The form and Substance of a Hospital Dental Program

Abstract

In recent years, we have witnessed the gradual erosion of the attitude that dental services in hospitals are elective. This change in position is not due to any new sensitivity on the part of the physician; our medical colleague continues to be only vaguely aware of the oral cavity. Nor has this turnabout been the result of some awak­ ening on the part of the hospital administrator, who readily acknowledges the importance of dental services but is obliged to concentrate his resources in programs of higher priority. The growth of hospital dental services has been the direct result of an overwhelming demand for complex oral health care and of the inability of the dental establishment to provide a suitable response. This is not true just for the ghetto, where the hospital represents the only health resource. In the suburban community, the afflu­ ent patient also is turning to the hospital for spe­ cial dental services that can be provided best in the safe, protective, and sophisticated hospital environment. Another factor has contributed to the growth of dentistry in hospitals. It is a phenomenon that often provides the initial stimulus for the or­ ganization of a formal dental service in the small hospital. For the individual dentist, it represents the most frequently expressed motivation for hospital staff membership. That factor is lone­ liness. Rene Dubos has observed that “ men seek contact with other living things.” To para­ phrase this: dentists seek contact with other dentists. It is part of the essential nature of pro­ fessional life to mingle with colleagues, to share experiences, to exchange ideas, to challenge, to criticize, and occasionally, to emulate. The den­ tist in the community, struggling to escape the restrictive environment of the private office, has turned to the hospital to gain an intellectual outlet. Ironically, the dental schools have been slow to recognize the rewards of hospital expo­ sure for predoctoral students and, with certain notable exceptions, have made only token ges­ tures in this direction. Nevertheless, it is clear that dentistry is on the move in hospitals—fa­ cilities are being constructed, the number of in­ ternships and residencies is increasing, and the rate of growth is accelerating.