Chapter 2 The International Association of Oral Surgeons (1962–1986

Chapter 2

The International Association of Oral Surgeons (1962–1986)

The beginning (1962–1971)

There is no doubt that the very first steps in establishing an international association of oral surgeons were taken by Fred Henny. He was an oral surgeon and chief of the departments of dentistry and oral surgery at Henry Ford Hospital in Detroit and in 1960, president of the American Society of Oral Surgeons (ASOS). He was also the editor-in-chief of the Journal of Oral Surgery. He attended a meeting of the American Dental Society of Europe in 1959 in Stockholm, where he came into contact with Gerry Leatherman, a British dental surgeon, who at that time was secretary general of the FDI.

While at the meeting, he made inquiries about the possibility of holding an international conference of oral surgeons with European colleagues. Leatherman advised him to make contact with Terence Ward, a consultant oral surgeon in East Grinstead, U.K. Fred and Lyall Bishop (the incoming president of ASOS) subsequently made a trip to London to meet with Terry Ward and some of Terry’s colleagues from the Oral Surgery Club of Great Britain. From this meeting emerged the idea of having a conference in London, to be organized by the British under the leadership of Terry Ward.

1962: The 1st ICOS, London

The Royal College of Surgeons, London The first International Conference on Oral Surgery (ICOS) took place at the Royal College of Surgeons of England on July 1-5, 1962. It was attended by 750 delegates and accompanying persons from over 40 countries. The particulars of this meeting were very well described by Bob Walker, one of the American attendees and one obviously very much impressed

IAOMS’ begInnIngS: SerendIpIty?

At first glance, it may look like a sheer coincidence that Fred Henny met Gerry Leatherman at the conference in Stockholm and made inquiries about the possibility of organizing an international conference on oral surgery. In retrospect, however, one can safely assume that the time was ripe. Europe had more or less recovered from the damage done by World War II and Americans were anxious to know how oral surgery had developed in Europe. The development of the airline industry made it possible to cross the ocean comfortably in a reasonable period of time, while the means of communication also had improved a lot. Yet, the development of the specialty on both sides of the ocean and indeed in all other parts of the world had progressed without much input from abroad. In fact, the world at that time was not familiar with the term “Globalization.”

In 1962, there were two journals in the U.S.A. dealing with oral surgery; the Journal of Oral Surgery, which was launched in 1943, and Oral Surgery, Oral Pathology, Oral Medicine which first appeared in 1957. Since 1955 the Germans had their Fortschritte der Kiefer-und Gesichts-Chirurgie, which were transactions of their yearly conferences, whereas the French had the Revue de Stomatologie since 1899.

It is safe to say that neither of these journals was read much outside the language area they represented. One can be fairly sure, therefore, that a great deal of ignorance existed about the state of the art of oral surgery on both sides of the Atlantic. The language barrier was huge and thus, it is understandable that Fred Henny sought to contact a British colleague. Although separated by a common language, they, at least, understood each other.

If Fred Henny had not taken the initiative, it surely would not have taken long before somebody else had. Yet the IAOMS thanks its inception to this visionary man.

Paul J.W. Stoelinga

From left to right: Jørgen Rud and Terry Ward at the 1st ICOS.

by the meeting’s pomp and grandeur. The conference sparked enough enthusiasm among participants to consider the foundation of an international association of oral surgery.

The person who had an enormous impact on the early years of the International Association of Oral Surgeons (IAOS) was Terry Ward. Fred Henny probably could not have found a better person to set up an international association. Terry Ward was the prototype of an English gentleman, at least in the eyes of non-Englishmen. He was a very self confident, headstrong person with a touch of arrogance, to put it mildly, an excellent speaker and writer of impeccable English, who had a healthy mistrust in anything foreign to him. He was also a very good organizer who was determined to make the IAOS a success. This is borne out by many notes in the minutes of meetings that most of the time he chaired himself but, above all, by his deeds.

The organization of the first ICOS was a great success thanks to his leadership and the support he had from his colleagues in the British oral surgery club. Terry was in his prime years in the British hierarchy, being the Dean of the dental faculty of the Royal College of Surgeons of England and also the first president of the British association, which was established in the same week as the first ICOS. At the London conference, he was asked to write the constitution of the International Association of Oral Surgeons (IAOS) during a meeting that was attended by Lyall Bishop, president of ASOS; Fred Henny; Jørgen Rud of Denmark and Martin Hut, at that time the president of the Dutch Association. Colleagues attending the conference were asked to join the to be established IAOS and apparently this campaign was very successful as the IAOS membership by June 1963 had already grown to 516.

The fellowship fee in those days was $15, or £5 per annum, an amount that would not change until 1990. One could also become a life member by paying a one-time fee of $300.

