Columbia Dental Medicine at 100 Years: People, Events, and Milestones that Define the School’s First Century

Thursday, February 2, 2017

By Martha T. Moore 

 

Thank Joseph Schroff and Sidney Kramer for signing up. The two men who enrolled as the first dental students at Columbia University in 1916 entered a fledgling program that would take nearly a decade to reach critical mass. Yet its essential philosophy—to be a dental school within the structure of a university—was already formally established. Like today’s 80 students in the class of 2020, the earliest dental students studied alongside medical students for their first classes. Unlike today, they had to trek from those basic science classes on West 59th Street to their clinical studies on East 34th Street, with a stop along the way to grab lunch at Horn & Hardart.

Thousands of students have graduated with Columbia dental degrees since Schroff and Kramer matriculated 100 years ago, and thousands of individual moments and decisions—by students, by faculty, in patient care, in the research lab, in the dean’s office—now make up the history of Columbia’s dental school. The College of Dental Medicine’s story is one of remarkable continuity: a commitment to educating dental students, to research, and to serving the community. To recognize the centennial anniversary of the College of Dental Medicine, the school’s magazine revisits—with the help of a new book authored by dean emeritus Allan J. Formicola—some of the critical moments, circumstances, individuals, and decisions that shaped the school and its students.

Alfred Owre: Prescient Yet Out of Step

When Alfred Owre arrived in 1927 to become Columbia’s dental school dean, he was an admired dentist and physician and a medical educator who had worked with William J. Gies on the landmark report that set the standards for training dentists within the broader context of medicine.

Six years later—having feuded with Gies, infuriated much of the dental profession, and alienated the Columbia faculty—Dr. Owre was forced out of his job.

Dr. Owre’s ideas on dental education and the structure of the dental profession are as relevant now as they were then—and no less controversial. The fight over his proposals for the dental school embodied the tensions inherent in viewing dentistry as an integral part of medicine and dental practitioners as independent professionals.

Born in Norway, Dr. Owre led the University of Minnesota’s dental school for more than 20 years before coming to Columbia. Tall and thin, an aesthete and passionate collector of cloisonné, over the course of his life Dr. Owre hiked thousands of miles, walking stick in hand. He stopped only for 10 minutes in each hour of walking, to rest and snack on the dark chocolate he carried, along with two toothbrushes and a pistol, in his knapsack.

His appointment as dean came shortly after the dental school had taken a leap forward. By 1920, the School of Dentistry of Columbia University, as it was then named, had absorbed two small start-up dental schools but still had only 20 students. A 1923 merger with the much-larger College of Dental and Oral Surgery allowed the Columbia program to reach critical mass. The merged school was renamed the School of Dental and Oral Surgery.

Dr. Owre’s first task was to move the dental school from its midtown location—in buildings that had been owned by the College of Dental and Oral Surgery—to the new Columbia-Presbyterian Medical Center in Washington Heights. The dental school and its 156 students moved into three floors in the Vanderbilt Clinic building, where it remains today. In 1929, Dr. Owre received an honorary doctorate from the university, one of the few dentists ever to be so honored. In 1930, he won a grant, worth nearly $1.5 million in today’s dollars, to study the causes of dental decay.

But then Dr. Owre opened the dental school’s new clinic in the Vanderbilt building on 168th Street. He said the clinic would serve middle-class patients unable to afford quality dental care. In the midst of the Depression, practicing dentists did not appreciate the competition—or the implication that patients were being forced to choose between unaffordably high fees or poor care.

 Dr. Owre also proposed that routine dental work be performed by technicians under the supervision of a dentist-physician acting largely as a stomatologist. This, Dr. Owre said, would make dental care more widely available and affordable at a time when there were too few dentists for the population.

Only too late did he add that this should be a gradual change in what he called the “medico-dental profession,” not a wholesale sacking of currently practicing dentists and dental students. Just two years into his appointment, wrote his biographer Netta Wilson, “the dentists of New York were coming to regard him as something of a fanatic.”

