By Charles B. Millstein, DMD, MPH, ALM

Background

After ten years as dean of Tufts Dental School, Cyril David Marshall-Day resigned in 1959. He was succeeded by another University of Rochester School of Medicine and Dentistry man, John W. Hein, the first Tufts graduate with both a dental degree (D.44) and a Ph.D. to become dean of his alma mater.

Hein had been a successful administrator and scientist at Rochester and had helped establish a dental research component at the new Colgate Palmolive laboratories in Northern, New Jersey (1). As dean at Tufts, he was faced with decreased enrollment, declining test scores of prospective students, alumni indifference, and a decrease in research activity.

During his short tenure, there was an increase in full-time faculty from 20 to 32 and the Department of Social Dentistry (1960-1961), the first of its kind in the nation, was established. Even though Hein succeeded in cutting the deficit in half, Tufts President Nils Wessell expressed doubts about the school’s future.

With the departure of John B. MacDonald, director of the Forsyth Dental Infirmary for Children, Hein, a Forsyth trustee, accepted the offer to become its new director. For him, it meant a chance to realize his dreams in administration and research without the many time constraints inherent in running a dental school. J. Murray Gavel (d.23), professor of operative dentistry and life-long supporter of Tufts, served as acting dean during the 1962-1963 academic year (2).

Dean Calisti

Louis J.P. Calisti, a faculty member since 1956, accepted the deanship in 1963. he was a graduate of the University of Pennsylvania Dental School and had earned an M.P.H degree from Harvard’s School of Public Health. He introduced modern dental public health concepts at the school and displayed a facility for acquiring federal grants in a time of government largess, which had created the Department of Social Dentistry while Hein was still dean (3).

As a dentist trained in public health, Calisti realized that the unmet needs of dental care could be met by devolving a trained cadre of dental assistants using the novel four-handed dentistry concept. With federal funding, he set out to establish dental auxiliary utilization (DAU) at Tufts.

In a location adjacent to the dental school, he created space for his project at no cost to the school. He recruited dentists from outside the facility to supervise the 10-chair clinic that utilized five trained dental assistants, a clinic manager, and a laboratory technician. Fourth year dental students enjoyed their first encounter with modern dental practice during each student’s rotation through the model clinic.

With grant money from the Manpower Development Training Act, Calisti supplied training for persons interested in becoming paradental professionals. In 1963, he met with staff from Northeaster University in Boston, and the Tufts-Northeastern Dental Assistants Program was created. Judy Harvey managed the program that included didactic work at Northeastern and clinical training at the Department of Social Dentistry. During the20 years that it remained in operation, the DAU program graduated 1,500 trained assistants.

Calisti realized the possibilities of matching government monies to complementary funds to complementary funds that might be raised by alumni or other donors for a new home for the dental school. During almost a decade of planning Calisti oversaw the rebuilding and streamlining of the outdated clinical facilities at 136 Harrison Avenue. This resulted in a smaller but more efficient clinic open for a longer period thereby increasing the clinic’s income (4).

As early as 1964, proposals were put forth for a new dental clinic building. The idea grew in scope and became the dental health science building. This was the first of three projected phases of a capital gifts campaign for the entire Tufts New England Medical Center (TNEMC).

Under the Profession’s Teaching Facilities Act, Tufts dental school received half of the projected $15 million. In the spring of 1970, the project was ready for construction bids. Although the original plan envisioned a 12-story structure, financial constraint limited it to 8 floors at a cost of $15 million of which the government contributed nearly $6 million.

The new building was designed by Architects Collaborative of Cambridge and built by the Barr and Barr Construction Company. It is contiguous to the Samuel Proger Health Services Building of the NEMC, and both buildings were dedicated in 1973. Dental Medicine and general medicine became philosophically and physically linked, for the betterment of each at the NEMC (5).

When Calisti became dean in 1964, he chose Donald Giddon, a graduate of Harvard’s dental school with a Ph.D. in psychology from Brandeis University, to pursue his pioneering work in social dentistry at Tufts. Giddon’s focus was on the dentist-patient environment including the doctor-patient relationship, and the dentist’s relationship to allied health professionals and institutions as well as the dentist’s responsibility to society. To achieve these goals, the department was enlarged to offer courses in social, psychlogical, legal, economic, historical, and political aspects of the practice of dentistry (6).