The draft of the constitution was sent back and forth to selected oral surgeons worldwide and, according to Walker and Rud (1996), was accepted on April 22, 1964 by the initial executive committee which was appointed by Terry Ward. The committee consisted of Fred Henny as chairman; Lyall Bishop; Pierre Cernea of France; Jørgen Rud as chairman of the 2nd ICOS in Copenhagen and Terry Ward as secretary general.

The constitution laid down the principles of the rules and regulations of the IAOS that for a large part are still valid today:

•The IAOS should consist of individual fellows. • Fellows present at the ICOS formed the “General Assembly.” • National associations could affiliate to the IAOS. • Representatives from affiliated national associations and the members of the executive committee would form the “Council,” the ultimate decision-making body of the IAOS. Pierre Cernea • The executive committee would be responsible for the conduct of the IAOS and answerable to council. • The day-to-day work would be done by the secretary general. Organizational meeting of the IAOS. From left to right: Gerry Leatherman, Daniel Lynch, Fred Henny, Sir Terence Ward, Lyall Bishop. The Danish delegation with Jørgen Rud (in the middle) at the Gala dinner at Guildhall, 1962. One of the first executive committee meetings. From left to right: Terence Ward, Terence Ward’s secretary Pamela Clark, Lyall Biship, Fred Henny, Jørgen Rud.

fred A. henny

Fred A. Henny was the first dedicated internationalist in American oral and maxillofacial surgery. Certainly, World War II exposed American military surgeons in the specialty to surgical practice in both Europe and the Pacific, but under less than expansive or otherwise ideal circumstances. Fred Henny, excused from that conflict by his responsibilities at Henry Ford Hospital in Detroit, one of America’s most dynamic wartime medical facilities, became attuned to matters European in the decades immediately following the war through his consultative relationships with military surgeons, his affiliations in veterans affairs and his enthusiasm for the developing kinship between professionals of English-speaking nations. These latter relationships, most notably with Dutch, Scandinavian and English colleagues, resonated in his binding friendship with Sir Terence Ward, their founding of the IAOS in 1962 and his role as its first president.Fred Henny, first president of IAOS, 1963–1968 The decades of the first and second world wars were the time of the slow maturing of the American specialty but only occasionally in those years was it represented in more expansive surgical arenas. It was in this milieu, however, that Fred Henny developed as a surgeon learning from whomever he could, daring when he had to, and by the 1950s, becoming a master in cleft, temporomandibular joint and malignant disease surgery. Among the Henry Ford Hospital staff of internationally recognized general surgeons, Henny was acknowledged to be the premier head and neck surgeon of the group.

The attributes which carried Fred Henny to prominence in America were chiefly four: • His consummate surgical facility • His admirable decorum • His political and organizational senses • His totally unselfish encouragement of his protégés and all young surgeons

He was able to keep his goals in focus with an indifference to ancillary considerations and those goals remained throughout his career the integrity and growth of his specialty. The much broader vistas of American oral and maxillofacial surgery today reflect Henny’s personal skills and teaching but, perhaps, more importantly, his tireless encouragement and aggressive incorporation of things international into training and practice everywhere.

Fred Henny’s surgical accomplishments elevated him to the presidencies of both the American Association of Oral Surgeons and the American Board of Oral Surgery, as it was called in those days. He served 13 years as editor of the Journal of Oral Surgery, he was honored as an outstanding alumnus of the University of Michigan at that institution’s sesquicentennial celebration and he was elected a fellow of the Royal College of Surgeons of England. In no role did he take more satisfaction, however, than in his service to the International Association of Oral Surgeons. Fred A. Henny was the paladin of American oral and maxillofacial surgery for his time and stands today as an international icon for all time. He left a legacy of truly worldwide proportion for his beloved specialty when he moved on to the better world in the early morning hours of January 10, 1989.

Bruce MacIntosh

1965: The 2nd ICOS, Copenhagen

The 2nd ICOS took place in Copenhagen on June 19–24, 1965. It was organized by the Danes under the chairmanship of Jørgen Rud, who incidentally missed the whole event because of acute appendicitis. This again was a very successful conference attended by 212 fellows of the IAOS, 189 non-fellows and 239 associates and guests. Forty percent came from the U.S.A., the remainder largely from Europe, 39 countries in all were represented.

A detailed report of this conference was written by Jørgen Rud which included particulars of the opening ceremony, scientific program, exhibition, banquet, transactions and various other items. The report probably served as the basis of the “ICOMS Rules and Regulations” for many years thereafter. Of particular note is the fact that a golf tournament was organized in which only 20 people participated. The report mentions that it became a loss to the organization! Other noteworthy facts are that Terry

From left to right: Fred Henny, Jørgen Rud, Terence Ward before the 2nd ICOS in Copenhagen.

