The Evolution of Dentistry

The following blog post has been written by Curatorial Assistant Varsha Jayaraman 

Dentistry is a branch of medicine specializing in the diagnosis and treatment of diseases and disorders of the teeth and gums, as well as ailments of the oral cavity and maxillofacial area.  It plays a vital role in health care.

The history of dentistry may be traced back to 7000 BCE in the Indus Valley Civilization (now Pakistan).  Researchers speculate that bead craftsmen used a drill made of flint heads to remove tooth enamel and rotting dental tissue.  Evidence suggests that this procedure was surprisingly effective.

Portable dental treadle drill (1900-1910), Museum of Health Care #010020064
Portable dental treadle drill (1900-1910), Museum of Health Care #010020064

The first professional European “dentists” were known as barber-surgeons.  Guilds of barber-surgeons were prominent in Europe beginning in the thirteenth century.  They were generally responsible for bleeding, cupping, leeching, giving enemas and extracting teeth.  Only in the early eighteenth century did the exclusive profession of dentistry emerge.

Pierre Fauchard of France (1678-1761) is known today as the “Father of Modern Dentistry.”  When he was 15 years old, he began his surgical training in the French navy.  He became particularly interested in diseases of the mouth as he was exposed to various illnesses of sailors while at sea.  Prominent on his voyages was scurvy, the “seaman’s disease”, which occurs due to a deficiency of vitamin C.  Scurvy is characterized by the formation of spots on the skin, spongy gums and bleeding from the mucous membranes.

After leaving the French Navy, Fauchard began working as a professional dentist in France.  His practice flourished and he earned a promising reputation as a dental surgeon, attracting patients from all over the country.  Fauchard composed his own treatise on the foundations of dentistry, Le chirurgien dentiste ou traité des dents (The Surgeon-Dentist, or Treatise on the Teeth), in 1728.  In it, Fauchard described the foundations of oral anatomy and physiology.

Pierre Fauchard’s Le chirurgien dentiste ou traité des dents (1728), http://www.hagstromerlibrary.ki.se
Pierre Fauchard’s Le chirurgien dentiste ou traité des dents (1728), http://www.hagstromerlibrary.ki.se

His treatise included a detailed description of methods for removing decay and restoring teeth, treating periodontal disease, and performing orthodontic surgery and tooth replacement.  His scientific, comprehensive approach was commended by fellow medical professionals and laid the groundwork for the future of dentistry.

In the early 1800s, dental technology quickly advanced.  Scientists made important breakthroughs in dental care, particularly in denture development: Italian physician, Giuseppangelo Fonzi developed porcelain teeth with baked-in retentive pins, and Charles Stent of England invented the impression compound, an important development for the future of dental prosthetics.

Rubber and porcelain dentures (1850-1900), Museum of Health Care #010020080
Rubber and porcelain dentures (1850-1900), Museum of Health Care #010020080

Three Americans also made discoveries that advanced dentistry.  Robert Arthur introduced cohesive gold foil used for soldering procedures and denture bases.  Horace Wells applied nitrous oxide anaesthesia, a crucial (and most certainly, welcome) addition to dentistry.

Nitrous Machine (1914), Museum of Health Care #010020449
Nitrous Machine (1914), Museum of Health Care #010020449

Finally, Charles Goodyear’s invented the vulcanization process of rubber, which revolutionized the materials used in dentistry.

Dentistry gained a foothold in Canada in the mid-eighteenth century.  As some European dentists arrived in the new colony, settlers quickly took up apprentice positions.  Dentistry was not practiced exclusively in Canada until the latter half of the nineteenth century.  By the 1850s, dentistry was mainly practiced by four groups: physicians who performed emergency dental treatment; medical school graduates who took some apprenticeship training and limited their practices to dentistry; apprentices to dentists who signed an indenture agreement; and dubiously trained itinerants or “quacks.”

There was an increasing concern over the number of charlatans who claimed to be serious practitioners of dentistry in the mid-nineteenth century in Canada.  In response, a number of “serious” professionals took it upon themselves to address the issue of quackery and fight for legislation to regulate the practice.  In 1867, Dr. Barnabus Day, a Kingston native and Queen’s University graduate, called a meeting of Ontario dentists at the Queen’s Hotel in Toronto on January 3, 1867, which ultimately gave rise to the Ontario Dental Association.  With more frequent committee meetings and a great deal of hard work, Dr. Day and his associates established the Act Respecting Dentistry, enacted March 4, 1868.  This bill granted full powers for licensing and regulating dentistry to an elected board of directors of the newly established Royal College of Dental Surgeons of Ontario (RCDSO).