In addition to the DAU program already under way, the department offered a program to try to break the poverty cycle at the Columbia Point Housing Development in Boston. The project was a pioneer venture into community health set in motion by Tufts School of Medicine and was initially funded by federal money through the Office of Economic Opportunity (7).

In time, support for the Kennedy-Johnson war on poverty eroded as the focus of the nation shifted toward ending the war in Southeast Asia. As government funding shrank for the DAU and social dentistry programs, the dental school did not wish to make up the deficit even though the concept of trained dental assistants was a successful reality. In addition, women had started to rethink their roles as paraprofessionals and sought different work-related opportunities.

In 1967, Dean Hallowell succeeded Wessel as president of the university. The dental school became a national center for dental students protesting the Vietnam War. Student unrest was rampant throughout the nation and culminated with the Kent State altercation in 1970.

As a consequence of his successful role in the planning of the dental health science building and his role in the administration of the Tufts-New England Medical Center (T-NEMC), Calisti was selected to create a medical center at the University of Southern Maine. He left Tufts in June of 1971 and was succeeded by Dr. Robert Shira (8).

Dean Shira

Shira took command in December of 1971. In the intervening period, associate dean, Thomas W. Murnane (D.62), served as acting dean. Shira had an international reputation in oral surgery. He had severed as assistant surgeon general and chief o the United States Army Dental Corps. He had been chief of the dental service of the Walter Reed Army Medical Center (1954-1964), and after a career in the military that spanned 33 years, (9) he retired with the rank of major general.

Shira’s name had been suggested to Dr. Al Uhlmann, provost at Tufts, by Dr. Walter Guralnick, who had served as a member of the ADA’s Council of Dental Therapeutics that Shira had chaired. The general made a favorable impression with Uhlmann, chairman of the search committee, Dr. Lauro Cavazos, Dean Maloney of the medical school, and the vice-presidents for finance and development.

As dean, Shira began by receiving suggestions from the dental students. He set up a professional dress code for the clinics. He met with alumni and reestablished a working relationship with them.

This led to the establishment of the Millennium Club (“M”) whose members gave $1,000 yearly to Tufts. J. Murray Gavel, Milton Myers, and Everett Shapiro helped the club get started. In 1971, alumni gifts totaled $23,000; today it is approximately $450,000, nearly half the funds coming from the “M” club membership.

After conferring with Drs. Murnane, Darzenta, and Schwartz, Shira called Drs. Orrin Greenberg and Walter Brown out of retirement to help in the preclinical and restorative departments. The dean chose an old friend from Chicago, Dr. Maury Massler, to head the Department of Restorative Dentistry.

Massler was an experienced educator who spent most of his professional life with Dean Schour at the University of Illinois Dental School. Massler initiated teacher-training courses and brought in new educational methods to the department which soon began to function more smoothly.

A few years later, Massler left this position to pursue his passion for geriatric dentistry. Shira appointed a retired Navy dentist-Joseph Evans, as the new chairman of the department.

The part-time chairman of endodontics, Arthur Pearson, died in 1973. He had succeeded Bernard Berg who created the department of root canal therapy in 1940. Cyril Gaum acted as interim director until Shira appointed another Navy retiree, Joseph Tenca, as the first full-time head of the department.

During October 1972, Irving Glickman suddenly died. He had been a driving force in the world of periodontology as well as in clinical research and continuing education. Irving Stern, a well-respected periodontist from the University of Washington, became the next chairman. Because he retained his residency in the state of Washington, it became difficult for him to perform his tasks adequately.

After a short period, he returned to Washington and was replaced by Dr. Jerome Smulow, an early graduate of Glickman’s postgraduate periodontal course. Walter Donnenfeld, an experienced clinician and Glickman’s first postgraduate trainee, became head of postgraduate periodontics.

The head of pediatric dentistry, Dr. Frederick Shiere, as well as his associate, Dr. Helmi Fogels, were willing to relinquish their teaching responsibilities to assume administrative roles. Shira made Shiere associate dean of admissions and Fogels assistant dean of special projects.

