The History of Dentistry



The History of Dentistry

St Apollonia the Patron Saint of Dentistry, meant to heal pain derived from tooth infection.

St Apollonia is popularly invoked against the toothache because of the torments she had to endure.
She is represented in art with pincers in which a tooth is held.

Dental History Timeline
Ancient origins
7000 BC Evidence of ancient dentistry has recently been found in a Neolithic graveyard in ancient Pakistan. Teeth dating from around 7000 to 5500 BC show evidence of holes from dental drills. The teeth were found in people of the Indus Valley Civilization.

5000 BC A Sumerian text of this date describes “tooth worms” as the cause of dental decay. Evidence of this belief has also been found in ancient India, Egypt, Japan, and China. The legend of the worm is also found in the writings of Homer, and as late as the 1300’s AD the surgeon Guy de Chauliac still promoted the belief that worms cause tooth decay.

2600 BC Death of Hesy-Re, an Egyptian scribe, often called the first “dentist.” An inscription on his tomb includes the title “the greatest of those who deal with teeth, and of physicians.” This is the earliest known reference to a person identified as a dental practitioner.

1800 BC In the 18th century BC, the Code of Hammurabi referenced dental extraction twice as it related to punishment. Examination of the remains of some ancient Egyptians and Greco-Romans reveals early attempts at dental prosthetics and surgery.

1700-1550 BC An Egyptian text, the Ebers Papyrus, refers to diseases of the teeth and various toothache remedies.

500-300 BC Hippocrates and Aristotle write about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.

100 BC Celsus, a Roman medical writer, writes extensively in his important compendium of medicine on oral hygiene, stabilization of loose teeth, and treatments for toothache, teething pain, and jaw fractures.

166-201 AD The Etruscans practice dental prosthetics using gold crowns and fixed bridgework.

Middle ages & The Renaissance
500-1000 During the Early Middle Ages in Europe medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period.

700 A medical text in China mentions the use of “silver paste”, a type of amalgam.

1130-1163 A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade—sharp knives and razors—were useful for surgery. After the edicts, barbers assume the monks’ surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210 A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400’s A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.

1530 The Little Medicinal Book for All Kinds of Diseases and Infirmities of the Teeth (Artzney Buchlein), the first book devoted entirely to dentistry, is published in Germany. Written for barbers and surgeons who treat the mouth, it covers practical topics such as oral hygiene, tooth extraction, drilling teeth, and placement of gold fillings.

1563 Batholomew Eusttachius published the first accurate book on dental anatomy, ‘Libellus de dentibus’

Der Zahnbrecher c.1568
(The ‘Toothbreaker’)
…………. quackery was still widespread and charlatans were a common part of rural life. Only the very wealthy could afford the skilled ‘operator for the teeth’. For many the only option was the village blacksmith and tooth drawer offering painful extractions.

1575 In France Ambrose Pare, known as the Father of Surgery, publishes his Complete Works. This includes practical information about dentistry such as tooth extraction and the treatment of tooth decay and jaw fractures.

1683 Antony van Leeuwenhoek identified oral bacteria using a microscope.

1685 The first dental textbook written in English “The Operator for the Teeth” written by Charles Allen.

18th Century

1723 Pierre Fauchard, a French surgeon publishes The Surgeon Dentist, A Treatise on Teeth (Le Chirurgien Dentiste). Fauchard is credited as being the Father of Modern Dentistry because his book was the first to describe a comprehensive system for the practice of dentistry including basic oral anatomy and function, operative and restorative techniques, and denture construction. His book also includes the statement that sugar derivate acids such as tartaric acid are responsible for dental decay.

1746 Claude Mouton describes a gold crown and post to be retained in the root canal. He also recommends white enameling for gold crowns for a more esthetic appearance.

1760 John Baker, the earliest medically-trained dentist to practice in America, immigrates from England and sets up practice.

1764 First lectures on the teeth at the Royal College of Surgeons, Edinburgh by James Rae.

1768 – 1770 Paul Revere places advertisements in a Boston newspaper offering his services as a dentist. In 1776, in the first known case of post-mortem dental forensics, Revere verifies the death of his friend, Dr. Joseph Warren in the Battle of Breed’s Hill, when he identifies the bridge that he constructed for Warren.

1771 John Hunter published “The natural history of human teeth” giving a scientific basis to dental anatomy.

1780 William Addis manufactured the first modern toothbrush.

1789 Frenchman Nicolas Dubois de Chemant receives the first patent for porcelain teeth.

1790 John Greenwood, one of George Washington’s dentists, constructs the first known dental foot engine. He adapts his mother’s foot treadle spinning wheel to rotate a drill.

1790 Josiah Flagg, a prominent American dentist, constructs the first chair made specifically for dental patients. To a wooden Windsor chair, Flagg attaches an adjustable headrest, plus an arm extension to hold instruments.

