Federation Dentaire Internationale. Dr. Paffenbarger has presented lectures, demonstrations, and postgraduate courses in Japan, the United Kingdom, the four Scandinavian countries, and Italy. He has been selected as the praelector for dentistry at the Scottish University of St. Andrews for 1959-60. He has an extensive acquaintance with dentists, dental research workers, and teachers from all over the world. I am sure his testimony will be helpful to the committee. The CHAIRMAN. Thank you, Doctor.

Now, Dr. Paffenbarger, we will be delighted to have you present your statement in any way you see fit.

Dr. PAFFENBARGER. Thank you.

In addition to the prepared statement, Mr. Chairman, may I have permission to make a few extemporaneous remarks?

The CHAIRMAN. Certainly; we will be happy to hear anything you desire to say.

Dr. PAFFENBARGER. The association appreciates this opportunity to present the statement in support of Senate Joint Resolution 41, and they recognize your particular efforts in the health field in legislation.

It has been the association's longstanding policy to support this type of work. And while we have leadership in the world in dentistry and possibly medicine and health, we must absolutely realize that so much of the information on which we have this supremacy has frequently come from other lands. And I think that the bill's provision for the interchange not only to this country but from this country is all important.

I am impressed by the number of research workers in foreign lands in dentistry that want to come here for further study. And this includes countries of Asia, Europe and the Latin American countries. I am also very much impressed by their inquiries: Can we get some of your teachers and researchers in the field of dentistry to come to our lands?

And so I think that this bill provides that sort of an opportunity to extend the present available sources in that respect and stress the need for training those who will train others.

We have had many visitors from foreign lands in our laboratories, and it has been our pleasure to be in some other lands. And while this exchange of technical knowledge, especially in the health sciences, is very important, I still feel that perhaps the primary purpose of all this is the creation of international good will.

There are so many things that create ill will that it behooves every one of us who has any contact with visitors from other lands, or who visit in other lands, to do everything we can to really become acquainted. And so we have made it a point to invite the visitors from foreign lands to our laboratories and to our homes as guests while they are here. And when you go to another land, you are invited into the homes. I think it is the highest sign of acceptance of the person as a person. And whatever you are trying to teach will be far more effective if they respect you and like you and realize that you are humble enough to know that you come there not only to give but to take. And so the selection of personnel in any of these programs is all important. And I do hope that professional societies and the universities will be amply consulted in the selection of these personnel.

Now, there are wonderful opportunities for exchange of information and for Americans to study abroad, as well as for foreigners to come here. I will give you one example-an interchange of information with the dental authorities in Oslo, Norway, and with our own Public Health Service here at Richmond, Ind. We were able to show by epidemiological studies just exactly how preventive good dental care is. A hundred children were examined in Oslo, Norway, where they had a school dental program since 1910. There were a hundred children examined in Richmond, Ind., where the Public Health Service had an experimental school clinic. Both of these sets of children, 13 years old, a hundred of them, had about the same caries experience, decay. Nine teeth per child were either missing, decayed, or filled. But the children in Oslo, Norway, that hundred children, only had six teeth, permanent teeth, missing, in all their dentition, while the hundred children in Richmond had one tooth per child, with a hundred teeth missing.

That is an example of where we got some good statistical data on what really good, adequate care can do.

Senator CLARK. May I ask a question, Mr. Chairman?

Doctor, I wonder if this might not lead into some further statistical research on the value of fluoridation to the water supplies of the great cities of the world.

Dr. PAFFENBARGER. Yes, sir, it certainly would.

Senator CLARK. You are familiar with the experiment in Philadelphia now!

Dr. PAFFENBARGER. Yes, sir.

But I am just citing this as one example to show how this interchange works both ways and how we need these other sources to evolve data that will be useful to us as well as to the rest of the world.

This year the association is going to celebrate its centennial, with a meeting in September in New York. And there are going to be approximately 2,000 dentists and dental researchers and teachers from other lands there. In fact, about a hundred of them are going to be on the actual scientific program.

The association feels keenly, and I am sure I speak also for the Federation Dentaire Internationale and for the International Association for Dental Research, that this is vital legislation. They would all work very closely with this new Institute that you are attempting to establish, and they have contacts which I think would be very, very useful.

Now, we only have one slight recommendation on this bill. On page 1 of the resolution, the bill states that it is establishing the National Advisory Council for International Medical Research and the National Institute for International Medical Research. And then on page 5, lines 15 and 16, the phraseology: "The National Advisory Council for International Health Research" is mentioned as being established by this joint resolution. And on page 14, lines 15 and 16, they speak of the National Institute for International Health and Medical Research.

