1940-1949: The ABP Becomes the Recognized Certifying Board for Periodontists
History of the Board
With the outbreak of World War II, U.S. isolationism ended and the country was swept out of the Depression and into battle. Unemployment practically disappeared, Victory gardens sprouted, and automobile production virtually ceased. When the war ended in 1945, the country was ready to turn its attention home. Levittown sprang up, Tupperware was invented, and television sets multiplied, bringing viewers the Original Amateur Hour, Texaco Star Theater and the Howdy Doody Show.
As the new decade opened, the first order of business for the ABP was to incorporate. Lawrence C. Mills, an attorney in Illinois, was retained to proceed with incorporation, which was completed in May 23, 1940. Before that could happen, some changes in the primary function of the Board had to be made so that it would be in compliance with Illinois law. To be in compliance, the articles of incorporation were rewritten so that the primary function of the Board shifted from the issuance of certificates to raising the standard of practice. “The examination of candidates who are qualified and the issuance of certificates are incidental to the purpose.” 1
Before any candidates could be examined, however, the Board members had to examine and certify each other. This was done at the third meeting on February 11, 1940, and certificates were issued. Dr. Arthur H. Merritt became the first Diplomate and Dr. Dickson G. Bell was awarded the second Diplomate Certificate 2. Officers of the first Board were Drs. Arthur H. Merritt, of New York City, Chairman; Olin Kirkland, of Montgomery, Alabama, Vice-Chairman; and Harold J. Leonard, of New York City, Secretary/Treasurer.
At this same meeting, after protests from Dr. R.W. Rule, Sr. of the Specialization Committee and Dr. Bell of the Board, that the original requirement of ten cases was “excessive,” this was “modified.”
According to Board minutes from that meeting, the examination process would consist of: “Three case reports of varied character, including a full set of Roentgenograms, study casts and photographs before and after treatment.” In September 4, 1940, meeting the Board determined that requirements for examination include five years of practice focused primarily on periodontology and “that the examinations be of such a character as practically to require at least a year of postgraduate education in preparation thereto.” 3
At the time, there were nine charter members. In addition to Drs. Merritt, Kirkland, and Leonard, they were Dickson G. Bell of San Francisco, California; M. Monte Bettman of Portland, Oregon; A. Wesley Bryan of Iowa City, Iowa; Edgar D. Coolidge of Evanston, Illinois; Austin F. James of Chicago; and Bernard D. Friedman, also of Chicago.
The Board recognized that the initial certification process would differ from later processes, once graduate courses leading to a degree in periodontology were well established. The constitution provided that candidates seeking certification prior to 1944, who were recognized by their peers as proficient in periodontology (and as a result had patients referred to them for such procedures) or who had been teaching for a lengthy period or time, or published in recognized journals, would be considered as having satisfied periodontal educational requirements.
In addition, candidates were also required to provide proof of graduation from a recognized dental school, membership in the ADA or equivalent foreign dental organization, and of “his high ethical and professional standing in the community and his professional experience.” 4 Candidates were also required to submit papers or books they had published and of at least ten “varied” cases that they had treated. A fee of $50 was charged for examination and certification if the candidate successfully passed. Candidates who failed had the option of retaking the exam within three years at no additional fee.
Early growth was rapid. On February 16, 1941, the applications of thirty-six “well recognized” periodontists were examined and certified. In October of the same year, five more were certified. Four were held for further study and two were rejected. At the time, procedures were deemed insufficient to examine and certify applicants who were not well known as competent. “The development of standards was in the hands of the Advisory Board for Dental Specialties and the Board had to mark time in some respects until the thinking for all specialties was better developed.” 5 While wartime restrictions on travel made Board meetings difficult, the ABP was able to meet in the summers of 1942 and 1943, then again in February 1945 to examine and certify many “well known” periodontists.
On October 16, 1946, the Board decided for periodontists with less than ten years in practice to present as qualified candidates they must have one academic year postgraduate education and four years of dental practice. Two years later, the Board decided that an approved three-year postgraduate or graduate courses could be substituted for one-year postgraduate work and four years of practice.
Preparation for certification continued to be debated and in 1947 discussions focused on what content matter was comprised in periodontology—which would be presented as postgraduate course material and also serve as the basis of Board examinations.
“I would suggest...additional emphasis...on pathology, diagnosis, interpretation of roentgenograms, and nutritional and endocrine relationships to oral disease....” suggested Dr. A.W. Bryan of Iowa City.
Others spoke to the issue of logistics: “By setting up...requirements that can be met only by the practitioner closing his office and returning to school for two years, we shall make it impossible for a large number of capable and experienced men to qualify as specialists,” said Dr. Houghton Holiday of New York City.
At the time, a 15-case report requirement was also debated. “A fifteen case report requirement is not unreasonable,” said Dr. R. Gordon Agnew of Toronto, Canada. But others disagreed: “An unfair hardship,” declared Dr. Samuel Charles Miller of New York City. “I am not in favor or requiring fifteen case reports at present,” said Dr. John Oppie McCall, also of New York City. “My idea is that few candidates will have the opportunity to bring together fifteen cases representing any considerable variety of basic conditions....”
As for the role of the ABP, Dr. Irving Glickman of Boston, Massachusetts, said, “The real goal of the American Board of Periodontology should not (be)...setting up requirements for certification, but rather in the...guidance of educational agencies in such directions as will achieve maximum qualitative improvements in postgraduate training.”
The 1940s closed on a high note for the Board when, in 1949, the House of Delegates of the ADA recognized the American Board of Periodontology as the official specialty board for the certification of periodontists. Only one other board was recognized earlier, the board for oral surgery.