Dentistry today is considered to be one of the top 10 most trusted and ethnically professions in the United States. And if you’ve ever had a tooth broken or your jaw injured at work, you know how incredibly important dentists are to our health. But do you know anything about the evolution of dentistry, or how it got to where it is today?
If you’ve ever been curious as to the history and evolution of dentistry, you’ve come to the right place. From the original dental drill in 7000 BCE to modern orthodontic treatment, keep reading to learn all about the long evolution of dentistry.
The Evolution of Dentistry in Ancient Times
One of the earliest records of dental practice — if not the earliest — dates back to 7000 BC, roughly 9,000 years ago. In the Indus Valley Civilization, in what is now modern Pakistan, bead craftsman may have used a drill made from flint heads to remove tooth enamel and rotting tissue. Not exactly the dental implants of today, but evidence indicates that these treatments were surprisingly effective.
Ancient records are sparse and changes happened slowly in early history, so the next significant evidence of early dentistry is from 2,000 years later, in 5000 BC. A Sumerian text from this period describes “tooth worms” as being responsible for dental decay. Around 1,400 years later, in 2600 BC, the world’s first known dentist died. An Egyptian scribed named Hesy-Re, his tomb had an inscription saying, “the greatest of those who deal with teeth, and of physicians.” This is the earliest reference to a dedicated dental practitioner yet discovered.
Long before the first health insurance plan existed, the evolution of dentistry took a leap forward with the creation of the Ebers Papyrus between 1700 and 1550 BC, which described dental diseases and remedies for toothaches; and again between 500 and 300 BC, when Hippocrates and Aristotle wrote about dentistry. Their works described the eruption pattern of teeth, as well as treatments like extracting teeth with forceps and using wires to stabilize fractured jaws and loose teeth. Although lacking the sanitation or machined precision of modern treatments, these methods are surprisingly familiar to us today.
Approaching the end of the years Before Christ, a Roman medical writer named Celsus wrote an extensive compendium on oral hygiene, stabilizing loose teeth, and treatments for toothache, jaw fractures, and even teething pain, in 100 BC. Then around 166 to 201 AD, a people group known as the Etruscans may have been the first to use dental bridges and gold crowns to repair teeth.
Advancing into the Middle Ages, a medical text from China dating to 700 AD mentions the use of “silver paste,” which was a type of amalgam. In the coming centuries in Europe, the evolution of dentistry would begin to accelerate around the thirteenth century.
Bridging the Gap Between Ancient and Modern Dentistry
The first practicing dentists in Europe were known as barber-surgeons. Not surprisingly, these early dentists would tend to people’s hair and beards as well as their teeth, forming a sort of double-practice that certainly wouldn’t make any sense to us today. A Guild of Barbers was established in France in the year 1210, and these barbers eventually evolved into two groups: highly-educated surgeons who performed complex operations and lay barbers, who focused on routine hygienic services. Fortunately for the people of France, around 1400 a series of royal decrees prohibited the less qualified lay barbers from practicing all but the most basic surgical procedures, which included bleeding, cupping, leeching, and extracting teeth. In retrospect, this foreshadowed the coming centuries, in which unqualified practitioners masquerading as dentists would harm many people before adequate regulations were passed to ensure only licensed dentists were allowed to operate.
The evolution of dentistry continued in Europe, first in Germany with the publication of the Little Book for All Kinds of Diseases and Infirmities of the Teeth by Artzney Buchlein. It was the first book devoted entirely to the subject of dentistry, published in 1530. The next significant step in dentistry’s evolution would once again take place in France, with Ambrose Pare, known today as the Father of Surgery, publishing his Complete Works in 1575. Although it would be a long time until the first root canal restoration treatment, these French dentists laid the groundwork for modern dentistry to come.
Probably the greatest advance in dentistry so far took place when Pierre Fauchard published his treatise on the foundations of dentistry, The Surgeon-Dentist, in 1728. Fauchard began his surgical training in the French navy when he was just 15 years old. After working for the navy, he became a professional dentist in France, where his practice and reputation flourished. His treatise described the foundations of oral anatomy and physiology, including detailed descriptions of methods for broken teeth repair, decay removal, treating gum disease, and performing orthodontic surgery. As his scientific approach laid the groundwork for the future of dentistry, he is remembered as the Father of Modern Dentistry.
Early Dentistry in the United States
After developing and maturing in France and Europe, dentistry spread to America in 1760, when John Baker came to America from England. He was the first medically-trained dentist to set up a practice in the young country.
Paul Revere, the American revolutionary famous for warning American soldiers of the British invasion, was also a practicing dentist, trained by Baker. He also performed the first case ever recorded of post-mortem dental forensics in 1776, by identifying his fallen friend, Dr. Joseph Warren, by a dental bridge he had constructed for him.
And between 1760 and 1780, Isaac Greenwood practiced dentistry as the first native-born American dentist.
The Continued Evolution of Dentistry
As the world moved on from the American Revolution and into the 1800s, dental technology began to advance quickly. Nicolas Dubois de Chemant — another Frenchman — received the first patent for porcelain teeth in 1789. And an Italian doctor named Giuseppangelo Fonzi created porcelain replacement teeth that had retentive pins baked-in. Meanwhile, Charles Stent of England invented the impression compound, which became an important tool in the world of dental prosthetics.
With American dentists now hard at work, the evolution of dentistry wasn’t restricted to Europe anymore. Robert Arthur introduced a cohesive gold foil to dental work, for soldering procedures and making denture bases. Horace Wells introduced the practice of using anesthesia for dental patients, made with nitrous oxide. And Charles Goodyear invented the vulcanization process of manufacturing rubber, which revolutionized the materials used in dentistry, as well as many other industries.
