What constitutes dental disease? (Dental disease can include cavities or caries and gum disease or periodontal disease. We now know that dental disease can lead to systemic, somatic disease.) What is the earliest record of dentistry?
Were teeth full of caries (cavities) in ancient times? (The mummies of this time prove that teeth were not necessarily bad, as we had assumed, without modern dental information and techniques. The wear from a rougher, non-processed diet removed small cavities before they had a chance to get established, and also helped to clean out the space between teeth. This rougher diet also helped to keep teeth straighter. This changed and caries became more common as we moved to the more modern world of the Renaissance. Changes included the technology to produce softer food, sugar, and the use of the fork.)
Aristotle mistakenly stated that men had 32 teeth and women had only 30. From this came the use of the term “wisdom teeth,” which only men supposedly had. Diocles advised rubbing teeth and gums with bare fingers using ground-up mint to remove particles of food, a forerunner of today’s modern “minty” toothpastes. What is the history of toothpastes? (Long ago, people used ground-up chalk or charcoal, lemon juice, ashes, or even a mixture of tobacco and honey to clean their teeth. It was only about 100 years ago that someone created a minty cream to clean teeth.)
China sets aside September 20th as a national holiday known as “Love Your Teeth Day.” The ancient Chinese wrapped tiny pieces of parchment containing written prayers and incantations around painful teeth. How do we celebrate teeth in the U.S.? (We have the annual observance of National Children’s Dental Health Month. It began as a one-day event in Cleveland, Ohio on 2/3/1941. The American Dental Association held the first national observance of Children’s Dental Health Day on 2/8/1949. This single-day observance became a week-long event in 1955, and in 1981 it was extended to a month-long celebration.)
What is a toothworm? (People of ancient times believed that a toothworm caused toothaches. They thought the worm just appeared, or drilled its way into a tooth. If the tooth pain was severe, it meant that the worm was moving around. If the aching stopped, then the worm was resting. People smeared their aching teeth with honey and waited all night with tweezers in hand, ready to pull out the toothworm.) Did the Romans have toothbrushes? (They were called “chew sticks” and were actually small branches, with one frayed end. They were rubbed on teeth to scrape off any particles.)
Ambroise Paré was an apprentice to a barber surgeon. His writings include dental extraction methods and reimplantation of teeth. He is also credited with being the first to use artificial eyes, hands, and legs.
Why is Pierre Fauchard regarded as the “Father of Modern Dentistry”? (He developed dentistry as an independent profession and came up with the title of “surgeon dentist.” In the United States, the degree conferred on dentists is Doctor of Dental Surgery [DDS].)
How did Paul Revere become involved in forensic dentistry? (He performed the first identification of a corpse based on dental history. The corpse was that of Dr. Joseph Warren, whom Revere identified by a two-unit bridge he had made for him years earlier.) What does a forensic dentist do today? (He performs dental identification of deceased individuals.)
What was John Greenwood’s claim to fame? ( He was one of George Washington’s dentists.)
What was George Washington’s dental history? Did he really have wooden teeth? (When George Washington was elected President, he had only one tooth—a lower left premolar. He never had wooden teeth. His dentures were manufactured from gold, hippopotamus tusk, elephant ivory, and human teeth.) Where was the first dental college established?
How did dentists learn their profession before dental schools? (They learned by preceptorship, where a practicing dentist trained another dentist on the job to perform dental duties.)
Who is the “Grand Old Man of Dentistry”? What does “extension for prevention” mean? (The margins of a filling or restoration were extended to within reach of a toothbrush for cleaning the tooth.) Instead of “extension for prevention,” today’s cavity prevention is designed to preserve the health of the tooth over a lifetime. Minimally invasive dentistry is the adoption of detection, diagnosis, limited surgical intervention for excavation of decay, and restoration, with a view toward maximum preservation of tooth structure and adjunctive remineralization therapy.
Dr. Black studied with his brother, a doctor, before going into dentistry. Dr. Black believed that dentistry should stand as a profession independent from and equal to that of medicine. His first book was called The Formation of Poisons by Microorganisms . What did Dr. Black use to study microorganisms? ( A microscope; he later formed a Microscope Club for the same reason. He obtained one of the first microscopes in Illinois and became the de facto consulting pathologist for the region. He developed modem techniques for filling teeth based upon biological principles and microscopic evaluation.)
