The Early Years NIDR by Marie Nylen

The first proposal for a dental institute was made in 1939, but it required exhausting efforts by many outstanding individuals and organizations both outside and inside the Federal Government before the Institute became a reality. That the effort became as successful as it did in spite of the many road blocks in its path is testimony to
the dedication and exceptional administrative skills of Doctors Dean, Arnold and Kreshover.

The establishment of the institute in 1948 as a part of the National Institutes of Health was indeed an auspicious occasion for Dentistry. It did not happen overnight. One important positive factor was undoubtedly the outstanding research conducted by Trendley Dean and
associates on the role of fluoride in causing mottled enamel and on identifying a potential role for fluoride in reducing dental decay. Dean, on the staff of the National Institutes of Health since 1931, seeing the need for scientists with expertise in chemistry, assembled a staff
that became the nucleus of the future NIDR, including Pokey Arnold, who joined the group in 1937.

Their further studies defined the level of fluoride that seemed to reduce decay without causing defects in the enamel, and finally led to the initiation in 1945 of a clinical trial comparing rates of dental decay in children from two cities, both using the same source of water, one
with 1 ppm fluoride added to its water supply and the other with none.

Arnold became Director in 1953 and in 1956 appointed Seymour Kreshover as scientific director, encouraging him to build up a broadly based dental science program, an effort made possible by the move to the Institute’s own building in 1961. Arnold and Kreshover also expanded the Institute’s clinical research efforts. At the same time, the American Dental Association mounted an intense and successful campaign on Congress to increase dental research funding. As a result, grant funding rose more than six times and, for the first time, the Institute’s extramural funding exceeded that of the intramural programs and the Institute realizing that Congress favored directed research reorganized extramural research by categories recognizable by disease and condition rather than by biomedical discipline.

Kreshover, thus, was the obvious choice to succeed Arnold as the Institute’s director. He had, after all, helped rewrite the road map. One of his major achievements was a drastic reorganization of the intramural program, which, while unpopular in some quarters, gave a firmer foundation and impetus to new promising scientific endeavors. The launching of the National Caries Program in 1971 was also a significant new step.

Dave Scott who had left the Institute in 1956 returned in 1976 as Director of the Institute following Kreshover’s retirement. He inherited an outstanding, well established program, but also found himself in an extremely competitive environment. Science is by nature a competitive endeavor and so was, and still is, NIH. By the
time Scott became director, NIH had 14 institutes, in addition to two centers and the Library of Medicine. I don’t know if NIDR was still the smallest of the Institutes, but if not the smallest, one of the smallest. I suspect that fact influenced some of the decision-making processes at the NIH level. As an example, the NIDR was not
included on the list to gain new space in the proposed addition to the Clinical Center although space was badly needed for the Institute’s highly regarded and promising pain and salivary research programs. In the end, Scott was successful in obtaining the additional space. He also achieved important increases to the funding of the Institute and significantly expanded the Institute’s effort in behavioral and social science research.

One persistent thorn in the side of all four directors were the efforts of the anti-fluoridationists to halt fluoridation of the Nation’s drinking water. Time and space does not allow me to give you the details, but I am sure that it had a particularly depressing effect on Dave Scott who was the only Institute scientist to participate in the original Grand Rapids studies from beginning to end and directly observed the benefits accrued in the process.