The ADA marked a turning point in ensuring that people with disabilities are not excluded from essential services — including healthcare and oral health.

“It will ensure that people with disabilities are given the basic guarantees for which they have worked so long and so hard, independence, freedom of choice, control of their lives, the opportunity to blend fully and equally into the rich mosaic of the American mainstream,” . “And legally, it will provide our disabled community with a powerful expansion of protections and then basic civil rights.”

Before the ADA, people with disabilities often faced widespread discrimination in medical settings. Many healthcare facilities lacked basic accessibility features. Progress started with Section 504 of the Rehabilitation Act of 1973, which prohibited disability discrimination in federally funded programs, including hospitals and clinics. However, protections were limited and gaps in access were still significant.

The ADA expanded these protections nationwide. Under Title III, healthcare providers — including dental practices — are considered public accommodations and must provide equal access to services. This means that medical and dental offices are legally required to make “reasonable accommodations” to ensure patients with disabilities can receive care.

These accommodations could include wheelchair-accessible entrances, modified equipment, extended appointment times, or alternative communication methods for patients with hearing, visual, or cognitive impairments.

Oral health is a critical but often overlooked component of overall healthcare, affecting nutrition, speech and the management of chronic diseases such as diabetes and heart conditions. Despite its importance, individuals with disabilities are significantly less likely to receive regular dental care and are more likely to experience untreated tooth decay and gum disease, .

The ADA directly addresses many of these issues within dental care. Dental offices must ensure that patients with disabilities are treated equally and cannot refuse care based solely on disability. Practices are expected to remove physical barriers when possible and provide reasonable modifications to policies and procedures. For example, dental offices may need to provide adjustable chairs or install ramps to accommodate patients during procedures.

In addition to physical accessibility, dental providers may need to provide visual aids or interpreters to ensure patients fully understand their treatment options.

Amendments and updates to the ADA have strengthened these protections, over time. The ADA Amendment Act of 2008 expanded the definition of “disability” to ensure more people are protected under the laws. Congress approved the ADA Amendments Act after a series of Supreme Court rulings narrowed who qualified as having a disability under the Americans with Disabilities Act. The amendments broadened the definition of “disability,” making it easier for individuals to show they are covered by the ADA and entitled to its safeguards.

As America approaches its 250th anniversary, the ADA stands as an example of progress in civil rights and healthcare inclusion. It has reshaped the expectations for how healthcare systems, including dental practices, serve individuals with disabilities.

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However, the rise ofĚýĚýcenturies caused the food system to shift to processed, convenient options.

Today, there is a growing movement back toward whole foods. This evolution has significantly shaped public health outcomes, highlighting the powerful connection between what Americans eat and their overall well-being.

In early agriculture America, people mostly consumed foods that were minimally processed, low in added sugar and high in fiber. Meals were prepared at home, often using fresh ingredients, which was better for overall nutrition, according to the Centers for Disease Control and Prevention (CDC).

According to theĚý, diets that are low in added sugars are strongly associated with reduced risk of diseases and tooth decay. Because the sugar intake was so limited, early Americans experienced less gum disease and fewer cavities compared to modern populations. Fibrous foods like vegetables and whole grains helped with naturally-clean teeth and stimulating saliva production, which aids in protecting against .

The dramatically reshaped the American diet. Advances in food processing introduced refined sugars, preservatives and ultra-processed foods into everyday life. Fast foods and packaged snacks became widely available and affordable, creating a culture of convenience.Ěý

Ěýlinks high consumption of ultra-processed foods to obesity, diabetes and cardiovascular disease.

Recognizing these risks, government leaders began promoting healthier eating. For example, former first lady Michelle Obama launched the in 2010 to combat childhood obesity by encouraging better nutrition and physical activity. Similarly, the Department of Agriculture introduced guidelines such as to help Americans make healthier food choices.

In more recent years,Ěýthere’sĚýbeen a growing push aimed at returning toĚýfarm-to-table principles, highlighting whole, organic and locally-sourced foods.

In recent decades, Americans have begun to recognize the negative health effects of highly processed diets. Because of this, aĚý has pushed a return to farm-to-table principles, emphasizing whole, organic and locally-sourced foods.