Dr. George White was brought to head oral pediatrics in the early seventies. During these early years, Shira created the Department of oral health services that included social dentistry along with prevention and nutrition and public health.

During these years of transition, A. Albert Yurkstas remained in charge of the department of complete denture prosthesis. Nicholas Darzenta became chairman of oral radiology after John Barr Retired. H. Chris Doku became the new chief of oral surgery after Taylor left, and Edmund Cataldo replaced Gerald Shklar as chairman of the department of oral pathology. (Shklar had accepted an offer to reestablish a department of oral pathology at Harvard.) During Shira’s seven year deanship there was almost a complete turnover of the clinical departments, so that they were now run by full-time tenured staff (10).

On April 4, 1973, Shira and the dental community celebrated the official opening of the new Tufts dental health service building. That same year, the Samuel Proger Health Service building was dedicated. Tufts University School of Dental Medicine had a permanent home within a growing modern medical complex (11).

During Shira’s many years in the military, he had lectured on oral surgery at dental symposia throughout the nation. Throughout his travels he met and remembered many in the dental establishment and decided to accept the challenge of several members of the Massachusetts Dental Society who asked him to run for the presidency of the American Dental Association (the last person to hold this position was Dr. Philip Adams in 1959-1950).

Even though Shira was thought of as an educator, army man, and specialist, his campaign strategy succeeded, and he was chosen president-elect during 1974-1975 and president during 1975-1976. He continued as editor of the prestigious journal, Oral Surgery, Oral Pathology and Oral Medicine, and remained president of the American Board of Oral Surgery during 1974-75.

Another problem that Shira had to solve shortly after unofficially moving into One Kneeland Street was the education of the first three-year class that began in 1972 and the graduation of the last four-year class in 1975. To ease the problem of adequate space created by two classes (three year and four year) at the school, Shira and his staff created an extern program.

Each senior spent six weeks in dental facilities external to the school. These included community clinics, the state’s institutional facilities, and public health clinics in other states. It gave the graduating senior a more complete work experience, and the externship has been woven into the permanent clinical curriculum.

With the assistance of his faculty and dedicated alumni, Shira was able to facilitate the move from four-year curriculum to one encompassing three years. Ironically, the program that had been hailed as a solution to solve a shortage of dental practioners and was supported with financial incentives from the federal government led to a surplus of new dentists in an oversaturated marketplace (12).

As Shira completed his official duties as ADA president, Tufts University inaugurated a new president, Dr. Jean Mayer, in 1976. A world famous nutrionist and professor at the Harvard School of Public Health, Mayer brought a new vision of what the future of Tufts could be. It was to become a major force in teaching, research, and professional education.

Meyer was the architect who oversaw the metamorphosis of tufts from a well-regarded regional university to a world force in education. He implemented this with an international board of overseers appointed by the trustees of Tufts University.

Mayer set out to create a School of veterinary medicine. Shira’s associate dean, Thomas Murnane, became assistant to the president and was placed in charge of the project (13).

By the end of the decade, Shira had successfully completed his tasks and the university’s administration was ready to choose a new dean. Shira was named acting provost and acting vice-president of the university and, eventually, provost and senior vice-president. Today, he is assistant to the president of the university.

Dean Johansen

With the selection of Dr. Erling Johansen in 1979 as dean of Tufts, a 50-year cycle was completed. It began in 1930 with basil Bibby, one of a small class of postdoctoral students that began training in basic biological sciences at the University of Rochester School of Medicine and Dentistry. Bibby became dean at Tufts in 1941 and brought the concepts of biological research with him. With a doctorate degree in dentistry and bacteriology, he held a joint teaching appointment in the medical and dental schools.

Before he left to become director of the Eastman Dental Dispensary in Rochester in 1947, he left Joseph Volker, his protege, as dean. Two years later, Volker accepted the position as founding dean of the University of Alabama School of Dentistry at Birmingham. Cyril David Marshall-Day, another post-doctoral Rochester trainee, replaced Volker in 1949 and, after a decade, was replaced by the fourth Rochester man and first graduate from Tufts, Dr. John Hein, who remained dean until 1962 (14).

