.), and M. Pharoah (D.D.S. 1975, M.Sc.) successfully begin the clinical trial of the ENDOPORE™ dental implant system on humans. This shorter implant system is more cost effective, less invasive, has a shorter healing period, and has greater resistance to torquing than the standards of practice (26). ENDOPORE™ received Health Canada approval in 1994 (27). 

1990: The Faculty of Dentistry published a brief summary of all the research that occurred at the faculty in a booklet simply called Faculty of Dentistry: Research. This booklet summarized the 8 research areas that were present at the faculty at this time: Biomaterials, Cancer, Caries/Saliva, Growth and Development/Gerodontology, Health Services/Health Education Research, Implantology, Pain Control/Neuromuscular Dysfunction, and Periodontal Health & Disease (21). In addition, it summarized the research projects of some of the faculty members active in these fields.  

The prominent role of the faculty in dental research in Canada and around the world was showcased in this booklet by the following statement: 

“The respect of peers for research contributions by our senior faculty is reflected in the election of a U of T researcher as President by the IADR membership at large, three times within the past 15 years! Faculty members have also served as Presidents of IADR groups in salivary research, cariology, dental materials, neuroscience, implantology and pulp biology” (21). 

1992: Dr. Robert Pilliar was named Director of the Centre for Biomaterials, Faculty of Dentistry until 1999, when it merged with other faculties to become the Institute of Biomaterials. 

1999: Institute of Biomaterials was established. Dr. Robert Pilliar, Director of the Centre for Biomaterials, Faculty of Dentistry was instrumental in the shaping of the Institute of Biomaterials and Biomedical Engineering (I.B.B.M.E.) Department. 

2016: Prof. John Davies, with a team of other Canadian researchers, published a paper demonstrating for the first time that stem cells can be used to deliver antibodies more effectively than administration of the antibodies themselves—and over longer periods of time (28). 

2017: Dr. Paul Santerre, chemical engineer, was the Associate Dean of Research in the Faculty of Dentistry from 2003 to 2008, and Director of the University of Toronto's Institute of Biomaterials and Biomedical Engineering (I.B.B.M.E.) from 2008-2013 (29). In 2017 he was awarded the Governor General’s Innovation Award for his creation of Endexo technology (30), a unique compound of surface-modifying macro molecules that are added to plastics during the manufacturing process of medical devices. The special coating helps reduce clotting when the devices are used to treat patients, reducing the risk of adverse reactions and potentially deadly complications. Now being used in commercialized products in Canada, the U.S. and Europe, Endexo is helping to improve treatment outcomes for thousands of patients (30).  

2018: The Faculty became the first dental school to create a link between research in fibrosis in the periodontium and in the kidney, lung, heart and skin. Our influential fibrosis research attracted more than $10 million in funding in one year solely to support this body of work (31).  

2018: Dr. Daniel Haas (Dean from 2012-2022) was the first Canadian to be awarded the International Federation of Dental Anaesthesiology Societies’ (I.F.D.A.S.) Horace Wells Award (32). This award goes to I.F.D.A.S. colleagues who contribute in an outstanding way to I.F.D.A.S. and/or to the field of dental anesthesiology. 

2019: The Faculty of Dentistry opened the Collaborative Advanced Microscopy Laboratories of Dentistry (CAMiLoD), an imaging facility available to researchers in the Toronto area. CAMiLoD uses atomic force microscopy, light and hard electron microscopy, confocal, sliding electron microscopy, epifluorescence microscopes, and wide field microscopy (34).  

See all Faculty of Dentistry Labs here.

2020: The Noma Action Group (N.A.G.) was formed by Dr. Daniel Haas and Dr. Joel Rosenbloom (35). N.A.G. is an organization that advocates for Noma, raises public awareness and educates healthcare professionals about the disease. Drs. Haas and Rosenbloom urged the Canadian Minister of Health to write a letter to the World Health Organization (W.H.O.), advocating for Noma to be added to the list of neglected tropical diseases (N.T.D.). A total of 32 countries followed Canada’s example and in December 2023, W.H.O. declared Noma an N.T.D. This changes the way Noma is viewed by healthcare professionals and increases the research funding and support for Noma worldwide (35).

2024: Dr. Ganss and Dr. Singhal receive $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 (37). Results will be used to inform diagnosis and treatment, but also inform education and outreach initiatives (37). This study was modelled after a national public health initiative in New Zealand by The 3D Group and its partners (37).  

2024: Dr. Chris McCullough received a 5-year C.I.H.R. grant for $750,000 to examine periodontitis and the destruction of periodontal tissue (36).