Dental education in North America underwent many changes by the mid-1800s.  The Baltimore College of Dental Surgery, founded in 1840, became the world’s first school of dentistry.  In 1867, the HarvardUniversityDentalSchool was the first school to issue the Doctor of Dental Medicine Degree.  By 1870, there were a total of nine dental schools in the United States.  Following this example, the next step for dentistry in Canada was the development of its own system of specialized education.  In 1868, the RCDSO Act allowed the Board of Ontario Dentists to establish a DentalCollege in Toronto.  By 1888, the College affiliated with the University of Toronto.  It conferred 25 Doctor of Dental Surgery Degrees (D.D.S.) to graduates in 1889.

In 1902, the Canadian Dental Association (CDA) was established after a three-day conference involving 350 dentists, more than 20% of all the dentists in the country at the time.

An important concern in the early twentieth century was the development of military dentistry.  In response to the lack of dental treatment during the Boer War (1899-1902), the CDA took measures to ensure that dentists were available during the First World War.  On May 13, 1915, the Canadian Army Dental Corps (CADC) was authorized for service and was responsible for providing dental examinations and treatment to all Canadian troops.  It was the first unit of its kind.  Following the success of this dental division, the Canadian Dental Corps (CDC) was called to service in the Second World War.  Throughout the war, this group of trained dental professionals rapidly expanded to include assistants and laboratory assistants, fundamentally enhancing the practice of dentistry. In recognition of the CDC’s unparalleled service during the war, King George VI granted the corps the title “Royal Canadian Dental Corps” (RCDC) in 1947.  Today, Canadian military dentists operate as the Canadian Forces Dental Services (CFDS).

Royal Canadian Dental Corps badge (1947-1980), Museum of Health Care #010020053
Royal Canadian Dental Corps badge (1947-1980), Museum of Health Care #010020053

Dentistry continued to expand rapidly throughout the 20th century.  An increasing number of graduate programs emerged specializing in various fields, including oral radiology, maxillofacial surgery, oral pathology, paediatric dentistry, and prosthodontics.  To promote high standards of specialization, the Royal College of Dentists of Canada was created by federal statute in 1964.  With this, the profession of dentistry expanded to include various auxiliary workers, including dental hygienists.

As can be seen from this brief history, dentistry has come a long way since the first dental drill was used thousands of years ago.  It has experienced extensive advancements in technology, training, and regulation from the eighteenth century to present times.  Let us all be thankful for these developments the next time we’re ‘stuck’ in the dentist’s chair.

Bibliography

BBC News (London), “Stone Age Man Used Dentist Drill,” April 6, 2006. http://news.bbc.co.uk/2/hi/science/nature/4882968.stm (accessed March 5, 2013).

Crawford, P. Ralph. A Century of Service: The Canadian Dental Association 1902-2002. Ottawa: The Canadian Dental Association, 2002.

de Vaux, Jean Claude. “Dental History  – About Pierre Fauchard.” Dental Honor Society | PierreFauchardAcademy. http://www.fauchard.org/history/articles/various/who-is-fauchard.html (accessed March 5, 2013).

Government of Canada. “CFHS – Canadian Forces Dental Services : an Introduction and History.” National Defence and Canadian Forces (DND/CF). http://www.forces.gc.ca/health-sante/pub/cfds-sdfc-eng.asp (accessed March 5, 2013).

Historica-Dominion. “Dentistry.” The Canadian Encyclopedia. http://www.thecanadianencyclopedia.com/articles/dentistry (accessed March 5, 2013).

Lynch, C.D., V.R. O’Sullivan, and C.T. McGillycuddy. “Pierre Fauchard: the ‘Father of Modern Dentistry’.” British Dental Journal 201 (2006): 779-781. doi:10.1038/sj.bdj.4814350 (accessed March 5, 2013).

Oldfield, Philip. Dental Roots: A History of Dentistry from Early Times to the Nineteenth Century. Toronto: University of Toronto, 1986.

Ontario Dental Association. “History, Mission & Vision.” YourOralHealth.ca. http://www.oda.on.ca/about-the-oda/history-mission-a-vision (accessed March 5, 2013).

University of Toronto. “Brief History of Dental Profession in Ontario.” Dentistry Library Blog – University of Toronto. http://uoftdentistrylibrary.blogspot.ca/2011/04/brief-history-of-dental-profession-in.html (accessed March 5, 2013).

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One thought on “The Evolution of Dentistry

  1. Pierre Fauchard of France (1678-1761) is known “Father of Modern Dentistry.Scientists important throughs in dental care, particularly in denture developmentsuch as Italian physician, Giuseppangelo Fonzi developed porcelain teeth with baked-in retentive pins, and Charles Stent of England invented the impression compound, an great development for the future of dental prosthetics.

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