Presidential Address by J. Gary Maynard, Jr. Distinguished guests, fellow officers, members of the Board of Trustees, past presidents, members and friends of the Academy, family and friends of mine, I appreciate your indulgence and attendance as I bring to you The State of the Academy my Presidential Address. In preparation of this address, I have tried to follow the guidance of several past presidents and other friends who suggested I: a) do a review of the literature; b) present it in an orderly form and; c) make it short and simple. In reviewing past Presidential Addresses, I noticed they share some common thoughts and traits. In talking with past presidents, there is consistency in the amount of anguish, worry, and stress experienced in writing the Presidential Address. I assure you I have suffered similar feelings and found this duty to be one of the most difficult I have had to fulfill all year. Yet, I was comforted, having polled a number of members, to know only a few actually read the published Presidential Address, (generally only presidents in preparation for their own Presidential Address) and -

fewer remember it! In the future, this year may be perceived as "the eye of the hurricane" having been preceded by Hurricane Ron, and followed by Dynamic Bill. My year has been, comparatively, a calm one. I believe, however, it has been an effective, productive year and hope the year's accomplishments will make a difference in our pursuits of the future. During Bob Koch's presidential year, I had the pleasure of serving on the Long Range Planning Committee to develop a strategic plan. In the following years, many Academy activities reflected that strategic plan. But, as so often happens, the plan began to develop "dust." New projects and programs outside the objectives of the plan distracted the Board of Trustees. This failure to rely on the Strategic Plan created confusion for staff and impeded our path for progress. This year, a Strategic Planning Committee, consisting of the officers and at least one trustee from each district was appointed to re-evaluate and modify the 1986 plan. A Membership Survey provided the knowledge base to evaluate the plan. The cooperation of the Meetings and Membership Services Department, and you, the members of the AAP, in developing, responding, collecting, and collating the information made the resulting Strategic Plan relevant. The Board reviewed, developed and prioritized objectives, and approved a three-year plan. To assure an ongoing three-year plan, the Board will review the objectives annually and all new programs will be evaluated against even



To prevent this plan from becoming another "dust collector" it was essential that Committee Chairmen become "Presented October 26, 1990


the 76th Annual TX.

Academy of Periodontology, Dallas,

Meeting of The American


involved. The first Committee Chairman Orienta-

tion, held in July, represented the culmination of two im-

portant endeavors: the

restructure of the Academy's committees and the development of the 1991-1993 Strategic Plan. To make the Strategic Plan viable, all committees must now develop operational plans for their assigned

objectives. An organization cannot function effectively and efficiently without a master plan. As our global economy faces an unpredictable future, our organization will have its fi-

nancial resources, its volunteer commitments, and staff affordability challenged. Without annual evaluation, we will not survive. I leave the presidency of the Academy comforted in knowing we have a plan with a mechanism for annual review, a plan that is mutually supported by its members and the governing body, and one that may be effectively implemented by committee and staff. As Stephen Goodman expressed in his Presidential Address "we are growing into the future because we are continuing to plan, and planning is doing things today to make us better tomorrow because the future belongs to those who make the hard decisions today." Because of the hard decisions we have made today, the future direction of the Academy stands assured. Providing better and creative benefits for our members is an ongoing commitment. This year several new services and programs were enacted. One of these, the Sponsor Program, pairs a sponsor or established member with a new member. The Sponsor Program recognizes the importance of the new individual's contributions to the Academy and

promotes supportive relationships.

Our new member packet was redesigned and updated to provide better access to and utilization of information, and to make a professional presentation comparable with the excellence of the AAP. We presented this packet, for the first time, at the New Member Luncheon yesterday. Through the persistence and dedication of Rosie Barnstable, our membership retention and our student membership enrollment are both 99.4%, probably the highest of all dental specialty organizations. This year we distributed the award brochure to all members at registration. Our annual award recipients are dedicated volunteers who deserve maximum recognition for their accomplishments. An Ad Hoc Committee chaired by Bob Koch recently developed more specific criteria for AAP awards. These criteria should establish more meaningful significance for meritorious service in the future. The future of all organizations belongs to the young. The membership rolls indicate 298 of us completed training and joined the Academy as active members prior to 1965. This represents only 7.8% of our current membership. Since

Volume 62 Number 2


1980, 1,594,

or 42%, of the membership completed their and became active or student members. We have training a funnel shaped membership many coming in and few

going out.

