A sequence had been established in the three-year program of the Boston Dental College which included anatomy, physiology, materia medica (introduced in 1895), histology, operative dentistry and dental anatomy, clinical dentistry, mechanical dentistry, dental techniques (introduced in 1896), and chemistry (which was required throughout). Bacteriology had been introduced in 1895, and in the senior year the student received instruction and practice in anesthetics. A review of the curriculum indicates continued stress on medical knowledge and on practical experience. The curriculum looked better on paper, however, than it was in actual operation. As has been indicated, the courses intended to provide a foundation in medical subjects were not always taught as advertised. The facilities for lecture, demonstrations, and laboratory work were so grossly inadequate that these various deficiencies had prompted the union with Tufts.

Opportunity for observation of surgical technique was still provided in 1899; in fact, the Boston Dispensary had been added to the earlier list. But the use of these resources was not systematic, and no schedule of visitation existed. Students were left very much on their own. The total charges had actually been reduced (to $115)

No significant changes were made in the entrance requirements inherited from the old Boston Dental College. High school graduation or examination continued to be the minimum expected. After 1910, holders of Regents' Certificates of the State of New York were exempt from entrance examinations, together with those holding a high school diploma or having pursued some amount of college or university work. When the unit system of computing secondary school work came into use in 1911, fourteen such units were required for admission to the dental school (although failure in as many as five units was allowed for conditional admission). Simultaneously, units were grouped into Required and Elective. English, elementary foreign language, elementary physics, elementary algebra, and plane geometry fell into the first category. Those admitted with advanced standing had to complete their last year in the Tufts Dental School. There was something of an effort to preserve a linkage, however tenuous, between professional and classical preparation, for students entering by examination were told to be prepared to demonstrate their knowledge (in writing) of such literary works as William Hickling Prescott's Conquest of Mexico, William Makepeace Thackeray's Henry Esmond, or Edmund Burke's "Speech on Conciliation with America," not to

The greatest immediate change in the dental school program was its extension to four years in 1900-1901, effective for all classes in 1902-3. The Tufts Dental School became the second of the fifty-four leading dental schools in the United States to take such a step, the University of Michigan having been the pioneer. Tufts could derive special satisfaction from the fact that the National Association of Dental Faculties voted to demand the same standard of its entire constituency after 1903. The entering class dropped from ninety-nine to forty-three in 1902-3, but immediately climbed again so that records were broken almost every year thereafter. The four-year program made possible new courses in embryology, physiology, and personal hygiene as well as more intensive work in such areas as pathology, orthodontia, and clinical dentistry in general. The first two years of work for dental students were almost the same as the corresponding years in the medical school. This underlined the fact that Tufts was in the forefront of the movement to teach dentistry as a specialty of medicine.

Supporters of the new program were grievously disappointed when, after only one year of the four-year course, the National Association of Dental Faculties reversed itself and returned to a three-year curriculum. This "retrograde step," having been adopted by all dental schools affiliated with the Association, left the Tufts Dental School in the unenviable position of either going along with the majority or attempting to go it alone. The school compromised by leaving the four-year program in its offerings but providing a three-year optional course. There was some feeling, at least at Tufts, that dental schools with university affiliations ought to drop out of the National Association and leave it and the three-year programs to proprietary and commercial schools.

Until the Boston Dental College united with Tufts, graduates received the degree of Doctor of Dental Surgery, as provided in its 1868 charter. After the union was accomplished, graduates obtaining a Tufts degree received the Doctorate of Dental Medicine

The acquisition of the dental school made new housing imperative. There were 176 students enrolled in the school in 1900- 1901, notwithstanding the fact that 30 per cent of the applicants had been rejected on entrance examinations. The College had also agreed to provide the school with a home as part of the arrangements of 1899. In the year before the dental school became formally a part of Tufts, enrollment in the anatomy course in the medical school jumped by fifty students who had come from the Boston Dental College. Anticipating that this might very well be a step in the complete absorption of the dental college, the Tufts Trustees began to look about for new quarters. At first they intended to buy additional land in the same block as the medical school building, but as soon as word got out, the prices of property shot up with astounding rapidity. Checked in this direction, the Trustees decided to purchase land at the corner of Huntington Avenue and Bryant Street across from the Fenway and to erect one building that would serve as a combined medical-dental facility.

