It is now my distinct pleasure to introduce
the dean of the Harvard School of Dental Medicine, Dr. Bruce
Donoff.
Dr. Donoff received his DMD from the Harvard School of Dental
Medicine and went on to earn his MD from the Harvard Medical
School as part of his residency in oral and maxillofacial
surgery at the Massachusetts General Hospital.
He continued to work at MGH, being named chairman and chief
of service in 1983 and becoming the first Walter C. Guralnick
Professor of Oral and Maxillofacial Surgery.
In his 28-year tenure as dean, Dr. Donoff
encouraged his students to become oral physicians
with a care and understanding for the whole body.
HSDM's mission reflects his aspiration
to break down traditional barriers
between oral and systemic health.
And in this way, he has truly served as the bridge
between HSDM and HMS.
Dr. Donoff's efforts were recognized
with the prestigious William J. Gies Foundation
Award from the American Dental Education Association
in 2004 for outstanding vision by
an academic dental institution.
Last month, Dr. Donoff announced his plans
to step down as dean of HSDM at the end of this year.
His legacy in leading an institution rich
in 150 years of tradition into the future of dental education
will never be forgotten.
It is my sincere honor and privilege
to introduce our Dean of the Harvard School of Dental
Medicine, Dr. Donoff.
Well, thank you so much.
Congratulations to all.
This is such a special day for all the graduates
of the Harvard School of Dental Medicine
and Harvard Medical School, the class of 2019.
Congratulations to you and to all your loved
ones who have helped you reach this point in your lives.
You are at a major milestone of a long journey of education
and training designed to permit you to help people
through the discovery, application,
and communication of knowledge, competence, compassion,
and caring.
The development of wisdom and clinical judgment
through lifelong learning and further experience
represents the road ahead.
Each year, I associate the graduating class
with a particular event or accomplishment
in order to create a lasting memory for myself.
This is easy this year, for you are the first class
to complete the Pathway program.
Not the old New Pathway, but the new Pathways Program.
You are also the first class, the dental class at least,
to complete all your national testing
exams without a single failure.
Congratulations.
Two years ago, we celebrated the 150th anniversary
of the founding of the dental school at Harvard University.
A momentous occasion as the first dental school
in America associated with a university
and its medical school, and the first to grant the DMD degree.
That philosophy is our legacy and our mantra.
This morning when I presented the degree candidates
to President Bacow, he granted their degrees
and welcomed them into a demanding branch of medicine.
It is no secret that medicine and dentistry
have evolved with an unnatural professional separation that
is helpful to no one and often leads to unnecessary suffering
on the part of patients.
No one quite knows whether the physicians who
started the Baltimore College of Dentistry in 1840
were thwarted by the University of Maryland
and its medical school or whether they
wanted to be separate.
This history, in fact, is taught to first year
medical dental students here at Harvard
in the Practice of Medicine course.
This began the siloing of the two fields, which
despite several attempts for change,
like the Gies Report of 1926 calling for dentistry to stay
close to medicine but separate, the Institute of Medicine
Report of 1995 calling for the integration, or by the first
ever Surgeon General's Report on Oral Health
in 2001, which called oral disease a silent epidemic
and noted that oral health is critical to general health
and well-being.
That siloization has remained until today.
Less so here.
Our belief that dentistry is a branch of medicine
distinguishes our education, our values, and the careers
of our graduates.
But increasing knowledge supports
the now widely recognized links between oral health
and medical health.
The mouth is often a wide open window
into what is happening in the rest of the body.
And sometimes a source of risk as well.
A second Surgeon General's Report on Oral Health
is now being prepared emphasizing
the importance of oral health to general health.
Louis Menand, in his treatise The Marketplace of Ideas,
states that the key to reform of almost any kind in higher
education lies not in the way that knowledge is produced,
it lies in the way that the producers of knowledge
are produced.
You will be the leaders in oral health because
of the way you were selected and the way you were produced.
And you will have an impact on health care as dentists.
It was Dan Federman, mentioned before,
former HMS Dean for Medical Education who called me
one day in 1986 when I was chief of oral and maxillofacial
surgery to say that he attended a session of the double AMC
meeting on teaching medical students
about dentistry and oral health, and Harvard should do this too.
In fact, the program was presented by Dr. Mort Lorber,
a DMD, MD graduate of HSDM.
Yes, there was a brief time when all dental students received
the MD as well as the DMD.
Dr. Lorber developed his course for students
at Georgetown Medical School.
So I, at the MGH along with Steve Sonis at the Brigham,
initiated sessions for medical students
during their clerkships in the Essentials of Dental
Medicine and Oral Health.
This led to the current Oral Health Day, which the combined
classes enjoy during the first year of the current curriculum,
the Pathways Program.
