On September 30, 2018, the orthodontic specialty lost one of its most prolific and esteemed contributors with the sudden death of William R. Proffit, DDS, PhD at age 82. Bill was one of the brightest stars in the orthodontic firmament of the 20th and early 21st centuries. He began his research, clinical practice, and teaching career in the 1960s, soon becoming well known for superior intellect, analytic ability, and overall skill in integrating and synthesizing large quantities of information. His emphasis on science and the role of evidence in decision-making predated evidence-based orthodontics. His gifted teaching and lucid lectures inspired thousands of orthodontists over the course of his career. He was proud to be considered orthodontics' “explainer-in-chief.” Contemporary Orthodontics (W. R. Proffit, DDS, PhD, and Henry W. Fields, Jr, DDS, MS, MSD) has been translated into 12 languages, used in dental schools and orthodontic departments worldwide and is the most comprehensive compendium of current orthodontic knowledge.
Bill Proffit's family called him Bob, his middle name; however, everyone else called him Bill. Early in his career, his nickname became Prof and from then on, most people who knew him well used this sobriquet. Prof was one of the first orthodontic educators to develop and utilize self-paced instruction as a method of imparting orthodontic information. Early in his career, he embraced jaw surgery in conjunction with orthodontics as a way of correcting those dentofacial deformities that could not be corrected with orthodontics alone. Surgical Correction of Dentofacial Deformity and Surgical-Orthodontic Treatment, co-authored with Dr Ray White, became a major source of information for orthodontists and oral and maxillofacial surgeons. The enhancement of the Angle classification with the development of the Ackerman-Proffit orthogonal analysis provided a framework for surgeons to better communicate with orthodontists in planning surgical treatment. When internet streaming emerged as an effective technology for distance learning in the 21st century, Bill saw its potential to compensate for the worldwide shortage of full-time orthodontic faculty.
In Bill's own view, his greatest achievement was developing what arguably was the finest orthodontic department in the world at the University of North Carolina (UNC). He served as professor and chairman of the Department of Orthodontics for 26 years. Orthodontists from all over the globe made Chapel Hill a destination on any trip to the United States. It had been Bill's long-standing dream to one day return to the Chapel Hill area where he grew up and received his undergraduate and dental education. Thus, it was extremely fortuitous that Ray White, Bill's friend and close colleague, was chosen in 1973 to be dean of the School of Dentistry at UNC. Dean White immediately recruited Bill to be professor and chair of Orthodontics at Bill's alma mater. Ray recalls that Prof saw great potential at UNC and was persuaded to return to Chapel Hill even with a significant salary cut. Through substantial grants from the National Institutes of Health (NIH) and increased clinic income, Bill was able to build a large full-time faculty at UNC. Bill also instituted an active continuing education program including mini-residencies for practicing orthodontists from around the world who wanted to update their knowledge. Within a few years, through the generous support of the loyal UNC Orthodontic Alumni Society, funds were provided to build a new modern clinic facility. Thus, it was not only Bill's native intellectual ability but also his pragmatic nature that led to his remarkable success in academic dentistry during a time when relatively few orthodontic departments at other schools prospered.
The Board of Trustees of UNC at Chapel Hill acknowledged Dr Proffit's contributions in 1992 by naming him W.R. Kenan Distinguished Professor, the university's most prestigious faculty honor. Other accolades include: 1994 American Dental Association Norton Ross Award, 2005 American Board of Orthodontics (ABO) Albert H. Ketcham Award, and 2017 inaugural American Association of Orthodontics (AAO) Lifetime Achievement Award in Orthodontic Research. To further recognize Dr Proffit, an Endowed Chair in Orthodontics is being created in Bill's honor at UNC with contributions from his friends, colleagues, and others who he impacted. The AAO has announced the lecture period during which Bill was due to speak in 2019 as the William R. Proffit Memorial Lecture. Kevin O'Brien, BDS, FDS, DOrtho, PhD, of Manchester, UK, will present the lecture “Standing on the Shoulders of a Giant: A Retrospective on Bill Proffit.”
With a passionate interest in trains from his boyhood, Prof was able to combine train travel with his lecturing all over the world. Over the years, he and Sara rode almost all of the luxury trains in the western and eastern hemispheres. Bill loved and enjoyed tennis for practically his entire life. Although he was able to beautifully mask his inherent competitiveness and easy loss of composure in everyday life, this did not extend to the tennis court. By the time he was in his twenties he had smashed several wooden rackets on the court after missing an easy shot. A favorite story about his competitive streak took place during an ostensibly friendly tennis match in 1963 during the time Prof and I were Lieutenant Commanders in the Public Health Service stationed at the NIH in Bethesda, Maryland. One day, while playing on a court adjacent to the Naval Ordinance Laboratory in Silver Spring, Prof's frustration threshold was exceeded when he hit an errant shot. A very high chain link security fence surrounded the vast naval laboratory site. The tennis court also had a high chain link fence and in between the tennis court fence and the naval laboratory fence was an approximately 10-foot strip of grass. If a ball went over the court's fence, it was a problem because one had to walk all the way around the court to retrieve the ball. Prof knew the drill well because, on occasion, in anger, he would toss his racket over the fence and have to retrieve it. This time in a fit of pique, Prof hurled the racket over the fence, but the racket not only sailed over the first fence, but cleared the naval lab's fence as well. This blunder necessitated driving for about a mile to the gate of the naval lab, and explaining to the security guard what had happened. Permission was needed to enter the high security property to retrieve the racket. The guard appeared to wonder how two seemingly normal adults could create such a dilemma.