The association suggests that where these different phraseologies occur, the word "health" be substituted for "medical," because, first, this is being established in the Department of Health, Education, and Welfare, at the U.S. Public Health Service, and at the National Institutes of Health.

In other words, it is the intent of the bill to cover all phases of health, medical, surgical, dental, hospital, pharmaceutical, nursing, sanitation, vocational rehabilitation, and so forth.

And in summary, Mr. Chairman, the ADA offers its support of this bill wholeheartedly.

Thank you, sir.

The CHAIRMAN. Thank you, Doctor.

Dr. Camalier, would you like to say a word?

You are an old friend, have been here many times, and you are always most helpful.

Dr. CAMALIER. Thank you, Mr. Chairman.

I do not think I can add anything to the testimony. I appreciate the opportunity of being here; but these men are expert witnesses. I thank you very much for the opportunity, however.

The CHAIRMAN. We certainly appreciate all three of you being here this morning.

I say again that which I have said a number of times before, there is no association or organization in America that has appeared before this committee more constructively than has the American Dental Association, or has proved more helpful to this committee. You gentlemen always come in a constructive way to offer constructive thoughts and suggestions and to be most helpful to this committee. And we deeply appreciate your presentation here this morning.

Dr. Besdine, you spoke of Dr. Paffenbarger as an eminent authority, and I want to say I certainly agree with you. We are delighted to have his word this morning and the fine support of the American Dental Association.

Dr. BESDINE. Thank you, Senator.

The CHAIRMAN. Your full statement, Dr. Paffenbarger, will go in the record following your presentation here.

Senator COOPER. I join the chairman in his statement of the appreciation of the testimony of Dr. Besdine and Dr. Paffenbarger and also, of course, the support of the American Dental Association. The CHAIRMAN. Senator Williams?

Senator WILLIAMS. No question.

I just want to comment that I am sure the support of this organization will be very helpful to the favorable consideration of the

measure.

I recall that this is our fifth day of hearings, I believe, and there has not been any opposition to the measure expressed in all these days of hearings. I understand from the staff that there has not been any opposition even in writing to the committee.

The CHAIRMAN. Gentlemen, we are most grateful to you. We certainly appreciate your presence here this morning and your very fine testimony.

Thank you very, very much.

(The prepared statement of Dr. George C. Paffenbarger follows:)

STATEMENT OF THE AMERICAN DENTAL ASSOCIATION PRESENTED BY GEORGE C. PAFFENBARGER, D.D.S., DIRECTOR, AMERICAN DENTAL ASSOCIATION RESEARCH DIVISION, NATIONAL BUREAU OF STANDARDS

The American Dental Association appreciates this opportunity to appear before this committee in support of Senate Joint Resolution 41.

Consistent with its long-standing policy of encouraging programs designed to further research in the health sciences, the association's house of delegates

in November 1958, adopted, enthusiastically, a policy statement (copy attached) approving the principles embodied in Senate Joint Resolution 41.

There would appear to be little room for dissent from the objectives sought to be attained through enactment of the joint resolution. The establishment of a world center for health research, as contemplated in the bill, would seem to be a step in logical progression toward the ultimate goal of abolishing disease on a global scale.

At the present time this country undoubtedly has world leadership in health research. There is no question but that the health research programs carried on at public and private institutions in the United States are the most comprehensive, enlightened, and productive in the world. It seems fitting, therefore, that this country should take the initiative in seeking to extend the benefits of health research to the peoples of all nations, but despite the splendid research work that is being done here and in some places abroad, much more remains to be done. Millions of people continue to suffer and die each year from ailments that almost surely are preventable. Mounting evidence in research leads to the conviction that for future generations of people, many afflictions that are now regarded as incurable will not only be susceptible of curative treatment but will be avoidable by immunization or other techniques as is the case today with smallpox, malaria, polio, and other diseases which a few years ago were regarded as virtually uncontrollable.

As of this moment, research scientists are on the threshold of discoveries that may relieve countless human beings of untold pain and suffering and extend their lives by many years. Nothing should be allowed to detract from or impede this vital work; everything possible should be done to encourage and accelerate its progress.

A long step forward in this direction would be the establishment of an institution to foster the free and unfettered exchange of scientific information and personnel among the countries of the world without hindrance by political boundaries or other manmade barriers.

Certainly the crusade against sickness and disease is one in which all countries can enlist, and from which all peoples can benefit. The place of medical discovery is not important; a cure for disease is a boon to all of humanity regardless of the country of its origin. A review of medical history will show that significant discoveries have not been limited to any geographic area; achievements have come from all corners of the world. The names in an international "Who's Who in Health Research" would doubtless read like the membership roster of the United Nations.

