Popularizing the toothbrush.

Abstract

TOOTH DECAY IN EUROPE and America is believed to have increased dramatically during the 19th century as a result of the growing general availability of refined flour and sugar in industrially processed foods. By the end of the century, surveys showed that between 90% and 95% of all children had untreated decaying teeth.1 Most children saw a dentist—if at all—only for emergency extractions. In 1910, local dentists examined 447 schoolchildren in Elmira, NY, and reported that only 22 of the children had teeth “in perfect condition.”2 The other children collectively had 2063 cavities and 617 “teeth and roots needing extraction.” Similar results were being reported from other towns and cities. Between 1910 and 1916, philanthropists built and endowed the first free and reduced-fee clinics for children and established the first schools for dental hygienists in Rochester, NY, Bridgeport, Conn, and Boston, Mass. By the 1920s, almost all American cities had free or reduced-fee clinics, and by 1950, such clinics were providing almost half of all oral health services delivered to children. Members of local dental associations staffed some clinics on a volunteer basis together with young dental school graduates seeking clinical experience. During the Great Depression, federal funds helped local and state governments to hire unemployed dentists. The first dental hygienists entered the schools to clean children’s teeth and teach them how to use toothbrushes.3 Some cities provided each child with a free toothbrush and tooth powder, while others sold them at 2 or 3 cents each. As in England, where toothbrushes were provided to all servicemen during World War I, this helped establish and extend the use of the toothbrush in working-class families.4 American schools also adopted the “toothbrush clubs” and “toothbrush drills” begun in England.5 This image, from a New York school, shows children demonstrating their newly acquired skills of toothbrushing.