19th Century
1801 Richard C. Skinner writes the Treatise on the Human Teeth, the first dental book published in America.

1820 Claudius Ash established his dental manufacturing company in London.

1825 Samuel Stockton begins commercial manufacture of porcelain teeth. His S.S. White Dental Manufacturing Company establishes and dominates the dental supply market throughout the 19th century.

1830’s-1890’s The ‘Amalgam War’ conflict. The Crawcours (two brothers from France) introduce amalgam filling material in the United States under the name Royal Mineral Succedaneum. The brothers are charlatans whose unscrupulous methods spark the “amalgam wars,” a bitter controversy within the dental profession over the use of amalgam fillings.

1831 James Snell designed the first reclining dental chair.

1839 The American Journal of Dental Science, the world’s first dental journal, begins publication.

1839 Charles Goodyear invents the vulcanization process for hardening rubber. The resulting Vulcanite, an inexpensive material easily molded to the mouth, makes an excellent base for false teeth, and is soon adopted for use by dentists. In 1864 the molding process for vulcanite dentures is patented, but the dental profession fights the onerous licensing fees for the next twenty-five years.

1843 First British Dental Journal was published.

1844 Horace Wells, a Connecticut dentist, discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his private practice. He conducts the first public demonstration of its use as an anesthetic in 1845 but the demonstration is generally considered a failure after the patient cries out during the operation. In 1846, another dentist (and a student of Wells), William Morton, takes credit for the discovery when he conducts the first successful public demonstration of the use of ether as an anesthesia for surgery. Crawford Long, a physician, later claims he used ether as an anesthetic in an operation as early as 1842, but he did not publish his work.

1855 Robert Arthur originates the cohesive gold foil method allowing dentists to insert gold into a cavity with minimal pressure. The foil is fabricated by annealing, a process of passing gold through a flame making it soft and malleable.

1858 Dental Hospital of London opened, the first clinical training establishment for dentists in Britain.

1859 Twenty-six dentists meet in Niagara Falls, New York, and form the American Dental Association.

1864 Sanford C. Barnum, develops the rubber dam, a simple device made of a piece of elastic rubber fitted over a tooth by means of weights, which solves the problem of isolating a tooth from the oral cavity.

1869 Dr. Robert Tanner Freeman, graduating from Harvard University Dental School, becomes the first African-American to earn a dental degree.

1871 A tooth coloured filling material, silicate cement, was introduced.

1871 James B. Morrison patents the first commercially manufactured foot-treadle dental engine. Morrison’s inexpensive, mechanized tool supplies dental burs with enough speed to cut enamel and dentin smoothly and quickly, revolutionizing the practice of dentistry.

1871 The American George F. Green receives a patent for the first electric dental engine, a self-contained motor and handpiece.

1877 The Wilkerson chair, the first pump-type hydraulic dental chair, is introduced.

1880’s The collapsible metal tube revolutionizes toothpaste manufacturing and marketing. Dentifrice had been available only in liquid or powder form, usually made by individual dentists, and sold in bottles, porcelain pots, or paper boxes. Tube toothpaste, in contrast, is mass-produced in factories, mass-marketed, and sold nation-wide. In twenty years, it becomes the norm.

1880 British Dental Association founded.

1884 Cocaine was introduced as a local anaesthetic by Carl Koller

1887 Stowe & Eddy Dental Laboratory, the first successful industrial-type laboratory in the U.S., opens in Boston, marking the ascendancy of the modern commercial dental laboratory. The earliest known dental laboratory in the U.S. was Sutton & Raynor which opened in New York City around 1854.

1890 Willoughby Miller an American dentist in Germany, notes the microbial basis of dental decay in his book Micro-Organisms of the Human Mouth. This generates an unprecedented interest in oral hygiene and starts a world-wide movement to promote regular toothbrushing and flossing.

1895 Wilhelm Roentgen (1845 – 1923),
a German physicist, discovers the x-ray.
In 1896 prominent New Orleans
dentist, C. Edmond Kells, takes the
first dental x-ray of a living person
in the U.S.

1896 Greene Vardiman Black, a leading reformer and educator of dentistry establishes the principles of cavity preparation. In 1908 (see below) he publishes his two-volume treatise: Operative Dentistry .

1899 Edward Hartley Angle classifies the various forms of malocclusion. Credited with making orthodontics a dental specialty, Angle also establishes the first school of orthodontics (Angle School of Orthodontia in St. Louis, 1900).

20th Century
1900 Federation Dentaire Internationale (FDI) is founded.

1901 Novocaine was introduced as a local anaesthetic by a German chemist, Alfred Einhorn. In 1905 Einhorn formulates the local anesthetic procain, later marketed under the trade name Novocain.

