Nicolae Testemianu State University of Medicine and Pharmacy

REPORT
The
Hystory of Dentistry

Faculty: Stomatology (3105)

20 15

The story of dentistry: Ancient origins

Archaeological evidence of the dentistry of antiquity suggests that treatment included medical
methods of combating dental affections, mechanical means of treatment such as retentive
prosthesis and the art of applying artificial substitutes for lost dental structures.
It is believed that the oldest civilization that knew something of dentistry was Egypt. The earliest
indication of such knowledge is found in the Edwin Smith Surgical Papyrus. It contains detailed
directions for the treatment of wounds about the mouth, but no mention is made of restoring lost
teeth resulting from these injuries. The hard tissues of the mouth were in general considered
untreatable. In closing his discussion on this topic one ancient Egyptian surgeon advises: "One
having a fracture of the mandible over which a wound has been inflicted and he has fever from
it, it is an ailment not to be treated".
Proving prehistoric mans ingenuity, researchers have found that dental drilling dates back 9,000
years. Primitive dentists drilled nearly perfect holes into teeth of live patients between 5500 and
7000 B.C. Researchers recently carbondated at least nine skulls with 11 drill holes found in a
graveyard in Pakistan. This means dentistry is at least 4,000 yrs older than first thought.

Researchers figured that a small bow was used to drive the flint drill tips into patients teeth.
Flint drill heads were found on site. This dental drilling probably evolved from intricate
ornamental bead drilling.
The drilled teeth found in the graveyard were hard-to-reach molars. Although it is speculated that
the drilling could have been decorative or to release evil spirits more than fighting tooth decay,
the hard-to-see locations of the drilled teeth in jaws seem to rule out drilling for decorative
purposes. No sign of fillings were found.
The story of dentistry: Middle ages and The Renaissance: Beginnings of the dental
profession
Dental treatment is as old as toothache itself. The middle ages was a brutal time for the toothache
sufferer, as the main treatments available were dubious toothache remedies and extraction.
Dentistry was not a profession in itself, and often dental treatment such as extractions and
tinctures were offered by barbers or barber-surgeons, and by the marketplace charlatan, the tooth

drawer, and later the 'Operator for the Teeth'. Dental treatments comprised tinctures and styptics extraction was a last and painful resort

Forceps and the 'Pelican' were the most common extracting tools. The dental pelican, invented in
the 14th century by Guy de Chauliac was often made by the village blacksmith, needed little skill
to use and often caused terrible damage and pain. The pelican was replaced by the dental key in
the 1700s which, in turn, was replaced by modern forceps in the 20th century.

Modeled after a door key, the dental key was used by first inserting the instrument horizontally
into the mouth, then its "claw" would be tightened over a tooth. The instrument was rotated to
loosen the tooth. This often resulted in the tooth breaking, causing jaw fractures and soft tissue
damage.
Oral hygiene during the middle ages was very basic. Teeth were cleaned with pieces of linen or
sponge, or by using toothpicks.

The story of dentistry: 18th Century: From toothdrawer to dentist

"Should enlightenment grow in the practice of dentistry, we might attain to progress and
engender new ideas..." Pierre Fauchard 1746
By the early 1700's, dentistry was considered a lesser part of medicine. By the end of this
century, it had begun to emerge as a discipline in its own right. In the late 1750's the term
'dentist', borrowed from the French, started to be used in Britain to describe tooth operators.
In this century the first real textbooks appeared including Pierre Fauchard's monumental work in
1723: 'Le Chirurgien Dentiste' (The Surgeon Dentist) marking the beginning of theoretical and
professional dentistry.
Teeth restoration procedure diagram made by Pierre Fauchard in the early 18th century.
Pierre Fauchard's dentist's drill made in the late 17th century.

Throughout this period of change quackery was still widespread and charlatans were a common
part of rural life. Only the very wealthy could afford the skilled dentist or operator for the teeth.
For many the only option was the village blacksmith and tooth drawer offering painful
extractions. Tinctures, toothpowders and abrasive dentifrices could also be purchased at the
market fairs.