Look carefully at Dr. Black’s dental treatment room. Compare this dental treatment room to today’s modern rooms. Would the dental professional stand or sit? (Stand.) Would the patient always be sitting or laying supine? (Always sitting.) Would there be suction or just a spittoon? (Spittoon only.) How would the patient’s mouth be rinsed? (Bulb with water.)
How did the discovery of x-rays change dentistry forever?
The first x-rays were called “roentgenograms.” Roentgen was awarded the Nobel Prize for his work in x-rays. (Tie this slide in with Chapter 38: Foundations of Radiography, Radiographic Equipment, and Radiologic Safety.)
What pain remedies were available for patients before there were pain control procedures such as nitrous oxide? (Brute force, alcohol, and opium were used. Dosing of oral drugs was inaccurate, leaving patients either undermedicated or overmedicated. Patients could die of exhaustion or shock if an operation lasted more than 20 minutes.) (Tie this slide in with Chapter 37: Anesthesia and Pain Control.) Was dentistry the first to use nitrous oxide? (Yes, but after Dr. Wells’ success, the medical community later modified and adopted inhalation anesthesia as a standard surgical management procedure.)
During her preceptorship with her husband and another local dentist, Emiline Roberts saved several hundred extracted teeth and secretly placed restorations in them to practice. Dr. Roberts trained her son, David, in a preceptorship in dentistry. Then she sent him to Yale University and Harvard's School of Dental Medicine. Today, women represent almost 50% of students in some dental schools.
Who was the first black male dentist? (Dr. Robert Tanner Freeman) Is there an association for the black dental professional today? (The National Dental Association [NDA] is a national forum for minority dentists and a leader in advancing their rights within the dental profession.) What is the relationship between the NDA and ADA? (NDA received ADA’s empathic support for its insistence on removal of racial discrimination in dentistry's predominant organization. In 1965, unprecedented action by the ADA House of Delegates nullified sanctioned racial discrimination within the dental profession.)
Look closely at the instruments. Note the forceps in the bottom drawer. Forceps are one of the oldest of all dental instruments. Forceps were known by such names as parrot’s beak, crow’s bill, and stork’s bill. Forceps were and still are the key instrument for extraction of teeth.
Lucy Hobbs-Taylor received credit for time as a preceptor in her husband’s practice.
Lucy’s admission to dental school prompted a dentist to write in the Dental Times that “the very form and structure of a woman unfits her for its duties” and that “the female of the species (does not have) the necessary strength which the practice of dentistry requires.” Does this prejudice (that women are not strong enough for dentistry) still exist today?
What would it have been like to be the first dental assistant? (The assistant’s duties, as listed by the ADA in its dental history records, included chair-side assistance, instrument cleaning, inventory, appointments, bookkeeping, and reception—not unlike today.) How did dental-assisting education start? (Other dentists began training dental assistants in their own offices. In 1930, a committee was formed to draft training courses to be used as educational guides. In 1948, the Certifying Board of the American Dental Assistants Association was established, now the Dental Assisting National Board. By 1950, there were one- and two-year programs for dental-assisting education.)
Who was the first female dental assistant? (Malvina Cueria.) Dr. Kells was also the first to use radiographs in dental practice. When, at age 40, he first began his work with X-rays, Dr. Kells was unaware of the unseen danger of cumulative doses of radiation. He often held the films in place with his own fingers. By the time Kells reached 50, he had developed cancer in his right hand. Over the next 20 years, Kells endured 42 operations. He progressively lost his hand, his arm, and his shoulder.
What happened to the first dental hygiene graduates? (Most of the 27 graduates of the first class were employed by the local Board of Education to clean the teeth of school children. The greatly reduced incidence of caries among these children gave strength to the dental hygienist movement.)
Is standing all the time while working on a patient hard on a dental professional? (Yes, today we recognize that it is important to practice the correct ergonomic standards to prevent work-related injury.)
What is the mission of the Commission on Dental Accreditation (CODA)? (Its mission is to serve the public by establishing, maintaining, and applying standards that ensure the quality and continuous improvement of dental and dental-related education and reflect the evolving practice of dentistry.) What dental professions does CODA regulate? (The scope of CODA includes dental, advanced dental, and allied dental education programs.)