Ward was reimbursed for nine trips to Copenhagen and that the total profit of the meeting amounted to $600.

Apart from an interesting scientific program and apparently a highly appreciated social program, the main thing about this conference was that the IAOS was now officially established as the general assembly approved the constitution. At this point, the IAOS had 567 fellows with six or seven affiliated associations, notably the American, British, Dutch, French, Israel and Scandinavian associations and probably Australia-New Zealand. More importantly, the international association was now on a solid footing with a “chosen” executive committee and a formal council. The initial executive committee did not change, however, with the exception that Fred Henny was now called “President.”

News Sheet begins

In the period before the third meeting in New York, Terry Ward began to send around a publication named News Sheet each year. The first appeared in 1965 and he continued to publish them until 1968. These issues contained very detailed information on the development of the IAOS in the early years, including the growth of the membership, the activities of the affiliated nations, changes made to the constitution and news about the upcoming ICOS.

The News Sheets were also a testimony to Terry’s commitment to the cause. They provided the fellows of IAOS with a feeling of belonging to an association which was clearly meeting a demand. The three years between international conferences were without any real activities but Terry made it sound as if a lot was going on. For instance, he reported on the major jump in membership right after the second ICOS to 662 fellows. The sheer fact that membership kept growing, albeit minimally, to 673 in 1968 and that four more national associations joined, attest to the vitality of IAOS at that time. The associations that joined were from Spain (1967), Canada (1968), Argentina (1967), and Cuba (1968).

Layout of News Sheet.

1968: The 3rd ICOS, New York

The third ICOS in New York in October 1968 was deliberately scheduled to take place simultaneously with the 50th anniversary meeting of the ASOS. This was a well-attended meeting by both Americans and Europeans but it was difficult to tell how many were there as fellows of the IAOS. This also was the meeting where Hugo Obwegeser introduced the sagittal split osteotomy to a large audience, signaling the beginning of a new era in orthognathic surgery.

The meeting again produced a boost in membership to 793 and the decision was made to use the first funds on scholarships that would allow trainees to work in selected centers abroad. It is not clear whether this was actually put into effect.

This was also the first time that the president wore a badge suspended from a crimson ribbon. This badge has been replaced by the current one but it resembles very much the first badge in that the IAOS symbols were also in gold on red enamel. The golden chain came in 1971 and was a gift from Andrew Linz. The IAOS medallion.

An important change in the constitution was made regarding the executive committee. From now on, the president would serve another three years as immediate past president on the executive committee. The officers of the IAOS in New York also changed with Terry Ward becoming president, Norman Rowe, the secretary general and Willem (Bill) A.M. van der Kwast came on board as chairman of the fourth ICOS, to be organized in Amsterdam.

It is of interest to note that three committees were set up: education, finance and research. They were chaired respectively by Norman Rowe, Elmer Bear and Bob Walker. There was apparently already a sense that the international association had a mission to fulfill as an initiator of guidelines for education and training. The following years will see this to be a constant issue in the discussions of the executive committee and council. Not unexpectedly, the first honorary member — Fred Henny — was chosen at this meeting.

SIr terence wArd

In 1960, when Fred Henny first met Terry Ward, Terry Ward probably knew more about Fred Henny than Fred Henny did about Terry Ward. Terry Ward had achieved eminence in the United Kingdom via an unusual and, in many ways, quite remarkable career path. His was not a privileged background. The son of a teacher in Edinburgh, he aspired to become a dental surgeon. Of modest means, he earned entry to the profession apprenticing as a dental mechanic. From there, it was his academic ability that secured his entry into Edinburgh University and it was through his skill as a dental mechanic that he was able to support himself through his student years. In 1928, he qualified in both Sir Terence Ward, president medicine and dentistry and joined a dental practice in the south of England in Hastings.of IAOS, 1968–1971; secretary general, 1963–1968 and It was World War II that changed his life. The British government established a 1971–1974 number of Emergency Medical Service Hospitals at the beginning of the war, one of which was at East Grinstead, a small town south of London. It was here that Archibald McIndoe and Kelsey-Fry (both later knighted for their work) established what became an internationally acclaimed burns and maxillofacial center. For Terry Ward, who already had a special interest in surgical dentistry, this was an opportunity. East Grinstead was not far from Hastings, so he went to see Kelsey-Fry and a relationship was established which was based on mutual respect and which continued until Kelsey’s death many years later.

