WHAT DO YOU WANT?

From time t o time s ince I hove been an a s soc ia t e member of t h e A- merican bs soc ia t ion of Public Eealth Dent i s t s , t h e question has been brought up as t o who s h a l l be ac t ive members of t k e A.A.P.H.D. and who s h a l l be assoc ia te members. Some of t h e s t a t e dental d i r e c t o r s who are members of tho assoc ia t ion are very pos i t ive t h a t t he ac t ive membership should be l imi ted t o s t a t e denta l d i r ec to r s only, Before permanently adopting euch a pol icy of aeolusion and exclusion, why not review t h e pas t , present, and futuro of t h e dental hea l th movement?

The w r i t e r has been a municipal dental d i r e c t o r only s ince 1933, and a t t h a t time the s t a t e d i r ec to r s were in a minority. m e n the Socia l Secur i ty program was es tab l i shed and most of' the present s t a t e dental di- r ec to r pos i t ions were created, t he re were many good municipal denta l pro- grams a l ready i n operation4 The U,S, Publio Health Servi.ce had i t s con- s u l t i n g serv ice , but t h a t was only s k e l e t a l i n nature a t t h a t time, Consequently, the new s t a t e direc- t o r s sought a l l t h e dental hea l th information on programs from a l l t h e sources they could f ind i n the coun- t r y ,

Tho i n t e r e s t i n g pnrt of t he early stewardship of these new s t a t e den- t a l d i r ec to r s was t h n t most of t h e i r de t a i l ed dentnl hea l th information on l o c a l programs had t o corn from the l o c a l a reas themselves4 Chances a r e t h n t many l o c a l d i r eo to r s l i k e myself reoeived many informational requests from t hese new s t a t e direc- tors, which were always gladly f u l - f i l l e d . The U.S4 Public Heal th Ser- v ice was always on hand for informa- t i o n i n e s t ab l i sh ing p o l i c i e s and administrative suggestions, but the

"proof of the pudding" i n any type of hetilth work l i e s i n the local community.

I n sunmine; up t h e situation, it seems t h a t t he i s o l a t i o n of any one group of den ta l h e a l t h personre1 without =king provision f o r regular oontact i n assembly meetings and 8-

q u a l i t y i n s o c i e t i e s only ac ts as a stymie for the good of t h e general movenent. The A , D A and the U,S, Public Health Service cont inua l ly send out l i t e r a t u r e c a m n d i n g t h e po l i cy of doing everything a t a lacar lovol. The denaely populated areas tire the proving grounds of t h e l o c a l level programs, and the only way i n which the s t a t e d i r e c t o r s and the U, S. Public Health Service people d i s - cover them i s through regular contact with these la rge loca l communities , The laws allow large c i t i e s t o s e t up independent hea l th units, and ne- c e s s i t y makes it mandatory t h a t lo - cal hea l th units be s e l f - s u f f i c i e n t i n many phases of t h e i r work,

In addi t ion , l o c a l hea l th people are usua l ly so busy wi th t h e i r own problems that t h e i r state and na- t i o n a l contacts a re l imi ted t o those o f necess i ty only. My experience i n the American Publio Henlth Associa- t i o n has been such thn.t t h e more s t a t e , na t iona l , and locnl denta l public h e a l t h people I have contact with, the b e t t e r able I a m t o go back and do A good Job in ny Iooal community4 This pr inc ip l e a l s o works i n reverse , because t h e s t a t e dental d i r e c t o r s cannot know all about lo - ca l programs unless t h e y come i n contcct r egu la r ly with the personnel doing the work. If s t a t e and f ede ra l men do not e n t e r t h e l o c a l communi- ties and seek information, chances are t hey w i l l nut ge t any of the in- formation unless t hey aomB in contact

August, 1946 - 204 WEAT DO YOU WANT?

with t h e l o c a l personnel a t conven- t i o n s and meetings,

In conclusion, I wish t o s t a t e t h a t t h i s d i s s e r t a t i o n is no t i n t h e na ture of a complaint agahnat any p d i c y . I t is an honest a t tempt t o eva lua te our dent31 h e s l t h movement. There must be unity of purpose, in- terchange of i deas , and honest-to- goodness elbow-rubbing t o achieve good programs and results i n any cause. If the k.A.P.H.3, chooses t o l i m i t a c t i v e membership t o s t a t e d i - r e c t o r s and U.S. Publ ia Heclth Ser- v i ce parsonnel only, t h a t i s t h e i r business and p rob lem However, such a c t i o n would au tomat i ca l ly l i m i t nc- t i v i t y t o t hose few workers and bo- come s e l f - l i m i t e d i n func t ion and scope. A t t h i s time my memory goes back t o t h e Gunn-Platt r epor t on Voluntary Heal th Agenaiss , which shows how independent 1 y , ex t rava g a d - ly , and i n e f f e c t i v e l y agencies can opera te unless s t r o n g coord ina t ion

is e s t a b l i s h e d and c a r r i e d out.

There i s n o t any n a t i o n a l nssocia- t i o n a t p r e s e n t which makes provi- sion f o r t h e ga the r ing t o g e t h e r of a l l the d e n t a l h e n l t h personnel cer- r y k g on programs i n t h e nat ion. The A.A.P.H.D. i s t h e only group of its kind a t present . If it f e e l s t ha t t h e o rgan iza t ion should remain i n i t s present oategory, t h e r e is no doubt t h a t ano the r den ta l s o c i e t y will s o m day s p r i n g up t o t a k e ca re of t h e balance of t h e d e n t a l pub l i c h e n l t h workers. If t h i s occurs , it w i l l be j u s t ano the r s o c i e t y w i t h a g r e a t dea l of d u p l i c a t i o n of effort and, consequent ly , less e f f iofency. The American Pub l i c Henl th kssoc ia- t i o n so lved t h i s problem some time ago and has been s t r o n g e r and b e t t e r organized e v e r s ince . Strange t o s a y , one can always learn something from another8

--L.A. Gerlach

THE EPI DEMI OLOGY OF "QWZSTI OED1 I RE k LLERGY"

My own p e c u l i a r r e a c t i o n , when I was a s ta te den ta l d i r e c t o r , t o t h e unending barrage of quo s t ionna i r e s which wns f i r e d a t me, cnused me t o suspec t t h a t eve.ntually I might be- corn a l l e r g i c t o them, w i t h n r e su l - t a n t v i b l e n t r e a c t i o n t o subsequent exposuresc Fortunately ( o r unfortu- n a t e l y ) , I changed ol imates before I beoame h igh ly s e n s i t i z e d , and I have s i n c e enjoyed a p a r t i a l , acqui red immunity t o ques t ionnai res ,

A more r ecen t experience , however, has convinced me t h a t most pub l i c

h e a l t h d e n t i s t s have con t rhc ted ques t ionnai re a l l e rgy" and t h a t

some ere prone t o t h e v i o l e n t ?em- t i o n s which I suspec ted might occur a f t e r prolonged exposure, I t so hap- pened, i n connect ion w i t h a paper I m s w r i t i n g , t h a t I was on t h e d i s - pensing end of a ques t ionna i r e on d e n t a l t r ea tmen t i n pub l i c h e a l t h d e n t i s t r y , which I compiled and s e n t t o a l l the s t a t e and municipal den- tal d i r e c t o r s . The r e s u l t s , which could h a r d l y be c a l l e d explos ive , are shown i n t h e table on t h e fol- lowing page;

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