What stands out about this picture? (The dentists are wearing street clothes, and are not wearing masks, eyewear, or gloves. Now we practice dentistry with strict infection control standards.) When was the first fully reclining dental chair introduced? (1958.) What does the seal for dentistry mean? (The design uses a serpent entwined about an ancient Arabian cautery in the manner of the single serpent of Aesculapius, the Greek god of medicine, coiled about a rod. The Greek letter ∆ for dentistry and the Greek letter O for odont (tooth) form the periphery of the design. In the background are 32 leaves and 20 berries, representing the permanent and temporary teeth.)
Compare this dental treatment room to the one used by Dr. Black and the old dental school. Does the dental professional stand or sit? (Sit.) Is the patient sitting or lying supine? (Lying supine.) Would there be suction or just a spittoon? (Suction is available.) How would the patient’s mouth be rinsed? (Hand water spray.) What is the dental professional wearing to help with infection control standards? (Lab coat, mask, eyewear, and gloves.) How often are dental-assisting schools reviewed to maintain their accreditation status? (Every seven years.)
What are the most recent advances in dentistry in the last 25 years? 1980s—Per-Ingvar Branemark describes techniques for the osseointegration 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 aesthetic dentistry. 1997—FDA approves the erbium YAG laser, the first for use on dentin, to treat tooth decay.
Many of the remarkable techniques in modern dentistry can be traced to the earliest times in every culture. List what we still use today in dentistry? (X-rays, local anesthesia, nitrous oxide, surgical instruments, amalgam, etc.) Think of dentistry’s past: first use of x-rays, first women dentist or dental assistant, first use of pain control. What will be the new “firsts” in the future of dentistry? Additional dental museums include the Pierre Fauchard Museum of Dental History at the Community College of Southern Nevada, United States, and the Pierre Fauchard Museum of Dentistry at Paris, France.
Learning Objectives <ul><li>Pronounce, define, and spell the Key Terms. </li></ul><ul><li>Describe the role of Hippocrates in history. </li></ul><ul><li>State the basic premise of the Hippocratic Oath. </li></ul>
A profession that is ignorant of its past experiences has lost a valuable asset because “it has missed its best guide to the future.” B.W. Weinberger Dentistry: An Illustrated History (Mosby, 1995)
Introduction <ul><li>Dentistry has a long and fascinating history. From the earliest of times, humans have been plagued by dental disease. </li></ul><ul><li>Many of the remarkable techniques in modern dentistry can be traced to the very earliest of times in every culture. </li></ul>
The Early Times The Egyptians <ul><li>Hesi-Re was the earliest dentist whose name is known. He practiced in 3000 BC and was called “Chief of the Toothers.” </li></ul><ul><li>Egyptian pharaohs were known to have suffered from periodontal (gum) disease. Radiographs of mummies confirm this fact. </li></ul>
The Early Times The Greeks <ul><li>Hippocrates (460-377 BC) earned the title of Father of Medicine. </li></ul><ul><li>Aristotle (384-322 BC), the great philosopher, referred to teeth in many of his writings. </li></ul><ul><li>Diocles of Carystus , Physician of Aristotle’s time. Recommended “rubbing the teeth and gums” as oral hygiene instructions </li></ul>
The Chinese <ul><li>By 2000 B.C. the Chinese were practicing dentistry. </li></ul><ul><li>Around the 2nd century A.D. the Chinese developed a silver amalgam paste for fillings (more than 1000 years before dentists in the west). </li></ul><ul><li>T’ing and Yu Shu described the entire process of swallowing in the eleventh century. </li></ul>
The Early Times The Romans <ul><li>Several Roman physicians wrote extensively about dentistry. Many people still believed in the theory of the toothworm being responsible for toothaches. Romans were skilled in restoring decayed teeth with gold crowns. They had a high regard for oral hygiene. </li></ul>
The Renaissance <ul><li>Leonardo DaVinci studied human anatomy and sketched every part of the human body. He was the first to differentiate between molars and premolars. </li></ul><ul><li>Ambroise Pare was the father of modern surgery. </li></ul><ul><li>Pierre Fauchard was the founder of modern dentistry. He developed dentistry as an independent profession from medicine. </li></ul>
Pierre Fauchard, the “Father of Modern Dentistry.”
