Jorgensen, Niels Bjorn (1894–1974)

Niels B. Jörgensen, DDS, pioneered use of intravenous sedation combined with a local anesthetic in dental operations, a breakthrough that became known as the “Loma Linda Technique.”

Early Life and Education

Born in 1894, young Niels was reared on a family farm on the island of Fyn in Denmark. He and his six brothers and sisters all had bad teeth, probably from the generous supply of candy supplied by his four toothless grandparents. When he was six years old, Niels suffered from excruciating dental pain. There were no dentists in the nearby isolated village. During evening meetings, older people in the family often discussed experiences with having teeth extracted. “Of course,” remembered Dr. Jörgensen, “the more gruesome the affair the better . . . . These stories prepared us children for the necessary ordeal.” A physician extracted his aching first permanent molars without local anesthesia. This experience profoundly affected his future treatment of dental patients as expressed in his personal motto, “For the comfort of the patient.”¹

When a youth of 18, Jörgensen became acquainted with the Seventh-day Adventist Skodsborg Sanitarium, near Copenhagen. One of its physicians, a Dr. Hindhede wrote extensively about Loma Linda health principles of nutrition. Jörgensen’s intention was to become a physician, but for several reasons his preference switched to dentistry.

Jörgensen came to the United States in 1919 after completing pre-medicine studies in his native Denmark. Based on high scores on the entrance examination to the University of Copenhagen, he was accepted by Harvard University and the University of California School of Dentistry and enrolled in the latter at age 25. Of 160 students in the school’s first four-year class, only 50 graduated. Local anesthesia was taught by lectures, but without a textbook.

Developing the “Loma Linda Technique”

After graduating in 1923 from the University of California School of Dentistry, Jörgensen completed a three-year oral surgery residency in hospitals of the Southern California Edison Company in the High Sierra. His studies in sedation continued as he observed hard rock miners and husky pick-and-shovel men fainting at the sight of a needle and dental chair. He started his practice in Los Angeles in 1926, the year before the use of local anesthesia in dentistry became widespread in America. At that time, patients were asked to choose between general anesthesia or suffering without it.

In 1942, Herbert Childs, DDS, of the White Memorial Hospital (now White Memorial Medical Center) department of stomatology, asked Dr. Jörgensen to lecture in anesthesia and sedation. He joined the faculty of the Loma Linda College of Medical Evangelists (CME) in 1942 as an associate professor in the School of Medicine. At that time, Jörgensen began his studies into sedation for pain control, mainly related to nerve blocks in the neck and skull. He eventually joined the first Loma Linda University School of Dentistry faculty as a professor.

While general anesthesia puts the patient to sleep, Jörgensen’s "Loma Linda Technique" maintained the patient's protective cough reflex and allowed cooperation with the dentist. The unique technique individualized the dosage of the medication, administering it in small increments, according to the patient's response. Dr. Jörgensen promoted the designation "Loma Linda Technique" (rather than the “Jörgensen Technique” as it was known by many of his peers). In particular, Forrest E. Leffingwell, MD, chair of the Department of Anesthesiology at CME/Loma Linda University School of Medicine from 1956 to 1968, is credited with having “incalculably aided” Jörgensen.

Films, Publications, Awards

Dr. Jörgensen’s teaching film, Inferior Alveolar, Lingual and Buccal Nerve Block, won the 1st Grand Prix award out of 70 films judged in the International Dental Film competition in Paris of March 1965. In all, Dr. Jörgensen made nine films. Schools of dentistry around the world have used these classics over the years. They have been translated into other languages and were kept in constant circulation by the Bureau of Audio-Visual Services of the American Dental Association. Dr. Jörgensen's textbook, Sedation, Local and General Anesthesia in Dentistry (1966), was distributed throughout the United States, Europe, and South America.

Dr. Jörgensen's teaching program at Loma Linda University anticipated by at least 15 years most of the recommendations in the “Guidelines for Teaching the Comprehensive Control of Pain and Anxiety in Dentistry,” published by the American Dental Association in 1971. In 1960, Jorgensen won the prestigious Heidbrink Award, presented by the American Dental Society of Anesthesiology. And in 1966, he received the John Mordaunt Prize, the highest honor of the British Society for the Advancement of Anesthesiology in Dentistry, being its sole recipient until his death in 1974.

Norman Trieger, DMD, MD, editor of the Journal of Anesthesia Progress, the official publication of the American Dental Society of Anesthesiology, referred to Dr. Jörgensen as “one of the giants in anesthesiology in dentistry, and in particular, in the education of the undergraduate student . . . [in the technique of] sedation.”

Dr. Jörgensen retired in 1969, but continued to be active in the LLU School of Dentistry as emeritus professor of oral surgery, teaching dental students his methods of pain control. At a 1969 banquet in his honor, Dr. Jorgensen summarized his credo:

When I was young I tried many types of dental care after three years of surgery training. But I had a dream. . . . I was up against the patients’ apprehension of pain and discomfort associated with dental work.

So I concentrated on learning how to control pain through the study of anatomy, physiology, and pharmacology, and learned to give a truly painless injection for all the nerve blocks. Then there was still the fear and nervousness, so I concentrated on overcoming that with intravenous premedication and nitrous oxide and oxygen. When you graduate you can go out and perform competent dental operations and make money. But it is not enough. . . . Your patient is a human being who has entrusted himself into your care; you are responsible for his well-being. The feeling of full responsibility makes you a good dentist [and] a Christian dentist must be a good dentist.²

When he was presented with the American Dental Society of Anesthesiology’s highest honor, the Heidbrink Award, in 1960, Dr. Jorgensen was characterized as a “mild-mannered gentleman who is widely respected for his intellectual approach to his scientific responsibilities.”³ Most School of Dentistry alumni influenced by Dr. Jorgensen will remember him as teaching at the chair the practical aspects of keeping patients comfortable.⁴ He died in Los Angeles, California, on August 15, 1974.⁵

Sources

“An Important Relationship Reviewed.” Anesthesia Progress 33 (September-October 1986): 262-264.

Hayden, Jess, Jr., “Niels Björn Jörgensen, DDS: the man, a legend.” Loma Linda University Dentistry 14 No. 1 (Summer 2003): 7-8.

Jörgensen, Niels Björn. “The History of the Loma Linda Technique.” Draft autobiographical manuscript received by the School of Dentistry dean’s office, October 13, 1976.

“Niels B. Jörgensen, D.D.S. obituary.” ARH, September 9, 1974.

Notes

1. Except where otherwise noted, this article draws on Jess Hayden, Jr., “Niels Björn Jörgensen, DDS: the man, a legend,” Loma Linda University Dentistry 14 No. 1 (Summer 2003): 7-8; and Niels Björn Jörgensen, DDS, “The History of the Loma Linda Technique,” autobiographical draft manuscript received by the School of Dentistry dean’s office, October 13, 1976.↩

2. Quoted in Hayden, Jr., “Niels Björn Jorgensen,” 7.↩

3. “An Important Relationship Reviewed,” Anesthesia Progress 33 (September-October 1986): 262-264.↩

4. Hayden, Jr., “Niels Björn Jörgensen,” 8 (photo caption).↩

5. “Niels B. Jörgensen, D.D.S. obituary,” ARH, September 9, 1974, 32.↩