The second half of the 20th century witnessed remarkable advancements in dentistry. From 1950 to 2000, the field of oral health saw significant innovations in technology, improved understanding of dental hygiene, and a focus on preventive care. This period marked the rise of new dental materials, procedures, and public health initiatives that reshaped how dental care was practiced, perceived, and delivered. In this article, we are continuing the work already started on the AlgerBlog, tracing the history of dentistry through the ages. In our last issue, we covered the first half of the 20th century. In this installment, we will explore the key developments of the second half of the century that contributed to the growth of modern dentistry.
Modern Dentistry in the Second Half of the 20th Century
Modern dentistry in the second half of the 20th century built on the post-war emphasis on preventive dental care and developing dental techniques. Earlier public education about oral health in the 1930s and 1940s helped make at-home preventative dental care, such as regular brushing, commonplace by mid-century. Similarly, the fluoridated public water trials that began in the 1940s gave way to the widespread adoption of fluoride in public water supplies by the following decade. The second half of the 20th century also saw developments in new technologies and dental techniques, such as fluoride toothpaste, advancements in dental materials and restorative techniques, refinements in dental X-rays and other imaging, the development of new light technologies, and the rise of cosmetic dentistry.
Fluoride toothpaste
Fluoride toothpaste started being marketed to the public in the 1950s. By that time, fluoride’s reputation for preventing tooth carries was well established in scientific circles, and the public was growing increasingly aware of its benefits to oral health. Cincinnati-based Procter and Gamble bought in big on this promise, committing more than $3 million to a 14-year Indiana University research project studying the preventative effects of stannous fluoride on tooth decay. By 1952, the company had developed a “cavity-preventing” fluoride-based toothpaste prototype, which they were using in clinical trials on 1500 children and 400 adults. The results of these trials showed that half of the participants had significant decreases in dental caries. By 1956, Procter and Gamble started selling their fluoride toothpaste, which they named Crest, promoting the cavity-fighting product with an iconic ad campaign that featured Norman Rockwell paintings of happy children and the caption: “Look, Mom! No Cavities!” Crest later received the first Seal of Acceptance from the American Dental Association.
Advancements in Restorative Dentistry and Dental Materials
Dental Materials
The 1950s also saw significant advancements in dental materials, which helped shape modern approaches to restorative dentistry. One of the most notable developments in dental materials was the widespread use of dental amalgam for fillings. Although amalgam, a mixture of mercury, silver, tin, and copper, had been used for several decades, it became the standard filling material in the 1950s due to its strength, durability, and cost-effectiveness. Despite initial concerns about the potential health risks associated with mercury, amalgam fillings remained the go-to solution for treating cavities well into the 21st century.
One big drawback of amalgam fillings, beyond the concerns over their mercury content, was their unsightly aesthetics. Amalgam fillings are metallic and thus notably contrast with the natural white shades of teeth. This issue motivated the rise of composite resins (tooth-colored fillings) in the 1960s and 1970s. Composite resin was introduced in the 1960s by Rafael Bowen DDS, who developed and, in 1962, patented Bis-GMA, a methacrylate monomer used in most modern composite resin restorative materials. Early composites were limited in their application due to their lack of durability and aesthetics, but they represented an important step toward more aesthetic restorative materials.
Dental Implants
The 1970s also witnessed the popularization of dental implants as a solution for replacing missing teeth. While the concept of dental implants can be traced back to the Mayan’s use of shell pieces as tooth replacements as far back as 600 AD, the breakthrough that gave rise to modern approaches to dental implants occurred in the 1960s with a Swedish orthopedic surgeon named Per-Ingvar Branemark. Dr. Branemark was experimenting with titanium when he discovered that bone fused with the metal material in a process known as “osseointegration.” He applied this discovery to a dental implant, introducing the first successfully fused modern dental implant in a human subject a few years later. The Swedish National Board of Health and Welfare approved dental implants as a viable restorative technology in the 1970s.
The Expansion of Dental X-rays and Other Imaging
Dental X-rays, which were first introduced in the late 1800s, continued to rise in popularity through the 1900s. By the second half of the 20th century, X-rays had become commonplace tools for dentists and orthodontists. By the 1990s, traditional film-based X-rays were being replaced by digital radiography, which allowed for quicker and more accurate imaging. Digital X-rays reduced patients' exposure to radiation and made it easier for dentists to store and share images electronically. This technology also paved the way for more advanced diagnostic tools, such as 3D imaging, which allowed for more precise treatment planning.
