Dentistry is a surprisingly old field of health care: infected teeth were first cleaned with flint tools 14,000 years ago; cavities were filled with beeswax in 4500 BC; dental prosthetics were found in remains of ancient Egyptians, Greeks and Romans; Etruscans produced appliances and bridgework in 700 BC; and the Roman writer Cornelius Celsus (25 BC to 50 AD) described managing diseases of the oral cavity with narcotics and astringents.
The French surgeon Pierre Fauchard (1678-1761) is widely regarded as the father of modern dentistry. His Le Chirurgien Dentiste, published in 1728 describes oral anatomy and pathology, orthodontics, procedures for removing decay, restoring teeth, replacing missing teeth, and managing periodontal disease. Fauchard linked sugar consumption to dental caries, introduced fillings for carious teeth and adapted tools from barbers and watchmakers to perform oral surgery. Dr. John Harris opened the world’s first dental school in Ohio in the early 1800s. Less than a century later, dentistry joined medicine as a respected field of health care.
Dentistry and a winning smile
But dentists haven’t had an easy row to hoe. The term dental phobia got 265,000 hits on 17.06.2017 compared to spider phobia’s 87,000*. It is a real condition which affects between 9% and 20% of the general population. Many of those with dental phobia only go to a dentist when driven to by extreme pain, creating a vicious cycle that reinforces the phobia. We were nervously amused by the anti-dentite episode in the American sitcom Seinfeld. And many of us see Orin Scrivello, DDS, the sadistic dentist of Little Shop of Horrors every time we lie down in the chair and hear the chilling sound of drilling in another room, knowing that it will soon be our turn, unless by some miracle, they didn’t find any cavities…this time.
*The reader will note that the proper term for spider phobia is arachnophobia, which got 1.5 million hits. It is impossible to separate out the same-named movie from the 1.5 million, which is why I compared spider phobia to dental phobia.
A large part of dental fear is illogical and was addressed with the introduction and universal adoption of high-speed (400,000+ rpm) drills in the 1960s and 1970s, long before many of us were either born or first went to a dentist. The last few decades have seen a range of innovations, not the least of which is the development of dental sealants. Also known as fissure sealants, these resin-based or glass ionomer formulations, when applied to the teeth after the adult molars come through can completely prevent caries.* Fewer cavities will go a long way towards minimizing the anxiety that future generations might have had when visiting a dentist. This, in turn, will increase the likelihood of them going for regular checkups and transition the field of dentistry from one of management to one of prevention.
*As an aside, my youngest son who just turned 27 and had his teeth sealed as a child has not had a single cavity and, not surprisingly, has no fear of dentists.
For better or worse, dentistry plays a central role in human psychology: the value of a beautiful smile in bolstering self-esteem cannot be understated. Gone are the days when an Austin Powers (image above) had to live with crooked, cracked, yellowed, or chipped teeth. Cosmetic dentistry offers a range of options including bleaches, polishes and veneers, which often bring back a confident smile. Where trauma or too many fillings over time resulted in the loss of one or more teeth, dental implants (image below) offer a far better option for most than dentures.