The roots of the Eastman Dental Institute

The roots of The Eastman Dental Clinic and Institute of Dental Surgery (established 1947) go back to Rochester, New York State, USA where George Eastman was born in 1854.

The Dental Clinic came about from an encounter between George Eastman, who suffered with a painful and ongoing dental problem, and his dentist Harvey Jacob Burkhart, who provided him with dentures that had a significant positive impact on George Eastman's appearance and physical function.

In 1915, George Eastman was persuaded to supplement the funding of the Rochester Dental Dispensary, after Harvey Jacob Burkhart had convinced him of the devastating consequences in adulthood of a lack of childhood tooth care. The new Forsyth Dental Clinic in Boston made quite an impression on George Eastman, so he decided to go one step further and create the new Rochester Dental Dispensary which aimed to eliminate mouth, nose and throat diseases in children. The $403,000 centre opened in 1917.

The first director was Harvey Jacob Burkhart, who would later be revered as the founding father of dental health. His notion that preventative dentistry would not be attainable without a new generation of hygienists to monitor young patients both at home and in school was seminal in the formation of a new kind of dental public health service.

Harvey Jacob Burkhart's Dental Dispensary provided the first structured training programmes in dentistry for children, influenced by the director's absorption of Abraham Flexner's 1910 Carnegie Report on American Medical Education, which stressed science-based medical education and the inspection of postgraduate training schemes.

Hence, Harvey Jacob Burkhart's Dental Dispensary provided the first structured education programmes in children's dentistry. Unfortunately, Harvey Jacob Burkhart did not get along well with the Dean of Rochester Medical School, George Hoyt Whipple, resulting in the Dispensary staying as a children's clinic until it merged with the Rochester Medical School in 1998, some 46 years after Harvey Jacob Burkhart's death.

London

George Eastman donated £200,000 in 1926 to fund a dental clinic in London, UK after being approached by the Chairman of the Royal Free Hospital, Lord Riddell. This was in addition to donations of £50,000 each from Lord Riddell and the Royal Free honorary treasurer.

On 20 November 1931, the Eastman Dental Clinic opened in front of Neville Chamberlain and the American Ambassador. The clinic was incorporated into the Royal Free Hospital and was committed to providing dental care for disadvantaged children from central London.

Unfortunately, by the time the London clinic was opened, George Eastman was in severe pain and his mobility was very limited. After meticulously redrafting his will, on 14 March 1932 George Eastman shot himself, leaving the note, 'To my friends, my work is done. Why wait?'

'Charitable causes, the arts and education had received £18 million from George Eastman over the years.'

Charitable causes, the arts and education had received £18 million from George Eastman over the years.

The Eastman Dental Hospital & Institute of Dental Surgery

In 1948, the Eastman became independent of the Royal Free and became the postgraduate dental institute of the Postgraduate Medical Federation.

The objects of the institute were to:

  • Train consultants, specialists and teachers in various branches of dentistry

  • Provide facilities for, and research by, members of staff and students

  • Provide clinical and laboratory facilities, and instruction for candidates working for higher degrees or diplomas

  • Provide short courses for general practitioners.

In 1948, the establishment of the Faculty of Dental Surgery at the Royal College of Surgeons by Professor Robert Bradlaw, and the foundation of the Dental Fellowship examination were fundamental to the future place of the Institute and Hospital in postgraduate dental study, both nationally and globally.

The institute has had an eventful history and has been under the direction of six very different deans throughout its time.

1948-1950: Alan Deverell

Alan Deverell, the director of the new Eastman clinic, was appointed as the first Institute Dean in 1948 until 1950. There were just four heads of department in 1948, but a key appointment was A. E. Denison, chief technician. He taught clinicians up until 1970 as well as founding technicians' courses and materials science development. During 1949, Ivor Kramer created a department of pathology and microbiology, and Guy Poyton and Vera Creaton opened the first civilian oral hygiene school in the UK.

'By 1950, England had free primary dental care so the Eastman no longer provided routine treatment...'

By 1950, England had free primary dental care so the Eastman no longer provided routine treatment, except for a casualty service under the name of the Eastman Dental Hospital.

Despite Alan Deverell's innate charm and renowned abilities as a consultant, he was not able to cope with the rapidly expanding educational nature of the Institute, so Professor Frank Wilkinson took over as Dean in 1950.

