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Lineup at Toronto soup kitchen during the Depression, when dentists often provided services for free. (CREDIT: SUPPLIED)

Depression-era dentistry

The post-war 1920s were a time of unprecedented economic growth and opportunity. The good times came to a halt, however, when the country’s economy was decimated by the stock market crashes of 1929, bringing about the Great Depression. Much as they had in the First World War, the ODA and its members took it upon themselves to help their community during this time of crisis.

Dentists continued to provide care to the public at reduced or no cost for the growing number of poor and unemployed Ontarians. In 1931, a free clinic was opened at Spadina House in Toronto and Peterborough dentists opened a free clinic in the Ovaltine Plant for people in the community to receive dental care.

As the Depression continued, the ODA realized the very real need to reach people in remote Ontario communities, and encouraged the provincial government to secure a railway dental car so they could provide care for people in northern Ontario. The dental train began service in 1931, thanks in large part to the Canadian Pacific Railway’s contribution of the rail car and free haulage. It was staffed by ODA member dentists and remodelled and equipped with funds raised by the Rosedale chapter of the Imperial Order of the Daughters of the Empire. The train was just like a modern dental office but on rails and able to travel along any train line in the province. Throughout its years of operation, dentists on board the train provided professional dental services to isolated communities along the Canadian Pacific Railway lines, helping ensure that Ontarians in need of care were getting help they could rely on.

Children brush their teeth at High Park Forest School in Toronto in 1913. Public health programs were supported by the ODA. (CREDIT: CITY OF TORONTO ARCHIVES)

Baby boom years

The end of the Second World War and the return of Canada’s veterans gave rise to the baby boom and a growth in dentistry. As the dental profession grew, so too did the belief that preventive care was essential for protecting teeth. In 1946, the ODA and Canadian Red Cross joined together to launch a pilot program in the Niagara district. Under this project, a specialist trained in dental public health provided education to parents, regularly inspected children's teeth and performed treatments in local dental offices. Two years after this program began, the overall dental health of children in the program improved, while other municipalities recorded annual increases in the number of childhood dental extractions and fillings.

The pilot program marked a positive turning point in dental public health in Ontario and the project quickly attracted the interest of health authorities in other municipalities throughout the province. The lasting impact of these educational efforts were reflected later in a public education campaign piloted in the 1970s in part by Dr. Samuel M. Green, a public health dentist and ODA member, and the Ministry of Health. “Murphy the Molar” character was a popular icon that those who were children in this era may fondly recall.

By 1950, eight out of 10 provincial governments had created dental health divisions. This was a welcome improvement because up until that point, public dental health initiatives depended almost entirely upon the voluntary efforts of dental organizations like the ODA. Informing the public on proper oral hygiene and getting people routine dental care became much easier.

Within the dental community, dental public health became the fifth dental specialty recognized by the Royal College of Dental Surgeons of Ontario, following orthodontics (straightening crooked teeth), oral surgery, periodontics (diseases and conditions of gum and bone) and paedodontics (children’s dental care).

In 1958, the ODA took over a provincially funded dental care program for low-income children but the dental services covered by the government were limited and the level of funding for dentists often didn’t cover the costs of treatment the children needed. It didn’t take long for everyone involved to realize the program needed improvement.

The ODA has always believed preventative programs and education are essential, so their proposed solution came in 1971 with the “dental plan for children.” The project called for incremental care “to make the benefits of dental health education, preventive dentistry and dental care available to all children and young adults, up to and including those 18 years of age.”

Today, the ODA and its member dentists continue to advocate for prevention, education and access to care for all Ontarians.

Fluoride makes an impact

As early as 1892, British researchers observed that fluoride seemed to have a role in preventing cavities, but only sporadic research was done over the years. In 1945 the Canadian and American governments began a joint study on the effects of water fluoridation on tooth decay. The Ontario town of Brantford was one of the test cities chosen, and within five years results showed that children who drank fluoridated water had 60 per cent fewer cavities than those who had not. By 1952, Toronto’s Board of Health approved community water fluoridation as a safe and cost-effective tool for fighting tooth decay. However, this landmark development in health care was not without its share of controversy, and it wasn't until 1963 that the city of Toronto began water fluoridation.

While science ultimately prevailed and many Ontario communities began water fluoridation, unfounded fears and conspiracy theories continued to make fluoride a controversial issue. Today, more than 30 countries around the world have community water fluoridation programs which provide more than 370 million people with optimally fluoridated water. The effective and inexpensive public health measure is proven to reduce the chance of developing cavities for everyone, regardless of their age, location or socioeconomic status.

For more than 60 years, fluoridation has been used safely and successfully across Canada and the United States. Years of scientific studies have not found any credible link between optimally fluoridated water and adverse health effects.

This content was produced by the Ontario Dental Association. The Globe and Mail was not involved in its creation.
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