Unit 14: Dentistry in the 20th Century PDF

Dentistry in the 20th century Historical context Discovery of fluoridation In the mid-20th century, it was discovered that fluoridation of water and toothpaste could prevent tooth decay, which led to a significant decrease in the incidence of tooth decay in the population. Technological and materi...

Dentistry in the 20th century Historical context Discovery of fluoridation In the mid-20th century, it was discovered that fluoridation of water and toothpaste could prevent tooth decay, which led to a significant decrease in the incidence of tooth decay in the population. Technological and material developments Development of X-ray technology implemented last century in the dental office by Kells. Development of more durable, safer and aesthetically appealing materials in fillings and prostheses. Increased emphasis on prevention and aesthetics As the importance of prevention in oral health became better understood, dentistry increasingly focused on oral hygiene promotion, patient education and prevention of dental disease. In the 20th century, dental aesthetics became an important concern for patients. Dentists began to develop treatments to improve the appearance of teeth and gums, including tooth whitening, dental veneers and orthodontics. Development of the medical approach to dentistry Dentistry has evolved to include greater attention to the relationship between oral health and general health. Dentistry now works in collaboration with other medical specialties to treat and prevent chronic diseases, such as diabetes and cardiovascular disease. Dental academic training Two professionalization models UNIVERSITY model INDEPENDANT SCHOOL model • Germanic world. • University of Vienna (Georg Carabelli) • Exclusivity of teachers for teaching and research. • Public expenditure. • The first dental institutes 1884. • United States. Hayden and Harris, create the Dental School of Baltimore (1840). • No basic studies were necessary. • Integration of the German model. STOMATOLOGY (Medical speciality) DENTISTRY (Independent career, practical training, advances in techniques and instruments) Preventive dentistry: Dental hygiene Alfred Fones (1869 – 1938) Irene Newman’s Dental Hygiene demonstration Bridgeport, Connecticut, USA First school of dental hygene (1913) Lowest death rate of any large city in the world during influenza pandemic (1918) First hygenist license to Irene Newman Irene Newman (1875 – 1958) Preventive dentistry: Dental hygiene Preventive dentistry: Fluoride In 1901 Dr. Fredrick McKay start a research on the brown mottling pattern (also known as “Colorado Brown Stain” ) on the enamel. This pattern was specially shown in the mouths of native-born residents (children). à City residents whose permanent teeth had calcified without developing the stains did not risk having their teeth turn brown. Young children waiting for their secondary set of teeth to erupt, however, were at high risk. àTeeth afflicted by Colorado Brown Stain were surprisingly and inexplicably resistant to decay. He believed stains were caused by some agent in the water people drunk but saw nothing when analyzed. Chemist HV Churchill noticed McKay’s research and performed his own test on waters of locations with the same problem. However, his lab used a much more developed technique (photospectrographic analysis) and observed a huge amount of fluorine à fluorosis. Preventive dentistry: Fluoride H Trendley Dean showed that levels of up to 1.0 ppm in drinking water did not cause enamel fluorosis in most people and only mild enamel fluorosis in a small percentage of people. He wondered whether adding fluoride to drinking water at physically and cosmetically safe levels would help fight tooth decay. He proposed to add fluorine into tap water as a preventive action. In 1944 he was allowed to test his proposal, and in 1945 he did so in Grand Rapids (Michigan). After 11 years monitoring, they showed that tooth decay fell a 60%. àBalance fluorosis-prophylaxis à Strengthening of teeth enamel à Stoppage of decay process à Prevention of mineral loss. Preven5ve den5stry First synthetic bristle toothbrush in market (1938). CREST ® awarded ADA acceptance as an effective decay preventive agent (first toothpaste) (1960). The impact of World Wars The large number of wounded soldiers during the World Wars, triggered major advances in surgery: 1 - Wound treatment and aseptics 2 - Development of 19th century anaesthesia 3 - Plastic surgery: The need to treat soldiers with facial injuries and physical deformities led to the development of plastic surgery techniques (à dental aesthetics). In dentistry, the importance of dental health to the general health of soldiers was recognised during the First World War. Poor dental health was a major cause of casualties on the war front. This led to the development of dental care programmes for soldiers, and the inclusion of dentists among military personnel. In addition, during World War II, more advanced dental prostheses were developed for soldiers wounded in combat, allowing many of them to regain their ability to chew and speak. The impact of World Wars Edward Hartley Angle (1855-1930) à Founded the Angle School of Orthodontia (1899) in St. Louis and others. Coined the term malocclusion and proposed a classification system for it (1890), which revolutionized the field of orthodontics (based on first molar position): à Normal occlusion. à Class I: An incorrect line of occlusion due to misaligned teeth, rotations or other issues. à Class II: A distal positioning of the lower molar against its upper equivalent, with no reference to line of occlusion given. à Class III: The lower molar being mesial to its counterpart, again without a noted line of occlusion. I II III The impact of World Wars Edward Hartley Angle (1855-1930) à Founded the Angle School of Orthodontia (1899) in St. Louis and others. He developed and improved orthodontic appliances to correct malocclusions, such as the ribbon arch appliance (it was actually the first braces system, and the first allowing rotation) A century of specialization Paedriatics Oral pathology Prosthodontics Dental Public Health and Preventive Dentistry Endodontics Periodontics Spain Diploma in Odontology (1901-1944) Requirements: 3 years of Medicine + 2 years of Dentistry (at dental school) Qualification: Dental care, Oral pathology and Dental prosthesis Diploma in Stomatology (1944-1986) Requirements: Full Medicine + 2 years of Stomatology (at stomatology school) Den[stry is considered a medical speciality BSc in Dentistry (Licenciatura en Odontología) (1986-2010) Requirements: 5 years Dentistry (at University) Dentistry is an independent discipline Degree in Dentistry (Grado en Odontología) (2010-Today) Requirements: 5 years Dentistry (at University) Trend: Minimal tooth destruction, maximal prevention. Minimal tooth intervention, maximal tooth preservation.