Introduction of Dentistry and Dentist Legislation in Canada
Dentistry started to gain a foothold in Canada during the eighteenth century, as European dentists began to arrive in the new colony and settlers rapidly took up apprentice positions. At first, however, dentistry wasn’t usually performed as a sole practice, but done alongside other types of medicine. By the time the 1850s rolled around, practicing dentists were divided into four groups: doctors who primarily performed emergency dental treatments; medical practitioners who were dentists only, who had received medical school and apprenticeship training; dentists’ apprentices who had signed an indenture agreement; and the most troubling of the four, under-trained and unqualified itinerants, better known as “quacks.”
Unfortunately, there were many charlatans in Canada at the time who claimed to be serious dentistry practitioners. Amid growing concern over these self-proclaimed dental professionals, several actual dentists decided to address the issue by fighting for legislation to regulate dental practices. A group of Ontario dentists met at the Queen’s Hotel in Toronto, called together by Dr. Barnabus Day, in 1867. The meeting would ultimately result in the birth of the Ontario Dental Association. After many hours of hard work, Dr. Day and his fellow dentists developed the Act of Respecting Dentistry, which was enacted on March 4, 1868. The bill gave full power to license and regulate dentistry to the newly formed Royal College of Dental Surgeons of Ontario, or RCDSO.
The Evolution of Dental Education
While Canada was still dealing with the charlatans, the United States was continuing its own evolution of dentistry. The first dental book ever published in America, the Treatise on the Human Teeth, was written by Richard C. Skinner in 1801. The American Journal of Dental Science began publication in 1839, becoming the world’s first dental journal. The next year in 1840, the Baltimore College of Dental Surgery was founded, becoming the first school of dentistry in the entire world. In 1859, 26 dentists met in Niagara Falls in New York to form the American Dental Association. In 1867, the same year as the Ontario Dental Association’s first meeting, the Harvard University Dental School was the first institution ever to issue a Doctor of Dental Medicine Degree. Two years later in 1869, Dr. Robert Tanner Freeman graduated from Harvard University Dental School as the first African-American to earn a dental degree. And by 1870, there were a total of nine different dental schools in the United States.
Following America’s example, Canada went on to its next step for dental evolution by creating its own system of specialized education for dentists. In 1868, the RCDSO Act granted the right to the Board of Ontario Dentists to form a dental college in Toronto. The college had affiliated with the University of Toronto by 1888, and in 1889 it conferred 25 Doctor of Dental Surgery Degrees to successful graduates. In 1902, after a three-day conference with 350 dentists — more than 20% of all dentists in the entire country at the time — the Canadian Dental Association, or CDA, was established.
The Evolution of Dental Equipment and Products
Simple products that we take for granted today, such as fine-bristle toothbrushes and teeth whitening kits, were completely unheard of just two hundred years ago. But starting in the early 1800s, dental practices finally started evolving to resemble the dentist offices we frequent today. Samuel Stockton started the S. S. White Dental Manufacturing Company in 1825, which for the first time commercially manufactured porcelain teeth. It would dominate the dental supply market for the rest of the nineteenth century.
In 1832, James Snell invented the first reclining dental chair. This followed the invention of Josiah Flagg, a prominent American dentist in the late eighteenth century, who constructed the first chair ever made specifically for dental patients — although this original invention was little more than an adjustable headrest and arm extension for holding instruments, fastened to a traditional wooden Windsor chair.
Not all events to come were necessarily positive, however. Two brothers from France, known as the Crawcours, introduced an amalgam filling material to the United States in 1833. However, the brothers were unscrupulous charlatans who relied on backhanded business methods. Their influence sparked the “amalgam wars,” a long and bitter controversy among dentists over the use of amalgam fillings.
We already mentioned Charles Goodyear’s invention of vulcanization, which is an industrial process for hardening rubber. The vulcanite, which resulted as a byproduct from the process, was cheap and easy to mold to the mouth, which is why it was such an excellent base for false teeth. Even though it was rapidly adopted for use, when the molding process for vulcanite dentures was patented in 1864, dentists resented the onerous licensing fees they were forced to pay. The dental profession fought these fees for 25 years.
Fortunately, there were positive changes yet to come for the dental industry. In 1871, James B. Morrison patented the first commercially manufactured foot-treadle dental engine. It was basically a mechanical device that spun dental burns at sufficient speed to quickly and smoothly cut enamel and dentin. Being an inexpensive tool, it revolutionized the dental industry for the better.
Then in 1877, the dental chair became an object of inventive attention once again, as the first pump-type hydraulic chair was introduced. Called the Wilkerson chair, it wasn’t much different from the impressive dental chairs you see in dentist offices today.
Finally, toothpaste as we know it was introduced in 1880 with the invention of the collapsible metal tube. Up until that point, dentifrice had only been available in liquid and powder form and was usually sold in boxes, bottles, and pots after being made from scratch by local dentists. Tube toothpaste was a simple industrial miracle, allowing mass-production and mass-marketing to begin. It became the norm across the nation in just 20 years.
With the introduction of tube toothpaste, the most recognizable, closest-to-home aspect of the modern dental industry was established. With diets changing and the high demand for tobacco products, the evolution of dentistry has continued since, though it may seem to go on at a slower rate. And it will continue to go on, as dentists, scientists, and researchers develop new technologies and discover more about the human body.
Hopefully you have found this to be an inspiring and informative history of dental practice. The next time you visit your local dentist, provided by your personal insurance plan, consider taking a moment to appreciate the hundreds of years and thousands of individual lives that have contributed to the medical wonders we have at our disposal today.