Early America <ul><li>Robert Woofendale was one of the first dentists in the colonies. </li></ul><ul><li>John Baker, M.D. , practiced dentistry in New York, Boston, and Philadelphia. George Washington was one of his patients . </li></ul><ul><li>Paul Revere , the famous colonial patriot, was a silversmith who became a dentist. He is credited with being the first to use forensic dental evidence to identify human remains. </li></ul><ul><li>(Cont’d…) </li></ul>
Early America <ul><li>(…Cont’d) </li></ul><ul><li>Isaac Greenwood was the first native-born American dentist. He studied under Dr. John Baker. </li></ul><ul><li>John Greenwood was the second son of Isaac Greenwood. He served in the American Revolutionary Army at the age of 14 years. He later became a dentist like his father. </li></ul>
Fig. 1-3 John Greenwood, dentist to George Washington (From Kock CRD: History of dental surgery, vol III, Fort Wayne, Ind, 1910, National Art Publishing.)
Learning Objectives <ul><li>Discuss the contributions of Horace H. Hayden and Chapin A. Harris. </li></ul><ul><li>Describe two major contributions of G. V. Black. </li></ul><ul><li>Name the scientist who discovered radiographs. </li></ul><ul><li>Name the physician who first used nitrous oxide for tooth extractions. </li></ul><ul><li>Name the first woman to graduate from a college of dentistry. </li></ul><ul><li>(Cont’d…) </li></ul>
Learning Objectives <ul><li>(…Cont’d) </li></ul><ul><li>Name the first African-American woman to receive a dental degree in the United States. </li></ul><ul><li>Name the first woman to practice dentistry in the United States. </li></ul><ul><li>Name the first dentist to employ a dental assistant. </li></ul><ul><li>Name the first female dental assistant. </li></ul><ul><li>Discuss the purpose and activities of the National Museum of Dentistry. </li></ul>
Educational and Professional Development in the United States <ul><li>Horace Hayden and Chapin A. Harris set the foundation for the profession of dentistry. </li></ul><ul><li>Together, they established the first dental college, the Baltimore College of Dental Surgery. </li></ul><ul><li>Today, it is known as the School of Dentistry at the University of Maryland. </li></ul>
Dr. Green Vardiman Black <ul><li>Known worldwide as G.V. Black, he earned the title of the “grand old man of dentistry. ” </li></ul><ul><li>He standardized the rules of cavity preparation and fillings. </li></ul><ul><li>He developed the principle of “extension for prevention.” </li></ul><ul><li>He taught in dental schools, became a dean, and wrote more than 500 articles and several books. </li></ul>
Fig. 1-4 G. V. Black, the “Grand Old Man of Dentistry” (From Kock CRD: History of dental surgery, vol I, Chicago, 1909, National Art Publishing.)
Fig. 1-5 Black’s dental treatment room, as reconstructed in Smithsonian exhibit
Wilhelm Conrad Roentgen (1845-1923) <ul><li>A Bavarian physicist who discovered x-rays in 1895. </li></ul><ul><li>His discovery revolutionized diagnostic capabilities and forever changed the practice of dentistry. </li></ul>
<ul><li>Fig. 1-6 Roentgen discovered the early potential of a radiograph beam in 1895. (Courtesy Eastman-Kodak, Rochester, NY.) </li></ul>
Horace Wells (1815-1848) <ul><li>Dr. Wells was the dentist credited with the discovery of inhalation anesthesia in 1844. </li></ul><ul><li>This was one of the most important medical discoveries of all time. </li></ul><ul><li>He realized the potential for pain-free dentistry by using nitrous oxide. </li></ul>
Women in Dentistry <ul><li>In the eighteenth and early nineteenth centuries, dental schools throughout the world did not accept female students. </li></ul><ul><li>Women such as Lucy B. Hobbs-Taylor and Nellie E. Pooler broke those barriers. </li></ul><ul><li>Emiline Roberts became the first woman dentist in the United States. At 17 years of age, she worked for her dentist husband, who trained her in his office to become a dentist. She later opened her own dental practice. </li></ul><ul><li>Today, women are active in dental associations, specialties, public health, and the military. </li></ul><ul><li>It is projected that by the year 2020, 20% of all dentists will be women. </li></ul>
Ida Gray Rollins (1867-1953) <ul><li>Ida Gray was the first black woman in the county to earn a formal DDS degree, and the first black woman to practice dentistry in Chicago. </li></ul><ul><li>She graduated from the University of Michigan School of Dentistry and practiced dentistry in Chicago until she retired in 1928. </li></ul><ul><li>In 1929 she married William Rollins and used the name of Dr. Ida Gray Rollins. </li></ul>
<ul><li>Fig. 1-7 Dental instrument kit belonging to Dr. Nellie E. Pooler. She practiced dentistry in Nevada City, California. She died in 1906. (Courtesy University of California, San Francisco, School of Dentistry.) </li></ul>
Lucy B. Hobbs-Taylor <ul><li>Denied admission to a dental college, Lucy B. Hobbs-Taylor went to work for a dentist, who trained her in his office to become a dentist. </li></ul><ul><li>Later opened her own dental practice in Cincinnati and then opened a dental office in Iowa. </li></ul><ul><li>Admitted to the Ohio College of Dental Surgery. She was the first woman to graduate from a dental school. </li></ul>
Fig. 1-8 Lucy B. Hobbs-Taylor, the first woman graduate of dental school (Courtesy Kansas State Historical Society.)