1903 Charles Land devises the porcelain jacket crown.

1907 William Taggart invents a “lost wax” casting machine, allowing dentists to make precision cast fillings.

1908 G. V. Black publishes his monumental two-volume treatise Operative Dentistry, which remains the essential clinical dental text for fifty years. Black later develops techniques for filling teeth, standardizes operative procedures and instrumentation, develops an improved amalgam, and pioneers the use of visual aids for teaching dentistry.

1913 Alfred C. Fones opens the Fones Clinic For Dental Hygienists in Bridgeport, Connecticut, the world’s first oral hygiene school. Most of the twenty-seven women graduates of the first class are employed by the Bridgeport Board of Education to clean the teeth of school children. The greatly reduced incidence of caries among these children gives impetus to the dental hygienist movement. Dr. Fones, first to use the term “dental hygienist,” becomes known as the Father of Dental Hygiene.

1924 American Dental Assistants Association is founded by Juliette Southard and her female colleagues. Female dental assistants were first hired in the 19th century when “Lady in Attendance” signs were routinely seen in the windows of dental offices. Their duties included chair-side assistance, instrument cleaning, inventory, appointments, bookkeeping, and reception.

1930–1943 Frederick S. McKay, a Colorado dentist, is convinced that brown stains (mottling) on his patients’ teeth are related to their water supply. McKay’s research verifies that drinking water with high levels of naturally occurring fluoride is associated with low dental caries and a high degree of mottled enamel. By the early 1940s, H. Trendley Dean determines the ideal level of fluoride in drinking water to substantially reduce decay without mottling.

1938 The nylon toothbrush, the first made with synthetic bristles, appears on the market.

1937 Alvin Strock inserts the first Vitallium dental screw implant. Vitallium, the first successful biocompatible implant metal, had been developed a year earlier by Charles Venable, an orthopedic surgeon.

1940’s 22,000 dentists serve in World War II.

1945 The water fluoridation era begins when the cities of Newburgh, New York, and Grand Rapids, Michigan, add sodium fluoride to their public water systems.

1949 Oskar Hagger, a Swiss chemist, develops the first system of bonding acrylic resin to dentin.

1950’s The first fluoride toothpastes are marketed.

1955 Michael Buonocore describes the acid etch technique, a simple method of increasing the adhesion of acrylic fillings to enamel.

1957 John Bordern introduces the high-speed air-driven contra-angle handpiece. The Airotor obtains speeds up to 300,000 rotations per minute and is an immediate commercial success, launching a new era of high-speed dentistry.

1958 A fully reclining dental chair is introduced.

1960’s Sit down, four-handed dentistry becomes popular. This technique improves productivity and shortens treatment time.

1960’s Lasers are developed and approved for soft tissue procedures.

1960 The first commercial electric toothbrush, developed in Switzerland after World War II, is introduced. A cordless, rechargeable model follows in 1961.

1962 Rafael Bowen develops Bis-GMA, the thermoset resin complex used in most modern composite resin restorative materials.

1980’s Per-Ingvar Branemark describes techniques for the osseo-integration of dental implants.

1989 The first commercial home tooth bleaching product is marketed.

1990’s New tooth-colored restorative materials plus increased usage of bleaching, veneers, and implants inaugurate an era of esthetic dentistry.

1997 FDA approves the erbium YAG laser, the first for use on dentin, to treat tooth decay.

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More facts & stories

The story of dentistry: Ancient origins

Archaeological evidence of the dentistry of antiquity suggests that treatment included medical methods of combating dental affections, mechanical means of treatment such as retentive prosthesis and the art of applying artificial substitutes for lost dental structures.

It is believed that the oldest civilization that knew something of dentistry was Egypt. The earliest indication of such knowledge is found in the Edwin Smith Surgical Papyrus. It contains detailed directions for the treatment of wounds about the mouth, but no mention is made of restoring lost teeth resulting from these injuries. The hard tissues of the mouth were in general considered untreatable. In closing his discussion on this topic one ancient Egyptian surgeon advises: “One having a fracture of the mandible over which a wound has been inflicted and he has fever from it, it is an ailment not to be treated”.

Proving prehistoric man’s ingenuity, researchers have found that dental drilling dates back 9,000 years. Primitive dentists drilled nearly perfect holes into teeth of live patients between 5500 and 7000 B.C. Researchers recently carbondated at least nine skulls with 11 drill holes found in a graveyard in Pakistan. This means dentistry is at least 4,000 yrs older than first thought.

Researchers figured that a small bow was used to drive the flint drill tips into patients’ teeth. Flint drill heads were found on site. This dental   drilling probably evolved from intricate ornamental bead drilling.