This shift reflects consumer awareness as well as public health advocacy. By learning from the past and responding to modern health challenges, Americans are beginning to reshape their diets once again.

According to theĚý, dietsĚýrich in fruits, vegetables and whole grains can reduce the risk of chronic disease and improve overall health.

Ultimately, the evolution of the American diet demonstrates how deeply food culture influences health outcomes. The transition from whole foods to processed diets led to an increase in rates of chronic illness and oral disease, while the current return to natural foods offers a path toward improvement.

From early farm-based diets to industrialized food systems and modern health initiatives, each phase has influenced public and oral health. As Americans continue to rethink their eating habits, it becomes clear that diet plays a critical role in maintaining a healthy life.

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Over the past centuries, however, that approach has transformed dramatically — expanding from basic medical treatment to a more comprehensive approach of health and well-being.

In the years following World War I, growing numbers of injured veterans exposed gaps in federal support systems. This prompted , a former Cincinnati judge, to establish the — now known as DAV (Disabled American Veterans) — in 1920.

Years later, in 1930, President Herbert Hoover created through an executive order consolidating various programs into a more coordinated effort. This move reshaped how the public and the federal government perceived compensation and other benefits for veterans.

The system broadened after World War II, with more than 16 million Americans serving in the war and becoming eligible for benefits after being discharged,Ěýaccording to the . At .

By the late 20th century, the scope of veterans’ health had widened again. Conditions like post-traumatic stress disorder and long-term rehabilitation needs reshaped how care was delivered, emphasizing overall well-being.

In 1978, the access to healthcare services by introducing specialized programs, including comprehensive physical examinations.

The following year, the VA initiated , which led to the creation of community-based designed to offer accessible mental health and readjustment counseling for veterans who were hesitant to seek care in traditional VA hospital settings. The VA took another step to address veterans’ mental health needs by establishing the in 1989.

Yet even as the system grew more comprehensive, some aspects of care remained limited. , in particular, has historically been restricted to veterans meeting specific eligibility criteria, such as those with service-connected dental disabilities. In 2014, a new initiative aimed to address this need: the .

VADIP allows eligible veterans, as well as certain family members and survivors, to purchase discounted dental insurance through private carriers. Among those providers is , one of two national insurers participating in the program.

Leaders today still continue their efforts in ensuring quality healthcare for veterans. In 2014, President Barack Obama signed the in response to a wait-time at VA facilities in Phoenix. The legislation expanded veterans’ ability to seek care outside the VA system when needed. During his first term in 2018, President Donald Trump signed the , further broadening access to community care and streamlining existing programs.

The evolution of veterans’ care mirrors a larger American story. What began as a system focused on immediate medical needs has grown into one that recognizes the importance of prevention, accessibility and quality for those who fought for the country.

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More recent research and updated clinical guidance from organizations like theĚý are now reshaping how it is evaluated and prescribed. As of late 2025, the FDA has removed the “black box” warnings from many menopause hormone therapy products.

“Millions of women were told to fear the very therapy that could have given them strength, peace and dignity through one of life’s most difficult transitions — menopause,” Health and Human Services Secretary Robert F. Kennedy Jr. said while announcing the changes.

For many women, especially those under 60 or within 10 years of menopause onset, HRT is nowĚý for managing symptoms and protecting long-term health. Today’s guidance is more precise, recognizing that risks and benefits depend on several factors including dosage and individual health history.

This change is more than just a reversal because it’s part of something deeper. Medicine is correcting years of blind spots in its study and treatment of women. It also mirrors a broader evolution in healthcare. For much of modern medical history, , with results generalized to women.

Even when women were included, studies often did not account for hormonal cycles, pregnancy or menopause. Researchers are recognizing that these transitions ripple across the entire body, influencing cardiovascular, skeletal, metabolic — and even oral — health.Ěý

Hormonal changes during both pregnancy and menopause can significantlyĚýimpactĚýoral health. During pregnancy, elevated hormone levels can increase susceptibility to inflammation, leading to conditions like pregnancy gingivitis and periodontitis, according to theĚý.ĚýSomeĚýĚýhave also linked poor oral health to adverse pregnancy outcomes, including preterm birth.