This year the Academy made monumental strides in understanding and supporting its younger members. I wish each of you could have been present for the first Young Periodontist Conference. This program, underwritten by Procter & Gamble, responded to the Young Periodontist Committee's objective "to maximize practice growth and financial success of the young periodontist." The committee, chaired by Richard Cutler, demonstrated diligence, excitement, and thoroughness in its work which was a testimonial to the young periodontists and their generation. There is no doubt following that weekend experience, that nothing but a bright future lies ahead for The American Academy of Periodontology. As responsible leaders we must permit them an opportunity to develop and guide the Academy, constantly seek means to harness their excitement and energy, and never stifle it. I feel confident about the future knowing the AAP is committed to its young members and, in turn, the young members are committed to the American


Much of the success of the Young Periodontist Conferbe credited to Barbara Connell, Director of Meetand ings Membership Services, and her staff, Jean Pierson, Rosie Barnstable, Linda Johnston, and Lynne Paul. Our Dallas Meeting is the first in which Barbara and her staff have had complete responsibility for planning and executing. I am sure you will join me in applauding their efforts. I was fortunate to have a strong trio responsible for organizing this meeting: Chairman and AAP Treasurer Leonard Tibbetts; Program Chairman Tom Wilson; and Local Arrangements Chairman L.K. Croft. These men along with their spouses, Mary Jane, Penny, and Lucy, have worked with other periodontists and their spouses to put together one of the finest Academy meetings ever. Texas has a reputation for doing things in a "Big Way;" this meeting only further bolsters that image. Now completing its fourth year, the Professional Partnership Program continues to thrive, as evidenced through the numerous local and regional meetings and C.E. courses at this Annual Meeting. The contributions that Steve Mackler and his committee have made in the past have been Herculean. His strong direction and enthusiasm for the program serve as a model for other committees. When the Strategic Planning Committee and the Board of Trustees developed objectives for the Strategic Plan, the importance of enhancing the relationship between the periodontist and general dentist was re-emphasized. The Committee's primary charge for the next year is to assess and plan the future direction of this key program. Successful periodontists of the past, present, and future will always have one thing in common: a well-developed, mutually supportive relationship with their general dentist referral base. The periodontist and the generalist must work ence can


together as a team. We cannot survive without them. In the spirit of cooperation, periodontists must be cognizant of the generalist's problems and be willing to share knowledge. The American Academy of Periodontology demonstrates this commitment to the general practitioner through its Associate Membership category. Its status is currently at an all time high in Academy history. I feel the principle reason for that "high" is the dedication and interest of the Associate Member Representative to the Board of Trustees for the past six years—Dick Wilson. Dick has served cooperatively on innumerable committees, spent weeks in the air traveling on behalf of the AAP, and written more AAP News columns than all past presidents combined. He has represented the Associate Membership earnestly, speaking when asked and always softly, but forcefully. He attended Board Meetings and Annual Meetings with the compulsion of a "30 year perfect attendance Rotarían"—all the time being denied the right to vote. Dick, you have made a meaningful and signal contribution to the Academy, and we, as periodontists, are indebted to your leadership and talents. Encouraging and inviting Dick Wilson to be active in The American Academy of Periodontology may well be my most significant single contribution to the Academy. Historically, the Academy has been committed to working in tandem with allied dental organizations. We have enjoyed another successful year which embellished these relationships. The AAP-AGD lecture series initiated last year has been completed. Nine well presented and received lectures were given by former presidents Erwin Barrington, Robert Schallhorn, and Myron Nevins. Almost without exception the series received rave reviews for its professional delivery of material and demonstrative show of cooperative spirit by the AAP. Cooperative efforts between the AAP and ADA continue to expand. Several years ago, Bill Wathen, former editor of the Journal of the American Dental Association, invited us to contribute to a special issue on periodontics in JADA. Eight subjects were selected and authoritative authors in each area were invited to submit articles. Myron Nevins and I served as co-reviewers and Rita Shafer, Managing Editor of the Journal of Periodontology, provided the expert technical advice. The combination resulted in the quality October issue of JADA. The authors are to be complimented on these contributions, which will serve as an important periodontics reference for general practitioners. Accolades


