Although modern dentistry dates back only to the 1700s, archeologists have provided evidence of dental treatment from thousands of years ago. The ancient Egyptians treated toothache and swollen gums in the 16th century B.C. The Greek physician Aesculapius was the first recorded supporter of tooth extraction around 1250 B.C., and Hippocrates wrote about dental diseases in the fifth century B.C. The Etruscan civilization used crowns and bridgework in the eighth century B.C. Some people in the Roman Empire wore false teeth, and the Greek physician Galen also wrote about teeth in the second century. From the ninth to 12th centuries, Arabic scholars who wrote about dental disease and treatment included Abulcasis and Avicenna. Arabians made toothbrushes by pounding the end of a stick. From the Middle Ages up to the early 18th century in Western Europe, teeth were extracted by barber-surgeons.
A French dentist, Pierre Fauchard, is called the father of modern dentistry. In 1728, he published a book, Le Chirurgien Dentiste (The Surgeon Dentist), that emphasized the importance of healthy teeth. He developed the first orthodontic treatment methods and devised a more advanced technique for making dentures.
Throughout the 1700s in America, dentists mainly pulled diseased teeth and provided dentures. Revolutionary War hero Paul Revere, a metalworker by trade, made dentures from gold and ivory. The first president of the United States, George Washington, was often said to have had wooden teeth; in fact, his denture teeth were made either of ivory or carved cow's teeth. English surgeon John Baker was the first dentist to practice in America in 1760, and Isaac Greenwood was the first dentist born in America. Greenwood's son, John, was the dentist that created Washington's false teeth.
While dentures remained very expensive for 150 years after Washington, the invention of vulcanized rubber in 1851 meant many more people could afford dentures. Porcelain teeth were attached to rubber that had been molded on a model of the mouth. In the 20th century, however, acrylic plastics replaced vulcanized rubber and porcelain in dentures.
The world's first dental school, the Baltimore College of Dental Surgery, was established in 1840 and the Harvard University Dental School was founded in 1867. It was the first dental school associated with a university. Currently, more than 1,400 dental and dental-related programs are accredited by the Commission on Dental Accreditation, including 67 pre-doctoral (DDS/DMD) programs.
The use of anesthesia during surgery was developed in part by two American dentists. In 1844, Horace Wells pioneered the use of nitrous oxide, or laughing gas. Dentists today still use nitrous oxide to relieve pain and anxiety. William Morton was the first to use ether as an anesthetic gas. Local anesthetic injections of novocaine were first recommended in 1906. Since then, dental researchers have continued to investigate other anesthetic methods to allow pain-free dental treatment. Not only are numerous local anesthetics available today, but some dentists also use a method that involves placing electrodes on the skin and using electrical current to prevent pain. For extensive dental procedures or for patients who are extremely anxious, dentists may use sedative medications or general anesthesia.
In the 1890s, an American dentist, G. V. Black, made significant changes in how dentistry was practiced. In addition to creating a foot engine to power the dental drill, he devised a cavity classification system that remains in use today. He also suggested that tooth decay and gum disease were infectious diseases caused by bacteria, decades before there was any scientific proof of his theory.
In 1895, Wilhelm Roentgen discovered X-rays. By the next year, X-ray images were being used in dentistry. Dentists use X-ray films, or radiographs, to detect tooth decay and other diseases that affect the teeth and jawbones.
The high-speed, air-turbine, dental drill became available in 1957. The high-speed drill allows dentists to remove decayed tooth substance much more rapidly and with much greater comfort for the patient.
The dental profession has been the driving force behind fluoridation of water supplies in the past 60 years. Widespread fluoridation has prevented tooth decay in children and adults. Because tooth decay has become less common, people are now retaining more teeth into old age.
Recent advances in technology and medical care are reflected in dental care. Bone grafting and bone regeneration use materials such as Gore-Tex. New medication technology allows dentists to place antibiotics between the gums and teeth to treat periodontal disease. Lasers are currently used for gum surgery; in the future, dentists may use lasers to drill cavities or make tooth surfaces more resistant to decay. The technology of computer-aided design/computer-aided manufacturing, or CAD-CAM, is also used in dentistry to make ceramic tooth inlays. Dental researchers continue to fine-tune filling materials. Although many tooth-colored filling materials are available now, they are generally not as durable as silver amalgam fillings.
Many dental schools are striving to educate dentists to become physicians of oral health. Today's dentist must be well versed in health issues that affect the body outside of the oral cavity. Patients with certain heart conditions, cancer, AIDS, or diabetes require special care from their dentists. People who take prescription medications may have oral side effects, such as dry mouth, and some medications affect dental treatment in other ways. Medical emergencies may occur in the dental office, so dentists and their staff must be ready to deal with them. Many people are nervous about receiving dental treatment, no matter how painless; thus, dentists also need to know psychology. In addition to examining the teeth and gums, dentists check their patients for signs of cancer in the mouth or head and neck. Because of the ill effects of tobacco on oral health, some dentists help their patients stop smoking or chewing tobacco.
A report published by the Dental Trade Alliance predicts that by 2025, the traditional model of dentist-owned practices may be replaced by corporate entities or large-scale practices that can offer a wider range of services and more flexible scheduling.