Dean Johansen’s unique background has helped make Tufts an international school of dental medicine. He received hi early education in hi native Norway and was one of 22 Norwegians chosen by their government and the Norwegian Dental School to attend Tufts immediately after World War II. This was part of his country’s effort to meet the urgent need for dentists caused by the closing of Norway’s schools of higher learning during the German occupation.

He graduated in 1949 with a class that included Drs. Yurksatas, Wilkins, Tillman, Quinn, Gallagher, Vetstein, and Kazis (15). Johansen chose to pursue a career in academic dental medicine and became a postdoctoral student at Rochester.

Hein completed his Ph.D. program at Rochester and became director of dental research until he took the position with the Colgate Palmolive Company. From 1955-1979, Johansen chaired the research program at Rochester and supervised the training of more dental researchers than anyone else in the country.

When the trustees of Tufts University chose him as their new leader, they chose a man of rare experience who had a broad international vision with a strong research orientation.

One of the major problems Johansen had to resolve was how to successfully phase out the three-year curriculum of 11 months a year to return the school to the traditional curriculum of 8 to 9 months a year.

Johansen worked with H. Chris Doku and a committee of other senior faculty members to make the necessary decisions to phase out the three year program by 1984. In response to the organized dentistry’s desire to decrease enrollment, they decreased the size of their incoming class from 156 to 128. At the same time, they kept the number of international students preparing for American Dental certification to 14 (16).
The dean was able to balance the operating budget by careful fiscal management and by acquiring more grant monies. Next, he sought funds to renovate and expand both clinical and research programs at the school. During his first three years the school acquired 30 to 40 needed operatories.

As part owner of the newly built Sackler building, the dental school, in conjunction with the medical and veterinary schools, acquired the use of both seminar and lecture rooms. Johansen has been the force behind renovation and enlargement of a number of clinical facilities in the department of orthodontics, pedodontics, and endodontics.

In research, his goal was to attain the high level of activity in significant clinical and experimental research for which Tufts was famous from the mid-forties under Bibby to the mid-sixties under Hein. Without state or federal assistance, money for renovation of older facilities and creation of newer ones had to come from capital fundraising. Friends and alumni who shared Tuft’s vision of expanded an intensified research have given generously.

At the present time, there are about 50 individual research projects in progress. Most of these are carried out by faculty members, but student involvement remains important in postgraduate specialty programs. Each year a number of summer research fellowships are awarded to dental students which, in cooperation with established investigators, enable them to pursue projects. This gives the students a basis for appreciation of the scientific foundation of our profession and may stimulate interest in an academic career.

Research brings revenues to a school through grants and contract. Its funds supplemented faculty salaries and reduce tuition. At present, Tufts received approximately $1.6 million in funded projects and hopes to increase this to $2 million before too long. By developing research alliances with other schools within the university and with other institutions, such as the Veteran’s Administration in Boston, Johansen foresees reaching this goal (17).

These are some of the tangible results of Johansen’s successful fundraising for dental research projects: the Harold Gelb Craniomandibular Pain Center (temporomandibular joint dysfunction); the Lawrence J. and Anne Cable Rubenstein Oral Health Clinic (specialized care to patients with serious medical conditions); the Herbert Margolis Clinical Research Laboratory (orthodontics); the Harold Berk Dental Health research Laboratory (pediatric dentistry); the Rudel Clinical research Laboratory (patient care); the Anthony L. Clark Oral and Maxillofacial Surgery Research Laboratory (lasers in dentistry, toxicology); the Dr. J. Murray Gavel Center for Restorative Dental Research (dental materials); the Maury Massler Geriatric Clinic; the Philip Williams Library (prosthodontics); the Everett Shapiro Library (orthodontics); a refurbished Irving Glickman Library (periodontics) and a dental museum.

With this newly created space and funding, Johansen has brought in a number of talented, young, well-trained research scientists who have increased the number of papers given by Tufts personnel at the yearly meeting of the International Association of Dental Research and other scientific conferences (18).