It didn’t help that Dr. Owre fired right back at his critics, calling members of one professional group “tradesmen and hucksters” and those who opposed him “the ignorant majority.” In the Red-fearing 1930s, he was an admirer of socialized medicine in general and the Soviet system in particular. When he died in 1935, two years after leaving his post under pressure, the dental school faculty memorialized his “prophetic attitude,” politely adding, “He walked ahead of his time, and therefore not always in step with his contemporaries.”

Has the College of Dental Medicine, as it is now named, caught up with its controversial dean? Columbia’s dental faculty practice, a modern version of Dr. Owre’s clinic, was inaugurated in the 1980s and expanded with new facilities in 2008. Dental therapists, similar to Dr. Owre’s technicians, are now allowed to practice in Maine, Minnesota, Vermont, and on tribal lands in Alaska. The innovation continues to be controversial and is opposed by the American Dental Association.

Dr. Owre would find the argument familiar. “He was prescient,” says former dean Ira Lamster, DDS, also a strong believer in integrating dentistry and medicine. “But they ran him out of town.”

Combined Medical and Dental Faculties

In 1945 Willard Rappleye, dean of the medical and dental schools, merged the dental faculty into the medical school. The move cost the dental school its accreditation from the American Dental Association and at least three faculty members, who resigned in protest.

Ironically, it was Alfred Owre’s forced departure that had brought the medical and dental schools closer together. Instead of replacing Dr. Owre, Columbia President Nicholas Murray Butler in 1934 simply gave Dr. Rappleye the additional title of dean of the School of Dental and Oral Surgery, with Dr. Arthur Rowe serving as associate dean for the dental school.

The subsequent merger of the two faculties set off a storm of objection from dental school alumni and split the faculty: Half voted for the merger, half against. The school’s loss of accreditation cost the graduates too: Some states refused to license Columbia graduates because their degrees were not from an accredited school. Faculty worried that Dr. Rappleye would favor the medical school over the dental school in financial matters and they noted that the dental school no longer controlled its own faculty appointment process.

The ADA felt a dental school should have a full-time dean. Columbia did not. “We aimed to train better dentists than before,” Dr. Rappleye said in 1945, when the state dental society asked the New York Regents to look into the merger of the two schools.

The ADA relented and reaccredited the dental school in 1951. Only after Dr. Rappleye’s retirement in 1958 did the School of Dental and Oral Surgery regain its independence, when university President Grayson Kirk elevated Gilbert Smith from associate dean to dean.

But the belief that dentistry and medicine are closely interrelated remains. Today, the very name of the dental school reflects it: In 2006, Dr. Lamster proposed the School of Dental and Oral Surgery become the College of Dental Medicine. “The old name was cute but sort of irrelevant,” Dr. Lamster says. The new name “reflected who and what we were. Dentists had to function in an inter-professional world.”

State Budget Crisis Transforms the Student Body

By the end of the 1980s, Columbia was very much a local school. To receive per-student funding from the state, the dental school had to enroll more than 70 percent of its students from within New York. First- and second-year students were worth $1,500 each; upperclassmen $2,500. State funds also subsidized the school’s dental clinic.

Enter Gov. Mario Cuomo and a multiyear state budget crisis. In a series of budget cuts, “capitation” funds and the dental clinic subsidies were slashed. Nearly 25 percent of the dental school’s revenue vanished. The dental school had to make painful cuts, including the layoff of part-time faculty members, and add evening and weekend hours to the teaching clinic to increase revenue.

To be sure, financial challenges have been more common than not in the school’s history, as any administrator will relate. “Every year, every month, every week,” says Dr. Lamster. In 1964, the ADA put the school’s accreditation on provisional status, which the New York Times, in a front-page story, indicated was due to inadequate financial support from the university. Columbia President Grayson Kirk admitted as much but said the university had no money to improve the dental school’s facilities.

But the state aid cuts of the early 1990s were different; they changed the makeup of the student body. Without a financial incentive to enroll mostly New York students, the dental school began to recruit nationwide. By 2006, 75 percent of the school’s dental students came from outside New York. The larger applicant pool has led to an increase in selectivity, resulting in students with higher test scores.