in order for Sam Low for his contribution

to the popular ADA Seminar Series, "The Team Approach to Periodontal Therapy." The course addresses how the

dentist determines the appropriateness of consultation with a specialist, as well as develops better communication skills. The series has been so successful that Alan Fetner has been asked to serve as a second presenter. Educating the public about periodontal disease and the role of the periodontist in its treatment has long been an Academy priority. In September 1991, the -ADA will launch the Periodontal Awareness Campaign. This program


J Periodonlol


February 1991


strengthen our position as the public's and profession's for periodontal information and has been a major planning function of the Public Communications Commit-



this year. For generations periodontists and the AAP have strongly advocated and exclusively taught the comprehensive periodontal examination. Its virtues in the detection of periodontal disease are proclaimed throughout the halls and clinics of academia as well as in private practices. However, the infrequency of its use and the lack of early diagnosis of periodontal disease signal a perplexing challenge to the profession and especially to periodontists. Early in my year as president, I appointed an Ad Hoc Committee on Periodontal Screening and Education Program, and named Paul Tannenbaum chairman. The Committee was charged to develop policies for a national periodontal screening and education program in cooperation with Chesebrough-Pond's. The committee members responded with vigor and creativity. They weighed their concerns regarding the periodontal screening program against the underutilized comprehensive examination. After discussion and debate, they unanimously agreed that the benefits of a screening program outweighed the potential risks. Following Board approval of the policy and program, an invitation was issued to the ADA to co-sponsor a two-phase National Periodontal Screening and Education Program. The ADA Board is scheduled to consider the proposal in January and, if approved, the next decade will witness a momentous, synergistic effort between, AAP, ADA and the corporate sponsorship from Chesebrough-Pond's all for the good of the profession and the public. This program will have major professional and public educational ramifications and will affirm the AAP as the leader and authority for periodontics in the nation. Since the departure of the Communications Director earlier this Fall, Robin Richman has provided staff support to the Professional Relations and Public Communications Committees and the Ad Hoc Committee on Periodontal Screening and Education Program. These committees with Chairmen Steve Mackler, Steve Buck, and Paul Tannenbaum and their members have performed outstanding services during the year. The Public Communications Committee has developed a new brochure "Periodontal Surgery: What Can I Expect," which makes its debut at this Annual Meeting. The highly successful and popular brochure "Gum Disease: What You Need to Know" has sold over 165,000 copies during the year and was recently translated into tee


Spanish. The Academy has initiated video news releases as a medium for relaying our messages to the public. Following the publication of Ray Williams' Medical Progress Report in the February issue of The New England Journal of Medicine, a VNR highlighting the report was produced by AAP and was aired nationwide. We commend Ray for his contributions to the Journal as well as his assistance with the VNR. Additional VNR have been released on implants in

conjunction with the implant media campaign, special issue on periodontics.

and the JADA

The Public Communications Committee's implant media campaign is well underway. Twenty-five hundred implant media kits and VNRs were sent to leading newspapers, magazines, and radio and TV stations in September. In preparation for the event, six national speakers, all officers and three national implant experts received spokesperson training. The campaign should position the periodontist as a team member for the placement, construction, and maintenance of the implant-supported prosthesis. As the scope of periodontics has broadened and periodontists are recognized as implant surgeons, it seems appropriate for the Academy to provide an arena for its members to learn about implant placement and implant-supported prosthesis, and to foster a team approach to the reconstruction of the partially or totally edentulous periodontal diseased patient. This modality of therapy provides a unique opportunity for general practitioners, prosthodontists, and periodontists to study, learn, and grow together. To meet these needs, the Organizing Committee on Implant Conference, chaired by Ron Nevins, developed the program for the June 1991 Implant Conference. This conference will provide an opportunity for Academy members to join with their referring general dentists and prosthodontists for a weekend of study and exposure to the experts while strengthening professional relationships. This conference can only provide a win-win result for all participants. During the year, this program has been planned, speakers invited, site selected (Washington, D.C.), and dates (June 21-23,

