is being spent within HEW for dental activities and what the sources for the funding are. Departmental dental affairs are a crazy-quilt of subsections, subdivsions and, not infrequently, afterthoughts. There is no unified Federal dental health policy. There never has been one. Arthur Flemming recognized this when he was Secretary and so has every last one of his successors in that post. But, like the weather, no one has been able to do much about it.

We would not contend that the Dental Advisory Committee proposal of section 1005 would totally reverse this long-standing chaos. We do believe that it is the place to start. It would mean that, for the first time, there would be a group of private citizens and public officials whose specific duty would be to scrutinize dental activities with an eye on their interrelationship and effectiveness within an overall Federal dental policy.

Equally important, the group would be in a position to communicate its findings and recommendations, on a continuing basis, directly to the Secretary.

Within the past year, Secretary Richardson instituted an ad hoc committtee to perform some of these overview functions. This is a genuine step forward and we believe that statutory existence of it is the logical and essential next step.

And now, Mr. Chairman, I should like to ask Dr. Smith to supplement my remarks on these three sections of S. 1874.

Thank you very much for your attention.

Senator KENNEDY. Could I ask, Dr. Deines, what your views are on group dental practice?

Dr. DEINES. The American Dental Association is encouraging group dental practices. There are several reasons for this, which I won't enumerate. But it certainly gives full coverage for the patients that are coming to the office, the office is covered all the time, it is not left vacant like a solo practice is. The backbone of our practice is solo practice. But we are encouraging group practices.

Senator KENNEDY. Do you have views about prepaid group dental practice, as well? Would you give us your own views?

Dr. DEINES. Our policy, in the American Dental Association-I am referring now to a resolution that was made last year-that wherever possible, if it was possible in a group practice to keep it from being a closed panel, that is what we recommend. That is what our policy reads.

As I say, we certainly encourage group practices and in some instances there are prepaid programs.

We favor the open panel type where the patient has a choice of his dentist.

Senator KENNEDY. Thank you.

Dr. SMITH. Mr. Chairman and members of the committee, the National Dental Association, let me say at the outset, is pleased to be able to join with our sister groups in giving Senator Magnuson's proposal an unequivocal endorsement. We feel strongly about all sections of this bill. We urge its passage.

The experimental care projects are, we think, exceptionally promising. They would enable the Nation and the profession to get off dead center and get going.

This Nation is, as the committee well knows, short of dentists. I might add that it is particularly short of dentists representative

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of minority groups, a fact that is exceedingly relevant to some of the problems we face. This overall shortage is compounded by maldistribution of such practitioners as we do have.

In this regard, statistics fall somewhat short of telling the whole story. The ratio of dentists to population for an entire State or section. for example, may look reasonably favorable. But put a map of, let us sav, the District of Columbia on the wall, put in a nin for every dental office location and a serious lack of balance is quickly evident. Do the same for Boston or Chicago, for New York or Los Angeles, for a long list of metropolitan areas and the result is the same.

At the present time, in addition to maintaining my private practice, as assistant professor of dentistry at Howard University and I am director of the Neighborhood Health Center serving the upper Cardozo area of Washington, D.C. In that capacity, I have had the honor of visits from the chairman of this subcommittee as he has pursued his keen interest in health matters. Other members of the committee. I know, have made similar visits elsewhere in the Nation.

You are all well acquainted with the desperate need for dental health care that is manifest among children in inner city areas, a need that is far from being met. What Senator Magnuson is saying with section 1001 is, simply, let us begin meeting that need and, in the process, learn as much as we can about the best way to do so.

Nor, of course, is it only the inner city child who is the victim. So too are large numbers of children, living in rural, sparsely settled areas of the Nation, as vou have just recently pointed out in some of your opening remarks, Mr. Chairman.

The dental profession has periodically carried out surveys of dental need among Americans. The most recent large-scale study was in 1965. The 38-page report issued as a result makes depressing reading and there is little reason to think that there has been any substantial change in the past half-dozen years.

Among a group of white, male children between the ages of 10 and 14, for example, relating to that study, nearly 62 percent were in need of an average of three fillings and nearly 19 percent needed extractions. Within that same group, a full 25 percent needed to undergo correction for malocculsion. Less than 23 percent had no dental care needs at all.

Among a group of black children between the ages of 10 and 19 surveyed at the same time, 78 percent needed an average of four fillings, almost half needed extractions, and some 17 percent needed to undergo corrections for malocclusions. Less than 15 percent of that particular group had no dental needs at all.

The same study included investigation on dental visits classified according to income levels.

Senator KENNEDY. When was that study taken?

Dr. SMITH, 1965.

Senator KENNEDY. Is that in a poverty area?

Dr. SMITH. It included the poverty areas, the rural poverty, th whole country, Senator.

Senator KENNEDY. That is nationwide?

Dr. SMITH. Yes. We would be happy to make it available to you Senator KENNEDY Would you?

Dr. SMITH. Yes.

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