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REMARKS  BY:	DONNA E. SHALALA, SECRETARY OF HEALTH AND  HUMAN SERVICES
PLACE:		New York University College of Dentistry Commencement, New York, New York
DATE:		June 1, 1999

Graduates. Family and Friends. Alumni. Faculty and staff. I'm delighted to be here in Carnegie Hall to share your joy, your achievement - and your relief in graduating from the NYU School of Dentistry.

I know that many of you are not from New York. In fact, you are a cross section of this country - and the world. Still, like you, I love New York. I've taught here. I've worked here. And, I've made lifelong friends here.

You should be particularly proud that you've earned your dental degrees at NYU. To illustrate my point, I'd like to take a minute to tell you a story. I once had a dentist here in New York who was an NYU grad. When he was graduating from high school, he wasn't sure where he wanted to continue his education. The summer after his senior year, his mother asked him where he was going to college. They lived across from Brooklyn College. But he told her he didn't want to go to Brooklyn. So his mother said, "You know your cousin loved that college he went to. I can't remember where it was, but it had three letters." "NYU?" he asked. "Yes! That's it!" So he went to NYU - first as an undergraduate, and then to the dental school. A couple years later, he ran into his cousin and said, "My mother told me about the college you loved, so I followed in your footsteps and went to NYU." His cousin replied, "NYU? I went to MIT."

All of which goes to prove that on the three simple letters - NYU - rests a reputation for excellence that is now your reputation.

So congratulations and take look around: You've made it here, and now you're certain to make it everywhere. While you're looking - take a moment to thank all the people who made this day possible. No pun intended: You are their crowning achievement. I'm talking about your families. Your friends. Your teachers. And the people of New York.

NYU is not only the largest dental school in our nation - it is also a leader in serving its community, with almost a quarter of a million poor and low income New Yorkers visiting your clinics for basic oral health.

Which raises this question: What it is about Hollywood? They manage to make and remake every kind of medical show imaginable - except one about the heroics of dentistry and dentists. Shakespeare certainly understood that there are times when the one person you most want sitting by your side is a dentist. In Much Ado About Nothing he wrote, "For there was never yet a philosopher that could endure the toothache patiently."

I certainly understand the importance of having a good dentist. Some of you may have seen my milk mustache ad. I did the ad to encourage girls and young women to add more calcium to their diet to fight osteoporosis. My dentist takes great pride in that ad, just as I take great pride in all of you. I know that tomorrow - and for the next three days - you and other dental schools in New York and New Jersey will be offering free public screenings for oral cancer at locations throughout this region. Lives will be saved because of your extraordinary effort. But the real challenge is what happens after this week. I believe these screenings should serve as a long overdue wake-up call about the dangers of oral cancer.

Making Americans aware of the need to screen for oral cancer - and the link between good of oral health and good health generally is not your responsibility alone. Government also has a critical role to play. That's why we've made dental and craniofacial research a growing part of our Department's mission.

That's why we recommended that states include dental care in their benefits package under our new Children's Health Insurance Program - which we call "CHIP." Of the 52 states and territories that have had their plans approved - only three have no dental coverage. Along the same lines, we want to make sure that children on Medicaid have access to preventive dental care.

We're working with Joe Garagiola's National Spit Tobacco Education Program, Major League Baseball and the ADA - to break the one hundred-year link between baseball and spit tobacco, itself a cause of oral cancer. I should add that Robin Ventura of the Mets and Paul O'Neill of the Yankees participated in a public service campaign that aired at several ballparks over the Memorial Day weekend promoting World No Tobacco Day.

Perhaps, most important, next year we will release the first Surgeon General's Report on Oral Health. This will be a landmark report on what we know, and what we must learn - and do - to prevent oral disease and promote good oral health. I commissioned this report in April 1997 - at the suggestion of my own dentist - in part to explore the growing evidence that poor oral health is associated with serious health problems including diabetes, heart disease and low birth-weight babies.

But that's only the beginning. The report will identify barriers to good oral health. It will look at emerging diagnostic technologies to keep you on the cutting edge. The report will address questions about new therapeutics - and raise awareness about barriers low-income people face in getting access to dental care. It will attempt to place oral health issues in the larger context of social customs, nutrition and economic progress. Finally, and most important, the report is expected to make recommendations about how all Americans in the 21st century can live healthier lives through preventive dental care.

You have already spent long hours promoting good oral health. After today, some you will stay in New York - like Bessie Delaney an African American woman who began practicing dentistry in Harlem in the early 1920s. Some of you will start new lives in other communities - or return to countries around the world. But wherever fate, ambition and opportunity lead you - your expertise and humanity are needed as never before. I don't have all the answers - all the guidance you need as you build your careers as dentists and dental hygienists. But I do have ten broad principles that can guide us as we look forward to a new century of good oral health.

First. Dentists must be a first line of defense against disease.

Dentistry is unique. From young children to seniors, people make regular appointments to see their dentists. Sometimes twice a year. That is often not the case with physicians and other health professionals. So dentists are like the first firefighters who show up at a burning house - ready to assess, treat and call for more help.

For dentists, that means asking questions like: What medications are you taking - and why? What are you eating? Are you staying away from tobacco? Are you getting enough physical activity? Are you having problems with speech or hearing? You're in a position to know the answers before anyone else, and to work in close collaboration with physicians, pediatricians, school nurses, other health professionals to assure good health and long life for millions of Americans.

Which brings me to my second principle. Dentistry must work hand in hand with public health and medicine.

A couple of years ago I gave a speech at the first joint meeting of the AMA and the American Public Health Association. Frankly, I wish the ADA was there too because my message was simple: The time has come for all health professions to work together and build a seamless system of care for the American people.

