What inspired you to become part of the dental profession?
I was always interested in science. Somewhere along the line I developed an interest in health. I remember when I was a boy in Harlem we would play stoopball. The rules were hit and go get, so if you hit it on a roof you had to get it. It was the rules of 'the hood' to retrieve your own ball, probably to encourage you not to get a home run. I hit the ball on the fire escape. When I went to get the ball, I fell on the fire escape and landed on the lower portion of my face, pushing my teeth up and in. I had to have orthodontics work done. It was then that I got exposure to the orthodontic setting from a patient perspective. My father's college classmate also was a family dentist who inspired me and was influential at an early age.

How long have you been involved in the profession?
I graduated in 1970 from Columbia School of Dentistry, so it has been about 33 years. I took a hospital-based internship at the University of Chicago Hospital and Clinic, then went to the University of Michigan School of Public Health.

What is your specialty, and how did you get there?
I chose administration and public health as my specialty. I grew up in Harlem in a family of modest means. In dental school we were taught restorative methods using gold. I knew that was expensive, which got me to thinking there must be methods of prevention that could eliminate the problem in the first place. I think I threw faculty and professors for a loop with my questions. Fortunately, several faculty members eventually steered me in the right direction.

In public health we are concerned about preventing disease, protecting health and promoting health for entire populations, often at the community level, but also at state and national levels. That is a huge challenge, whether it is oral health conditions, influenza, food-borne illness or health threats that evolve from the environments in which we live.

After graduating from the University of Michigan's School of Public Health, I worked in Soul City, North Carolina, which was a "new town" development at the time. I was part of the health team that developed a health center at the site. From there I went to the Seattle-King County Department of Health in Washington state, where I served initially as dental director. After several years I became the director of the county division of the department. Following that broader role in public health I became the director of public health programs and services for the Los Angeles County Department of Health.

How do you address health care disparities among minority populations within your profession?
There are many issues, but we need to look at the problems of oral cancer, which has the highest rate occurring among African American males. Blacks in general are less likely to be diagnosed. Among African Americans, oral cancer is generally found later in its stage of development, and five-year survival rates are the lowest of all the population groups. Influences are smoking practices, alcohol, lack of proper oral diagnosis and assessment at whoever's hands they find themselves -- whether it is the physician, nurse, nurse practitioner or dentist. If a physician is looking at the back of the throat and pharynx with a tongue blade, it is also important to look more fully at other oral health tissue formation that may seem odd.

This leads directly to the issue that oral health is inseparable from general health. It is in the same domain as medicine. Too frequently, non-oral health providers ignore the oral cavity. Making a diagnosis is not the issue; just taking the time to observe and make a referral is all that is needed. Another connection between oral health and general health is found with diabetes. Diabetes is a co-factor in the development of severe advanced periodontal disease -- and there is evidence that suggests that periodontal disease can affect glycemic control in diabetic patients.

How did you have the opportunity to be involved with the Surgeon General's report?
When I was director of public health in Los Angeles County, I was contacted about leading the project. I had to think about it for a while. I made the decision to take on this challenge. I am glad that I did.

It was a thrilling moment when Surgeon General Dr. David Satcher issued and released the Surgeon General's Report on Oral Health at a local elementary school in Washington, D.C., in May 2000. The report has been widely read. It has stimulated renewed and vigorous interest in oral health and its related issues, among them disparities in oral health among population groups. The document has been cited and referred to often in health literature. The report also has served as an important starting point for developing oral health plans for states and concerned organizations.

Under the leadership of the current Surgeon General Dr. Richard Carmona, we have developed A National Call to Action to Promote Oral Health, highlighting the actions that need to be taken to address pertinent oral health issues. Surgeon General Carmona released the Call To Action in April 2003.

Copies of the Surgeon General's Report on Oral Health and the National Call to Action can be accessed at: www.surgeongeneral.gov/topics/oralhealth.

What do you like best about working in the field?
Both of these reports carry unique messages to the general public, health professionals and those who are interested in oral health. To be part of fashioning those messages has been very rewarding. It's a one-of-a-kind experience. For two U.S. Surgeons General to issue significant documents on oral health underscores its importance.

What, if any, barriers or challenges have you personally had to overcome?
When I started as a dental student, it was lonely from a cultural perspective. I was the only minority in the school. There were only a couple of members of the faculty that I could relate to.

What can be challenging within the profession?
Within oral health and the profession of dentistry there are always challenges to get oral health accepted as part of general health. Dentistry is a vital health service. It's important for those in health care to understand the role oral health plays and the medical links.

The challenge with the public is to achieve greater appreciation of the importance of oral health. The words we speak. The food we eat. Our smile. The emotions we express. Our sense of self. The ability to get a job. These are all intimately connected to oral health. It affects our entire personality, but unfortunately, for too many people it gets distilled down to a tooth or hole in the tooth. The issues of oral health far exceed matters of teeth. Oral health affects diet, nutrition and the ability to socialize. It's about oral health literacy. Improving oral health literacy doesn't happen overnight, it's developed over years.

What are your proudest accomplishments in your profession? In your life?
Along with having the opportunity to work on these reports, when I was elected president of the American Public Health Association was a proud moment. I'm also proud of the many years that I spent as the director of public health in Los Angeles County.

Personally, I am proud of the fact that I had the opportunity to attend the March on Washington in 1964 and share in the moment when Dr. Martin Luther King Jr. spoke. The following week I had a physics exam for a summer school class I was taking at NYU, and I questioned whether or not I should attend. I have always been glad that I was there for that moment.

Who is/are your role model(s) or mentor(s)?
Clifton Dummett, D.D.S., is a wonderful role model. Dr. Irwin Mandell, a Columbia University professor, who put his arm around me and said that I was asking the right questions about prevention. He helped me find the path to public health.

What are your plans for the future?
The future is rich with opportunity. I'd like to work more directly in an academic setting. Throughout my career I have been an adjunct professor at several universities. It would be challenging to be more directly involved in academic health centers to affect curriculum to focus more on the importance of oral health and its associations with general health.

What words of wisdom do you have for students just graduating?
Be open to the richness of opportunity and the breadth of variety that training in oral health and dentistry provides. Move from the narrow part of the education funnel to one that opens broadly. The practice of dentistry is fulfilling and can provide an open door to numerous opportunities. There's public health, which focuses on the prevention of disease at the community or individual level; research; teaching; and practice settings beyond private practice too numerable to list. There are many avenues that can be pursued. You need to be flexible to opportunity. Unless you travel down these avenues, you never have the opportunity to observe.

What do you like to do in your spare time?
I am an avid train collector, with a full set in my basement. I also try to ski as much as I can. I like to fly fish and jog.