New Light Technologies
The second half of the 20th century also saw the rise of a couple of key light-based dental and orthodontic tools, including the AlgerLight and laser dentistry.
The AlgerLight
The AlgerLight was the brainchild of David Alger, D.D.S., M.S.D., who conceived of the dental light during his residency in the 1960s. Recognizing a need for more operatory space and freedom of movement, Dr. Alger developed a prototype of the innovative ceiling-mounted light, which uses converging light beams to provide dentists and orthodontists with the focused light needed to perform procedures without sacrificing floor space. By the 1970s, a refined model of the AlgerLight was enjoying increasing sales, and over the decades, the AlgerLight added design features, including a footswitch and wireless RF controller. By the 1990s, the AlgerLight was becoming the standard of excellence for dentists and orthodontists who wanted a ceiling-mounted operating light.
Laser Dentistry
The introduction and increased use of lasers in dentistry marked another big breakthrough in light-based dental technology. The first laser was invented and operated by Theodore Maiman on 16 May 1960 at the Hughes Research Laboratory in California. Maiman exposed an extracted tooth to his laser that same year, but it would be decades before lasers started to be used effectively as dental tools. The first dental lasers came on the market in the late 1980s, and laser dentistry became a popularizing notion in the 1990s. Laser dentistry uses focused light to treat various dental conditions. They were initially used for soft tissue surgeries, such as the removal of gum tissue, and eventually expanded applications to include hard tissue procedures, such as cavity preparation. Laser technology offers less pain, faster healing times, and more precise results compared to traditional methods.
The Rise of Cosmetic Dentistry
The 1980s saw the mainstream rise of cosmetic dentistry. Breakthroughs in dental procedures and new materials from previous decades, paired with patients’ increasing interest in aesthetic options, culminated in a cosmetic dentistry boom. The increasing interest in cosmetic dentistry is reflected in the formation of the American Academy of Cosmetic Dentistry (AACD), which was established in December 1984 by founder Dr. Jack Kammer and co-founder Dr. Jeff Morley. The AACD is a professional organization “devoted to the art and science of cosmetic dentistry.” While not listed by the American Dental Association as one of their nine dental specialties, cosmetic dentistry has emerged as a professional focus for modern dentists, and cosmetic dental services are actively sought after by patients.
Popular Cosmetic Dentistry Services: Teeth Whitening
One of the most significant developments in cosmetic dentistry came with the advent of professional teeth whitening services in the 1980s. Previously, teeth whitening had been limited to over-the-counter products with varying degrees of effectiveness. However, in the 1980s, dental professionals began offering more advanced whitening treatments using stronger bleaching agents, which provided quicker and more effective results. One such product, peroxide, had been used as an oral antiseptic gel for decades by the time it started being used as a whitening agent by dentists starting in the 1980s.
Popular Cosmetic Dentistry Services: Porcelain Veneers
Another popular development was the use of porcelain veneers, thin shells of porcelain that are bonded to the front surface of the teeth to correct imperfections like chips, cracks, and discoloration. Dental veneers were first introduced by California dentist Dr. Charles Pincus in 1928. In 1959, Dr. Michael Buonocore had a breakthrough in veneer application techniques when he pioneered the practice of “etching,” the use of a weak acid to adhere veneers to tooth enamel. This process was further refined in 1982 by researchers Simonsen and Calamia, who strengthened the veneer-tooth bond by adding an adhesive resin to the etching process. Porcelain veneers quickly became a popular choice for those seeking to enhance their smiles, especially among celebrities and high-profile individuals.
Looking to the Future
From the 1950s to 2000, dentistry underwent a profound transformation driven by technological innovations, new materials, and a greater focus on prevention and cosmetic dentistry. The field moved away from simple "fix-it" solutions toward a more comprehensive model of care that incorporates prevention, restoration, and enhancement.
In the next AlgerBlog, we will conclude our history of dentistry with a look at modern dentistry of the 21st century. Visit algerinc.com to continue your education of dental history, learn about other interesting topics, and--if you’re a practicing dentist or orthodontist--read about Alger Inc.’s prized piece of dental technology: the AlgerLight with LED.