No Man is an Island

Some 300 years later Marco Polo left the luxury and wealth of his native Venice to travel to far-off China and the court of the great Kublai Khan. His was not a speculative journey into the unknown, but a deliberate business venture. He had heard the stories of earlier travellers, who had told of a brilliant and skilled civilization and of fabulous silks and treasures. Marco Polo was in commercial competition with other merchants and traders, and he wanted to enhance his professional reputation and personal wealth by being able to offer his customers the latest and best goods money could buy.

Much more recently, early in the 20^th century, Dr. Albert Schweitzer gave up the comfort and professional lifestyle he enjoyed in his hometown in Alsace to travel to Gabon in West Africa. His motivation was neither speculative nor was it to acquire personal wealth or enhance his professional reputation. Quite the opposite. He decided to give up the comforts he had acquired because of a deep-seated conviction that Western medicine should be taken to a part of the world it had never previously reached, and where it was most desperately needed.

These are just 3 examples of the many reasons for crossing international boundaries. The first, inquisitive, speculative and almost entirely motivated by self-interest. The second, partly for reasons of self-interest and personal aggrandizement, but also to acquire new skills and products for the benefit of future clients. The third, almost entirely for the benefit of others and at considerable personal cost.

Some years before Dr. Schweitzer established his hospital in Lambaréné, a group of dentists meeting in Paris agreed that an international dental congress should be held on a regular basis. At this congress, the latest techniques, materials and equipment would be presented by the leading international experts of the day, thus enabling dentists from around the world to benefit directly from their expertise. In 1900 the Fédération Dentaire Internationale (FDI) was born. Those attending the first FDI meetings came mostly out of curiosity. However, when they returned home, they appreciated the importance — both to themselves and to their patients — of keeping abreast of the latest clinical developments, and soon realized the opportunity such meetings provided for gaining first-hand knowledge of the latest in dental research, techniques, equipment and materials from around the world. Thousands of dentists worldwide now attend this international congress every year, the benefits of which are as valid today as they were nearly a century ago.

In my recent presidential address to the 2001 British Dental Association national dental conference, I highlighted 2 issues of particular significance at the present time. Firstly, that of change and, more importantly, the speed at which change is taking place, not only as it relates to dental techniques, materials and equipment but also as it relates to the way dental care is delivered. Secondly, the issue of quality and the increasing demands and expectations that an increasingly educated and informed consumer society makes on service providers such as ourselves. Our patients now have easy access to international information and expertise through the Internet, and in recent years, some have even demonstrated a willingness to cross international boundaries to obtain treatment which may be available, or perceived to be of higher quality, in another country. Likewise, we must demonstrate our professional commitment to lifelong learning if we are to retain our patients’ trust.

The FDI has an increasingly important role to play in this context. The FDI’s mission statement — to advance and promote the art, science and practice of dentistry — includes both the dissemination of the latest international clinical research and dental developments through congresses, educational programs and publications, and the provision of a worldwide information centre accessible to dentists and national dental associations alike. But for any international health care organization, such activities represent only part of its wider responsibilities. For too long, the FDI was seen solely as a “rich man’s club,” unaffordable and thus largely irrelevant to those who potentially had most to gain from it. However, during the past decade considerable change has taken place. In recent years a fund has been established to provide assistance for dental projects in developing countries. The FDI is also increasingly working with other global health organizations such as the World Health Organization. Major international health projects can most effectively be coordinated by an international dental organization able to draw on the support of its member associations.

Although it was almost 400 years ago that John Donne wrote that “no man is an island,” it is the 20^th century phenomena of air travel, television and the Internet that have brought us together into an almost single global entity. The demands of our patients for more sophisticated treatment, the rapid development of new dental materials and techniques, the information explosion, and the needs of the developing world all provide an ever greater challenge for international health care organizations. The FDI World Dental Federation now embraces more than 140 national dental associations and 700,000 dentists. For these dentists the FDI’s role as an international forum where the latest dental information can be obtained has never been more important, and the potential of the Internet as a means of disseminating clinical knowledge worldwide will offer yet greater opportunities for dentists in the years ahead. As for those in the developing world, where dental care is still almost unobtainable, an international organization conscious of its worldwide ethical responsibilities provides a glimmer of hope for the future. 

Dr. Swiss is chairman of the FDI special committee on ethics and legislation and is editor of FDI World. He is currently president of the British Dental Association.