1950-1959: Professor Frank Wilkinson

Professor Frank Wilson, previously Dean at Melbourne and Manchester, created a full department range at the Eastman, including children's, oral surgery, radiography and prosthetics.

His international connections allowed the Eastman to blossom into an international excellence centre of higher training. Thirty percent of trainees hailed from the commonwealth and 14% from elsewhere in the world, representing 22 countries in total. A review in 1956 indicated that a high number of students from the six years previously had achieved prestigious appointments, including consultants and senior lecturers.

Dr L E Claremont (First Director, Eastman Dental Clinic 1931)

Professor Frank Wilkinson resigned reluctantly in 1959 at 70 years old, having established an internationally respected multi-disciplined further education dental school.

1959-1970: Sir Robert Bradlaw

Dean at Newcastle prior to the Eastman, Sir Robert Bradlaw was the catalyst for a close relationship with the Department of Health and the Royal College of Surgeons.

In anticipation of the departure of the Royal Free in 1967, plans were drawn to rebuild the Eastman on the St. Mary's Hospital site. Simultaneously, Eastman's teaching concept altered, with MSc courses of the University of London being introduced. This overtook the long general subjects course for the FDSRCS, and challenged students and staff with its research dissertation.

1970-1983: Professor Ivor Kramer

Being a deputy Dean since 1950 meant that Professor Ivor Kramer was a natural successor to the Deanship. By 1979, students from 38 countries attended the Institute and the MSc courses had grown. A period of steady development, epitomized by the Kramer lectures, preceded a subculture of change that came with the anticipated move to the St. Mary's site.

The sum of £100,000 was donated by Kodak to assist in the establishment of new laboratories for research, and the merger of all the specialised institutes with multi-disciplined undergraduate teaching hospitals resulted in the deconstruction of the Postgraduate Medical Federation.

In 1975, the economic collapse together with setbacks with local planning resulted in the halting of the Eastman-St. Mary's build at a very late stage. Now isolated, the Eastman battled for survival elsewhere, with the plan of taking over two floors of the Guy's Tower Block coming to no fruition.

'Necessity forced an oral research laboratory to be set up in a derelict wing of the Royal Free, which would eventually become the first of the Eastman Research Laboratories.'

Necessity forced an oral research laboratory to be set up in a derelict wing of the Royal Free, which would eventually become the first of the Eastman Research Laboratories. Following some wrangles with the NE Thames Regional Health Authority and the Department of Health, Ivor Kramer saved the day by storming Whitehall and convincing the civil servants to fund the essential expansion on the old Royal Free Hospital site. It was acquired for £2.5 million.

Part of the main production laboratory (Prosthetics). Lower ground floor, south wing (now X-ray Department offices) Circa 1950

1983-1993: Professor Gerald Winter

The Eastman's period of expansion coincided with the appointment of Professor Gerald Winter as Dean. The completed refurbishment of the old Royal Free Hospital buildings for the Eastman was completed in 1988 and opened by Princess Anne.

St. Mary's Kodak money funded a research facility extension and the number of postgraduate students more than doubled. The creation of the dental practice centre in the Levy wing allowed for extra income through general practitioner courses. Other new departments created at this time included oral biology and biomaterials science. An outstanding investment for science came from Nicola Boissard, which formed the beginning of a fund to create a Chair in Oral Biochemistry, now known as the Boissard Chair in Cell Biology.

At this point, the tradition of self-regulation in research was deprofessionalised. The Research Assessment Exercise (RAE) was factored in and the Eastman began with a rating of two in 1984, followed by a three in 1988. A four was expected in 1992 but a surprise came when the Eastman was awarded another two. Professor Winter led the institute in a judicial review, which revealed strange scoring methods and demonstrated the actual strength of the Eastman's research. Crucially, widespread support was garnered for radical changes in the assessment process.

In 1992 the Institute's title was changed to the Eastman Dental Institute (EDI).

1993-present: Professor Crispian Scully CBE

Professor Crispian Scully, Dean at Bristol, was invited in 1993 to take the Deanship. At that time, funding was via the British Postgraduate Medical Federation but then became directed through the principal university colleges and a merger with the London Dental Institute seemed to provide an academic presence north of the Thames.

