Ancient Dentistry in Egypt

• Dentistry is one of the oldest professions, with roots in ancient pre-history, focused on problems with teeth and ways to alleviate them
• 7,000 B.C. marks dentistry as one of the oldest medical professions

Ancient Egyptians

• The oldest civilization showing evidence of ancient dentistry was in Egypt (2900BC)
• Egyptian medicine was subdivided so physicians only healed one disease
• Dental physicians existed since the early third millennium
• Lioness Sekhmet was believed to bring epidemics/diseases, and was the patroness deity of doctors and goddess of war
• Amon, Horus, and Duaw were gods for eye disease treatment
• Hathor and Taurt were goddesses of childbirth
• Imhotep was Chief vizier to Djoser, an architect/astrologist, founder of Medicine in Egypt, and a god of Medicine
• Hesy-Ra was the earliest known dentist physician and "Chief of Dentists and Doctors” who was also named“Chief of the Tooters”
• Hesy-Ra was the greatest physician who treat teeth; he was the first to recognise periodontal disease
• Hesy-Ra drilled holes in teeth to help drain the infection and he performed advanced dental techniques like root canal therapy
• Hesy-Ra recognized the symptom of Diabetes
• Ancient papyri contain prescriptions to dental diseases, such as pyorrhea, loose teeth, dental caries and abscesses
• The Ebers Papyrus is considered the most important medical textbook in ancient times, containing over 700 medical remedies
• The Edwin Smith Papyrus, the oldest surgical document, discussed facial trauma, fractures, treatment of abscesses, and suturing of lip wounds
• Tooth worm was believed to be a cause of dental pain

Other Ancient Civilizations

• Sumerian text and writings of Homer include content on dentistry, also found in ancient India, Egypt, Japan, and China
• Surgeon Guy de Chauliac promoted dentistry in 300 AD

Dental Diseases and Common Problems

• Common dental issues included tooth wear, apical abscesses, gum disease/periodontal disease, and dental caries
• Attrition's cause is a coarse diet and was a common dental disease in ancient Egypt
• Dental caries were more common among the elite than the lower class

Ancient Dental Management

• Dental management included utilization of drugs such as mouth washes, ancient Egyptian toothpaste, tooth whitening, and tooth brushing
• Bow & flint-tipped drills were used to drill holes in ancient Egyptian teeth

Ancient Dental Remedies

• Loose teeth were fixed with crushed seeds, ochre, and honey
• Septic teeth were treated with cumin, colocynth & frankincense
• Toothaches were treated with ground vegetable & mineral substance with honey
• Healthy teeth could be achieved using Mandrake and species of Potentilla, chewed and spat out
• Inflammation of the gums (stomatitis) was treated with homely dates and beans mixed with milk, chewed and spat out, and repeated for nine days

Ancient Greek Dentistry

• Hippocrates, the father of medicine, discussed eruption and function of teeth and wrote on radical methods in treating tooth woes
• Hippocrates treatments included tooth extraction, tooth ointment, and oral tissue cauterization
• Aristotle described tooth development, tooth decay, and gum infection and used forceps and wires for removal
• Aristotle stated that men had 32 teeth, women had 30, and coined the term "wisdom teeth"
• Claudius Galen/Galenos first deduced that teeth are made of bone with nerves

Oral Hygiene Pioneers

• Diocle of Carystus, a philosopher & pioneer in Greek medicine, recommended regular oral hygiene by rubbing teeth and gums
• Barber dentists practiced as early as 3500 BC in Rome and used dental keys & dental pelicans, precursors to modern day forceps

Dentistry as a Profession

• Not fulltime dentist, main focused is removing infected teeth for alleviating pain purpose, not preventive care
• In 1800, dentists and surgeons separated as a profession; The last barber-surgeon died in the 1820s

Modern Dentistry

• Dentistry is now a profession that involves using prevention and treatment of oral disease, including disease of the teeth and supporting structure
• It focuses on the study, diagnosis, prevention, management, and treatment of the oral cavity and craniofacial complex
• Dentists (DMD) prevent, diagnose, and treat diseases, injuries, and malformation of the teeth, jaws, and mouth and who makes and inserts false teeth
• Areas where dentists practice includes public health, community dental care, and hospitals

Dental Hygienists

• Dental Hygienists prevent dental disease, specializing in cleaning, polishing, and radiographing teeth, periodontal treatment, and patient education
• Dental Hygienist's scope of work includes patient screening, radiographs, calculus and plaque removal, applying preventive materials, and teaching oral hygiene strategies
• Dentechs perform dental lab procedures under written orders from a licensed dentist
• Dental assistants aid the dentist in diagnosis, treatment, and dental care; they may be an RDA, a CDA, or an RDAEF

Dental Specialties

• Oral surgery deals with diagnosing and treating oral conditions requiring surgical intervention and other conditions of jaws and mouth structures
• Orthodontics prevents and corrects irregular teeth as well as relationship of upper and lower jaws by the use of braces
• Paediatric dentistry focuses on the oral health of children from infancy through the teen years
• Endodontics maintains teeth through root canal treatment (endodontic therapy procedure)
• Periodontics diagnoses, treats, and prevents diseases and disorders of the gums and other structures around the teeth
• Prosthodontics replaces missing teeth and associated soft/hard tissues with prostheses (crowns, bridges, dentures)
• Restorative dentistry repairs or replaces damaged/missing teeth and helps to improve oral health and function