The upper classes could afford a greater range of treatments, including artificial teeth (highly
sought after by the sugar-consuming wealthy). Ivory dentures were popular into the 18th century,
and were made from natural materials including walrus, elephant or hippopotamus ivory.
Human teeth or 'Waterloo teeth'-sourced from battlefields or graveyards-were riveted into the
base. These ill fitting and uncomfortable ivory dentures were replaced by porcelain dentures,
introduced in the 1790's. These were not successful due to their bright colours, and tendency to
crack.

"Dental Reformers like John Tomes found dentistry as a Craft, and left it as a Profession" Sir
Robert Bradlaw CBE, 1980
Sir John Tomes (1815 - 1895) c.1875
The British Dental Association, formed in 1880 with Sir John Tomes as president, played a major
role in transforming and regulating the dental profession in England.
The story of dentistry: 19th Century: Advances in science and education

Before the 1800's, the practice of dentistry was still a long way from achieving
professional status. This was to change in the 19th century - the most significant
period in the history of dentistry to date. By 1800 there were still relatively few
dentists' practicing the profession. By the middle of the 19th century the number of
practicing dentists had increased markedly, although there was no legal or
professional control to prevent malpractice and incompetence. Pressure for reform
of the profession increased.

The introduction of anaesthesia had a dramatic effect on dentistry. Alongside ether

and chloroform, nitrous oxide became the most preferred option and most surgeries
were equipped with general anaesthetic equipment by the end of the century.

Many people were now prepared to have their rotting teeth extracted, which led to
an enormous demand for cheap and efficient dentures. The introduction of vulcanite
in the mid 19th century meant that now dentures could be mass-produced and
affordable, replacing the expensive ivory versions.

In London in 1820, Claudius Ash, a goldsmith by trade, began manufacturing highquality porcelain dentures mounted on 18-carat gold plates. Dentures were made of
Vulcanite from the 1850's on, a form of hardened rubber (Claudius Ashs company
was the leading European manufacturer of dental Vulcanite) into which porcelain
teeth were set. In the 20th century, acrylic resin and other plastics became known.

Dental Technician in a German Dental Laboratory. Stahlgebissmacherei der

Zahnklinik der Friedrich Krupp A.G. Essen ca. 1885.

20th Century

1900 - Federation Dentaire Internationale (FDI) is founded.

1901 - Novocaine was introduced as a local anaesthetic by a German chemist,
Alfred Einhorn. In 1905 Einhorn formulates the local anesthetic procain, later
marketed under the trade name Novocain.
1903 - Charles Land devises the porcelain jacket crown.
1907 - William Taggart invents a lost wax casting machine, allowing dentists to
make precision cast fillings.
1908 - G. V. Black publishes his monumental two-volume treatise Operative
Dentistry, which remains the essential clinical dental text for fifty years. Black later
develops techniques for filling teeth, standardizes operative procedures and
instrumentation, develops an improved amalgam, and pioneers the use of visual
aids for teaching dentistry.
1913 - Alfred C. Fones opens the Fones Clinic For Dental Hygienists in Bridgeport,
Connecticut, the worlds first oral hygiene school. Most of the twenty-seven women
graduates of the first class are employed by the Bridgeport Board of Education to
clean the teeth of school children. The greatly reduced incidence of caries among
these children gives impetus to the dental hygienist movement. Dr. Fones, first to
use the term dental hygienist, becomes known as the Father of Dental Hygiene.