Menopause presents a differentĚý.Ěý have been associated with dry mouth, burning mouth syndrome and an increased risk of periodontal disease. Bone density loss can also affect the jaw, potentiallyĚýimpactingĚýtooth stability.

In some cases, patients are pushing the system forward. AĚýĚýunderscoresĚýthis shift. Delta Dental reports that women are increasingly seeking menopause-specific dental benefits, reflecting a growing awareness of how hormonal changes affect oral health.Ěý

There’sĚýalso a parallel push for sex-specific research and more inclusive clinical trials on the federal level recently. In 2016, the National Institutes of Health implemented aĚýĚýrequiring researchersĚýto design studies that include both female and male subjects. The goal was to improve the quality and reliability of research, while making sure the findings work for both men and women.Ěý

In 2024, Joe Biden aimed at advancing women’s health research. It directed federal agencies to strengthen data collection, expand funding and address long-standing gaps in how conditions affecting women are studied and treated.

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Preventive care became institutionalized through national guidelines, federal policy and school-based programs by the late 20th and early 21st centuries. The transformation included not only medical practices like vaccinations and screenings, but also oral health initiatives, nutrition standards and broader lifestyle changes.

The development of national recommendations has been one of the most significant drivers of the shift towards preventive care. In 1984, the U.S. Department of Health and Human Services (HHS) convened the first .

Organizations like the and the USPSTF helped to establish standardized guidelines for vaccines, screenings and routine checkups. These recommendations helped define what preventive care should look like across the country and, over time, federal policy reinforced these standards.

One example is the passage of the during Bill Clinton’s presidency. The expanded access to health care and incorporated preventive elements into federal programs. It also expanded Medicare coverage for preventive services like cancer screenings and diabetes care.

Another example is the Affordable Care Act, which without cost-sharing, making prevention more accessible and routine for millions of Americans.

School vaccines

Schools also played a critical role in normalizing preventive care, particularly through vaccination requirements. ensured that most students received essential vaccines before attending school. This led to prevention becoming a shared public responsibility, with schools becoming central points of enforcement and delivery.

Dental sealants and school-based prevention

Oral health is another example of how prevention expanded beyond traditional medicine. Over time, dentistry has become increasingly integrated into public health through programs like . Supported by the , these programs deliver protective coatings to children’s teeth and can significantly reduce their risk of cavities.

Although it’s considered largely preventable, tooth decay is still the most prevalent chronic disease, according to the . The inclusion of oral health in school and community programs has been part of recognizing that dental health is essential to overall well-being.

Nutrition guidelines and preventive lifestyle

Preventive care has also expanded into lifestyle and behavioral guidance.

In 1977, the Senate Select Committee on Nutrition and Human Needs released , often called the McGovern Report. It marked the first time the federal government urged Americans to cut back on fat, saturated fat, cholesterol and added sugars to reduce chronic disease risk. The report also encouraged eating more complex carbohydrates — including fruits, vegetables and whole grains — a shift that drew strong opposition from the meat and dairy industries.

The , released by USDA and HHS in February 1980, went a little further, laying out seven core recommendations aimed at improving health and reducing chronic disease. That report urged Americans to eat a balanced variety of foods, maintain a healthy weight, and limit their intake of fat, sugar, salt and alcohol.

Through a combination of federal guidelines, school-based systems and expanded definitions of health, prevention was transformed from an abstract ideal into a practical, everyday expectation.

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Recognized by the Centers for Disease Control and Prevention as one of the of the 20th century, community water fluoridation is the controlled adjustment of fluoride levels in public drinking water to the concentration recommended for preventing tooth decay.

Unlike some medical achievements that can often depend on an individual’s access to care, fluoridated water reaches entire populations at once. shows fluoridated water prevents at least 25% of tooth decay in both children and adults.

The also found that communities with populations of 1,000 or more experience an average return on investment of about $20 for every $1 spent on community water fluoridation. On average, people living in areas with fluoridated water save approximately $32 per year by avoiding the costs associated with treating tooth decay.