One building to serve two schools not only seemed the most economical and efficient solution but was quite in harmony with an educational philosophy which posited the close relationship of the two professions. The very fact that the two schools shared a common dean was a working out of this principle. As President

The close ties already existing between the medical and dental schools in curriculum, use of facilities, and the sharing of a dean were carried over into other areas of administration. One discrepancy that existed at first between the two schools concerned faculty compensation. Teachers with professorial rank in the dental school at the time it became part of Tufts were on salary, which was, of course, a first claim upon income. In the medical school, however, the faculty was, as one person put it, "in a relation of quasi-partnership." Nominally without salary, the medical faculty shared, as has been noted, in the distribution of annual surpluses. The financial arrangement of the dental faculty, coupled with the uncertainties in medical faculty remuneration because of possible increases in fixed charges or decreases of income, brought the adoption of a Trustee policy. The Executive Committee of the Trustees decided in 1901 that the distribution of surplus revenue of the medical school should be discontinued, and that the faculty of both medical and dental schools should be placed on straight salary. This turned out to be not so much of a revolutionary policy as it might have appeared, for the annual salary scale, which ranged from $1,700 down to $50 and averaged less than $500, was still dependent on the

The principal source of income from which the medical school faculty was being paid without dipping into the limited resources of the College continued to be student charges. Tuition in the medical school was raised from $125 to $150, effective September 1904. This did not actually mean an increase, for the separate graduation fee of $30 was abolished and made a part of the regular tuition. A corresponding raise was made in the dental school so that tuition was made uniform.

Both medical and dental schools grew so rapidly in the next few decades that quarters previously considered adequate were outgrown time after time. For many years the infirmary connected with the old Boston Dental College had been located in one of the buildings on Tremont Street in which space had been rented. One year after the new facilities had been completed, the infirmary was moved into it. Within four years, the addition of a clinic and expansion of infirmary and laboratory accommodations were being recommended by President Hamilton. Extensive remodeling and the addition of a fourth floor in 1910 to the Huntington Avenue building supplied a chemistry laboratory and new lecture rooms. An anatomical building provided in 1916 for the use of schools was enlarged in 1917 and again in 1920, to include chemical laboratories. An ex-stable on Mechanic Street of unprepossessing appearance, and known officially as the Medical School Annex and unofficially but quite accurately as "the Barn" by several generations of pre-medical and pre-dental students, was leased until mid-1928. The close instructional ties between the two schools were more or less consistently maintained, for in the 1920's, when the Carnegie study of dental education in the United States was made, medico-dental subjects were being taught to dental students in separate classes, but by members of the medical faculty, and in laboratories used in common.

Both dental training and service expanded rapidly after 1900. The dental school first offered summer school courses in physiology and histology in 1905. The area of greatest activity and influence was the dental infirmary under the leadership of Dr. Edward W. Branigan, who had been on the faculty of the Boston Dental College and who until his death in 1911 was one of the best-known members of the dental faculty. The practice had been followed for many years of charging only a nominal fee covering no more than the cost of materials, and of quietly treating without charge dozens of patients who could afford to pay nothing. In 1902-3, for example, 120 patients were treated daily, but less than half were charged anything at all. Such a social service was considered doubly worthy, for it extended much-needed benefits to a segment of society not otherwise able to receive them and at the same time exposed advanced dental students to all kinds of clinical material. The infirmary was literally overwhelmed with customers. In 1903 the Executive Committee of the Trustees considered the feasibility of sending out an appeal for funds to subsidize what amounted to a free community service. The sum of $4,000 a year (the income from $100,000) was the goal. Part of the prompting for the decision to make the appeal came from a group of philanthropically inclined citizens interested in free dentistry for the poor. A committee had visited the Tufts Dental School and had been so impressed with it that they recommended "an appeal to the public for a sum sufficient to enlarge very materially the scope of the Infirmary." A decade later, nearly four-fifths of the free dental work in Massachusetts was being done under the direction of the officers of the dental school.

The Tufts Dental School had by 1912 become the twelfth largest such school in the United States. Even more worthy of pride was the fact that in that year its students attained the highest percentage of successful examinations of any school before the state Boards of Examiners.[5] 

One of the most important events in the history of the dental school (and, some thought, in the history of dentistry itself) was the establishment of the Forsyth Dental Infirmary for Children.

