HOW IT EVOLVED: Connections Dentistry and Medicine
By Richard A. Glenner, D.D.S.
Ever since the early days of the dental profession in the United States, practicing dentists have recognized the relationship between dentistry and medicine.
In Colonial times, physicians lectured to medical students on dentistry. These men who had a knowledge of anatomy, physiology, and other subjects related to the practice of medicine, were the primary educators of dental practitioners in this country. This was in contrast to the apprenticeship training of many dentists. Dentistry had not yet reached the status of a profession. For the most part, it was considered a part of medicine, and as a result physicians extracted teeth and treated other dental problems.
Throughout the 18th century, most dentistry was performed by itinerants. However, late in that century, there were dentists living and practicing in large cities. According to the noted dental historian, Milton B. Asbell, "the fallacy that the dental art was founded upon the practice of barbers, bloodletters and mechanics should be laid to rest. Unfortunately this baseless notion persists, even today, a disservice to public and profession alike, obscuring the considerable contributions of competent and dedicated men with professional qualifications. The Colonial era was the germinal period of modern dentistry. The emergence of the surgeon ushered in a new day of professional health care. These were an elite group, whose contributions resulted in the development of several currents of dental practice, initially as a branch of medicine, later as an autonomous health care profession with advanced technical and social commitments."1
Most of the early books published on dentistry in this country were written by men with medical backgrounds. Examples of this are A Treatise on the Management of the Teeth, by Benjamin James, M.M.S.S. (member Massachusetts Society of Surgeons), 1814, and The Family Dentist, by Josiah E Flagg, M.D., M.M.S.S., 1822.
In 1829, eleven years before the first dental college in the world opened in Baltimore, Samuel Sheldon Fitch, M.D., Surgeon Dentist, first published his book, A Syst of Dental Surgery, in Philadelphia (second edition, 1835).2 This is considered the best text of its time in the United States a complete systematic American treatise on the practice of dentistry. It is believed to be a compilation of everything of importance then known and contains an impressive bibliography The author, a graduate of Jefferson Medical College of Philadelphia, was proficient in foreign languages, enabling him to quote extensively from the works of foreign authors. Fitch devotes a chapter to diseases produced by diseased teeth. He discusses Tic Douloureux, pain in the ear, inflammation of the eyes, nervous disorders, epilepsy, hysteria, headaches, etc .3,4
Although dentistry took a new direction in Baltimore in 1840, with the
opening of the first college in the world devoted exclusively to dentistry,
this change was gradual. The dental profession no longer wanted to be
a branch of medicine, as was ophthalmology It was no longer necessary
to go to
medical school to study dentistry Medical subjects, such as anatomy and physiology were taught in dental schools, along with the mechanical aspects of dentistry. With the opening of new dental schools across the country, the profession gradually became an independent entity As a result of the Gies Report in 1926, proprietary dental schools were eliminated and dental education in the United States came under the auspices of universities.
Dentistry's many contributions to medicine have been well documented by another noted dental historian, Malvin E. Ring. 5 According to Ring, the discovery of anesthesia by the dentist, Horace Wells, of Hartford, Connecticut in 1845, has been a great boon to mankind by helping alleviate human suffering. Other contributions noted by Ring were the use of metals in surgery, the use of the high speed turbine drill in surgery, and the use of dental techniques to fabricate maxillofacial prosthetics to reconstruct the faces of cancer victims and in plastic surgery.
Over the years, both the medical and dental professions have encouraged research the result of which has been the development and use of new antibiotics, anesthetics, and medicines.
Today, there is much in the dental literature describing in great detail the relationship between periodontitis and heart disease. The public is being made more aware of the dangers of poor oral hygiene and lack of dental care This as a result of much research being done by the dental profession.
Another relationship between the healing arts can be observed clinically when making a combination cast metal acrylic partial denture for a patient, and finding on the health record that the patient has an artificial hip. It should be realized that the same materials were used in the construction of both. In fact, these particular plastics and metals were first used in dentistry Therefore, we can see that the same materials can be used to construct appliances that can help a person eat better and walk better. Implants are another entity utilized clinically by both the medical and dental professions.
The medical profession has made contributions to dentistry and the dental
profession has made contributions to medicine. This tradition has continued
to the present time and the two will continue to be interconnected.
- Asbell, Milton B. Dentistry, A Historical Perspective, Pennsylvania, Dorrnce & Co., 1988, p. 95.
- Fitch, Samuel S. A System of Dental Surgery, Philadelphia, Carey, Lea & Blanchard, 1835, pgs. 279-322.
- Lufkin, Arthur W, A History of Dentistry, Philadelphia, Lea & Febiger, 1938, p. 175.
- Asbell, Milton B., Dentistry A Historical Perspective, Pennsylvania, Dorrance & Co., 1988, p. 125.
- Ring, Malvin E., Dentistry's Contributions to Medicine, J Maryland S Dent Assoc, Vol. 34, No. 4, Winter 1991.
DR. GLENNER is past Historian of the American Academy of the History of Dentistry. Reprint
requests should be directed to the author at 3414 W. Peterson Ave., Chicago, IL 60659.
Article orginally published in the Journal of the History of Dentistry
Vol. 49, No. 2/July 2001 copyright ©2001, all rights reserved