Our initiative to integrate oral health and medicine,
which began four years ago, seeks
to advance the education, clinical practice, outcomes,
and policy regarding comprehensive disease
management and the economic imperative of good oral health.
We work with the medical school's primary care center
to foster integration and hope to create an integrated
medical-dental practice that will be a teaching
unit for all students.
Only two weeks ago, I had the privilege
of listening to two MD, MPP students
discuss their reasons for pursuing primary care
and family medicine at a session billed
as a revolution for primary care.
One of those students is graduating today.
I like revolutions.
Goodness knows the American health care system
needs some transformations.
We believe in integrating oral health and medical care.
Doing this will be difficult and take at least another month.
It will require one, change the cultures of medicine
and dentistry, develop new payment models,
improve shared information systems,
and improve outcome measurements.
When I had just become a professor and head
of oral maxillofacial surgery at the MGH and Harvard,
I had a series of patient encounters
that were remarkable because of the patients involved
but also because each was prescient
of the remarkable future of health care
that you, the graduates, are now entering.
First, I had a patient whom I had cared for two years
before present for a tooth extraction.
He said hello, and then told me to put on gloves.
This was 1982.
He said put on gloves before examining him.
Mind you, most dentists and physicians
did not wear gloves for general exams at the time.
He said he had just returned from Seattle
where he'd had a bone marrow transplant, developed
graft versus host disease, and had something called an HIV
infection.
In the next year, I had many calls
from dentists distraught because they
had cared for a patient who then told them
that they might have AIDS.
You cannot believe the distress and emotional climate of these
calls.
Interestingly, even late into the 1980s
as I toured patient doctor one and had a patient from the AIDS
action committee attend the meeting,
students would ask if it was OK to shake hands
with the speaker.
A disease that was a diagnosis for death
is now a treatable illness.
That is part of health care's past and future,
and science made it possible and makes it possible.
Pursuit of science and primary care are not incompatible.
I also recall a group of a dozen young women with tongue cancer
who were the antithesis of the usual oral cancer patients.
They had none of the usual risk factors,
and despite detailed study of them all,
we could not identify any reason for them to have such cancers.
However, just last month it was shown that these patients have
a marker PD-1, which can be a very useful indicator
for patients with a relatively well-behaved tongue cancer.
I just received a New England Journal email from the Editor
in Chief's "12 Most Important Papers Since 2000."
I'm sure many in the audience did as well.
One of those papers was about HPV infection, the vaccine,
and prevention of cervical cancer.
But in fact, its relationship to oral pharyngeal cancer
is as important, and vaccination prevents this oral cancer
as well.
Why shouldn't mucosa in one orifice of the body
be different from another.
We have come a long way and science makes this possible.
Medical treatment of surgical disease
is becoming a reality for dental decay as well as cancers.
We've come a long way since Australian physicians Barry
Marshall and Robin Warren won a Nobel Prize in Medicine
in 2005 for the discovery that gastric ulcers are
caused by bacteria.
The discovery of a helicobacter pylori
was groundbreaking and opened up the study
of the human microbiome, which is so important to today's
understanding of many diseases.
It will just take one of you to discover
how the human immune system turns these normal inhabitants
into pathogens.
I liken the concept of natural microbes being involved
in disease with the realization in the mid-1800s
that cholera could be transmitted by water,
when at the time only airborne spread of disease
was acknowledged.
So congratulations to the 34 individuals
receiving the DMD degree, the 11 with honors in a special field,
and the five receiving the degree with general honors,
the 19 receiving the Master of Medical Science degree,
and the eight receiving the Doctor of Medical Science
degree.
And congratulations to all the residents and fellows who
are receiving specialty certificates
and will go on to make an impact in their chosen fields.
Always remember, we are privileged to take
care of people.
Treat them well.
Treat them kindly, and treat them with respect.
Above all, treat them all equally
with one high standard of care.
Don't allow Missions of Mercy, thousands
of people lined up for free dental care
once a year, to become the profession's
scar of oral health delivery for the under served.
Don't permit our growing elderly population's oral health
needs from being excluded from Medicare.
Your achievements should make you very proud.
Those who have helped you reach this day and those
who have nurtured and sustained you share that pride.
The entire HSDM community and I feel no small measure
of joy and pride in your accomplishments.
We look forward to your futures with justifiably high hopes.
Congratulations class of 2019.
I hope your memories of HSDM and HMS
will always remain a treasured part of who you are
and who you become.
Be the leaders you are in transforming oral health care
and health care through science, policy, and compassionate care.
Most importantly, do the right thing, especially
when no one is watching.
And now I would like to invite Associate Dean for Dental
Education Dr. Sang Park to join me
on stage for the conferring of the DMD Degree.
Thank you very much and congratulations.