In regard to the specific provisions of Senate Joint Resolution 41, little need be said in justification of the proposal to provide machinery for the pooling and rapid international interchange of health information. Obviously, there can be no defense of a situation in which progress in the health sciences may be held up or retarded because of artificial barriers to or lack of facilities for adequate communications between scientific investigators. Nor can there be valid criticism of the proposal to provide a system for the coordination of the total research effort in order to make the most effective use of critical manpower and avoid waste and duplication.

Perhaps the single most significant aspect of Senate Joint Resolution 41, from the standpoint of both immediate and long-term advancement in research, is the provision for training additional research workers and for making maximum utilization of those presently available. The No. 1 need today, at least in this association's chief area of interest, is for additional skilled investigators. Many extremely promising areas of investigation are not now receiving adequate study simply for lack of sufficiently trained personnel. This is why this association has supported the domestic training and fellowship programs in the past and today is supporting the proposal for a similar program abroad.

Unfortunately, there are at the present time foreign scientists with special skills and talents who are not able to conduct the research investigations of which they are capable because of lack of adequate facilities. This is a situation which should be remedied and is covered in Senate Joint Resolution 41. There are laboratories and research institutions in foreign countries that presently can offer special training by highly qualified personnel utilizing facilities and subjects for study that are not available in the United States. American students should be encouraged to visit these places for extended periods to acquire the knowledge and training that can be provided. The type of activity to be encouraged is exemplified by the experience of an outstanding dental scientist who went recently to study in D'Allemagne's crystallography laboratory in

Belgium and brought back invaluable information and techniques which he is now teaching to others in the United States. Similarly, foreign health scientists should be encouraged to come to this country for the interchange of scientific knowledge, information and techniques. Some excellent programs along this line already are in existence and have proved invaluable, but the surface has only been scratched. The joint resolution wisely makes provision for additional encouragement and support of this kind of worthwhile venture.

The joint resolution also would authorize support for research projects to be carried on in foreign countries. This phase of the proposal is of special interest to dentistry for there are particular populations in various parts of the world that would provide an extremely fertile field for epidemiological research studies. Much can be learned about the relation of nutrition and dietary habits to oral diseases from studies of people who live on severely restricted or primitive diets. Much could be learned from epidemiological studies in areas such as parts of India and Egypt where periodontal disease is endemic and begins at unusually early ages.

Nutritional and similar studies can most profitably be carried on in foreign villages or areas where the habits and customs are fairly easily defined rather than in the United States where undue complications arise from the high level civilization and communication.

Existing facilities for coordinating international dental research and exchanging information are not as effective as they should be. The International Association for Dental Research, the leading international dental research organization, is doing an excellent job insofar as its limited resources permit. However, at best, its meetings and publications provide only a limited exchange of information.

The Federation Dentaire Internationale, which this year will meet in New York in conjunction with this association's 100th anniversary meeting, is making a significant contribution in bringing together some of the world's leading dental scientists. The federation also provides, through its publications, the means of disseminating an important portion of the world's dental research reports. However, in dentistry, as in other phases of the health sciences, the growing volume of research has overtaxed the existing facilities of established journals and library facilities. Translators, abstractors, indexers and publishers cannot keep up with the present load and will fall farther behind as progress in research continues. This situation is particularly acute regarding reports of dental research conducted in non-English speaking countries.

Specific examples could be given of cases where foreign scientists developed testing apparatuses, mechanical devices or clinical techniques which are superior to and less expensive than those used in this country and where, because of lack of adequate means of communication, several years elapsed before reports of such developments reached our own scientists.

This kind of occurrence demonstrates the need for encouraging and supporting "international communication in the medical and biological sciences, international scientific meetings, conferences, translation services and publications" as provided in the joint resolution.

În passing, it might be of interest to describe briefly the international phase of the association's forthcoming centennial session to be held in New York in September. It is expected that over 2,000 dentists from foreign countries will be in attendance. At least 100 of these will participate in the scientific program to be presented. Simultaneous translation will be provided at the scientific session as well as at several scientific conferences for foreign guests that are being organized cooperatively by the American Dental Association, the Federation Dentaire Internationale and other agencies such as the International Associaiton for Dental Research, the American College of Dentists and the American Association of Dental Schools. Additionally, the American Dental Association is sponsoring postsession tours to encourage foreign representatives to visit our research and educational institutions and to confer with dental scientists in various parts of the country.

In this way, the association seeks to make its own small contribution toward attaining a measure of international cooperation and mutual understanding of the health problems in our field of scientific endeavor.

The association has only one suggestion for amending the provisions of Senate Joint Resolution 41. It will be noted that on page 1 there is reference to the establishment of the "National Institute for International Medical Research" while on page 14 the joint resolution is referred to as "The International Health and Medical Research Act of 1959." It is recommended that in