Working together means learning from each other - and sharing information. Dentistry, medicine and public health cannot be separate trains running down parallel tracks - each unaware of, and uninvolved with, the other two. In other words, the human body is one, and in the 21st century we must have one public health system capable of healing it.

Third. All of us need to look beyond our professional backyards.

Here, I'm not just talking about dentistry, medicine and public health working together. This principle is about expanding the definition of what it means to be a dentist. To think "outside the box."

We've already seen examples of dental professionals thinking - and working - beyond the usual confines of the dentist's chair. The Milk Matters campaign - which promotes strong teeth and bones and is supported by organized dentistry - is a good example. So too is the fact that some dentists conduct smoking cessation classes. The point is: All of us must take the blinders off; tear down the professional walls; and work to fill public health gaps wherever - and whenever - we can.

On to my fourth principle. We must focus like a laser on prevention.

Prevention works - and no profession has done a better job of it than dentistry. Fluoridation is over a half- century old in the United States - and has saved literally countless teeth and lives.

One of today's most important battles is against Early Childhood Caries - a disfiguring form of tooth decay. Early Childhood Caries is a complex and not fully understood disease. But it is preventable. Prevention starts with good prenatal care for the mother and her baby. But because caries is an infectious disease - treatment must include good oral hygiene for everyone involved with the child, and the use of fluoride, sealants, good nutrition and regular visits to the dentist.

While I'm on the subject of children: I mentioned CHIP - our children's health insurance program, which, in New York, is called the CHPlus plan. My message to you about CHIP is simple: You are treating - and will continue to treat - CHIP eligible children in your offices and clinics. Talk to their parents and caregivers. Tell them about CHIP - and encourage them to get their children signed up.

Fifth. We must make sure that research not only survives - but thrives.

I believe HHS has the strongest science and research team ever assembled in the history of the country. But hiring the most brilliant leaders in science and dentistry is not enough. We must also make sure that our research institutions are supported by stable funding.

The Administration has already agreed to increase the budget of NIH by 50 percent over five years. This year the budget of the National Institute of Dental and Craniofacial Research will be 234 million dollars - a 12 percent increase over 1998. Last year NIDCR awarded the NYU College of Dentistry over 1.5 million dollars for dental research. CDC, the Health Resources and Services Administration and other federal agencies are also making a major commitment to improving dental health. So, when it comes to science, we must cast our net far and wide - making sure it pulls in dental research that begins before the baby is born and extends to the end of life. Oral health must not be shortchanged!

Making sure that oral health is not shortchanged is what my sixth principle is all about. We must train tomorrow's dental workforce today.

Let me start by congratulating you and your families for overcoming what I know is a real hardship. I'm talking about the high cost of a quality dental education like the one you've just completed at NYU. Our nation's health care workforce is not only costly to train - it often does not match our needs. In some health fields, we have an excess of qualified professionals. In others - such as primary care - we face a real shortage. That puts dentists in a unique position. As I suggested, you are strategically placed to serve some of these primary care needs.

As for dental education: I commend NYU for leading by example in making sure we train qualified African American and Hispanic dentists, and for the expansion of your health curricula to general health issues. You've also been great on HIV. Which brings me to my seventh principle. We must eliminate the shame of racial disparities.

In April, the CDC, the National Cancer Institute and the American Cancer Society reported that the overall death rate from cancer is falling. The same report noted that African Americans have the highest rates of lung cancer, prostate cancer and colon cancer. The same turns out to be true for oral cancer. That's why NIDCR is a major contributor to the Oral Health Research Center at NYU - which focuses on oral health research for minority populations.

Eighth. Our bioethics must be as sophisticated as our science.

Dentistry is very much at the center of our revolution in gene therapy. The human genome project will lead to better treatments for periodontal disease - and actually help us rebuild teeth. We're learning how saliva can kill microbes. But all our revolutions in health care raise serious ethical questions.

We must never create a world in which our genetic map is used to deny jobs or health insurance.

We must never create a world where medical and dental breakthroughs simply widen the gap between the haves and the have-nots.

And, above all, we must never create a world where our science gets ahead of our ethics - or eclipses our fundamental sense of humanity, fairness and values.

On to my ninth principle. We must help the rest of the world build a public health infrastructure.

As I said, I know that your class has many foreign graduates. I share your concern about dental health around the globe.

Two years ago, on a trip to Vietnam, I had the opportunity to honor some of the heroes of Operation Smile. This initiative by dentists and physicians is giving children in poor countries a joy they otherwise would probably never know, the chance to look in the mirror for the first time and see a beautiful face - and a beautiful future.

But much more needs to be done internationally to improve oral health. We should do this because it's right, and because it's in the interest of our own country to have a strong public health system - including dental care - in every other country.

Which brings me my tenth and last principle: All of us must leave our mark.

This is a great day of celebration for you and your families. But as Winston Churchill said, "It is not the end. It is not even the beginning of the end. But is perhaps the end of the beginning." The question is: Where do we go from here?

One place to start is making sure we meet our country's goals for oral health. These include everything from reducing tooth loss, to annual exams for oral cancer, to better dental services for poor children.

But principle ten is really about morality.

It's about believing in our hearts that good health for each of us depends on good health for all of us.

It's about being friends to the friendless - and an outstretched hand of hope to those who fear they will never see hope again.

It's about being inspired to work with your colleagues in other health professions.

And most important: It's about wearing your invaluable training as dental professionals as a badge of honor, a sacred trust, and a sign that the healing arts in your well prepared hands - like the great music played in this great hall - will endure forever.

Thank you very much.