Dentistry

By the end of the fifteenth century, the emphasis on obedience to authority was changing, in part under the influence of advances such as the discovery of the printing press in 1436. Dentistry benefitted from the new spirit of inquiry. Contemporary thinkers, such as anatomist Andreas Vassalius (1514-1564) challenged classical ideas about dentistry. One indication of the stagnation of independent thinking was Vassalius's successful challenge of Aristotle's belief that men had more teeth than women.

Ambrose Pare (1510-1590), a Frenchman trained as a barber surgeon, gained fame as one of the great medical Teeth damaged by dental cavities can be excavated and filled with amalgam. Illustration by Hans & Cassidy. Courtesy of Gale Group. and dental surgeons of the era. His work resembled the work of a contemporary oral surgeon, focusing on the removal of teeth, the setting of fractured jaws and the draining of dental abscesses. He published extensively, documenting methods for transplanting teeth and for creating devices that held artificial teeth made of bone in place using silver or gold wire.

The eighteenth century saw many significant advances in dentistry, many of them inspired by the work of Pierre Fauchard (1678-1761). By the year 1700, Parisian dentists such as Fauchard were considered members of a distinct profession, complete with an examining board for new dentists. Fauchard's work is best known through his writing about the profession in the 1728, two-volume, Le Chirurgien Dentiste, a 863-page tome. In the book, Fauchard explained how to fill teeth with lead or gold leaf tin foil, and various types of dentures. He also told how to make crowns from ivory or human teeth, how to straighten teeth, and how to protect teeth against periodontal damage.

Fauchard also took aim at some of the dental superstitions of the day, which included the erroneous belief that worms in the mouth played a role in tooth decay. His information was not all accurate, however, and Fauchard did suggest the use of urine as a mouth wash.

Another great eighteenth century finding was the development of porcelain, glazed white clay, as a substance for false teeth. Prior to this time, ivory was commonly used. Carving ivory was time consuming and difficult. The first porcelain teeth were developed by M. DeChateau, a French druggist, and M. Dubois De Chamant, a dentist.

DeChateau was frustrated that his teeth had discolored due to the chemicals he tasted while mixing substances for customers. After noticing that the chemicals never discolored his porcelain mortar and pestle, DeChateau decided that porcelain teeth would save him embarrassment and unhappiness. Gaining the help of DeChamant, the two men discovered a way to effectively fit and create a pair of false teeth made of porcelain, gaining a patent on the teeth in 1788.

The nineteenth century saw the development of many dental tools and practices that would be the bedrock for twentieth century dentistry. Many of the great advances were made by Americans, who emerged as great dental innovators. The world's first dental school, the Baltimore College of Dentistry, opened in 1847, providing an organized curriculum to replace the apprenticeship system.

At the start of the century, false teeth were available to only the affluent. They were made of porcelain, which was not expensive. But they needed to be fastened to plates made of gold or silver, which were costly. The successful vulcanization of rubber in 1830 by American Charles Goodyear brought cheap false teeth to the masses. Now false teeth could be attached to vulcanized rubber, and dental laboratories emerged everywhere to keep up with the demand.

The development of anesthesia in the United States was a technological breakthrough which revolutionized surgical and dental practice. Many innovators experimented with the use of gases in the eighteenth and nineteenth centuries. Joseph Priestley, a British cleric, invented nitrous oxide, or laughing gas, in 1772. The substance caused euphoria, then sedation and unconsciousness.

Though researchers explored the application of nitrous oxide and ether in the early nineteenth century, the gases were not used for anesthetic purposes until the 1840s. Physician Crawford Williamson Long, a Georgia physician, first used ether to remove a tumor from a patient in 1842. Dentist Horace Wells used nitrousoxide on patients having their teeth pulled in 1844.

But dentist William Thomas Green Morton is widely credited with the first public display of anesthesia, in part because of the great success of his public demonstration and in part because of his canny alliance with influential physicians. Morton successfully extracted a tooth from a patient anesthetized with ether in 1846 in Boston.

Ether, nitrous oxide and chloroform were all used successfully during tooth extraction. But these gases were not effective for many other procedures, particularly those which took a long period of time to complete.

A breakthrough came in the form of the drug cocaine, an addictive drug derived from coca leaves which was highly valued in the nineteenth and early twentieth centuries for its pain-killing power. In 1899, cocaine was first used in New York as a local anesthetic to prevent pain in the lower jaw. Cocaine was effective but habit-forming and sometimes harmful to patients. The development of procaine, now known as novocaine, in 1905 provided dentists with a safer anesthetic than cocaine. Novocaine could be used for tooth grinding, tooth extraction and many other dental procedures.

Development of a drill powered by a footpedal in 1871 and the first electric drill in 1872 also changed the practice of dentistry.

Another major discovery of the era was the x ray by William Conrad Roentgen of Germany in 1895. The first x ray of the teeth was made in 1896. At the time, there was some skepticism about x rays. The Pall Mall Gazette of London railed in 1896 about the "indecency" of viewing another person's bones. William Herbert Rollins of New England reported as early as 1901 that x rays could be dangerous and should be housed properly to prevent excess exposure. Contemporary dentists continue to use x rays extensively to determine the condition of the teeth and the roots.