Dr. Myron Allukian, Jr., a board-certified public health dentist and former president of the , noted that the first conducted in 1945 showed a dramatic reduction in tooth decay, with rates declining by roughly 50 to 70%. As a result, national organizations started supporting fluoridation as a public health measure.

“In 1950, the supported fluoridation, as did the ADA (American Dental Association), as did the federal government,” Dr. Allukian said. “Since then, we’ve had thousands of studies done on fluorides and fluoridation, and we have found that it’s really the foundation for better oral health.”

Dr. Allukian explained that fluoride strengthens tooth enamel, making it more resistant to the acids produced by bacteria in the mouth.

He said the process is especially important during childhood, when teeth are still developing because it helps to make teeth more decay-resistant over time.

“So we already have fluoride in the water. We already have it as part of our body, but with fluoridation, we increase the amount slightly. So while the teeth are growing, the fluoride becomes part of the tooth to make it stronger.”

Dr. Allukian described dental disease as a neglected epidemic due to its widespread impact on communities — particularly during World War II, when many military draftees were rejected because of poor oral health and untreated tooth decay. He also pointed to the oral health struggles of the nation’s first president as an example.

“George Washington, as President, had four sets of false teeth because he lost all his teeth due to tooth decay, and gum disease. So when you have a disease that affects everyone, what can you do to benefit everyone? And that’s what water fluoridation does.”

Dr. Allukian emphasized that community water fluoridation was developed as a solution to a widespread public health problem. Rather than relying on individual dental care, he said fluoridation provides consistent protection to entire communities.

“So we’ve had over 80 years of experience showing that fluoridation is safe and effective, irrespective of age, gender, income, education, culture and ethnicity, so it helps everybody.”

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Historically people living in rural areas have faced limited access to medical and dental care due to provider shortages, geographical barriers and economic challenges. These obstacles have shaped the evolution of how health care is delivered to people in these communities.

In the late 19th and early 20th centuries, rural health care often relied on isolated physicians who served large geographic areas, and would sometimes be the only doctor for miles, according to the University of Nebraska Medical Center.

In 1921, the Sheppard—Towner Act created the first nationwide federal effort to support maternal and infant health, according to the Embryo Project Encyclopedia. It offered matching funds to states to help lower high death rates among mothers and babies, especially in rural communities.

Advocates said the program was essential for reducing the nation’s infant mortality rate. With federal support from the Sheppard—Towner Act, states opened nearly 3,000 prenatal clinics, held more than 180,000 infant‑care classes, conducted over three million home visits by public health nurses, and distributed educational materials nationwide between 1921 and 1928.

In 1946, President Harry S. Truman signed the Hill-Burton Act, also known as the Hospital Survey and Construction Act, into law. The policy provided grants and loans to support the construction of hospitals in communities that lacked adequate medical facilities.

The legislation had a strong impact in the south, where many new facilities were built using funds from the bill. However, the law also reinforced the belief of “separate but equal” in health care. After several lawsuits led by the National Association for the Advancement of Colored People, the “separate but equal” aspect was overturned by a federal court in 1963.

Over time, systemic disparities in rural health care have become more apparent. According to the Centers for Disease Control and Prevention, data shows that people living in rural areas are more likely to experience higher rates of chronic disease including heart disease and diabetes. They’re also more susceptible to premature death caused by chronic conditions.

Additionally, many rural communities face shortages of dental professionals, and financial barriers can make it difficult for providers to practice in underserved regions. A 2018 report found that older adults living in rural areas face higher rates of complete tooth loss, often as a result of untreated decay or advanced gum disease.

In response to these disparities, innovative solutions were created to close the gaps — one of the most significant advancements being the rise of telehealth. Telehealth allows patients to consult with health care providers remotely using digital technology, reducing the need for travel.

The American Telemedicine Association reports that telehealth usage rapidly increased during the COVID-19 pandemic, accelerating its adoption in rural areas.

Similarly, teledentistry has also transformed access to oral health care. The American Dental Association notes that teledentistry enables remote consultations, screenings, and patient education, which are particularly beneficial for underserved rural populations.

