The Early Days of Dentistry

American culture has a healthy appreciation for doctors and the life saving knowledge they possess thanks to shows like ER, Grey’s Anatomy, and even House.  Perhaps it’s because an emergency root canal makes for less than compelling drama, but dentists don’t receive the same kind of appreciation patients generally reserve for those with an M.D. after their name.

When asked, most people will give you a long list of thing they’d rather do than visit the dentist. The thought of needles, drills, and someone else’s hand in their mouth make many people neglect their teeth in ways they shouldn’t, unless they hope to have the smile of a professional hockey player one day.

Considering how far medicine has come in just the last 150 years (a lobotomy was still an acceptable means of treatment for schizophrenia until the late 1960s for example), imagine what visiting the dentist was like during the early days of the profession.

During the Middle Ages, monks and barbers (yes, the same kind that still cut hair today) acted as dentists to those in enough pain they didn’t mind becoming afternoon entertainment. It wasn’t uncommon for tooth extractions to be held in the middle of the town square, on a stage, surrounded by jugglers and members of the community standing around gawking.

By the early 19th century, dentistry had begun to resemble the profession we know today. In U.S., the dental profession first began to organize itself in the mid-19th century, when the American Dental Convention and the American Dental Association, the country’s two leading dental organizations, were formed in 1855 and 1859, respectively. Since the concept of preventative dentistry (brushing and flossing regularly) didn’t become part of mainstay dentistry until after World War II, the job of the 19th century dentist was one of pulling teeth and drilling and filling cavities.

Finding the right material to use in early dental fillings could easily be described as a process of trial and error. Lead was once considered an acceptable material to use as a dental filling because the metal was soft, ductile, and easy to use. Fortunately, the metal proved too soft to stand up to the rigors of daily chewing, and was quickly abandoned for a stronger, but equally as malleable material, gold.

A popular, but expensive choice, gold was installed by repeatedly ramming small amounts into the cavity with a sharp instrument until the cavity was full. Patients who could not afford gold were given tin fillings instead. Unlike gold, tin was not as effective a material for use in fillings, and could easily oxidize in the mouth, turn black and cause tooth decay.

Other materials that were tried, but found unsuitable for dental use, included platinum (too hard), silver (oxidized too quickly), aluminum (not malleable enough), and even asbestos, which was used to fill the gap between a filling and a sensitive tooth. Dentists first began using amalgam fillings, which closely resemble filling used today, during the Civil War, and have made steady progress in dental technology ever since.

So the next time you start dreading a trip to the dentist, just remember that it could be worse, and that at least there won’t be anyone juggling nearby.

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