The long climb: From barber-surgeons to doctors of dental surgery

This is the first scholarly history of dentistry written in the past 26 years, using as a jumping-off point Asbell’s Dentistry: A historical perspective (1988). Other books published during that period have been of limited scope, were for popular consumption, or were essentially picture books. The author is a professor emeritus in the Department of Periodontics and Implant Dentistry at the Stony Brook (New York) School of Dental Medicine, a former dean, and one of the school’s founding fathers. Garant was the coauthor of Cell biology of tooth enamel and the author of Oral cells and tissues . He has written several articles on the history of dentistry, but this is his first book on the subject. In his preface, Garant asks, “Why publish another book of this nature?” The reason, he explains, is his belief that “a new narrative, highlighting some of the personalities and the controversies . . . [for those] . . . who might otherwise find a void in their education when it comes to understanding the history of their profession.” This might hold true if it were the first book ever written on the subject. But the potential reader wants to know, “What does this book says that hasn’t been said before?” One possible answer is that it brings dental history up to date. Unfortunately, this doesn’t happen, as we shall see.

Keeping true to his title, Garant depicts dentistry as a calling with its roots in pain, fear, ignorance, fragmentation, and charlatanism. These origins help explain why it was a latecomer among the learned occupations. Another reason was that dentistry was a spin-off from medicine, but its practitioners were often craftsmen of various types—both in skills and in morals. Only through the efforts of “the courage and determination of dentistry’s pioneers” did our profession rise to the position it holds today.

The author depicts this struggle in a highly detailed narrative in 13 chapters. One dilemma that a historian faces is whether to present his or her account chronologically, topically, or with a little of each. Garant’s approach is to present the first 7 chapters more or less chronologically and cover important personalities in chapter 8, “Exemplars of the new profession.” Then follow 6 topical chapters on the dental specialties (orthodontics gets the most coverage, with 42 pages). The final 3 chapters treat ethics, research, education, and miscellaneous issues.

Each chapter ends with a useful summary. End-of-the-chapter references attest to the thoroughness of this author’s research and use of primary sources. The index is adequate, but for a book containing such abundant material, one might expect to see more detail.

Judging by the thickness of this almost-500-page book, one would expect to follow the historical trail up to recent times, especially what has happened in the 26-year interval during which we have awaited a comprehensive update. Although Garant has thoroughly delved into dental research, education, and licensure, he omitted the developments of implants, esthetic dentistry, laser treatment of tooth decay, and computer applications to dentistry. As far back as 1900, I was unable to find local anesthesia, the temporomandibular joint, dental hygienists (Alfred Fones), dental bonding/acid etching, women in dentistry, or 4-handed dentistry/dental assistants mentioned. The author might have deliberately chosen to emphasize ancient, medieval, and colonial dentistry at the expense of more recent aspects. Perhaps this is what he meant by “From Pierre Fauchard to G. V. Black.”

Of particular interest to orthodontists is, of course, chapter 13, “Orthodontics.” Although the period covered is limited (ending with Calvin Case), the narrative is detailed and accurate. Many in our specialty might be surprised to learn that some things that we consider today’s state of the art were known almost 200 years ago: guidance of eruption, slenderizing, control of the e-space, relative anchorage, and the constancy of intercanine width. The sections on cleft lip and palate, orthognathic surgery, and vulcanization are also of interest, as are the sketches of orthodontists who made contributions outside the specialty (eg, Frederick McKay and Rodriques Ottolengui).

Despite the shortcomings, The long climb is a landmark book that should be useful as both a textbook and a reference book. I recommend purchase if you are a history buff or feel inadequate about your knowledge of early dental history. In any case, $38 is not a substantial outlay to place this interesting book on your shelf, considering the cost of dental books today. Remember, we are dentists first.

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Apr 6, 2017 | Posted by in Orthodontics | Comments Off on The long climb: From barber-surgeons to doctors of dental surgery

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