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The General Dentist - Early 1960's
by Richard A. Glenner, D.D.S. - The early 1960's were years of transition for the dentist practicing general dentistry That which began to occur at this time would have occurred about ten years earlier if it wasn't for the Second World War. During this period, there were many advances made in science and technology, which helped win the war. In peacetime these would have been translated into progress to further private industry and scientifically oriented professions such as medicine and dentistry. After the war, many of the advances made were channeled into the private sector...
How it Evolved: The General Dentist - Early 1960's
The early 1960's were years of transition for the dentist practicing general dentistry That which began to occur at this time would have occurred about ten years earlier if it wasn't for the Second World War. During this period, there were many advances made in science and technology, which helped win the war. In peacetime these would have been translated into progress to further private industry and scientifically oriented professions such as medicine and dentistry. After the war, many of the advances made were channeled into the private sector.
The first sixty years of the 20th century were years for the most part, when the practice of dentistry in the United States remained basically the same. Dental students were taught by men and women who themselves were taught in the late 19th or early 20th centuries.
In the 1950's, after the war, although the older generation of instructors still set the curriculum, a new generation of dentists came on the scene with new ideas, materials and concepts. Many of these conceived in the military, resulted in the development of new techniques, medicines, instruments and equipment.
From the beginning of the 21st century to 1960, dentistry was pretty much business as usual. If one went into a dental office during this period, it would appear to resemble an office of today there being a chair, cabinet and after the 1920's an X-ray machine, as well as a dentist neatly attired. Upon closer examination, one would begin to see many differences. These we shall point out in this paper.
In the first half of this century, a dentist was a person who for the most part, was expected to perform most of the duties incumbent upon a practitioner.
But in the latter part of this century, with the advent of specialties, it was realized that one person couldn't know nor do it all. In other words, with all the changes and advances in dentistry, there were no Leonardo da Vinci's practicing dentistry. As the later half of the 20th century began, changes were occurring in all aspects of the dental profession and continue to occur to the present day that affect the way dentistry is practiced today.
A young dentist starting out in the early 1960's, first of all, found himself in a new era of sterility. While many dentists continued sterilizing their needles and various other instruments by placing them in boiling water, this new group of dentists began practice using sterile disposable dental needles, which were first introduced in 1959. Disposable needles were first used during the Second World War. Besides this, the use of an autoclave increased. Cold sterilization became commonplace. This replaced the concept that most dental instruments only had to be as clean as knives and forks. Prior to this an autoclave was basically used for surgical instruments. It was not until more than several decades later, that infection control in a dental office was again upgraded. Disinfection and sterilization after each patient increased to the level it is today. Currently, there is not a dental office in the country without an autoclave, and dentists use of gloves, eye protection, protective uniforms, and surgical masks have become the standard.
The introduction of high-speed drills in the late 1950's meant that most dentists in the early 1960's acquired one. Some dentists obtained belt driven high-speed drills and others air-driven high-speed drills, which they usually attached to their units. Older dentists, with existing offices, were inclined to use belt-driven drills, so they did not have to purchase air-compressors, especially if there was not enough room for them. On the other hand, dentists just starting out and first equipping their offices, were able to allow room for air-compressors.
High-speed drills and the water coolants that accompanied them, brought about changes in equipment, as well as office design. At first, portable suction units were either attached to the dental units or were next to them in mobile cases. Gradually, these units were placed in either a basement or another room. When high-speed drills, with their attached water coolants became available, although many dentists continued to work standing-up, many dentists were more comfortable working in a sitting position. Thus, the increased use of the dental stool. At this time, many dentists also realized that it was healthier for them to work sitting down, rather than standing up, with the patient in a reclining position. With this in mind, some dentists tipped their conventional chair backward to work, while others, primarily dentists starting out who were going into new offices, purchased the newly introduced dental chairs - some motorized conventional chairs with motorized backs, while others were true contour chairs. Still other dentists purchased contour seat adapters to convert their conventional chairs.
In the early 1960's, dentists who were working sitting down began to realize that their units and cabinets were too high and difficult to reach. Although a few lower units came on the market, it was, for the most part, several years before new delivery systems and cabinetry became available. In the meantime, dentists found it awkward to work, stretching for instruments and medications. Some dentists began to practice four-handed sit-down dentistry, but again, it was also several years before this became the standard.
In the early 1960's, new safer x-ray machines, with better radiation protection and electronic timers, were replacing the older unsafe ' machines.
In clinical dentistry, advances were also beginning to change the way the general dentist practiced. With the introduction of new impression materials, such as rubber base, indirect procedures became commonplace. As a result of this, the era of the dentist constructing gold inlays and crowns in his office laboratory was coming to an end as these procedures were taken over by commercial laboratories. Dentists could now take impressions, send them to a laboratory, have the restorations made and insert them. The complex method of using copper band impressions with compound in conjunction with plaster impressions, was no longer necessary to construct crowns and bridges. Also the technique of doing a direct wax-up in the mouth to construct a gold inlay was eliminated. More time became available to work at the chair. Dentists no longer had to stay in their offices at night and do laboratory work. Most laboratory work necessary to construct dentures had already been taken over by commercial laboratories.
As for operative dentistry - amalgams, gold inlays and silicate fillings were for the most part still the norm. When preparing amalgam, excess mercury was removed by the use of a squeeze cloth. It was some time before pre-filled amalgam capsules were generally used. The silicate fillings that were placed were known to last on average only three to four years. Although acrylic filling materials were available, it would be several years before the concept of bonding, composite filling materials and bonded composite fillings would become the standard.
Beckett (1998) does attempt to put a silver lining on the dark cloud of this tragic tale writing that Apollonia accepted her inevitable demise but chose to bring it about in a fashion that would cause her persecutors to think more deeply and because she was determined to spare them the sin of killing her. One less well-knowm version of her story is told as follows:
In the early 1960's, although general dentists had been referring to orthodontists and oral surgeons for many years, the age of specialty began to take hold. Although general dentists still practiced oral surgery, endodontia, and periodontia, as some still do today, many now referred cases to specialists in these fields. Many general dentists still continued treating children, but others, as they had for years, availed themselves of dentists who were specially trained in pediatric dentistry.
With the increased number of specialists and general dentists furthering their education, the quality of dentistry being practiced in America continued to increase.
In conclusion, we can see that the early 1960's were important years of transition. Changes were occurring in the practice of general dentistry that would continue to the present day.
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. 48, No. 2/July 2000 copyright ©2000, all rights reserved
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