In 1940, Ward joined the Royal Air Force and served as a specialist dental officer until the end of hostilities. By that time, he had an established reputation as an innovative and brilliant oral surgeon. Kelsey-Fry saw him as his natural successor at East Grinstead, where he became head of the then dental department in 1948. Despite its wartime reputation, the Queen Victoria Hospital at East Grinstead was a small regional hospital with none of the facilities and academic ambience of a teaching hospital in a major city. But Terence Ward was unusual because he was one of the first genuine specialist oral surgeons. As a result, trainees competed vigorously for his attention and the new Ministry of Health rapidly came to appreciate his political skill. He became a consultant adviser to the government and played a leading role in the early development of hospital dentistry within a new nationalized health service.

In his professional life, Terry Ward had two great loves: the Queen Victoria Hospital at East Grinstead and the Royal College of Surgeons of England. He ran his hospital department as an ever-expanding family. Surgical trainees came from all over the world to obtain experience at his hands, while he himself was invited far and wide to operate and lecture. He never appeared to treat one patient differently from another and was equally at home with kings, dictators and the internationally famous as he was with the day-to-day problems of his outpatients at home.

He had an equally charming disregard for the value and quality of the many gifts he received, such that garish diplomas and executive toys sat side-by-side on his desk with exquisitely crafted statuettes and other “objets d’art,” for he never threw anything away.

In his hospital, he was a tireless worker and his staff had to rise early to get round the wards before him. He had equal time for the problems of all levels of staff, from secretary to the senior trainee and he inspired a particular kind of loyalty.

Ward was a man of mischief, and would spend as much time organizing a practical joke on a colleague as he would in preparation for an important meeting with the Minister of Health. One new trainee in the 1960s, intent on making an impression, invited “the boss” for dinner and was immediately asked whether dress should be formal. “Oh no sir, quite casual,” came the innocent reply, only to find that his distinguished patron had delegated his clinical responsibilities and spent most of the day with the full-time assistance of his secretary in obtaining a long-haired wig and a flowing robe with bells attached (appropriate to the post-Beatles, hippy generation), in order to arrive in “casual” dress for dinner.

From the point of view of the modern international oral and maxillofacial surgeon, it is important to see Terence Ward in a proper historical perspective. He was trained essentially as a dentist, albeit with a double degree, which, in those days, was mainly a passport to a fashionable dental practice. He was fortunate (if that is the right word) to gain experience in wartime. He then used his skills, experience and political ability, along with a few others of like mind, to establish oral surgery as a specialty in United Kingdom hospitals open to dental surgeons, enjoying the same salary and status as their medical colleagues.

It was perhaps because of this battle on behalf of dentistry that he resisted making the double degree a requirement, never realizing that in Europe, it was the only route into basic surgical training, which was to become essential to the development of oral and maxillofacial surgery in the 21st century. Unusually, however, in 1960, he was one of the very few with a truly international perspective and realized the importance of uniting oral surgeons both at national and international level, a perspective which he fortunately shared with Fred Henny. These two men will always enjoy a special place in the history of IAOMS.

Norman Rowe kept the secretariat at the Royal College of Surgeons of England. The IAOS was recognized as a charity and, therefore, exempt from paying taxes. He continued to send the News Sheets to the fellows at the same frequency of one a year until 1971. After that year, the International Journal of Oral Surgery was thought to be the vehicle for messages to the fellows.

It is noteworthy to mention here the liaison the IAOS had with the FDI (now known as the World Dental Federation). The IAOS officially affiliated with the FDI and from the available minutes of executive committee meetings from this period, it appears that subsequent executive committees were very concerned that oral surgery be represented at FDI meetings. This stance was followed until 1986.

There was no question about the association’s vitality at this stage. The leadership of the IAOS was in the firm hands of Terry Ward, who single-handedly picked Bill van der Kwast as the chairman of the next organizing committee. His appointment, without consulting with the Dutch association, raised some eyebrows and Bill had some explaining to do at their business meeting. Yet, he received full support from his Dutch colleagues but he was closely and frequently monitored by Sir Terence, as were the Danes in the years before.

One of the most important decisions that this executive committee made was to begin an International Journal of Oral Surgery. This was a highly appropriate move at this stage of the association’s development as it was difficult for colleagues from non-English speaking areas to publish in peer-reviewed journals.

They found an eminent scientist in the person of Jens Pindborg, a world-renowned oral pathologist from Copenhagen, to take on the job of editor. Pindborg was recommended by Jørgen Rud, who had also made contact with Munksgaard publishers in Copenhagen. One may wonder whether the selection of Pindborg was a wise decision given the fact that he was by no means a surgeon. However, given the circumstances, i.e. the necessary frequent contacts with the publisher and the lack of a suitable candidate on the European continent who was a surgeon with a reasonable command of English, it was a sensible decision at that time.

