This House of Noble Deeds: The Mount Sinai Hospital, 1852-2002

16 Department of Dentistry

16 Department of Dentistry ALTHOUGH THE SCOPE of modern dental training and practice embraces all the diseases and abnormalities of the mouth and jaws, it is the core identification with the decay, infection, and loss of teeth that established dentistry’s importance in public health. This was officially recognized at the Mount Sinai Hospital in 1910 with the appointment of Milton Simon as Dentist and Samuel M. Getzoff as Adjunct Dentist, thus establishing the Dental Department. In the beginning, the attending dental staff, which included Maurice Green and Louis Bieber, conducted an inpatient clinic and made ward rounds twice weekly to care for the dental needs of hospitalized patients. During these early years, the dental staff exemplified one of the goals of the institution, namely that all staff members be active participants in medical research. Mount Sinai dentists were among the first in the United States to use procaine, synthesized in Germany by Alfred Einhorn in 1905, as a local anesthetic. Guido Fischer was a leader in testing the principles and methods in the administration of procaine. When Fischer later came to the United States, Leo Stern, who joined the Mount Sinai staff as an Assistant Dentist in 1915, traveled the country with him to demonstrate the use of procaine to dentists.1 Stern had served as Director of the Commission on Standardization of Local Anesthesia of the Dental Society of the State of New York from 1913 until 1915. The early use of procaine by dentists at The Mount Sinai Hospital signaled the beginning of a medical approach to pain control and the widespread use of local anesthetics within the specialty. Mount Sinai would continue to be at the forefront of advances in hospital dentistry throughout the history of the department. The Dental Service played a significant role in Mount Sinai’s overseas effort during World War I. The table of organization of Base Hospital No. 3 called for two dentists; Leo Stern and Jacob Asch would serve in France with the unit until May 1919. The fifty-bed facial fracture ward (“jaw service”) became one of the largest and most active 182 dental centers in the Allied Expeditionary Force, receiving a special commendation for the development of oral surgery techniques for trauma management. In May 1919, Harry Goldberg was appointed Dentist to the Hospital. Stern joined him as Assistant Dentist a few weeks later, and together they organized a comprehensive dental service staffed by five voluntary clinicians to care for the dental needs of the hospitalized patients. Space, operating equipment, and nursing assistance were provided in the basement of the Administration Building on the north side of 100th Street. At the time, the theory of focal infection and its role in the pathogenesis of many systemic diseases had wide credence, and large numbers of patients were referred from the medical and surgical services for dental roentgenographic examination and for the removal of all teeth that might be presumed to harbor sepsis. In 1924, enlarged dental quarters were constructed and equipped on the third floor of the Administration Building. In addition, an OutPatient Clinic housing six dental units was located on the second floor of the Out-Patient Building. As the role of the Dental Department expanded, areas of specialization emerged, attracting prominent dentists and teachers: Joseph Schroff in oral surgery, Harry Shapiro in anatomy and numerous others. Clinical training programs in oral surgery, orthodontics, periodontics, and prosthetic dentistry brought considerable attention with an augmentation of the staff to more than forty dentists by 1935. Goldberg established a dental House Staff in 1932, appointing Marvin Freid and Herbert Goodwin as the first Interns . During the decade prior to World War II, departmental research was multifaceted. Auto-polymerizing methyl methacrylate was clinically tested as a replacement for silicates for cosmetic fillings and as a vehicle to permit rapid prosthetic repairs, as were alginate impression materials. Interdepartmental collaboration increased, and studies of lesions of the mouth, jaws, and associated structures were published. Major contributions were made to identifying the role of dental calculus aspirated during sleep or anesthesia in the pathogenesis of lung abscess .2,3 The manifestations of oral side effects of the anticonvulsant phenytoin, or dilantin sodium, were described in an original study by Stern and Leon Eisenbud (who first joined the staff as an Intern in 1940)4 and by Stern, Eisenbud, and Jack Klatell.5 Metastatic carcinoma to the maxilla, a rarely reported lesion, was described.6 DEPARTMENT OF DENTISTRY 183 [18.189...