In this blog article, we look at modern dental history of the 19th century to document the practices of that era and where they fall in the greater evolution of dentistry as a practice and profession. Thus far, in our dedicated dental history blog series, we’ve considered the state and developments of ancient dentistry up through dentistry in the Age of Enlightenment in the 17th and 18th centuries. In this latter article, we also backtrack to give a brief overview of some of the influential contributions of dentistry in the Middle Ages to help contextualize the Age of Enlightenment as a turning point in the growth of dentistry toward a more modernized approach. In this blog, we’re continuing to scrutinize the development of modern dentistry by focusing specifically on how dentistry was applied in the 19th century. But what is “modern dentistry”?
Defining “Modern Dentistry”
Our definition of “modern dentistry” considers dentistry of the 18th century forward, following the initiation of the Age of Enlightenment that intrinsically tied the practices of dental healthcare to science and logic. In the centuries that followed, dentistry grew into the recognizable field and practice we know it to be today--driven by science and innovation and organized within a recognized medical specialty. It is in this latter distinction that 19th-century dentistry made one of its most lasting impacts with the emergence of modern dental schools. The century had its fair share of notable figures, technological advancements, and theoretical growth, too, starting in 1801 with the publication of Richard C. Skinner’s 26-page pamphlet, A Treatise on the Human Teeth, which stands as the first dental publication in the US.
Dentistry as a Medical Specialization and Formal Education
The 19th century saw the emergence of dentistry as a distinct profession, separate from other medical fields and with its own requisite knowledge needed to master it. This shift was marked by the establishment of dental schools and professional organizations in the US in the mid-1800s. The US, by that time, had become a global leader in dental innovation as evidenced by its formation of key dental institutions, including dental journals, schools, and professional organizations.
19th-Century Dentistry and Education
The American Journal of Dental Science became the first American dental journal when it began publishing in 1839. The following year, respected dental practitioners Horace Hayden and Chapin Harris founded the first American dental school in Maryland’s Baltimore College of Dental Surgery, earning the duo the moniker the “Fathers of Dental Education.” The school offered formal education and training in dentistry and introduced the Doctor of Dental Surgery (DDS) degree, one of two base-level dental degrees that still exist to this day. The Harvard University Dental School became the first university-affiliated dental institution when it was founded in 1867. The dental degree awarded at Harvard is the Dentariae Medicinae Doctorae (DMD), a DDS equivalent degree with a Latin name, per the university’s tradition. These institutions and others that followed played a crucial role in professionalizing the field, establishing practice standards and promoting the importance of dental health.
The First American Dental Societies
Also in 1840, the American Society of Dental Surgeons was formed in New York City. While an important initial step toward standardizing and legitimizing the fledgling dental specialty, the organization was short-lived. It dissolved by 1856, opening the door for the American Dental Association (ADA), which was founded in 1859. The ADA, which remains a central institution of modern dentistry further cemented dentistry as a recognized profession. The ADA has played a pivotal role in setting educational standards and advancing dental research. Its formation was a significant milestone in the movement towards regulated and scientific dental practices.
Technological Advancements of 19th-Century Dentistry
Technological inventions and advancements of the 19th century were instrumental in shaping modern dentistry. The development of new materials and tools greatly improved the precision and effectiveness of dental treatments.
Advancements in Dental Materials
Porcelain
The 19th century saw significant advancements in restorative dental materials, such as the expanded application of porcelain for replacement teeth. Porcelain teeth were used prior to the 19th century, specifically in 18th-century France. However, their use significantly expanded in the US after Philadelphia-based dentist Samuel Stockton White began commercially manufacturing porcelain teeth through his S.S. White Dental Manufacturing Company in the mid-1840s. The success of porcelain teeth was ultimately due to their combination of durability and natural appearance.
Gold and Amalgam
In addition to porcelain, gold became one of the defining dental materials of the day. Gold was used at the time to make gold dentures, and gold foil became an increasingly popular dental filling material throughout the century. As has been noted in past blog articles, gold foil has been used for teeth fillings for centuries prior in China and elsewhere. Its continued success in 19th-century America was due to its malleability, durability, and effectiveness. However, gold was expensive and less accessible to the general population, making it a less-than-ideal material for the masses. This led to the development of alternative materials, such as amalgam, which was introduced in the early 1800s. Amalgam, a blend of mercury with silver, tin, and other metals, was both durable and cost-effective, making it a popular choice for fillings. Despite initial resistance due to concerns over mercury toxicity, amalgam eventually became widely accepted in dental practice.
Vulcanized Rubber
Lastly, Vulcanized rubber played a significant role in 19th-century dentistry. An American chemist by the name of Charles Goodyear invented the vulcanization process for hardening rubber in 1839. The process rendered low-cost Vulcanite, which was used by American dentists as custom-molded bases for dentures.
An Impactful Discovery: Dental Anaesthesia
19th-century dentistry also saw numerous advancements in dental tools, including a couple of dental engines, which afforded dental tools like drills the power necessary to cut through the various layers of the tooth; the rubber dental dam, used to isolate the tooth from the oral cavity; the first pump-type hydraulic dental chair; and the collapsible metal toothpaste tube. However, the most impactful new tool to 19th-century dentistry has to be the discovery of anesthesia.
The introduction of anesthesia was another landmark development. Prior to the 19th century, dental procedures were performed with minimal pain management, leading to significant patient discomfort. The advent of nitrous oxide (laughing gas) and ether anesthesia in the mid-19th century revolutionized dental care by allowing more complex procedures to be performed with reduced pain and stress. This development not only improved the patient experience but also expanded the range of treatments that could be safely carried out.
Dental History: On to the 20th Century
The 19th century set the stage for many of the dental practices and principles that continue to be relevant today. The establishment of dental schools and professional organizations helped to formalize and standardize dental education and practices. Technological innovations, such as the development and expansion of dental materials and the discovery of anesthesia, revolutionized the field, making dental procedures more comfortable and effective. As a result, the 19th century stands as a pivotal period in the history of dentistry, marked by significant progress and transformation. Moving forward, we will set our eyes next on the dental advancements of the 20th century. Keep checking in on the AlgerBlog to continue your education through the modernizing years of dental history.