The period between the third and the fourth conferences went without further activities. It is, therefore, somewhat surprising that despite this, the membership grew quite substantially from 793 just after the New York meeting to 843 in the year before the fourth ICOS.

Norman Rowe, secretary general, 1968–1971

1971: The 4th ICOS, Amsterdam

The Amsterdam conference, held from May 17 to 21, 1971, was again a great success with approximately 800 attendees, including accompanying persons. The conference was opened by H.R.H. Prince Bernhard of the Netherlands. Those attending probably remember most especially the reception offered by the Dutch government, at the “Rijksmuseum” where drinks were served literally under the eyes of Rembrandt’s “De Nachtwacht.” One cannot imagine this happening today.

During the conference, Prince Bernhard of the Netherlands became the second honorary member of the IAOS. At this meeting one more national association became affiliated: the Brazilian “Collegio.” It was also recognized that fellows not represented by a national association would be represented by two council members from countries without any affiliated national associations.

From left to right: Terence Ward, Prince Bernhard, Bill van der Kwast.

Prince Bernhard of the Netherlands followed by the executive committee of IAOS and the organizing committee on the way to the opening ceremony. The person on the far right is the Mayor of Amsterdam.

Participants enjoy a drink in front of Rembrandt’s “De Nachtwacht” – The Night Watch. From left to right: Don Juan Carlos, the Prince of Spain, Jørgen Rud, IAOS president, Victor Sada, Chairman of the Spanish organizing committee.

Membership as a result of this meeting rose to 938. Jørgen Rud was chosen president and Terry Ward again became the secretary general. He wouldn’t let go! Victor Sada from Spain was named chairman of the fifth ICOS, to be organized in Madrid in 1974.

It is probably fair to state that at this time the IAOS had achieved a very respectable status and already had considerable impact on the development of oral surgery throughout the world. If one looks at the years that national associations were founded in the various corners of the globe (see addendum), it is tempting to assume that oral surgeons who came from countries with no national association, attended one or more of the four ICOS and returned home to take local initiatives and assist in founding their own national associations. Additionally, after nine years, the organization had outgrown its teething problems with a membership that had almost doubled and the affiliation of 12 national associations.

The IAOS was ready to consolidate and further expand. It was no coincidence that the further evolution of the organization followed the boost the specialty received from two relatively new directions in oral surgery: pre-prosthetic and orthognathic surgery (see chapter 1). These developments created an enormous expansion of scope for the specialty and thus, a demand for manpower and not just in the countries where oral surgery was already established. During this time period, it seemed clear that the absolute number of oral surgeons had grown and was continuing to grow worldwide.

Consolidation and expansion (1971–1986)

1972’s major event was the launch of the International Journal of Oral Surgery in June of that year. The Journal appeared six times annually and had an “International News” section. It is interesting to note that the leading article in the first issue was written by Terry Ward. The Journal, however, was not made mandatory to the fellows, which meant that the news section did not reach all of the membership. The executive committee also soon recognized that “there might be subjects not fitted for publication in a journal but only to fellows.” For this reason, in 1974, the decision was made to reinstate a News Sheet now called the Newsletter, which would appear twice a year from then on.

Given the association’s growth, it became clear that more steering was needed between meetings, especially as initiatives began to emerge regarding the organization of a workshop about education in Madrid. For these reasons, council and the general assembly agreed to set aside funds for annual executive committee meetings. This proved to be a big step forwards as a growing organization, such as the IAOS, required a structured way of conducting business, particularly since real business had entered the organization with the introduction of the Journal.

1974: The 5th ICOS, Madrid

The fifth ICOS in Madrid (from April 21–25, 1974), was also very successful, although its main event, a workshop on “Training in Oral Surgery” chaired by Terence Ward, could hardly be called a success as it caused a clash between colleagues with medical degrees and those with dental backgrounds. The report Jørgen Rud, president, 1971–1974 on the workshop that was sent to all fellows six months later (see addendum) was written in very diplomatic language, particularly in its statement that the IAOS was not the organization to impose any specific training program on any country.

From left to right: Dan Laskin, Sandy MacAlister, Bill van der Kwast. Jørgen Rud passes on the presidential chain to Sandy MacAlister.

The Newsletter’s coverage of the event reported that: “It is not to be expected that results from discussions where oral surgeons from so many countries meet for the first time will satisfy everyone.” No one expected this. The value of such worldwide discussions on a subject which is of great importance to us all is, first of all that everyone is confronted with views from other environments which may stimulate discussion of national training programs. The present workshop document should, therefore, not be looked upon as the official IAOS recommendation, but regarded as a basis for further discussion.” These lines are presumably from Terry Ward. Those fellows who were involved in the Tenerife and Bermuda conferences and with the final discussions about the “Guidelines” could not have agreed more with this introduction.