Perhaps the experience that most shaped Prof's life was having orthodontic treatment as an adolescent by Dr Baker. He was so fascinated by the experience, by college age he was determined to study dentistry and then specialize in orthodontics; however, Prof's mother who was the chairperson of the Chemistry Department at nearby Campbell College wanted him to study medicine. Edna Proffit, who was a very bright and assertive woman, had been accepted to medical school after college but wasn't able to matriculate due to financial constraints. She knew Prof's academic potential better than anyone. Edna believed her only son was destined to make a major contribution to any field he chose, and she felt medicine would be a superb choice in terms of the possibility of transforming some aspect of an important field with such great social value. After much negotiation with his mother who adamantly opposed his plan to study dentistry, they struck a deal whereby, if Prof would earn a PhD in a basic science in addition to attending dental school, he would gain her blessing. Retrospectively, it is no surprise Prof was determined to choose his own career path. His major criterion was he wanted his career to be fun on a day-to-day basis. Unlike his mother, he had not given much thought to how he might one day positively impact society. By the time he became chair of Orthodontics in Chapel Hill, he established the goal of training excellent orthodontists who would choose to practice in all of the hundred counties of North Carolina. He envisioned this cohort to consist of men, women, and people who had previously been underrepresented in the profession.
Ed Thomas, a successful local pharmacist in the neighboring town of Erwin, asked Bill's mother if she could tutor his daughter who had been accepted in the Pharmacy program at UNC. Mrs. Proffit declined the request because of her busy schedule but she told Mr. Thomas her son Bill, who was in high school, was a gifted chemistry student and might be willing to accept the assignment. Thus began a collaboration between Bill and Sara, which lasted 65 years. In less than a year of tutoring, their chemistry became sufficiently intense that Bill and Sara eloped to South Carolina. Bill was 17 and Sara, 18. The next year, Bill matriculated at UNC as an undergraduate. Bill and Sara lived on campus in a retrofit army barrack from World War II in a section of the campus called “Victory Village.” This small community was reserved for married couples at UNC, a population that had grown as a result of the G.I. Bill. As can be inferred from the description of these facilities, this was not luxury living even by dormitory standards. In Bill's junior year in college, he became a member of Phi Beta Kappa. With the intention of following the agreed educational plan he had forged with his mother, he applied to dental school at UNC and was immediately accepted. According to some of his dental school classmates, Bill was a bit of a rebel and was always willing to write petitions for his classmates who were protesting some perceived injustice by the faculty. Of course, Prof was prudent enough to not sign the petitions, but the administration was always curious who the student might be who could have written such an elegant and cogent treatise.
After graduating from UNC School of Dentistry, Bill applied and was accepted to a PhD program in physiology at the Medical College of Virginia (MCV) in Richmond. The school today is called Virginia Commonwealth University (VCU). Since Prof was eager to get on with his orthodontic training, he managed to complete his PhD in a record two years. His favorite story about his time in Richmond was his oral exams and thesis defense. The chairperson of the department, Ernst Fisher, was a Jewish refugee from Austria who had managed to immigrate to the United States in the beginning of the World War II. The conference room at MCV was on an upper floor of the science building and the expansive windows overlooked the train tracks and depot below. Over the two-year period, it had become well known among the faculty and graduate students that when Bill was attending a seminar in the conference room, he seemed to be as interested in the trains as he was in the topic being discussed. Dr Fisher, with his very heavy German accent, greeted Prof and said his first question was what time the next train would pass through the train yard below. Prof looked at his watch and said, without hesitation, the next Seaboard train to the Carolinas would be in three minutes. Dr Fisher made small talk for the next 3 minutes and when the seaboard train chugged past, Ernst Fisher exclaimed, “Perfect, I have no more questions. Does anyone have any other questions for Bill or comments?” Retrospectively, perhaps the most important event for Prof in Richmond was meeting Ray White, Jr, a Virginia native, who was a PhD candidate in anatomy and an oral and maxillofacial surgery resident at MCV. Ray became a lifelong friend and colleague.
After finishing his PhD at MCV, Prof was accepted in the orthodontic program at the University of Washington in Seattle. At the time, this was arguably the best post-doctoral program in orthodontics in the world. The department was 13 years old and Dr Alton Moore was the inaugural chairman. Dr Moore was a Brodie graduate from the University of Illinois and Brodie had studied in the last class at the Angle School in Pasadena, California, in 1928. Thus, Bill Proffit's orthodontic pedigree was a third-generation Angle orthodontist and a direct descendant of Angle himself. Prof was a member of the Angle Society for more than 45 years. The faculty at Seattle consisted largely of part-time orthodontists who were members of the Northwest Orthodontic Study Club, which consisted of highly talented and innovative orthodontists from the State of Washington. One of the members of Prof's class was Arthur Dugoni, who later became president of the American Dental Association and dean at the University of the Pacific School of Dentistry in San Francisco. Dr Dugoni served as dean of the school for 28 years. In 2004 the University of the Pacific School of Dentistry was renamed the University of the Pacific Arthur A. Dugoni School of Dentistry.