“It did make us stronger,” says Allan Formicola, DDS, dean emeritus, who led the dental school through the years of slashed public funding.

Between 1986 and 1993, seven private universities shut down their dental schools, in part due to the loss of state and federal aid. Columbia’s near-death experience also increased the university’s determination to make the dental school fiscally sound, Dr. Formicola says. “It made everybody realize: They wanted the dental school.”

Into the Neighborhoods: A Community Dental Program

Too many kids at I.S. 143 had toothaches. They sat outside principal Phyllis Williams’ office, in too much pain to sit in class and learn. And Washington Heights had few, if any, dental services for them.

That’s what Ms. Williams wrote to Dr. Formicola shortly after he became dean of the School of Dental and Oral Surgery in 1978. “It was one of those transformative letters,” Dr. Formicola says.

His reaction: “Of course we’ve got to do something. We needed not to lose sight of the fact that we were part of the community.”

The dental school’s response was a turning point: the beginning of community-oriented programs that have led CDM and its students to provide dental care for underserved children and elderly patients both in its neighborhood and overseas.

“If you want your students to understand the needs of the underserved, you have to get them out there,” Dr. Formicola says.

Community DentCare, an expansion of the school’s teaching clinic, was created to get dental students and dentistry into the community. In 1996, the first Community DentCare clinic opened in an 8-by-10-foot room at Principal Williams’ middle school.

The program now has six in-school clinics and is on its second mobile van, dedicated in 2009 by Alex Rodriguez, the Yankees slugger who was born in Washington Heights. Mr. Rodriguez provided funds for the new van from his foundation.

The idea of bringing dental care to children by putting clinics in schools can be traced to early in the school’s history when Frank Van Woert, chairman of the dental school from 1923 to 1926, tried to do the same thing. “He made a valiant fight for this project, and its lack of progress is not an indication of the time and energy he put into it,” the 1928 Columbia Dentor yearbook said in describing Dr. Van Woert.

Launching DentCare required no less “dogged determination,” Dr. Formicola says. “Where do you park a 36-foot van in Manhattan? And where do you get gas for it?”

The dental school already had a history of focusing on under-served patients. As early as 1951, the school established a post-doctoral program in care of those who were then referred to as “handicapped.” A program to care for patients with intellectual and physical disabilities began in 1974.

But Community DentCare took dental care to patients, not the reverse. And it led to further efforts: In 2004, the dental college launched ElderSmile, a prevention and treatment program with two community clinics, further expanding opportunities for dental students to work outside the campus.

“DentCare focused on our commitment to the underserved and vulnerable populations,” says Dr. Lamster, who was dean when ElderSmile launched. “We built on it.”

That in turn has led to the realization that the university’s mission is now a global one. For the past decade, international programs have brought new perspectives to dental students and faculty. In 2005, the dental school signed a research and education partnership with Osaka Dental University in Japan, the first of at least 10 agreements that have enabled Columbia students and faculty to teach, study, and observe abroad, while welcoming their international counterparts to New York. Columbia signed an agreement last summer with the Francisco Marroquín University School of Dentistry in Guatemala to facilitate exchanges between the two schools. In 2017, CDM students will travel to Guatemala City to conduct an oral health needs assessment in the community in advance of future service learning there. Another recent agreement, announced in April 2016, links the College of Dental Medicine with the University of Nairobi on a project to improve the oral health of children with HIV.

The dental school’s global health externship program has long partnered with nongovernmental organizations to create opportunities for students to work on dental care missions abroad with a substantial percentage of the student body traveling abroad, but the school is now working to transform its model of global service learning, says Dean Christian S. Stohler, DMD, DrMedDent.

“We are moving away from the mission model, where students offer one-time treatments which have minimal long-term impact. Our new programs start with needs assessment, build local capacity, and participate in inter-professional care as well as follow-up treatment in partnership with other schools, such as nursing, social work, public health, and many more. This is the type of work that will truly strengthen global oral health, and it gives our students a true service learning experience.”

