TRENDS IN DENTAL PUBLIC HEALTH IN THE UNITED STATES AND CANADA

Abstract

DENTAL public health programs-if they Li are to have any meaning-must be a forceful expression of the interests and the needs of people. They cannot be planned, talked about, or judged apart from the social, intellectual, and economic context in which they exist. Over the last 15 or 20 years that context has been vastly altered. As a result, both the scope and content of dental programs also have changed. .The most important of the broader social trends influencing the dental and public h-ealth professions in both the United States and Canada is, witlhout question, the gradual acceptance of increasing responsibility on the part of government for the health and welfare of its citizens. Evidence of this social movement, which has found expression in a series of legislative proposals and actions, can be seen most clearly in Canada, particularly in its western Provinces. There social legislation affecting health services has been broadened rapidly during the last decade. The Hospital Insurance Act and the Saskatchewan Medical Care Insurance Act are the best known examples. In both countries the influence of community forces on the health professions is increasing steadily. Nothing which has happened in the last 30 years is of greater significance or of more importance to dental public health. This iincreasing influence of community forces clearly means that the public views good health care as a right, not a privilege. It means that oni tllis continent neither the medical nor the dental profession can arbitrarily organize and control its practice without due respect for the wishes and the needs of the community. It means that, inevitably, there will be changes in tlhe methocls of organizing and delivering health services, including dental care. These changes in social philosophy have altered the role of the public health dentist as well as the attitudes of the dental profession toward that role. Where once the public health dentist was looked upon with some suspicion, now he is more likely to be seen by the dental profession as a friend and ally in a rapidly changing world. Thoughtful leaders within the profession realize that the trend toward more formal planning for social purposes is not a plot fabricated by the public health profession but a reflection of a basic change in the attitudes of the people. The public health dentist, with his understanding of professional problems and his competence in community affairs, can be a decisive influence in the development of healtlh programs which serve the best interests of both the public and the dental profession. That is exactly the role that today's public health dentists are trying to assume. Against this background of major change in society's attitude toward government and professional attitude about public health, I should like to review some specific trends in dental Dr. Galagan is chief, Division of Dental Public Health and Resources, Public Health Service. The paper was given as an address at the American Dental Association Pan American Conference on Dental Public Health held in Miami Beach, Fla., on October 27, 1962.