The true measure of a man is the manner in which he lived his life, his character, and how he conducted himself as a husband, father, grandfather, great-grandfather, and friend. Bill Proffit lived his life as a caring, generous, and devoted family man. But, over the years, he discovered he had two families, both of which he loved dearly. First and foremost were Sara, Lola, Ed, and Glenn; but, on the other hand, he developed an ever-enlarging professional family. This situation has been the classic dilemma of geniuses throughout history. How does one balance two great loves?
The proof that Bill achieved equilibrium in this regard is that Lola, Ed, and Glenn have all grown up to be outstanding people who have married wonderful spouses and have raised terrific children and, in turn, marvelous great-grandchildren who he doted over, which was a bit of a surprise to the children's parents. Prof not only was dedicated to Sara for 65 years and to their children, but he also loved his extended family. He had favorite aunts and uncles who, as they got older, Prof and Sara would visit even more often. When these relatives needed anything, Prof and Sara were there to help. As for his professional family, Prof has successfully educated at least two generations of orthodontists who have made lasting contributions in academia, research, and private practice.
From the time he and I began our collaboration at NIH 55 years ago, Prof was an orthodontic true believer and he dearly loved his chosen field. As much as he enjoyed debunking unverifiable claims made by orthodontic manufacturers and practitioners on the lecture circuit, he was rarely willing to be an iconoclast when it came to challenging some of the dogma, which still serves as the basis for some of orthodontic practice. Prof had learned his lesson of not getting out ahead of the thinking of the powers to be in organized orthodontics and to not buck the system. In 1970, Prof sat for the exam to become boarded by the ABO. Since the only cases he had that were well documented enough were surgical cases, he presented these rather than complying with the set requirements of the board. One has to remember that, at that point, maxillary surgery had not yet become available, so all of Prof's cases were some variation of mandibular surgery. In short, his treatment results did not meet the arbitrary standards of the board and his cases were not accepted. It was the first time Prof had ever failed at anything. Although extremely bitter over the ABO decision, he followed their recommendation and presented additional cases some years later and became a Diplomate of the board. It is ironic that, 35 years after his rejection by the ABO, Prof was awarded the Ketcham Award, which is the ABO's highest honor.
As serious as Prof could appear to his students, nirvana for him was a good tennis match followed by a cold beer. He had a marvelous, often ribald, sense of humor and he was a great storyteller. He loved to share the things he held dear. With students and colleagues, it was his encyclopedic knowledge that he freely shared nearly every day of his adult life. With family and friends, it was his love of model railroads or anything having to do with trains and his beloved gardens, which he tended to with great care. In 1964, on a train trip to California to attend a meeting, Prof and I stopped in Wyoming to see Prof's uncle (his father's brother) and his family who were ranchers. It was there that Prof became enamored of Stetson 10-gallon hats and bolo ties, which his uncle and cousins were wearing. From that time on, the bolo tie was Prof's signature attire. Some years later, when Prof's dermatologist told him to wear a broad rim hat to avoid additional sun on his face, it was rare to see Prof outdoors without his Stetson.
Prof was extremely generous with gifts from his greenhouse and garden. At Christmastime, he would give carefully nurtured amaryllis bulbs, which were lovingly grown with precision to be ready to bloom at Christmas. Each of these gifts that meant so much to him became gifts straight from his heart. Prof's clippings from the greenhouse that were transplanted to gardens far and wide are a metaphor for the seeds of knowledge that he planted in his students who have successfully grown to maturity, putting roots down all over the world.
Needless to say, Prof was brilliant. From my vantage point, he was perhaps the most intelligent person I have ever known. Yet, he did not consciously try to impress anyone. He was an entirely authentic person without any pretense. That said, he was a complicated man and, in many ways, not a “what you see is what you get” kind of guy. His manner of speaking was not what he would describe as “cultured Southern,” yet he was very sophisticated. He appeared humble but, at the same time, he loved the limelight. He almost always evaluated the success of his major lectures by the number of people in attendance and the level of applause when he finished a talk. Prof did not set out to make as much money as he might have made in private practice but, as time went on, he was extremely pleased with the substantial honoraria that orthodontic groups were willing to pay for him to lecture.
Prof, you had a wonderfully productive and fulfilling life. You accomplished more than you could have even imagined when we commenced our orthodontic journey. You've now made it to, in railroad parlance, the end of the line with no regrets in any of the decisions you made during your lifetime and there was nothing notable remaining on your bucket list. Apparently, the fates determined you were ready for eternal peace. I can't tell you how much you'll be missed here on earth, particularly by Sara, Lola and Mike, Ed and Melissa, Glenn and Laura, their children, and their children's children. Just know your many close friends, admiring students and colleagues wish you well on your celestial journey to that terminus in the sky. Godspeed!