Research Goes 3-D

It is a humming $300,000 machine that Jeremy Mao, DDS, PhD, believes will soon lead to the regrowth of teeth, knee cartilage, even internal organs.

Dr. Mao, who came to the College of Dental Medicine in 2007, is using a 3-D printer to create an artificial meniscus that, once implanted in a knee, will stimulate the regeneration of cartilage using the patient’s own stem cells. CDM’s Center for Craniofacial Regeneration is a recent and prominent example of a research mission that has been part of the dental school since its founding, despite the historical challenges of space and budget constraints. Dr. Mao’s work is an example of the school’s growing focus on research since the arrival of Dr. Stohler.

Dr. Mao’s knee implant, honeycombed with channels and seeded with protein growth factors, acts as a scaffold for cartilage regrowth. In 2015, Dr. Mao succeeded in regenerating cartilage in sheep and is working toward human trials.

“When we first got the printer, I thought, ‘Gee, this is going to be really powerful,” Dr. Mao says. “Now, more and more people are seeing the utility of 3-D printing and there’s tremendous excitement for its use in medicine.” Dr. Mao has used a similar implanted scaffold to regenerate teeth in animal studies and to develop a replacement temporomandibular joint.

Dental research at Columbia actually predates the founding of the dental school. William J. Gies, the medical school biochemistry professor and early proponent of a Columbia dental school, began studying saliva and caries as early as 1910. He helped found the Journal of Dental Research in 1919 and was its first editor. Research by dental students also began early: The William Jarvie Society for Dental Research was formed in 1920 (its first president, perhaps not surprisingly, was Columbia’s first dental student, Joseph Schroff) and continues today.

Throughout much of the dental school’s early history, research focused on tooth structure, decay, and restoration. Beginning in the late 1960s, Irwin Mandel, DDS, reenergized research efforts, centered on the salivary chemistry laboratory he established to study the relation of saliva to oral and systemic disease. Without the persistence of Dr. Mandel, the first winner of the American Dental Association’s Gold Medal Award for Excellence in Dental Research, “there would be no significant clinical research” at Columbia, microbiologist and dental faculty colleague Solon A. Ellison, DDS, PhD, now professor emeritus of dentistry, wrote in 1992.

More recently, the college’s research has cut an interdisciplinary swathe: the relationship of oral health to overall health. Panos Papapanou, DDS, PhD, and Evanthia Lalla, DDS, have investigated the link between periodontitis, vascular disease, and pregnancy outcomes; Dr. Lamster and Dr. Lalla have investigated the use of oral disease for early diabetes identification. Burton Edelstein, DDS, who also has an MPH, has focused on social and behavioral determinants of oral health. He pursued the use of behavioral risk management tools for children’s oral health, all in keeping with the dental school’s historic view of oral health as a part of overall well-being. Or, as Dr. Mao puts it: “Dentistry is much more than just the teeth.”

 

TIMELINE

1898

School’s Guiding Light

William J. Gies, PhD, the future guiding light for Columbia’s dental school, joins the Columbia University faculty at age 26. His research on the causes of dental caries leads him to meet leading dental practitioners in New York, who together will found a dental school at Columbia.

1916

Founding Document

A group of prominent New York dentists, physicians, and scientists submits a proposal to establish a dental school. The proposal, titled “A Dental School on University Lines,” sets forth the enduring principles that general health and oral health are closely related and that the school of dentistry should have close ties with the medical school.

1917

Dental School Established

Columbia University Trustees establish the Columbia University Dental School retroactively to Sept. 17, 1916. The school is co-located with the College of Physicians and Surgeons on 59th Street. Two students enroll. Later that year the New York Post-graduate School of Dentistry and the New York School of Dental Hygiene are merged into Columbia’s dental school.

1919

Journal of Dental Research

William J. Gies, PhD, establishes the Journal of Dental Research, which enhances the research mission of dental schools across the nation.