In addition to technological advancements, public programs such as Medicaid have played a critical role in improving rural health care access. According to the American Hospital Association, Medicaid covers over 16 million people in rural communities, helping to address common barriers faced by residents.

Although challenges remain, rural health care in the United States has evolved significantly from traveling physicians to technology aimed at reducing the disparities.

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However, over the past 250 years, the understanding of mental health has shifted drastically. What was once not widely discussed is now a cornerstone of public health, reshaping how we treat the mind as part of the body.

In the , mental illness was largely addressed through institutionalization in state mental hospitals, which were known as insane asylums. However, these hospitals were often overcrowded with poor living conditions for patients.

“People with mental health conditions were frequently placed in asylums where the focus was more containment, rather than treatment,” Dr. Pierluigi Mancini, interim president and CEO of , said. “There was very little scientific understanding of mental illness and stigma was even more profound than there is today.”

In the 20th century, reformers like helped spark a national movement through his own lived experiences. During his time in both public and private institutions, Beers endured and observed severe mistreatment, Mancini said.

“So our founder, Clifford Beers, wrote his memoir ‘A Mind That Found Itself,’ where he very graphically described the maltreatment that he received, both at public and private institutions,” Mancini said.

These experiences inspired Beers to launch a reform movement, the National Committee for Mental Hygiene, which ultimately became .

Mancini noted that the movement gave birth to many other partner organizations that also address mental health.

“He helped expose those conditions and helped spark this movement that we have today that continues to be focused on reform, on dignity of the individual, and early intervention,” Mancini said.

The conversation surrounding mental health has continued to evolve over time, with society slowly but surely addressing mental health more.

In 1949, Mental Health America launched Mental Health Week, which later became Mental Health Month. Mancini called a transformative moment.

“It brought mental health out of the shadows into the public conversation, where we finally had a space where we can talk about mental health, we can talk about mental illness and we can talk about recovery,” he said.

Today, mental health is recognized as closely connected to physical well-being, shaping how individuals think, feel and function in their daily lives.

According to the , individuals with depression are more vulnerable to chronic conditions such as heart disease, diabetes and stroke. Chronic stress can also further impact the body — increasing the risk of heart attack, stroke and premature death.

also points to a link between mental and oral health. Findings from the National Library of Medicine link mental health conditions with tooth loss, periodontal disease and tooth decay. Additionally, mental health challenges can disrupt sleep, contributing to insomnia, nightmares and irregular sleep patterns.

“So mental health is foundational to everything that makes society function — education, workforce, productivity, family stability and community resilience,” Mancini said.

He highlighted how far society has come in dealing with a topic that was once deeply stigmatized, including greater access to treatments and medications.

“But the real measure of our progress is going to be whether every person, regardless who they are, where they came from, can experience mental health as a fundamental part of their well being,” Mancini said.

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Efforts to establish health insurance can be traced back to the early 20th century, long before employer-sponsored plans became the norm. Most people paid for medical and dental care out of pocket. In 1912, Theodore Roosevelt’s Progressive Party supported the idea of insurance —including health insurance — as part of a greater effort to protect workers. In 1915, the American Association for Labor Legislation drafted a bill for mandatory health insurance, but it was not enacted.

As hospital bills increased in the 1920s and 1930s, some insurance plans started to emerge to help people pay for care. In 1929, Baylor Hospital in Dallas, Texas, created a prepaid insurance plan that allowed teachers to contribute small monthly payments in exchange for future hospital care, according to published by the Delaware Journal of Public Health. That model was the foundation for what later evolved into Blue Cross plans.

In the 1930s, the country was in the midst of the Great Depression and millions of Americans were struggling to find work or afford basic necessities. The economic state highlighted the need for stronger social policies, particularly to protect employment, provide retirement security and ensure access to healthcare. In response, President Franklin D. Roosevelt created the Committee on Economic Security to study these challenges and recommend solutions. Although the committee’s work helped shape programs like Social Security, a proposal for national health reform did not advance.