1991) approved. During the year, a newly established Publications Department acquired joint responsibility for two major AAP publications—the Journal and the AAP News. The publications of the Academy continue to provide membership and the profession with the latest in research and clinical developments as well as interesting news issues. This year they have done it with a face lift! The Journal of Periodontology and the AAP News were redesigned for better readability and professional appearance. We commend Bob Genco, Editor,

and Rita their continuing role in source



Shafer, Publications Director, for

making the Journal the primary periodontal "cutting edge" research and

The AAP News, written and nurtured by Katie Goss, Assistant Publications Director, continues to be the Academy leader among publications read "most regularly and in its entirety." By consolidating several formal publications into one, increasing the number of issues, and enhancing the publication with a new design, the AAP News has become even more popular and readable. I particularly appreciate Katie's wise and positive encouragement as I prepared my President's Column. Rita and Katie are assisted by Publications Assistant Kelly Wool. The revision of the Glossary of Periodontal Terms is well underway due to the efforts and commitment of the "Seattle

Volume 62 Number 2

Connection." The committee of Bill Dahlberg, Robert Johnson, and Jim Easley has spent countless hours studying and meticulously evaluating current and new terms to update this important publication. The never-ending task of reviewing, developing, and writing research or position papers falls into the hands of three committees: Therapeutic Modalities Committee, Burton Langer, Chairman; Pharmacotherapeutics, chaired by Mike Newman; and Research in Periodontology, chaired by Bill Ammons. During the year these Committees have submitted and the Board has approved a number of important revised and new position papers. Our congratulations and thanks to these Committees for their unselfish and untiring attention to these responsibilities. According to the Membership Survey, the development of AAP patient education brochures and scientific publications has become one of the most important and expected membership benefits. The sales of these publications have likewise become an increasing essential part of our budget revenue. Non-dues revenue has steadily increased over the past five years from 57% to 71%. This increase results from member-driven demands for quality publications, which have been satisfied by committees developing and writing papers, and the marketing efforts of the staff. Don Morin, Director of our Business and Financial Affairs Department, and his staff are responsible for the promotion and sales of these publications. Don has brought fiscal expertise and sound judgment to the Academy and has forestalled a dues increase for several years. In these days of budget restraints and financial stresses, his proficiency benefits all members. Don's ability to recruit, hire and, train employees also deserves praise. Two of his department members, Leslie Paplinski and Julie Ray, were recently transferred to other departments with increased responsibility. Their positions have been filled by Shawn Uhe and Peggy Hoyle. The Academy has a responsibility to the public to assure that future periodontists receive postdoctoral education commensurate with patient treatment needs. The Academy must take a leadership role in guaranteeing appropriate changes in postdoctoral curricula. To this end, the Committee to Revise Postdoctoral Accreditation Standards, cochaired by Bill Becker and Ray Williams, planned and organized a Consensus Conference to Revise Postdoctoral Accreditation Standards. This workshop will develop revisions to the current accreditation requirements. The resulting document will be submitted to the ADA Commission on Dental Accreditation for review and approval. As the complexities of periodontal care increase, educational and training requirements must accommodate and reflect these changes. Three years of postdoctoral training may become an essential element of this requirement. I encourage all Academy members to support their respective educational institutions, postgraduate directors, and workshop participants as they wrestle with these issues. Staff support to this Committee has been under the Department of Scientific, Clinical and Educational Affairs,



directed by Patricia Norfleet. Pat provides superior direction to the Committee facilitating timely progress. Another committee providing untiring leadership and direction this year to the membership is the Committee on Dental Care Programs, chaired by Jerry Zackin, and its Subcommittee to Revise Current Procedural Terminology (CPT 6), chaired by David Plessett. Jerry had provided incredible leadership to this Committee through many perceived "stormy seas." Its regional and Annual Meeting workshops, plus the one conducted at the Young Periodontist Conference, were well attended and provide everchanging and helpful insurance information. The CPT 6 revision process is moving assuredly towards completion. Thank you, David, for your guidance and expertise. Program Coordinator Theresa McSwiggin's dedication and assistance to this Committee and to the membership has been espe-