History of Dental Assisting <ul><li>C. Edmund Kells , a dentist in New Orleans, was credited with using the first dental assistant. </li></ul><ul><ul><li>She was a “lady in attendance,” making it respectable for women patients to go into a dental office unaccompanied. </li></ul></ul><ul><li>Dr. Kells soon realized that this lady could be a valuable asset, and by 1900, he was working with both a chairside dental assistant and a secretarial assistant. </li></ul>
Fig. 1-9 C. Edmund Kells and his “working unit,” about 1900. Assistant on the left is keeping cold air on the cavity while assistant on the right mixes materials and “secretary” records details. (From Kells CE: The dentist’s own book, St. Louis, 1925, Mosby.)
History of Dental Hygiene <ul><li>Irene Newman was the first person to be trained as a dental hygienist in Bridgeport, Connecticut, in the early 1900s. </li></ul><ul><li>A dentist, Alfred C. Fones , believed women could be trained to provide preventive services, allowing more time for the dentist to perform more complex procedures. </li></ul><ul><li>Dr. Fones opened the first school for dental hygienists in 1913. </li></ul><ul><li>The school exists today as the Fones School of Dental Hygiene, University of Bridgeport. </li></ul>
<ul><li>Fig. 1-10 Dental hygienist during the 1960s working in a standing position (From Daniel SJ, Harfst SA: Mosby’s dental hygiene:concepts, cases, and competencies–2004 update. St. Louis, 2004, Mosby; Courtesy Fr. Edward J. Dowlin, S.J. Marine Historical Collection, University of Detroit Mercy, Detroit.) </li></ul>
Dental Accreditation <ul><li>By 1900 the profession of dentistry had become well established and dental schools were being developed across the country. </li></ul><ul><li>The educational requirements for dentists, dental hygienists, and dental assistants have increased dramatically over the years. </li></ul><ul><li>Today, the Commission on Dental Accreditation of the American Dental Association sets the standards and accredits dental educational programs. </li></ul><ul><li>Accreditation assures the students, public, and profession that the program meets high standards. </li></ul>
Fig. 1-11 Dental students at University of California, San Francisco, School of Dentistry treat patients in the dental clinic in the early 1900s. (Courtesy UCSF School of Dentistry.)
<ul><li>Fig 1-12 Modern dental assisting students practicing chairside skills with their instructor in an accredited dental assisting program </li></ul>
National Museum of Dentistry <ul><li>The Dr. Samuel D. Harris National Museum of Dentistry is an affiliate of the Smithsonian Institution. </li></ul><ul><li>It is built on the grounds of the Baltimore College of Dental Surgery , the world’s first dental college. </li></ul><ul><li>It provides many interactive exhibits, historic artifacts, and engaging educational programs. </li></ul><ul><li>Visitors learn about the heritage and future of dentistry, achievements of dental professionals, and the importance of oral health in a healthy life. </li></ul><ul><li>For more information, visit the web site: http://www.dentalmuseum.umaryland.edu/ </li></ul>
<ul><li>Fig. 1-13 The Samuel D. Harris National Museum of Dentistry (Courtesy the Samuel D. Harris Museum of Dentistry, Baltimore, MD.) </li></ul>