The drilled teeth found in the graveyard were hard-to-reach molars. Although it is speculated that the drilling could have been decorative or to release “evil spirits” more than fighting tooth decay, the hard-to-see locations of the drilled   teeth in jaws seem to rule out drilling for decorative purposes. No sign of fillings were found.

“The time for extracting a dental lesson from history is ever at hand for dentists who are wise” Demosthenes

The story of dentistry: Middle ages and The Renaissance: Beginnings of the dental profession

Dental treatment is as old as toothache itself. The middle ages was a brutal time for the toothache sufferer, as the main treatments available were dubious toothache remedies and extraction. Dentistry was not a profession in itself, and often dental treatment such as extractions and tinctures were offered by barbers or barber-surgeons, and by the marketplace charlatan, the tooth drawer, and later the ‘Operator for the Teeth’. Dental treatments comprised tinctures and styptics – extraction was a last and painful resort

Forceps and the ‘Pelican’ were the most common extracting tools. The dental pelican, invented in the 14th century by Guy de Chauliac was often made by the village blacksmith, needed little skill to use and often caused terrible damage and pain. The pelican was replaced by the dental key in the 1700’s which, in turn, was replaced by modern forceps in the 20th century.

Modeled after a door key, the dental key was used by first inserting the instrument horizontally into the mouth, then its “claw” would be tightened over a tooth. The instrument was rotated to loosen the tooth. This often resulted in the tooth breaking, causing jaw fractures and soft tissue damage.

Oral hygiene during the middle ages was very basic. Teeth were cleaned with pieces of linen or sponge, or by using toothpicks.

The story of dentistry: 18th Century: From toothdrawer to dentist

“Should enlightenment grow in the practice of dentistry, we might attain to progress and engender new ideas…” Pierre Fauchard 1746

By the early 1700’s, dentistry was considered a lesser part of medicine. By the end of this century, it had begun to emerge as a discipline in its own right. In the late 1750’s the term ‘dentist’, borrowed from the French, started to be used in Britain to describe tooth operators.

In this century the first real textbooks appeared including Pierre Fauchard’s monumental work in 1723: ‘Le Chirurgien Dentiste’ (The Surgeon Dentist) marking the beginning of theoretical and professional dentistry.

Teeth restoration procedure diagram made by Pierre Fauchard in the early 18th century.

Pierre Fauchard’s dentist’s drill made in the late 17th century.

Throughout this period of change quackery was still widespread and charlatans were a common part of rural life. Only the very wealthy could afford the skilled dentist or operator for the teeth. For many the only option was the village blacksmith and tooth drawer offering painful extractions. Tinctures, toothpowders and abrasive dentifrices could also be purchased at the market fairs.

The upper classes could afford a greater range of treatments, including artificial teeth (highly sought after by the sugar-consuming wealthy). Ivory dentures were popular into the 18th century, and were made from natural materials including walrus, elephant or hippopotamus ivory.

Human teeth or ‘Waterloo teeth’-sourced from battlefields or graveyards-were riveted into the base. These ill fitting and uncomfortable ivory dentures were replaced by porcelain dentures, introduced in the 1790’s. These were not successful due to their bright colours, and tendency to crack.

“Dental Reformers like John Tomes found dentistry as a Craft, and left it as a Profession”  Sir Robert Bradlaw CBE, 1980
Sir John Tomes (1815 – 1895) c.1875
The British Dental Association, formed in 1880 with Sir John Tomes as president, played a major role in transforming and regulating the dental profession in England.

The story of dentistry: 19th Century: Advances in science and education

Before the 1800’s, the practice of dentistry was still a long way from achieving professional status. This was to change in the 19th century – the most significant period in the history of dentistry to date. By 1800 there were still relatively few ‘dentists’ practicing the profession. By the middle of the 19th century the number of practicing dentists had increased markedly, although there was no legal or professional control to prevent malpractice and incompetence. Pressure for reform of the profession increased.

The introduction of anaesthesia had a dramatic effect on dentistry. Alongside ether and chloroform, nitrous oxide became the most preferred option and most surgeries were equipped with general anaesthetic equipment by the end of the century.

Many people were now prepared to have their rotting teeth extracted, which led to an enormous demand for cheap and efficient dentures. The introduction of vulcanite in the mid 19th century meant that now dentures could be mass-produced and affordable, replacing the expensive ivory versions.

In London in 1820, Claudius Ash, a goldsmith by trade, began manufacturing high-quality porcelain dentures mounted on 18-carat gold plates. Dentures were made of Vulcanite from the 1850’s on, a form of hardened rubber (Claudius Ash’s company was the leading European manufacturer of dental Vulcanite) into which porcelain teeth were set. In the 20th century, acrylic resin and other plastics became known.

Dental Technician in a German Dental Laboratory. Stahlgebissmacherei der Zahnklinik der Friedrich Krupp A.G. Essen ca. 1885.