History of Dentistry
Commission on Dental Accreditation of the American Dental Association Commission that accredits dental, dental assisting, dental hygiene, and dental laboratory educational programs.
Dental treatise (TREE-tis) Formal article or book based on dental evidence and facts.
Periodontal (per-ee-oe-DON-tul) disease Infections and other conditions of the structures that support the teeth (gums and bone).
Preceptorship (PREE-sep-tor-ship) Study under the guidance of a dentist or other professional.
Silver amalgam (uh-MAL-gum) paste A mixture of mercury, silver, and tin.
Dentistry has a long and fascinating history. From the earliest times, humans have suffered from dental pain and have sought a variety of means to alleviate it. As they developed tools, humans also cleaned and cared for their teeth and oral cavity. Early toothbrushes ranged from wooden sticks with frayed ends for scraping the tongue to ivory-handled brushes with animal-hair bristles for cleaning the teeth.
It is easy to believe that the ideas and techniques used in dentistry today have been recently discovered or invented. Actually, many of the remarkable techniques in modern dentistry can be traced to the earliest times in every culture. People may think of “cosmetic dentistry” as a relatively new field, but skulls of ninth century BC Mayans have numerous inlays of decorative jade and turquoise on the front teeth. Skulls of the Incas discovered in Ecuador have gold pounded into prepared holes in the teeth, similar to modern gold inlay restorations. As early as the sixth century BC, the Etruscans were able to make false teeth using gold and cattle teeth (Fig. 1-1). More than 2200 years ago, a cleft palate was repaired on a child in China. Muhammad introduced basic oral hygiene into the ritual of Islam in the seventh century AD. He recognized the value of Siwak, a tree twig containing natural minerals, as an oral hygiene device.
As B.W. Weinberger noted in Dentistry: An Illustrated History (Ring, 1995), a profession that is ignorant of its past experiences has lost a valuable asset because “it has missed its best guide to the future.” Table 1-1 lists major highlights in the history of dentistry.
|3000–2151 BC||Egyptians||Hesi-Re is earliest dentist known by name.|
|2700 BC||Chinese||Chinese Canon of Medicine refers to dentistry.|
|900–300 BC||Mayans||Teeth receive attention for religious reasons or self-adornment.|
|460–322 BC||Greeks||Hippocrates and Aristotle write about tooth decay.|
|166–201 AD||Romans||Restore decayed teeth with gold crowns.|
|570–950||Muslims||Use Siwak as a primitive toothbrush.|
|1510–1590||Ambroise Paré||Writes extensively about dentistry, including extractions.|
|1678–1761||Pierre Fauchard||Becomes “Father of Modern Dentistry.”|
|1728–1793||John Hunter||Performs first scientific study of teeth.|
|1826||M. Taveau||Introduces amalgam as “silver paste.”|
|1844||Horace Wells||Uses nitrous oxide for relief of dental pain.|
|1859||American Dental Association is founded.|
|1885||C. Edmund Kells||Employs first dental assistant.|
|1895||G.V. Black||Becomes “Grand Old Man of Dentistry” and perfects amalgam.|
|1895||W.C. Roentgen||Discovers x-rays.|
|1908||Frederick McKay||Discovers that fluoride is connected with prevention of dental caries.|
|1913||Alfred C. Fones||Establishes first dental hygiene school in Bridgeport, Connecticut.|
|1923||American Dental Hygiene Association is founded.|
|1924||American Dental Assistants Association is founded.|
|1948||Dental Assisting National Board is founded.|
|1970||Congress||Creates Occupational Safety and Health Administration.|
|1978||Journal of the American Dental Association||Publishes a report on infection control for dental offices.|
|1980||First cases of what later became known as acquired immunodeficiency syndrome (AIDS) are reported.|
|1982||First hepatitis B vaccine becomes commercially available.|
|1983||Human immunodeficiency virus (HIV) is identified as the cause of AIDS.|
|2000||Oral Health in America: A Report of the Surgeon General is released.|
|2003||Centers for Disease Control and Prevention||Releases Guidelines for Infection Control in Dental Health-Care Settings—2003.|
As long as 4600 years ago in Egypt, physicians began to specialize in healing certain parts of the body. A physician named Hesi-Re was the earliest dentist whose name is known. He practiced about 3000 BC and was called “Chief of the Toothers and the Physicians.” Three teeth fastened together with gold wire, apparently an early fixed bridge, were found with the remains of an Egyptian who lived about 3100 BC.
A radiograph of the skull of Thuya, mother-in-law of Pharaoh Amenhotep III, showed bone loss in her jaws, an indication of periodontal disease. Some dental problems have been attributed to the Egyptian diet, which was primarily vegetarian. Grain was ground with stone pestles, which mixed sand and grit into the food, resulting in severe wear of the occlusal (biting) tooth surfaces and exposure of the pulp.
During the fifth century BC in Greece, the practice of medicine and dentistry was based on the worship practices of the priesthood. Priests would give patients a sleeping potion and perform healing rituals. During this period, Hippocrates (460–377 BC) began to outline a rational approach to treating patients. He suggested that four main fluids in the body—blood, black bile, yellow bile, and phlegm—along with heat, cold, dry air, and wet air, must remain in balance, or disease would occur. His approach to treatment of patients earned him the title “Father of Medicine.”
Hippocrates stressed the importance of keeping the teeth in good condition. His writings described the teeth, their formation, and their eruption, as well as diseases of the teeth and methods of treatment. He also developed a dentifrice and mouthwash. The famous Hippocratic Oath, a solemn obligation to refrain from wrongdoing and to treat patients with confidentiality and to the best of one’s ability, still serves as the basis of the code of ethics for medical and dental professions.
Aristotle (384–322 BC), the great philosopher, referred to teeth in many of his writings. However, he mistakenly stated that the gingiva was responsible for tooth formation, and that men had 32 teeth and women had only 30. Many of his erroneous ideas were not corrected until the Renaissance.
Diocles of Carystus, an Athenian physician of Aristotle’s time, recommended rubbing the gums and teeth with bare fingers and “finely pulverized mint” to remove adherent food particles. Other materials used to clean the teeth included pumice, talc, emery, ground alabaster, coral powder, and iron rust.
By 2000 BC, the Chinese were practicing dentistry. They used arsenic to treat decayed teeth. This probably relieved the toothache. About the second century AD, the Chinese developed a silver amalgam paste for fillings, more than a thousand years before dentists in the West used a similar substance. In the eleventh century, T’ing To-t’ung and Yu Shu described the entire process of chewing and swallowing. Their description of the process was accurate, but they were incorrect about what happened to the food when it reached the stomach. They believed that digestion was a result of vapors arising from the spleen.
When the medical profession in Rome was just beginning, dentistry was already being practiced. Several Roman physicians wrote extensively about dental treatment, although many people still believed that a “toothworm” was responsible for toothaches. In addition to extracting teeth, the Romans were skilled in restoring decayed teeth with gold crowns and replacing missing teeth by means of fixed bridgework.
The Romans had a high regard for oral hygiene and developed tooth-cleaning powders made from eggshells, bones, and oyster shells mixed with honey. Dinner guests of upper-class Romans picked their teeth between courses with elaborately decorated toothpicks of metal, often gold, and were invited to take their gold toothpicks home as gifts.
Cornelius Celsus (25 BC–50 AD) wrote De Medicina, />