World War II played a vital role in changing the American health insurance system. During the war, the government controlled how much companies could pay workers. In return, companies started offering extra benefits like health insurance to attract employees. Federal tax policy also started excluding employer-paid health insurance premiums from employees’ taxable income, which made employer-sponsored insurance appealing for both companies and workers.

After the war, employer benefits continued to expand and dental coverage began to follow a similar path. For decades, dental care had largely been excluded from early health plans, leaving a lot of patients to pay full costs out of pocket.

A turning point came in the mid-1950s on the West Coast. Labor groups representing longshoremen began looking into ways to provide dental care for workers’ families after recognizing that many could not afford treatment.

In 1955, several dentists in California worked with unions and employers to develop one of the first large-scale prepaid dental care programs for longshoremen and their families. This led to the Washington Dental Service being established in 1954, and the Oregon Dental Service and the California Dental Association Service in the following year. What started as an effort to address unmet needs for a certain group of workers ended up changing how Americans get oral healthcare.

The history of health insurance in America shows that it was not just about hospitals and doctors. It was also about workers, labor groups and policymakers who recognized the importance of workers’ health.

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Two landmark policies, the creation of the in 1970 and the passage of the in 1993, reflect how workplace protections expanded to address both physical safety and family well-being.

OSHA and the push for safer workplaces

The origins of the OSHA date back to a period when industrial progress often came at a steep human cost.

By the mid-20th century, workplace injuries and deaths were common across the United States. Safety protections varied widely by state and many industries operated with few enforceable standards.

During the 1960s, public attention increasingly focused on dangerous factories, unsafe mines and exposure to toxic substances that could cause long-term illness.

In 1968, President Lyndon B. Johnson urged Congress to enact a national job safety and health program, but the proposal did not pass.

Two years later, Congress approved the Occupational Safety and Health Act of 1970. President Richard Nixon signed the legislation into law on Dec. 29, 1970.

While signing the bill, Nixon called it one of the most important pieces of legislation passed by Congress.

The law created OSHA and tasked the agency with setting and enforcing workplace safety and health standards for most private-sector employees and some public workers.

OSHA conducts workplace inspections, investigates complaints and requires employers to maintain working conditions free from recognized hazards.

The agency also develops rules limiting exposure to harmful chemicals, requiring protective equipment and establishing standards for emergency preparedness and fall prevention.

According to since OSHA’s creation the rate of workplace injuries and fatalities has declined significantly.

Family leave as a public health policy

More than two decades later, workplace protections expanded beyond job safety to address family health and caregiving.

“This sends a clearer signal than any words any of us could utter that we have tried to give this government back to the American people,” Clinton said while signing the legislation.

Originally, the law applied to childbirth, adoption and serious health conditions.

Congress expanded the policy in 2008 and 2009 to include protections for military families dealing with deployment-related needs.

Recent research highlights how workplace policies can influence health outcomes beyond the job.

A found that children whose parents lack access to paid sick leave are significantly less likely to receive preventive dental care visits.

The findings underscore a broader reality: Worker protections often extend beyond employees themselves, affecting the health and stability of their families.

The evolution of policies protecting American workers illustrates the growing recognition that worker health plays a key role in sustaining families, strengthening communities and supporting the nation’s economic well-being.

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Before antibiotics, modern surgical tools, or organized emergency response, individuals were forced to be creative as they faced human suffering. The Civil War not only reshaped the nation, but it also transformed how medical care was practiced on the battlefield.

At the center of this transformation were pioneers who challenged tradition and laid the groundwork for systems of care that continue today. Among them was Clara Barton, whose vision changed humanitarian aid forever. Barton is best known for founding the American Red Cross in 1881.

Liz Witherspoon, the co-founder of the Clara Barton Fund and a member of the board, said Barton was inspired after she recognized the urgent need for better logistics and supplies to reach soldiers who were caring for the wounded and the dying.

“So she organized many, many wagons full of supplies and medicine, food and other things to get to the soldiers during the Civil War,” Witherspoon said.

Barton had to request permission to get to the front lines — something that was very unusual for a woman at the time.

