The History of the Department of Periodontology

[From the 1958-1959 Hya Yaka/Yearbook]

History of Department of Periodontology from 1909 to 1959

Since periodontal disease is of ancient lineage among "refined" people, Cleopatra may have been bothered by bleeding gums. Macbeth was probably plagued by periodontal disease and certain ladies of the court of Queen Elizabeth could remove lower incisors bound together by deposits of dental calculus.

Ancient remedies for periodontal disease were often a bit weird. In early Roman times, urine was considered a good remedy to strengthen the gums. Thus patrician ladies included on their dressing tables an onyx bottle containing the urine of an "innocent boy." It may be apropos that urea is a prominent constituent of present-day ammoniated dentifrices. However, in some areas, there has been real progress in the science and art of periodontology. The Department of Periodontology of this faculty has played a leading part in promoting that progress.

"About 1909 or 1910, he established the first chair for the exclusive teaching of periodontology found in any college in the world." That statement referred to Dr. A. J. McDonagh and to this department of which he was the first professor. The quotation is part of an eulogistic memorial editorial in the Journal of the Canadian Dental Association in the issue of March, 1942, one month after the death of Dr. McDonagh.

Dr. McDonagh was intensley devoted to promoting the welfare of mankind. In addition to his broad knowledge of periodontal disease, he had an Irish flair for oratory and debate. Thus he was a provocative and intresting teacher. The great respect in which he was held by other members of the staff allowed him to introduce a Department of Periodontology in the faculty even though none had existed in any school of dentistry before.

In the year 1900, some of the dentifrices sold to the public were obviously harmful to the teeth and most of the tooth brushes which were available were bulky, awkward tools. During 1901 and 1902, Dr. McDonagh organized a group of the leading dentists of the Toronto area to establish the Canadian Oral Prophylactic Association. They designed an excellent dentifrice and an excellent tooth brush. For more than thirty years the profits from the sale of these products were devoted to the support of dental research in this faculty and to the publication of reports arising from dental research projects. At this time, there was no other source of support for dental research.

In 1914, Dr. A. J. McDonagh and nineteen other dentists of this continent founded the American Acadmey of Periodontology. He was elected president of the Academy in 1920. During nearly thirty years he maintained a close contact with the rapid development of knowledge concerning periodontal disease. His teaching in this faculty was therefore always at the leading edge of progress.

Dr. H. K. Box, who succeeded Dr. McDonagh as Head of the Department of Periodontology in 1927, was a world leader in the development of knowledge of the histopathology of periodontal disease. Beginning as early as 1911, Dr. Box published a succession of papers describing the histopathology of periodontal disease. He was a main proponent of the teaching concerning the effects of traumatogenic occlusion on the periodontal tissues. Additional research projects related to the formation of dental calculus, the presence in the periodontal tissues of necrotic tracts, oxygen insufflation, necrotic gingivitis and new attachment of detached periodontal tissues,

Dr. Box was the first dentist to achieve a Ph.D. degree at the University of Toronto—in 1920. In 1921, he was the first person to be elected a Fellow of the American Academy of Periodontology. Many other honors were conferred upon him, including Fellowships in the Royal Society of Medicine and in the Royal Microscopical Society of England. The very wide knowledge which he amassed through his own studies and through his wide-spread contacts in the fields of science were the basis of his brilliant teaching in this faculty.

During Dr. Box's regime as head of the department, an almost continuous increase of lectures, demonstration clinics and clinical practice relating to periodontal disease was achieved. His zeal in searching for new knowledge stimulated his staff. Just a few days before his death on May 24th, 1956, he outlined wiht great enthusiasm new research studies which he was anxious to develop as a joint effort of the members of the department. During the earlier part of his teaching career Dr. Box had as staff Drs. W. G. Trelford, Chas. Sutton, Alvin Snell and R. M. Box. Nearly all of the present staff of the department were closely associated with Dr. Box during the later years of his work in this school.

The main purpose of the department at present is to stimulate research concerning the nature of periodontal disease and to train general practitioners of dentistry in the science and art of recognizing and controlling the disease. The value of the specialist in periodontics is considered to be mainly in the role of stimulating progress, particularly when they serve as teachers and research workers.

During the last few years, a particular effort of the department has been to gain the interest of the students early in the total course. As part of this effort, the Department of Periodontology was the first in the faculty to employ T.V. for the demonstration of clinical conditions. It was also first to present to the first and second years clinical cases as a preview introduction to clinical practice. This effort has had some measure of success. It is proposed to broaden its scope as an orientation to the applications of basic sciences in clinical practice. It is applications of basic sciences in clinical practice. It is hoped that the student of the future may find increased interest in the study of the basic sciences simply because he will be convinced that the sciences are applicable in practice,

POST-GRADUATE COURSES

For many years the Department of Periodontology has conducted two one-week refresher courses per year. These courses were very popular, particularly with our confreres from the United States who frequently constituted a majority of the registrants. This programme has been suspended during the past two years in order to provide more staff hours for undergraduate teaching. In the new building it is intended that several plans for refresher courses in periodontology will be available.

GRADUATE COURSES

In 1946-47, the Royal College of Dental Surgeons of Ontario made provision for the certification of specialists in periodontics. A course of training to allow graduates in dentistry to qualify as periodontists was then established in our department. Until 1955-56, the course required one academic year. At present the course is of two academic years duration.

Graduates may also take courses leading to the degrees of Bachelor of Science in Dentistry (B.Sc.(D)) or Master of Science in Dentistry (M.Sc.(D)) or Doctor of Philosophy (Ph.D.) in which the research project and the clinical practice portions of the course relate particularly to periodontal disease. In these courses clinical practice is a minor portion an dmain emphasis is on basic science courses and research projects. Since the greatest progress int he understanding and control of periodontal disease will be achieved by well-trained research workers and teachers, our department will encourage outstanding students to take the science courses.

DENTAL HYGIENISTS

Members of the staff of this department urged establishment of the course to train dental hygienists. We are convinced that well-trained auxiliary personnel will assist the dental profession to provide more and better service to the bublic of Canada. There is, in Ontario, an important and almost unique feature of the philosophy and definition concerning hygienists. They are being trained so that a dentist may assign to a hygienist a significant portion of the treatment programme for a patient who has periodontal disease. We honestly admit that their work will not be confined to scaling and polishing the crowns of the teeth.

Our department has been active in training final year dental students in team-work practice. They are encourage to assign to the dental hygienists portions of the treatment of their patients.

The present staff of the department is a team composed of Drs. W. G. McIntosh, H. J. Wildfong, J. E. Speck, D. L. Anderson, D. S. Moore, H. A. Hunter, A. M. Hunt, J. Sim and C. H. M. Williams. They represent an excellent balance of knowledge and ability in areas ranging between advanced pure research and the most refined phases of clinical practice. In quality, our staff is outstanding. We do need an increase of staff hours in proportion ot student hours—and this improvement is planned.

And now for the crystal ball department. We expect that periodontal therapy will become just as integral a portion of the general practice of dentistry as cavity preparation is now. To promote this attitude in the new building, instructors in the clinic will be general practitioners and periodontists will serve only as consultants.

The biological sciences will probably have increasingly important applications to the clinical practice of dentistry.

Research projects concerning the nature of periodontal disease will probably continue to increase in number and in scope.

Prevention of periodontal disease will probably require many years of exciting research and education.

[Dr. C. H. M. Williams]