The meeting was well attended and three new national associations joined: Hungary, Mexico and Venezuela. The executive committee for the first time had a new face as president: Alton D. “Sandy” MacAlister from New Zealand. Jørgen Rud became secretary general, while Terry Ward stayed on as past president and “chose” Andrew Linz as representative of ASOS in the executive committee. Sydney was chosen as the new venue for the 6th ICOS with Frank Helmore as chairman of the organizing committee. This was certainly a right choice as the Association of Australian and New Zealand Oral Surgeons (ANZOS) was one of the founding associations of the IAOS. For the first time, however, mention is made of a competition between cities of different countries to be candidates for the organization of an ICOS.

H.R.H. Prince Juan Carlos of Spain and Sir Terry Ward were appointed honorary fellows. As a result of this meeting, the secretariat moved to Copenhagen. The membership, as reported in the autumn issue of the Newsletter of 1974, had risen to 1,048.

Very little happened in the years between 1974 and 1977, the year the sixth ICOS was to be held, apart from the appointment of Erik Hjørting Hansen, in 1976, as the new editor-in-chief of the Journal. He had been working very closely with Jens Pindborg, which guaranteed a smooth transition. He would hold this position until 1988.

1977: The 6th ICOS, Sydney

The sixth ICOS in Sydney almost turned into a fiasco because of a strike of air traffic controllers which ended just before the meeting. Frank Helmore and his organizing committee must have drawn a sigh of relief when the strike was called off. The attendance, as could be expected, was less than in previous years but still totaled 557 delegates, including accompanying persons, with 28 countries represented.

Everyone enjoyed the hospitality of the Australian and New Zealand colleagues. The highlight of this meeting was the reception in the Sydney Opera House foyer overlooking the Sydney harbor. At this meeting, a golf tournament was also organized, as had occurred at previous conferences.

From an organizational point of view, an important change in the regulations was in order, given that Council now consisted of 21 national associations representing 96 percent of the membership. This implied that the actual power was in the council rather than in the general assembly. Consequently, in Dublin three years later, it was decided “that decisions taken by Council shall not require approval from the General Assembly.” This regulation still exists today.

Another item that was decided in Sydney was the re-introduction of life membership, something that had been instituted from the inception of the IAOS but had been discontinued for unknown reasons. For $300, one could become a life member of IAOS. The idea behind this was that the bulk money would generate interest and thus, predictable income. In reality it did,

Sir Herman Black, Chancellor of Sydney University, addresses the 6th ICOS.

Opening Ceremony at the 6th ICOS in Sydney.

Sandy MacAlister hands over the chain to Bill van der Kwast, president, 1977–1980. Geoffrey Howe, president, 1980–1983

however, treasurers to come would consider this money as not suitable for covering the running expenses of the association but rather to cover special events.

Although it was decided in Sydney to hold educational symposia between ICOS, this did not actually happen because of time constraints but also because of financial limitations. The IAOS, however, took the initiative to hold a workshop on European oral and maxillofacial surgery in 1977 in Copenhagen, which was attended by 19 colleagues from Belgium, Denmark, France, Israel, Great Britain, Spain, Switzerland, the Netherlands and West Germany. There were also two observers from the U.S.A.

This meeting exposed the fundamental differences between various continental European countries and the Anglo-Saxon world at that time. The “double-degree” issue was prominent and caused a split among the participants. In 1980, the education committee, under the chairmanship of David Gutman from Israel, produced a report containing “Guidelines for the Education and Training of the Oral and Maxillofacial Surgeon.” This report was based on the outcome of the workshop in Madrid in 1974 and the meeting in Copenhagen in 1977. It was published in English, German, French and Spanish in the fall 1980

Newsletter. (see addendum)

1980: The 7th ICOS, Dublin

In the period leading up to the seventh ICOS in 1980 in Dublin, there were again very few activities reported except that the Newsletters in those days provided excellent information on the activities of affiliated associations but also reports on the membership and the financial situation of IAOS.

The president of this period, Bill van der Kwast, traveled to various parts of the world to make contacts with colleagues from affiliated but also non-affiliated associations. He mentions in his report, which is the only one available for his period, that he visited India twice and even went to the AAOS and ANZOS meetings and the Philippines, apart from various visits to European meetings. He took his representative task very seriously but there are no signs of truly governing an international association as we know it now. Mention is only made of one executive committee meeting in East Grinstead to prepare for the Dublin meeting. One can hardly imagine that the “retired” Terry Ward was not involved in this meeting.