1922

First DDS Degree

Joseph Schroff becomes the first recipient of a Columbia DDS degree. He also earns an MD degree from the College of Physicians and Surgeons. He goes on to serve on the dental school faculty for many years.

1923

School Merges with College of Dental and Oral Surgery of New York

The Columbia University Dental School changes its name to the School of Dental and Oral Surgery—SDOS—when it merges with the College of Dental and Oral Surgery of New York, established in 1892. The two buildings the college occupies on East 34th and 35th streets become Columbia University property. Students take basic science classes in the morning on 59th Street, then walk down to 34th and 35th streets for dental technique classes.

1926

William J. Gies Publishes Landmark Report

“Dental Education in the United States and Canada” is published by the Carnegie Foundation for the Advancement of Teaching. It contains 250 pages of text and more than 400 pages of appendices, including descriptions and evaluations of existing dental schools, each of which Dr. Gies visited during five years of research. He uses the Columbia school as the model for the future of all dental schools. “Dental Education in the United States and Canada” remains a seminal piece of research within dentistry.

1927

Alfred Owre Becomes Dean

Dr. Owre is recruited from the University of Minnesota. He brings 17 faculty members from Minnesota to join him at Columbia. Dr. Owre’s vision of rigorous education fits in well with the School of Dental and Oral Surgery, but many of his ideas regarding the structure of dentistry as a profession are considered controversial. Resistance to his ideas grows, leading to a leave of absence in 1933.

1928

School Moves to 168th Street

SDOS moves into the top three floors of the Vanderbilt Clinic building on West 168th Street, where the College of Physicians and Surgeons and the Presbyterian Hospital also move to form a historic academic medical center.

1934

Willard Rappleye Becomes Dean

Dr. Rappleye, dean of the College of Physicians and Surgeons, takes on the additional role of dean of the dental school, serving as dean of both schools for the next 25 years. Dr. Rappleye appoints Dr. Arthur T. Rowe, the head of prosthetics, as associate dean to carry out day-to-day operations. He later appoints Houghton Holiday, Bion East, Maurice Hickey, and Gilbert Smith (who later becomes dean) as associate deans.

1935

2 Faculty Members Murdered

Victor Koussow, a quarrelsome school laboratory technician, fatally shoots Associate Dean Arthur Rowe and Dr. Paul Wiberg and injures one other faculty member. He commits suicide as police arrive to investigate.

1945

School Formally Merges Into the Faculty of Medicine

The school becomes part of Columbia’s Faculty of Medicine, which leads to a controversy with the Council on Dental Education, the accrediting agency.

1947

First Postdoctoral Candidates Graduate

SDOS issues postdoctoral certificates in four specialty areas: oral surgery, general dentistry, periodontics (one of the first programs in the United States), and orthodontics, a program that dates back to 1917.

1950

Pedodontics Postdoctoral Specialty Program Established

Now called pediatric dentistry, the postdoctoral pedodontics program is established by Ewing Cleveland McBeath, DDS, MD. It is one of the earliest programs of its kind in the world.

1959

SDOS Separates from theFaculty of Medicine

Columbia University approves a separate faculty, the Faculty of Dental and Oral Surgery. The associate dean’s position under the former arrangement is restored to dean. Gilbert Smith becomes dean of SDOS.

1968

Melvin Moss Becomes Dean

A professor in the P&S anatomy department, Dr. Moss recruits new full-time faculty and strengthens the research mission of the school.

1973

Edward Zegarelli Becomes Dean

Dr. Zegarelli, an eminent oral pathologist and 1941 SDOS graduate, serves as dean from 1973 until he retires in 1978. By the time he retires, he will have spent his entire professional career on the faculty of SDOS.

1977

Vanderbilt Clinic Renovated

SDOS facilities on Vanderbilt Clinic floors 7, 8, and 9 undergo a total renovation with modern operatories and new equipment.

1978

Allan J. Formicola Becomes Dean

Dr. Formicola is the first dean in
50 years to be appointed from outside the faculty. He previously served as acting dean at the New Jersey Dental School and on the faculties of the University of Alabama and Georgetown University. He serves as dean of SDOS for 23 years.