cially praiseworthy. According to a Business


Magazine report, by


year 2040, 20% of the American population will be older

than 65. The report also advises that 11% of the population over the age of 65 now accounts for 35% of the nation's health care expenditures. According to the 1985-86 NIDR National Survey of Oral Health in the U.S. Employed Adults and Seniors, 42% of those over 65 were toothless. Those with teeth are at risk for the full range of oral diseases including decay on crown and root surfaces, periodontal disease, oral cancer, and tooth loss. To respond to the needs of this enlarging populace, the Clinical Practice Affairs Committee was charged to develop a long-range plan for geriatric care. The Board accepted, in principle, an outline of a 10-year plan for geriatrics and appointed an Ad Hoc Steering Committee on Geriatric Issues. We compliment Arnold Binderman and his Committee for their excellent efforts and report. The Central Office staff of the American Academy of Periodontology is the envy of all specialty organizations. This is principally the result of the work and organizational abilities of Alice DeForest. When I took over as president, my prior association with Alice had been only cursory. Even though I had utmost respect for her, I had no idea of the depth of her leadership skills. Prior presidents speak of her as: "a fresh breeze on the scene," "a leader by her example" and "Alice has truly given of herself to the Academy." It is difficult for me to find additional words to express my admiration and sentiments about Alice the person, the administrator, the leader, the "Mother Hen," the facilitator, the consultant, the critic, the criticized, the articulate orator, the detailed note taker, the author, and at the same time a loving, devoted wife to Paul for 20 years! We are indeed fortunate to have you, Alice, as our Executive Director and I thank you for your dedication and support to the AAP. Alice would be the first to share the success of her accomplishments with her dedicated Deputy Executive Director, Nadine Seidman. Nadine is typically quiet—but supportive; agreeable—but will debate; gentle—yet force—



fui as she fulfills her responsibilities to the president, president elect, executive director, and all others that call on her for assistance and direction. Whatever success I have had as your president, I owe much of it to the guidance and care of these two. Alice and Nadine are supported by Hazel Gamble, Gloria Huerta, Julie Ray, Maria Equihua, and Audrey Baznik. All of these women deserve laurels for their efforts. We read about the reduction of periodontal disease, the increase in courses on soft tissue management and periodontal care by the general practitioners, and of cost containment by industry resulting in employee insurance benefits being modified. We know of the reduction in dental school enrollment, yet the stability in the number of postdoctoral students in periodontology. All of these issues have the potential to affect each of us. As I talk with periodontists across the country, there appears to be a consensus about the following: 1. Periodontists are seeing fewer patients with gingivitis, early Periodontitis, as well as fewer generalized advanced cases.

2. There is an increase in referrals for diagnostic services, particularly in the area of oral medicine and mucocutaneous lesions, as well as therapeutic services for localized osseous and soft tissue defects, surgical crown extension, reconstruction and regenerative procedures, and implants. 3. There appears to be a gradual improvement in the

general dentist/periodontist relationship. 4. There is increased public awareness

of periodontal disease. 5. There is both excitement and apprehension about future technology and therapeutic advances. As we analyze these common issues, we can be proud of the advances the profession has made for the public in reducing the ravages of periodontal disease. We should compliment the Academy's role in improving diagnostic and therapeutic skills of the generalist which has resulted in earlier detection of disease, reduction in disease severity, and referral for localized surgical services. The Periodontal Screening and Education Program and Professional Partnership Program will continue to produce substantive chañes in periodontal disease detection, public awareness of the disease, and improve our professional relationships. There is still a great deal yet to be done! I know under the leadership of Bill Becker, Seb Ciancio, Mike Newman, Leonard Tibbetts, and Don Adams the Academy's continued commitment to its mission will be enlarged. The Academy has always applied strict criteria for the acceptance of corporate funds. We welcome the financial support of commercial firms, realizing that without their assistance many Academy projects would be postponed or cancelled. For example, the World Workshop held in 1989, and the Young Periodontist Conference this past July, were supported by corporate underwriting. Next year's Post Doctoral Directors' Workshop likewise is supported by corporate sponsorship. Commercial contributions also help support