Dental Amalgam

• Dental Amalgam is an alloy made by mixing mercury (Hg) with a silver (Ag), tin (Sn) alloy
• Skinner's definition of amalgam is a special type of alloy in which one of its constituents is mercury

History of Amalgam Use

• Amalgam's first use was in China; Sukung (659AD) mentioned silver-mercury paste
• Ishitichen used 100 parts Hg, 45 parts Ag, and 100 parts Sn in 1578
• LiuWen-Thai (1508) and Li Shih-Chen (1578) discussed using 100 parts mercury to 45 parts silver and 900 parts tin
• In the 1800s, an alloy of Bi, lead, tin, and mercury plasticized at 100 "C poured directly into cavity in France

Key Figures in Amalgam Development

• Bell advocated for room temperature mixed amalgam use in England, 1819
• M. Traveau is credited with advocating for the first form of amalgam paste in France, 1826
• Crawcour brothers introduced amalgam to the US, 1833
• G.V. Black developed a formula involving 67% silver, 27% tin, 5% copper, and 1% zinc in 1895
• Skinner added copper (Cu) to the amalgam alloy composition in a small amout in 1946
• In 1971, Johnson designed a spherical particle alloy comprised of Ag-64%, Sn-26%, Cu-10%
• The first single composition spherical alloy named Tytin (Kerr)(silver/tin/copper) created by Kamal Agar,
• 1980's, alloys similar to Dispersalloy and Tytin was introduced.

Amalgam Advantages

• Easy to use/manipulate, with less microleakage and is relatively inexpensive
• Presents excellent wear resistance, minimal postoperative sensitivity, and not technique sensitive
• Bonded amalgams have "bonding benefits" that increases tooth structure
• Restorations finish in one sitting, without requiring too much chair side time
• Good compressive strength, well condensed/triturated and has good sealing ability due to corrosion
• Non aesthetic- not appealing, with tarnish and corrosion

Amalgam Disadvantages

• Presents metallic taste and galvanic shock with tooth discoloration, without chemical adhesion
• Mercury toxicity can promote plaque, delayed expansion, and weakens tooth structure

Amalgam Composition

• Silver(Ag): approximately 2/3rd of amalgam alloy.
• Tin(Sn): Increases flow, Controls the reaction between silver and mercury
• Copper (Cu): Contributes mainly hardness and strength.
• Zinc(Zn): Helps in decreasing marginal failure, Acts as scavenger of foreign substance
• Indium(In)/Palladium(Pd): Help to increase the plasticity and resistance to deformation

Amalgam Controversies (The Amalgam War)

• 1845: American Society of Dental Surgeons condemned all filling material other than gold
• German dentist, Dr. A. Stock showed mercury could be absorbed from dental amalgam, leading to serious health problems
• In 1980, seminars/writings of Dr. Huggins proposed that mercury was responsible for affecting cardiovascular system

Dental Radiography

• Dental Radiography is used to take images of the teeth, bones, and soft tissues
• Purpose: Detects pathology/anomalies/un-erupted teeth; it can be used to determine presence/absence of teeth

Parts of Dental Radiography

• Tube Head; Cylinder, Extension arm, Control panel

Dental Radiography Types

• Types include: periapical, bitewing, and occlusal

The History of Dental Radiography

• Wilhelm Conrad Roentgen (1845-1923) discovered x-rays during 1895.
• Roentgen's first experiment was on his wife, Bertha’s, first use for industries uses

Dental Radiography Innovators

• Heinrich Geissler built vacuum tube
• Johann Wilhelm Hittorf used vacuum tubes and discovered a cathodic ray
• William Crookes redesigned tube's and discovered streams of charged particles during the 1870s
• Philip Lenard found rays could penetrate a thin window of aluminum after leaving a tube with cathodic rays
• Otto Walkhoff made the 1st dental radiograph

Other Names in Dental Radiography

– W.J Morton, C.Edmund Kells William H. Rollins Frank Van Woert Howard Riley –

Porcelain History

– Porcelain was first fabricated for earthenware pots for domestic use. – Porcelain is a ceramic “Greek word keramos mean “potter’s clay,” and has been used to produce pots. – 10,000 B.C. the start of human usages. – 700 B.C. the start of artificial teeth. – 1789 first porcelain tooth – 1774 improved the “mineral paste teeth. – 1808. – 1817, Planteau – 1822, Peale – 1825 commercial porcelain – 1837 England ash version – 1839 effective use – 1844 founded porcelain designs – 1903 the crowning

Porcelain Classification

• Can be based on uses/indications, indications of the jaw, indication of principal crystal phase, or fabrication.

• Can be based on Ultra-Low fusing(High Translucency), to firing temp.

• Can be based on a number of usages, matrix fabrication. – Is often and almost always translucent, opaque or transparent – – –