The Forsyth Infirmary, with a building dedicated in 1914 and in full operation by January 1, 1915, was an interesting experiment in inter-institutional cooperation. Although technically an independent agency offering complete oral health service for children, it was associated educationally with both Tufts and Harvard. Among the incorporators and Trustees were President Hamilton, Dr. Branigan of the dental school, Dr. Timothy Leary of the medical school, Dean Harold Williams of both schools, and Sumner Robinson, a Tufts Trustee since 1891.[6]  At the time the Infirmary was chartered, a proposal was made to give Tufts College exclusive and formal control but rejected because it was deemed advisable, for the best interests of the enterprise and the dental profession at large, to have control shared by more than one educational institution. Harvard conducted advanced work for the Infirmary interns at its own medical and dental schools, engaged in collaborative research, and furnished lecturers from its dental faculty. Members of

The relationships among the Forsyth Infirmary, Tufts, and Harvard were made even more intricate and interlocking by the establishment in 1916 of the Forsyth-Tufts Training School for Dental Hygienists. Members of the Forsyth staff, and of the faculties of the dental schools of both Tufts and Harvard, constituted the Board of Instruction. The Training School was created to prepare young women for oral health service, namely, to teach oral hygiene in the public schools or other institutions, to practice prophylactic cleaning of teeth, and to act as dental nurse in institutions or for dentists. Instruction was included in pediatrics, endocrinology, nutrition and diet, anesthesia, and pre- and post-operative surgery of the nose, throat, and mouth. Graduation from an accredited high school or equivalent was needed for admission. Over 1,000 hours of instruction, laboratory, and clinical and in-service work were required for a certificate. Most of the training was received in the Forsyth Infirmary. By 1926 the Training School (which by then had become known as the Forsyth School for Dental Hygienists) had produced 440 graduates. The existence of both the Infirmary and the Training School, as unique assets to dental education, provoked enthusiastic approval from the compilers of the Carnegie Report on Dental Education in 1926. Dispensary and hospital facilities in which dental students could receive accredited instruction or perform stated clinical service by the mid-1920's were the Boston City Hospital, the Boston Dispensary, the Massachusetts Homeopathic Hospital, the Massachusetts School for the Feeble Minded, and the Roxbury Hospital. No accredited instruction was provided at the Forsyth Dental Infirmary after 1923-24.

All told, the Tufts Dental School was a strong school with an excellent reputation when the Carnegie Report was made. It had graduated an average of seventy students annually since 1900, with a total of 1,840 by 1925. Although the bulk of its student body were still from Massachusetts (over 60 per cent), the proportion was declining. Enrollment had averaged well over 350 for the past decade and there was no indication that the numbers would decline. The dental school was maintaining the Class A rating that had been granted in 1918 by the Dental Educational Council of America. Since 1921, one year of approved work in an accredited college had

[1] The legislative act of union of 1899 had made no stipulation about degrees, as this was considered a prerogative of the Corporation.

[2] Gies, "Dental Education," Carnegie Foundation, p. 392. Harvard and North Pacific College of Oregon were the other two. The degree had been originated at Harvard in 1869 as a way of recognizing dentistry to be just as much of a healing art in its way as medicine.

[3] The sum was originally to have been borrowed from the Massachusetts General Hospital at 4 per cent for five years, but for some reason the decision was made to obtain the money from other sources.

[4] One unhappy result was the necessity of transferring much of the medical-dental sinking fund to meet the loss.

[5] Tufts had less than 5 per cent failures in 1912, according to the report of the National Association of Dental Faculties. Failures of students of other dental schools ran as high as 50 per cent.

[6] President Hamilton served on the Infirmary's Board of Trustees until his resignation from the Tufts presidency in 1912. In anticipation of the educational purposes that the Forsyth Infirmary might serve, and in view of the close relationship between the Infirmary and the College, the Tufts Trustees had the College charter amended to allow the latter to receive gifts and bequests "for the education of men or women in other institutions, incorporated in this commonwealth for that purpose, and associated with it, but not a part of the college now maintained." The amendment was approved February 28, 1910-Acts and Resolves, Commonwealth of Massachusetts, 1910, Chapter 133.