The development of dentistry, 1000–2000

Abstract

Plerre Baron trained in deinsity in Paris, France, and also has a degree in medical history. He divides his time between dental practice and his personal historical research. For several years he has researched the history of density. Since 1996 he has been vice president of the the Société Française of Histoire de l'Art Dentaire. Around the year 1000, Abulqasis, an Arabic surgeon in Córdoba, dedicated many pages of his vast Al tasrif, a medical encyclopaedia in 30 volumes, The development of to dentistry. He described tooth extraction and tartar removal methods, he emphasised the role of oral hygiene and recommended the use of tooth-cleaning rods and powders. Older copies of Abulqasis' treatise contain many drawings of devices for removing dental tartar. This approach is not far removed from the recommendations of today's parodontology. A few years later, Constantine the African, born in Carthage, went to the medical school in Salerno where there were some Arabic manuscripts. These works, developed from Greek sources, in turn inspired by ancient Egyptian writings, were translated into Latin during the middle ages and contributed to the making of European medical knowledge. Europe witnessed the establishment of dentistry as a self-standing medical science in the 18th century. In the seven centuries between 1000 and the 1700s, progress was not very impressive. During the 16th century, anatomical investigation flourished and the first books on dentistry were published: the Artney Büchlein in Leipzig in 1530 and Bartolomeo Eustachius' Libellus de Dentibus in Italy in 1563. The surgical treatises of Ambroise Paré, Urbain Hémard, or Walter Hermann Ryff testify that dentistry did exist, albeit still in rudimentary form. Charles Allen's The operator for the teeth, published in 1685, is the first book on dentistry written in English. But dentistry's solid foundations were laid in 1728 with Pierre Fauchard's Le chirurgien dentiste ou traité des dents. This hugely successful book was reprinted with additions in 1746 and 1786. During the 18th century, France's golden age of dentistry, about 70 different books about dental care were published in France alone. Nicolas Dubois de Chémant was the pioneer of the use of porcelain for dentures. Despite the persistence of humoral theories in medical thought, the 18th century gave birth to today's dentistry, which rests upon major principles established at the time. But thinking probably came before doing. Many procedures and prostheses were described, but were not actually used at that time. Archaelogical remains from those times are scarce. At any rate, the 18th century initiated a wave of progress that was most spectacular during the 19th century thanks to a more rigorous organisation of the professiota. In 1839, the first school of dentistry, the first journal devoted to dentistry, and the first scientific dental association were founded in Baltimore, USA. In Europe, schools and faculties, journals and societies appeared everywhere. A degree became mandatory to practise dentistry almost everywhere in the world. Technical progress was quick. Fauchard cleaned caries by means of a bow drill, dentists later used milling cutters–at first manual ones, later operated by clockwork devices–until 1871 when Morisson developed his foot lathe. Williamson's electric lathe appeared in 1890. After the first dental chair was depicted in Maury's book in 1828, dental chairs were continuously improved: crank-operated in 1860, foot-lever operated in 1877. New procedures followed: fillings with amalgams, root-canal therapy, bridges, crowns, post-crowns, and mobile dental prostheses. The first radiographic machines were introduced at the turn of the century. Scientific progress went hand in hand with technical advances. Anaesthesia, pioneered by Wells in 1844, was increasingly used. With the publication in Philadelphia in 1890 of Micro-organisms of the human mouth W D Miller swept away all ancient theories about dental caries and introduced the chemical-bacteriological theory, still valid today. During the 20th century, purely dental scientific research sought to elucidate the mechanisms of destruction of dental hard tissues and of their supporting tissues and so allowed advances in the care and comfort of patients. All the ideas proposed during preceding centuries can now finally be put into practice: implants, glueing, or highly sophisticated orthodonty. Use of laser beams and of imaging during procedures, or of computer-assisted design of prosthetic pieces are major advances at the end of this century that will without doubt be further developed in the future.