r reviewing the inventory of the Roger Adams papers and consulting with University of Illinois archivists, the first author identified 319 documents (1,551 pages) related to SRF/ISRF. Additional material authored by SRF, ISRF, and WSRO was located through a WorldCat search, including annual reports, symposium proceedings, and reviews of research. Documents were carefully reviewed for relevance to dental caries research and policy.
In 1943, SRF was founded in New York, New York. In 1949, SA was created to oversee the research activities of SRF (the research arm) and the newly created Sugar Information (the public relations arm). In 1968, SRF dissociated from SA and was reorganized as ISRF. SA joined ISRF as a member (shown as a dotted line). In 1973, SA discontinued Sugar Information because there was no longer a meaningful separation of duties between SA and Sugar Information. In 1978, ISRF was reorganized to become WSRO, and SA joined WSRO as a member.
National Institute of Dental Research documents.
We located sources related to the NIDR NCP through searches of PubMed and WorldCat, and by contacting NIDCR directly. Materials included NCP primary publications [40–45] and two historical reviews commissioned by the NIDR: a description of the first decade of the NCP by its project officer, William E. Rogers , and a history of the NIDR by historian Ruth Roy Harris .
Findings were assembled chronologically into a narrative case study. Part of the analysis called for systematically comparing two key reports for similarities: (1) Dental Caries Research—1969 , a document submitted by ISRF to the NIDR, and (2) the NIDR’s 1971 Opportunities for Participation in the National Caries Program , which defined the research priorities at the launch of the NCP. Both documents were entered into Microsoft Word using a monospaced font at 12 characters per inch (average of 12 words per line). After line numbering both documents, we compared the documents, classifying each line of the 1971 NIDR document and the 1969 ISRF document as different, paraphrased, or verbatim. “Paraphrased” was defined as some identical words with the same overall meaning.
Emergence of the National Caries Program, 1966–1967
Table 1 provides a timeline of events during the planning and launch of the NCP.
In June 1966, President Lyndon Johnson initiated a major reappraisal of National Institutes of Health (NIH) research agendas, requesting that directors of NIH institutes submit their programs’ “priorities and objectives in the national attack on disease and disability” . The NIDR Director Seymour Kreshover’s report to President Johnson in November 1966 stated that “an accelerated program of research during the next decade could reasonably provide the means for virtual eradication of dental caries” .
The threat of the NIDR’s dental research program to the sugar industry began to crystallize in July 1967, after the president praised Kreshover’s report . While it had long been known that bacteria caused tooth decay , Kreshover based his plans on the work of NIDR scientists Robert Fitzgerald and Paul Keyes, who had singled out the bacterial strain Streptococcus mutans as a major culprit in the production of acids that caused dental caries [55,56]. Research suggested that sucrose was more hazardous than other types of sugars because it caused S. mutans to form dextrans, sticky molecules that caused the bacteria to tenaciously adhere to one another in the plaque and on the tooth’s surface . The NIDR’s increased interest in S. mutans brought renewed scrutiny to sucrose consumption and dental caries risk.
In October 1967, the NIDR’s National Dental Advisory Council identified three main areas of emphasis to inform research priorities to eradicate caries: reducing the virulence of bacteria once exposed to sugars, fluoride delivery, and, of most concern to the sugar industry, dietary modification . A particular threat was research conducted by NIDR scientist Robert Stephan, initiated in the 1940s, on the “cariogenic” (decay-causing) potential of foods [58–60]. According to Step