1982

Dental Hygiene Program Closes

As community colleges across the country establish two-year dental hygiene programs, enrollment of students in university programs drops precipitously. Columbia decides to close its program.

1988

New Residency Program at Harlem Hospital

The Harlem Hospital-SDOS Special Postdoctoral Residency Program is established to train underrepresented minority residents in dental specialties, and 23 residents from Harlem Hospital complete specialty programs in such fields as periodontics, endodontics, orthodontics, and pediatric dentistry. Graduates become faculty members at Columbia, staff at Harlem Hospital, and practitioners in their specialty fields.

1993

Graduate Publishes Best-Selling Book, “Having Our Say”

Elizabeth (Bessie) Delany, a 1923 graduate, publishes a book of life stories with her sister, Sarah (Sadie) Delany, a graduate of Teachers College. The book recounts stories from the lives of these two extraordinary African-American women who grew up in the post-Reconstruction South and lived in New York City during the Harlem Renaissance. The book includes Dr. Delany’s stories of breaking barriers to become a dentist.

1995

Community DentCare

SDOS establishes the Community DentCare network to provide care in public schools and Head Start centers. A grant of $1 million from the W.K. Kellogg Foundation supports the effort.

2000

SDOS Leads $26 Million Project

SDOS is selected by the Robert Wood Johnson Foundation as the national program office for the “Pipeline, Profession & Practice: Community-Based Dental Education” demonstration project, the largest foundation initiative in dentistry ever funded. The W.K. Kellogg Foundation and the California Endowment also provide funds for the project. The 10-year project funds 23 dental schools to implement programs for students to study and treat patients in community clinics and encourages schools to increase underrepresented minority student applications and enrollment.

 

2001

Ira Lamster Becomes Dean

Formerly vice dean of SDOS and director of the Division of Periodontics, Dr. Lamster serves as dean from 2001 to 2013. He proposes to change the name of the school from the School of Dental and Oral Surgery to the College of Dental Medicine to reflect changes in the way dentistry is practiced.

2006

SDOS Becomes the College of Dental Medicine

Columbia’s Board of Trustees approves the school’s name change to the College of Dental Medicine. The new name better reflects the school’s comprehensive biomedical approach in its missions.

2009

Dental Research Complex Constructed

A major new research complex is constructed on the 12th floor of the Vanderbilt Clinic, permitting the dental school to recruit new research faculty and expand its research program.

2010

DDS-MA Program with Teachers College

Roseanna Graham, DDS, becomes the first graduate of this dual degree program. She goes on to earn a PhD in science education,
also a first, and joins the College of Dental Medicine faculty.

2013

Christian Stohler Becomes Dean

Dr. Stohler comes from the University of Maryland School of Dentistry, where he served as dean for 10 years. Dean Stohler launches his tenure by fostering dialogue to collaboratively chart the course toward advances in the curriculum, research, and international opportunities, among others. He oversees the expansion of the dental school’s clinic space onto the Vanderbilt Clinic’s fifth floor, increasing clinic space by 25 percent.

2014

Gies Award

The College of Dental Medicine is awarded an American Dental Education Association Gies Foundation Award for its Community DentCare program.

2014

School Receives HEED Award

The College of Dental Medicine is awarded the first of its three consecutive annual Higher Education Excellence in Diversity Awards for outstanding commitment to diversity and inclusion. It is the first dental school in the nation to win such an award. Dr. Dennis Mitchell established the Office of Diversity Affairs at the College of Dental Medicine, and he is also vice provost for faculty diversity and inclusion for Columbia University.

2016-17

School Turns 100

The College of Dental Medicine celebrates its first 100 years, as detailed in a comprehensive history book written by Allan J. Formicola, dean emeritus. The college launches new, long-term initiatives, spurred in part by a probing self-study in advance of CODA accreditation. Among the initiatives is the revamping of the curriculum to keep pace with—and lead—research, teaching, and practice of oral health care in the 21st century.