“She had to use a lot of political savvy, a lot of advocacy, a lot of persistence, to go to the lawmakers and to the military and to get that coveted pass that allowed her to go to the front lines,” Witherspoon said. “But many people believe that she was a nurse who went and aided the wounded in the Civil War, but she was really at first, a supply chain expert and logistics expert who brought supplies.”

Barton served as Red Cross president for 23 years before retiring.

“If you think about — every day you turn on the news, you hear about the Red Cross assisting with fires, floods, natural disasters, wars, and that is the organization she founded in the 1800s, and it’s very hard to think of any other organization founded by a woman that still has the impact and influence today that she established it with,” Witherspoon said.

Barton was not alone in her innovation during the Civil War. According to , several prominent dentists enlisted on both sides of the war — including Dr. Charles Koch and Greene Vardiman Black.

According to , dental services did not seem to be a priority for the federal government at the start of the Civil War. served from and carried a small satchel with dental instruments and medicine for oral pain.

After the war, Congress faced mounting pressure from professional dentistry to establish a dental corps.

Barton and Koch are just two stories of medical innovators during the Civil War. They made significant efforts to turn disorder into structure, and improvisation into ongoing practices. Their work saved lives in the moment and advanced disaster response, medicine and humanitarian care.

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Even the nation’s first president, George Washington, and even sought treatment from French-born dentist Dr. Jean-Pierre Le Mayeur for his advanced techniques.

When America gained its independence, the practice of dentistry was evolving into a special practice separate from medicine, according to Dr. Scott Swank, a clinical associate professor at the University of Maryland School of Dentistry and curator at the

“They are surviving,” Swank said. “They’re making enough money to just do dentistry. But then in 1837, the U.S. goes through this terrible economic depression.”

Job losses caused by the economic state led some men to consider taking up dentistry.

“So all these men are out of a job, and they’re seeing dentists still doing pretty well, so they just start. There’s no regulation against it — you can either just start doing it, you can read the books, you can (be an apprentice) under a person that’s already doing dentistry,” he said.

Swank said established dentists worried that the lack of formal standards allowed nearly anyone to practice and could damage the career’s credibility with the public.

“And they knew at this point, that in order for dentistry to survive public perception, it would have to become its own profession,” he said.

Dr. Horace H. Hayden and Dr. Chapin A. Harris were among the dental practitioners who recognized the need for formal dental education and asked the University of Maryland to create a dental department.

Swank said the university was ambivalent about their request, leading the men to petition the General Assembly of Maryland.

“The state assembly says yes, so they give their blessing in 1839; but the governor doesn’t sign the bill or the charter until 1840, so that is the official year that the Baltimore College of Dental Surgery really gets founded,” Swank explained.

With just four professors, the Baltimore College of Dental Surgery became the first dental school to open in the world; but the milestone was met with some contention.

Swank said dentistry previously relied on preceptorships — an apprenticeship model in which dentists trained newcomers for a fee. After BCDS was created, the school not only represented change, but also a financial loss.

“They were super upset about it, because they saw that as a hit to their income, basically. But at that point, people started to realize that this is the way things are going to have to be,” he said.

Despite some initial resistance, BCDS eventually served as a model for institutions that followed. The Ohio College of Dental Surgery and the Philadelphia College of Dental Surgery were among the earliest schools chartered after BCDS.

“But all of the schools, especially the ones in Philadelphia and Ohio, were largely based on the system that the Baltimore school had in place,” Swank said.

Almost 200 years later, what started as a contested idea has grown into more than 70 accredited dental schools throughout the country.

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Although it’s unclear exactly how the wooden teeth myth got started, Amanda Isaac, chief curator at George Washington’s Mount Vernon, said it appears to have taken hold in schools and in popular media by the late 19th and early 20th century. Isaac also noted that the origin of the myth could be linked to the appearance of his surviving dentures.

“They’ve aged over time,” Isaac said. “Washington was a great wine drinker, including sweet after-dinner wines like port that would stain the teeth, and so the thought is that people just misinterpreted what they were seeing. They saw these yellowy brown artifacts and thought they were made of wood, when in fact, they were just stained.”