However, the possibility that there would be a transfer of research to Queen Mary College became apparent, so the Institute affiliated with University College London with complete entry taking place in August 1999.

Prior to this was the entry of the Eastman Dental Hospital (EDH) into the UCL Hospitals Trust in 1996, meaning that the Eastman Dental Hospital is now part of a large network of surgical and medical excellence. A new hospital for the Trust was opened in 2006 and the University College Hospital cruciform building refurbished as a world research centre.

'In 1997, the Research Assessment Exercise awarded the Eastman five out of five...'

In 1997, the Research Assessment Exercise awarded the Eastman five out of five, owing much to Crispian Scully's efforts. In 1999 the Quality Assurance Agency teaching review gave 23 out of a possible 24 marks.

Highlights since 1993 include:

  • Queens Award for Higher Education 2002

  • International recognition of success in research and education

    • World Health Organization collaborating centre

    • Grant funding from Medical Research Council, National Institute for Health USA, European Union

    • High quality publications in international high impact journals, eg Journal of Clinical Investigation, Journal of Experimental Medicine, Lancet, New England Journal of Medicine

    • Prizes at International Association for Dental Research

    • British Medical Journal commendation for medical writing

  • Highest research publication record

    • Greatest number of publications of all UK dental institutes

  • Increased grant funding

    • Over 115% increased grant funding

  • Tremendous increase in resources

    • Over 75% increased income

  • Increase in quality staffing

    • More than 45% increase in staffing

    • Greatest focus of senior dental staff in UK

  • New courses

    • Masters in Clinical Dentistry in Fixed & Removable Prosthodontics, Endodontics, Periodontology, Paediatric Dentistry

    • Certificates and Diplomas in Clinical Dental Sciences, Conscious Sedation and Pain Management, Endodontics, Implantology, Paediatric Dentistry, Special Care Dentistry

  • Novel academic departments and their new courses

    • Continuing Professional Development Unit housed in dedicated facilities offering continuing education to all members of the dental team in the form of part-time programmes and distance learning

    • Dental and Medical Informatics Department

    • Implantology Department; Masters in Implant Dentistry

    • Oral Medicine Department; Masters in Special Care Dentistry

    • Transcultural Oral Health; Masters and distance learning courses

  • New research and education facilities

    • New information centre

    • New media centre

    • New and refurbished research laboratories

    • New teaching laboratories

    • New information technology, computer-assisted learning and teledentistry units

    • New international centre for excellence in dentistry

    • Committee for Vocational Training attracted to EDI

    • National Centre for the Continuing Professional Education of Dentists attracted to EDI

  • Greatest focus of postgraduate dental education in Europe

    • Largest concentration of postgraduates in UK and in Europe

    • 60% of postgraduates from UK, 40% overseas

    • Over 50 different countries represented.

The success of the Eastman owes something to each of its teachers, clinicians, scientists and postgraduates. It was Harvey Jacob Burkhart's original influence, however, that won the support of George Eastman for dentistry. Harvey Jacob Burkhart's initiative spawned the specialist clinics in Europe.

George Eastman himself was also a crucial character who was both industrious and cunning. His exploitation of patents and competitors no doubt was instrumental in the success of the EDI. In addition to dentistry, he also invested millions of dollars in education, promoted equal opportunities in the work place, funded affordable housing and green areas within the urban environment and supported the arts.

Honour the past and celebrate the future

Following recent discussions on the future of the Eastman, the hospital and institute have been warmly embraced by both University College London and University College London Hospitals Trust as well as the Department of Health and the Chief Dental Officer – ensuring a secure future.

To reflect 60 years of success and a bright future, the Eastman is holding a celebratory congress at the Eastman in Central London in April 2008. This meeting will appeal to all through a challenging educational and research programme looking at the Eastman's activities on Thursday 3 April as well as a clinical CPD day on the topical issue of 'Implants vs teeth' with parallel sessions for all members of the dental team on Friday 4 April.

Please hold these dates for your diary. This is a limited attendance meeting. To register your interest, please contact Victoria Banks via email at v.banks@eastman.ucl.ac.uk, by telephone on 020 7905 1251 or visit http://www.eastman60.org.uk.