The dental school has expanded its international contribution to dental health. Fifteen percent of the students working toward their DMD degree, as well as 48 percent of those registered in postgraduate programs, hold visas from foreign countries. In addition, Tufts has a two-year curriculum that leads to a DMD degree for foreign-trained dentists wishing to acquire a U.S. degree. In continuing education, Tufts has been especially active in France (Talloires). This unique program features a didactic and clinical component and is conducted partly here and in France.

Foreign countries have requested advice and assistance in planning and development of dental educational programs. Under the sponsorship of the U.S. Treasury, Tufts is assisting in the establishment of a dental school at King Abdulaziz University in Jeddah, Saudi Arabia. Tufts’ faculty members were invited to visit Zaire to make recommendations to build a new educational system and to give advice on the country’s oral health problems.

With the United Nations’ sponsorship, the government of Guyana requested a three-person team from Tufts to study its oral health educational service program. These are areas of expertise often neglected in many countries that can only be supplied by trained dental personnel as part of Tufts’ vision of improved world health (19).

During the 12 years of Johansen’s leadership, Tufts has been fortunate in acquiring major gifts from alumni to upgrade facilities for social as well as educational activities. The dedication of the Becker Alumni Center in 1989 is a prime example of the beneficence. Through Becker’s generosity, the school has built a board room, a student living room, adjoining seminar room, and a photographic gallery.

A generous gift by the Loh family of Hong Kong provided necessary funding for improved facilities in the dean’s office reception are which have added immeasurably to the school’s social potential (20).

Another large financial gift came from a classmate of Becker’s class of 1934. Dr. Abraham I. Neidle and his wife bequeathed their $2 million to Tufts. With this money, the school has a greater ability to offer substantial assistance to financially needy students (21). Other funds provide low interest loans for the students while in school.

As the author of this article completed a guided tour of the new facilities created during Johansens’ deanship, he was reminded of the profession’s indebtedness so well verbalized by Hong Kong industrialist C.S. Loh when he addressed the dental school’s graduating class of 1987. “The Chinese have a saying of which, when translated, means ‘when you drink from a spring, always remember its origin’. I am sure you will all remember the debt that you owe to this school and that in the practice of you profession and in your everyday conduct, you will repay this debt many times over (22).”

References

1. Millstein, C.B. Research at Forsyth-1915-1990, MDS Jour, 39:75.

2. Miller, R.E. Light on the hill – A history of Tufts University since 1952. Cambridge, MA: Massachusetts Market Books, 1986, p. 364.

3. Interview with Ms. Judith Harvey, Forsyth Dental Center, Boston, MA, Apr. 3, 1990.

4. Interview with Dr. Louis Calisti, Forsyth Dental Center, Boston, MA, Apr. 3, 1990.

5. Miller, pp. 365-67

6. Deranian, H. Martin and Shklar, Gerald, Tufts centennial issue, Bull. of Dent. 18
(June 1970): 26.

7. Miller, p. 354

8. Interview with Calisti

9. Miller, p. 368

10. Interview with Dr. Robert Shira, Tufts Univeristy School of Dental Medicine,
Boston, MA, Apr. 2, 1990.

11. Miller, p. 366.

12. Interview with Shira.

13. Miller, pp. VII-VIII.

14. Millstien, C.B. The coming of age of dental biological research and those who led the way. Bull. Hist of DENT. 34 (Apr. 1986): 42.

15. All around the world, a class marks its renunion. Den. Rec., Winter 1990:7.

16. Fourteen graduate from international program. Dent. Rec., Fall 1989, 12-13

17. A leader in dental research. Den. REc., Winter 1989, 2.

18. Dedicated to research excellence. Dent. Rec., Winter 1989, 1,6.

19. Zaire asks dental school for assistance – Tufts dentists share expertise. Den. Rec.,
Winter 1990, 18-19.

20. Alumni center exceeds expectations. Dent. Rec., Fall 1989, 1.

21. Dr. Abraham Neidle, D 34, gives generously to scholarship fund. Dent. Rec.,
Winter 1990, 8.

22. C.S. Loh is honored through a gift to the school. Den. Rec.,b Winter 1990, 8.