Washington started losing his teeth at just 24 and endured dental troubles for much of his life. He frequently noted his dental struggles in diary entries, writing about tooth aches, inflamed gums and dentures that didn’t fit properly.

“In terms of dental history back then, the standard procedure is if you had any type of dental tooth pain, they would extract it,” she said. “There wasn’t any type of fillings or caps you could do, there wasn’t any intermediary remedial care,” she added, noting how far dental care has advanced.

In fact, Washington’s dentures were made of several materials — including cow, horse and human teeth. In May 1784, a Mount Vernon journal of accounts by Washington of nine teeth from enslaved people.

“And then there’s some additional metals — iron for the springs, brass and silver used to adhere all this together,” Isaac said.

Despite his discomfort, Washington’s dental troubles unexpectedly helped mislead the British Army in 1781, when a letter he wrote to his French dentist ended up in the hands of the British commander, Sir Henry Clinton. The documents caused British leaders to believe American and French forces posed no immediate threat to Yorktown, Virginia, where General Lord Charles Cornwallis’s troops were positioned.

“He’s focused on thinking that Washington is going to be elsewhere, and doesn’t reinforce Cornwallis, which is a pivotal, crucial decision that allows the French and Americans to corner him and force the surrender,” Isaac said.

Even though his troubles played an unexpected role in America’s victory, Isaac said Washington was very self-conscious about his teeth, to the point that he used coded correspondence with his dentist in attempts to keep it private.

“By the time he was president, he only had one natural tooth left in his mouth, and then as now, having a beautiful smile and a pleasant appearance was a great status symbol,” she said.

Isaac said the story about Washington’s teeth reveals a human side of the man known as the country’s first commander in chief.

“Washington became such a great leader, someone who was known for his self-control, his ability to make good decisions, but his dental history helps us see that other side of him, his weakness,” Isaac said.

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In the messages, which recently resurfaced, Jones described a hypothetical scenario in which he would kill then-Virginia House Speaker Todd Gilbert. The messages were sent to Republican House of Delegates candidate Carrie Coyner.

At the time, Jones wrote:

• Three people, two bullets
• Gilbert, hitler, and pol pot
• Gilbert gets two bullets to the head
• Spoiler: put Gilbert in the crew with the two worst people you know and he receives both bullets every time

Polling

Since the discovery, Jones has faced numerous calls from both Democrats and Republicans to drop out of the race. Polls have also between him and Republican incumbent candidate Jason Miyares.

Kyle Kondik, managing editor of Sabato’s Crystal Ball from the University of Virginia Center for Politics, said whether or not Miyares is really leading in polls remains to be seen.

“I don’t think we’ve really gotten true, nonpartisan polling of the race. Since the news about Jay Jones came out, there have been a few polls — including one from Jones’ campaign — that showed Jones losing ground, which makes sense. I mean, this is a huge story in Virginia politics,” Kondik said.

Thursday’s AG debate

The candidates for attorney general are set to have their first and only debate on Thursday.

Kondik said Miyares will likely try to ensure Jones’ text messages stay front and center in the minds of voters.

“I think the key thing is, what happens in this debate, and does it either sustain or stall this story?” Kondik said.

He also highlighted new advertisements incorporating the text messages from Jones.

“Miyares has already run, what I think are, some pretty effective ads using this text messaging story against Jones. And so he should be able to have some sort of advantage on that down the stretch of the election,” Kondik said.

National politics and ticket splitting

Despite the recent controversy surrounding Jones, Kondik said the current political environment still favors Democrats in Virginia politics. He also pointed to the polling in Virginia’s race for governor, which shows Democrat Abigail Spanberger leading Republican candidate Lt. Gov. Winsome Earle-Sears.

“The challenge is, I think, it’s still probably a Democratic-leaning environment overall, in Virginia and nationally in 2025,” Kondik said. “I do think Abigail Spanberger is still favored in the governor’s race, and then the question is whether there are long enough coattails to allow Jones to win.”

He said ticket splitting has been on the decline in Virginia and it’s a great test to see how potent ticket splitting is.

“It’s possible that Jones gets beat up on this story for the rest of the campaign, but still is able to win just because of these bigger picture factors,” Kondik said.

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