As usual, the ICOS in Dublin was the main event of IAOS in this period and was again very well organized by the organizing committee under the chairmanship of Ian Findlay. The president of Ireland, Dr. Patrick J. Hillary, opened the conference in the St. Patrick’s Cathedral; as a result, an honorary membership of the IAOS was conferred upon him. The conference attracted 900 attendees, 548 of whom were delegates, certainly a good attendance, which resulted in a modest profit for the meeting. According

From left to right: Ian Findley, chair of the Irish organizing committee; Jørgen Rud; Bill van der Kwast; Andy Linz and the dean of the college of surgeons.

Bill van der Kwast presents Dr. Patrick Hillary, the President of Ireland, with IAOS cuff links. OpenIng cereMOny — dublIn

St. Patrick’s Cathedral

The official opening of the 7th ICOS in Dublin took place, not surprisingly in Catholic Ireland, in St. Patrick’s Cathedral in the presence of Dr. Patrick Hillary, the president of the Irish Republic. According to Catholic tradition, it is the privilege of the Bishop to enter the church first. For this reason, the dignitaries of IAOS had to wait in the back of the cathedral for him to arrive. When he entered the church, he was followed by the boy’s choir who would sing during the opening ceremony. President Bill van der Kwast and Sir Terence Ward followed behind the boys, leading Sir Terence to remark to van der Kwast, “William, it must be a sign of age to have to run after the choir boys.”

Bill van der Kwast

7th ICOS, Dublin, Ireland. From left to right: the Bishop of London, Bill van der Kwast and the Dean of the College of Surgeons of Ireland. In the background are members of the executive committee.

From left to right: Wilfried Schilli, chairman of the 8th ICOS organizing committee and Hans Dieter Pape, chairman of the ICOS scientific committee

to the official report, it was particularly the symposia led by Norman Rowe and David Poswillo that made the meeting a successful scientific event.

The executive committee following this ICOS underwent a profound change as several new faces from various countries came on board. Geoffrey Howe became the new president, while Bill van der Kwast became the new secretary general. Jørgen Rud, who had been present from the very beginning with Terry Ward, finally retired from the executive committee and was rightly made an IAOS honorary member. The chairman of the organizing committee for the eighth ICOS in Berlin was Wilfried Schilli.

Despite the strong representation of European members in the executive committee during the ensuing period, very little progress was made in the effort to bring together the different opinions regarding the building of the specialty. This probably had to do with the fact that the president was located in Hong Kong. Consequently, there simply is not any documentation of any activity during this period of time, apart from the organization of the Berlin meeting.

1983: The 8th ICOS, West Berlin

The Berlin meeting introduced a novelty with a “Consensus Conference” on “The relative roles of vestibuloplasty and ridge augmentation in the management of the atrophic mandible,” chaired by Paul Stoelinga. It was held one day before the official opening and was a great success, at least that was the opinion of all of the panel members, who had gone out of their way to bring their prosthodontists to the event. However, there was only one person in attendance: the incoming president, Daniel Laskin. Unfortunately, the organization had not included this symposium in the ICOS program announcements, although it was announced in the Newsletter. The proceedings subsequently were published and had quite an impact among interested colleagues. Most surgeons and prosthodontists who were involved became lifelong friends and had many contacts afterwards.

The 8th ICOS had a modest attendance given the location and the fact that the German-speaking area was the cradle of European oral and maxillofacial surgery.

There were 567 delegates and 230 accompanying persons. Unfortunately, there is no report available about this meeting but the organization was excellent and the ambiance left little to desire. It was not a financial success, as the organization took a loss. The new executive committee, however, under the presidency of Dan Laskin, made some important decisions that had far-reaching effects. • First, and most importantly, the much desired name change came about. From 1984 on, the association’s name was to be “International Association of Oral and Maxillofacial Surgeons (IAOMS).” The journal name change followed only in 1987. • Second, this executive committee found it necessary to meet between the triennial meetings and, in fact did, contrary to previous committees. • Third, the secretariat moved from Amsterdam to London, as David Poswillo took over as secretary general. • Fourth, this committee recognized the importance of communication so as to involve the membership in the business of the IAOMS. For this reason, the Newsletter underwent a facelift with David McGowan appointed as editor. Each issue would have reports from the president and the secretary general, along with pertinent information of the IAOMS’ state of affairs, such as finances and membership details, including the names of new members. The Newsletter also encouraged national associations to publish announcements of their meetings and to report on their activities. In addition, the publication announced the new affiliated national associations.

While the revised Newsletter was meant to appear twice a year, in actual fact, it would appear only once a year until 1989. It became clear from the preceding nine years that the IAOMS had been struggling with its position. On the one hand, it had achieved a respectable status, whereas on the other hand, there was a demand for further action that was frustrated by the limited funds available. The financial position did not allow for a professional secretariat as had been discussed several times in previous years.