1924 - American Dental Assistants Association is founded by Juliette Southard and

her female colleagues. Female dental assistants were first hired in the 19th century
when Lady in Attendance signs were routinely seen in the windows of dental
offices. Their duties included chair-side assistance, instrument cleaning, inventory,
appointments, bookkeeping, and reception.
19301943 - Frederick S. McKay, a Colorado dentist, is convinced that brown stains
(mottling) on his patients teeth are related to their water supply. McKays research
verifies that drinking water with high levels of naturally occurring fluoride is
associated with low dental caries and a high degree of mottled enamel. By the early
1940s, H. Trendley Dean determines the ideal level of fluoride in drinking water to
substantially reduce decay without mottling.
1938 - The nylon toothbrush, the first made with synthetic bristles, appears on the
market.
1937 - Alvin Strock inserts the first Vitallium dental screw implant. Vitallium, the
first successful biocompatible implant metal, had been developed a year earlier by
Charles Venable, an orthopedic surgeon.
1940s - 22,000 dentists serve in World War II.
1945 - The water fluoridation era begins when the cities of Newburgh, New York,
and Grand Rapids, Michigan, add sodium fluoride to their public water systems.
1949 - Oskar Hagger, a Swiss chemist, develops the first system of bonding acrylic
resin to dentin.
1950s - The first fluoride toothpastes are marketed.
1955 - Michael Buonocore describes the acid etch technique, a simple method of
increasing the adhesion of acrylic fillings to enamel.

1957 - John Bordern introduces the high-speed air-driven

contra-angle handpiece. The Airotor obtains speeds up to 300,000 rotations per
minute and is an immediate commercial success, launching a new era of high-speed
dentistry.
1958 - A fully reclining dental chair is introduced.
1960s - Sit down, four-handed dentistry becomes popular. This technique improves
productivity and shortens treatment time.
1960s - Lasers are developed and approved for soft tissue procedures.

1960 - The first commercial electric toothbrush, developed in Switzerland after

World War II, is introduced. A cordless, rechargeable model follows in 1961.
1962 - Rafael Bowen develops Bis-GMA, the thermoset resin complex used in most
modern composite resin restorative materials.
1980s - Per-Ingvar Branemark describes techniques for the osseo-integration of
dental implants.
1989 - The first commercial home tooth bleaching product is marketed.
1990s - New tooth-colored restorative materials plus increased usage of bleaching,
veneers, and implants inaugurate an era of esthetic dentistry.
1997 - FDA approves the erbium YAG laser, the first for use on dentin, to treat tooth
decay.

21st Century Dentistry The Future Is Now

We are already experiencing enormous changes, and the 21st Century will surpass even the
immediate past for remarkable advances in the human condition. The decades just ahead promise
an avalanche of scientific and technological discoveries, as well as economic, social, and
political changes on a scale never experienced before in human history. The biological and
digital information revolutions are rapidly converging with clinical dentistry as they are with
medicine and pharmacy.
Profound improvements in health promotion, risk assessment and disease prevention, as well as
diagnosis, therapeutics, biomaterials, and treatment outcomes within healthcare will change
world health.
For example, can you imagine the day your dentist will grow you a real tooth to replace one that
has been lost? Prescribe medication tailored not only to your ailment, but also your genetic code?
Protect babies from tooth decay before they even have teeth? It's not as far off as you might
think. The dental profession is at the threshold of amazing new discoveries. As these 21st
Century technologies become available, it will become equally as challenging to make sure
people in all walks of life benefit from this extraordinary surge in knowledge.

Lose A Tooth Grow Another

The possibilities sound almost miraculous: growing new enamel, dentin and cementum all the
parts of a tooth and even complete teeth themselves, using one's own saliva to diagnose and
determine risk for disease, devising new ways of using biological materials to judge the
effectiveness of treatment, and creating new tests to determine who is at risk for diseases and
disorders. These innovative diagnostics, therapeutics and biomaterials, coupled with tissue
engineering, will come from an increased understanding of human and microbial genomes the
entire makeup of these organisms' genes. And they will all be available in your dentist's office!
We also will continue to see advances in digital dentistry computer assisted radiography (xrays), aided by nanotechnology manipulating matter at the molecular or even atomic level.
New, better, and smarter technology will continue to emerge and influence the practice of
dentistry and the depth and breadth of oral health education. The public, too, will become more

sophisticated in understanding the processes of prevention and treatment through access to the
Internet and other sources of information.

Investigating new technologies and biologic materials are improving diagnostics and
therapeutics in dentistry and medicine.

Sources: Engleza pentru studenii de la stomatologie de V. Muhina.

Moscova, 2003

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