J Periodontol 1991


many Annual Meeting functions and several of our honors and awards. Our guidelines, like those for the review of display advertising, are considered among the strictest in dentistry. In order to avoid potential conflict, which might jeopardize an extremely important project, the Board endorsed in principle the ADA's "Guidelines for Corporate Sponsorship of Health Education Materials." The primary difference between the ADA guidelines and ours is that we have not permitted the mention of a specific product or brand name on any published materials while ADA does permit such mention. This decision represents a deviation from previous policy, but I have no doubt that the positive impact of our cooperative programs far outweighs any perceived risk to the Academy's integrity. I share a quotation from Bob Koch's Presidential Address, "Properly handled, the public and the Academy of Periodontology can benefit from sound educational efforts provided by AAP and underwritten by commercial concerns." I congratulate the Board of Trustees for approving a plan to develop written guidelines for corporate sponsorship and monitor closely our conflict of interest policies. The Board of Trustees has approved the formation of an AAP Foundation. Relying principally on conributions, the Foundation is proposed to provide funding in areas that are not currently addressed by the Academy. In the membership survey, 37% indicated that they would give to a foundation as part of an annual campaign. I ask you to support this Foundation with your contributions. I practiced periodontics the first 19 years of my life without being a diplomate of the American Board of Periodontology. Yet, I found obtaining diplomate status an immeasurable source of professional and personal satisfaction and proves that even an "older dog" can learn new tricks. It is an achievement that I encourage all non-certified periodontists to consider! During the year, a new format for the Board examination was developed, which hopefully will promote more periodontists to become Board certified. The Board of Trustees continues to pledge its support to the Board, and I challenge all postdoctoral program directors to motivate their students to seek Board certification. The death of Saul Schluger and John Prichard has deeply touched the hearts of many members of the Academy. Their contributions to education, research, and clinical practice and their leadership to the Academy were monumental. We will miss them both, and I know you all would join me in expressing our sympathy to their families. To serve as President of the American Academy has been a prestigious honor. There is no way I could have managed this responsibility without a strong Central Office Staff, private practice support, and equally committed family. I would like to say thanks to my office staff who are with me today: Betsy Hawkins, Office Administrator, and my three hygienists—Elaine Loftin, Susan Elliott, and Barbara Gilbert Homan, who collectively have worked for me 70 years. To my associate Benita Miller, I thank you for the many hours you have covered the office in my absence. I

Volume 62 Number 2

would also like to express my appreciation to the rest of my staff who is at home, Fran, Mary Ann, Denise, Mike, and especially my surgical assistant, Paige Lewis, who, for many days when I was in town, worked along side me from 7:00 a.m. to 7:00 p.m. The greatest sacrifice made for me to hold this position has been that of my family. Without their constant support, comforting smiles, and reassuring words I could never have made it. For the many evenings and days that I was away from each of you—I can never return them. But, knowing you each as I do, I believe you would have expected no less commitment from your husband, father or from yourselves. To Sara, Catherine, John Gary, and Mason, I appreciate your understanding and thank you for your love. To the new members of our family, Jeff Armstrong and Jeff Sommers, I appreciate your presence today, and compliment you on your wisdom.



To my mother Grace and mother-in-law Sara, I say thank you. Your pride in me has kept me motivated. Finally, to the foundation of the Maynard family, Sallyalways willing to listen, giving advice only when asked, genuinely suppporting and encouraging me, guiding me, but never criticizing me—my best friend, no more perfect a mate could a man have—thank you. To Clifford Ochsenbein—a special thank you for accepting me as a graduate student and giving me the opportunity to be a periodontist. To Ron and Bill—the three of us have had a unique opportunity to serve our fellow professional friends. It was fun! May history show we made a difference. To you the members, I thank you for permitting me this opportunity to serve your organization. Our future is secure due to your dedication and commitment.

Presidential Address. The state of the American Academy of Periodontology.

164 Presidential Address by J. Gary Maynard, Jr. Distinguished guests, fellow officers, members of the Board of Trustees, past presidents, members an...
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