The secretaries general used local secretarial staff to run the administration and at the same time served as association’s treasurers. The income was limited

indeed and hardly enough to conduct day-to-day business. The ICOS were not particularly profitable either, with rather small profits in Sydney and Dublin and a loss from the conference in Berlin. Most importantly, however, the association was led by busy clinicians who simply did not have enough time to put in more managerial professionalism. There were, for instance, no executive committee meetings between the conferences, despite an earlier decision to set aside money for these meetings to happen. The new executive committee in Berlin made a start bringing about some changes and certainly made a correct analysis when Dan Laskin formulated the goals for his term of office “to improve communications, to expand our educational activities and to increase the involvement of the fellowship.” Those goals could have been written today.

It is of interest to learn that a meeting was organized in 1984 between the executive committee of the European Association of Maxillofacial Surgery (EAMFS) and representatives of the IAOMS executive committee. David Poswillo, the secretary general at that time, writes, “There was an obvious interest on both sides in maintaining regular contact between the associations with a view to closer ties, possibly federation and in the long term, to a World Federation of Specialist Associations.” It was also decided that a liaison committee be set up to report back to their respective executive committees. Sadly, this never occurred, but how close these thoughts were to the recommendations of the Tenerife and Bermuda conferences!

This executive committee was also the first to write guidelines for governing international conferences. This document underwent several corrections and extensions over the years but the sheer fact that it existed was important and it was a move in the right direction. Daniel Laskin, president, 1983–1986

1986: The 9th ICOMS, Vancouver

The apotheosis of this period was the 9th ICOMS in Vancouver organized by our Canadian colleagues under the capable chairmanship of Alva Swanson. Vancouver, at that time, was also hosting a World Exhibition, which formed a real attraction for those who attended. This was the first really big meeting with 795 delegates and 263 accompanying persons from 39 countries.

The scientific meeting was excellent and included three symposia and several limited attendance clinics and

The executive committee of IAOS at the 8th ICOS in West Berlin. Front row from left to right: Geoffrey Howe, Wilfried Schilli, Dan Laskin, David Poswillo, David Gutman, Basilio Arienza. Second row: members of council.

Dan Laskin presents Bill van der Kwast with a pin for his service as secretary general from 1980–1983. The executive committee and councilors at the 9th ICOMS in Vancouver. Front row from left to right: Al Swanson, Geert Boering, David Gutman, Wilfried Schilli, David Poswillo, Dan Laskin, Jean-Marie Vaillant and Basilo Arienza.

no less than 254 oral presentations. It is worthy of note to read the titles of these symposia as they still would be relevant in the present day: “The maintenance of stability in facial advancement procedures; Tissue transfer in consideration of maxillofacial repairs and alveolar ridge replacement with alloplastic materials.”

The social program was also memorable, particularly the ladies’ program, as they were very well looked after by a special ladies committee.

Three new honorary fellowships were awarded: Bill van der Kwast and Norman Rowe received their distinction at the meeting but Gerry Leatherman, the person who brought Fred Henny into contact with Terry Ward, was awarded his designation in 1987 at an executive meeting in London at the Royal College of Surgeons. He was then in his late 80s and wrote to the secretary general these memorable words: “As an old man with a listening heart rather than a listening head, I am really very conscious of the honor offered to me and which is totally unexpected. One is more forgotten than remembered at my time of life. Naturally I am delighted to accept when your Executive next meets in London.”

At the Council meeting in Vancouver, it was decided to terminate the official affiliation with the FDI, which had existed from the beginning.

The membership had grown in this period from 1,074 to 1,737 and there were 25 affiliated national associations by the end of 1986. The French had two affiliated associations but one councilor, whereas the five Scandinavian countries were represented by one councilor. Gerry Leatherman

References

Kwast van der, WAM, personal communication. Minutes of Executive Committee and Council meetings 1965–1986. Newsletters, 1976–1986. Rowe NL, News Sheets of IAOS, 5–7, 1968–1971. Stoelinga PJW, Editor, Proceedings Consensus Conference: The Relative Roles of Vestibuloplasty and Ridge Augmentation in the Management of the Atrophic Mandible. (8th International Conference on Oral Surgery).Quintessence Publishing Co., Inc. Berlin, 1984. Walker RV, Rud J. History of the International Association of Oral Surgeons 1962–1986 and International Association of Oral and Maxillofacial Surgeons 1986–1996. Int J Oral Maxillofac Surg 1996: 25 254–63. Ward TG, News Sheets of IAOS, 1–4, 1965–1968.