Ambroise Paré (1510-1590), a barber-surgeon to four French kings, replaced hot oil cauterization of bleeding wounds with ligature. This, along with his wound dressing technique, changed surgery forever.
Soothing Wound Dressing
Prior to Paré’s innovation, hot boiling oil poured in a wound, without anesthesia, was thought to “purge” gunshot wounds of the presumed poisonous nature of the gunpowder. Many of the soldiers died of shock and sepsis following such excruciating treatment. Paré, known as “the gentle surgeon,” invented the use of a soothing wound dressing, thereby reducing pain caused by the hot oil and greatly enhancing wound healing and survival. His ligature of blood vessels and wound dressing technique changed surgery forever.
The toothbrush has ancient roots. But the invention of the commercial mass-produced toothbrush is attributed to the Englishman William Addis, who in 1770 came up with the idea while in prison. Using swine bristles thread through holes at the ends of a carved cattle bone, he created the first toothbrush prototype. Once released from prison, he started to mass-produce it. The first three-row bristle toothbrush was invented in 1844 and the first nylon toothbrush was commercialized by DuPont in 1938. The first electric toothbrush was created in 1939.
Amalgam was introduced in the US in 1833 as a material for tooth restoration by two Englishmen, the Crawcour brothers, amid considerable animosity and professional jealousy from colleagues. Amalgam contained shavings of silver coins, tin, and mercury mixed into a paste. It has been the dental restoration material of choice for the past 180 years, and only recently has it become displaced by advances in highly fracture-resistant aesthetic bonding materials.
Dr. Horace Wells, a dentist from Connecticut, who was responsible for the use of anesthesia in dentistry, had an impact on both medicine and dentistry. He was the first patient to have a tooth extracted under nitrous oxide (NO) anesthesia.
Following a demonstration the day before, during which Wells observed the use of NO for public entertainment, one of the performers, who was under the influence of the anesthetic, seemed unaware of an open flesh wound on his leg and of pain from a self-inflicted wound he had incurred while prancing around on stage. Wells instantly realized the implications for painless surgery and arranged for a demonstration in his practice. The next day, Dec 11, 1844, Dr. John Rigg, a local periodontist, performed an extraction on Wells. Gardner Quincy Colton, the itinerant entertainer who brought NO to town, was at hand to administer the anesthetic. The extraction was painless even though the subsequent public demonstration at Massachusetts General Hospital was a dismal failure. That doomed the use of NO in general surgery. However, present at that failed demonstration was a former student and partner of Wells,’ a part-time medical student and adventurer, William Morton, who subsequently went on to use ether as a surgical anesthetic. On October 16, 1846, the first public demonstration at Massachusetts General Hospital, dubbed "ether day," with Morton present, was a rousing success. It set the stage for painless surgery in the US and around the world.
In the mid-19th century, dentures to replace missing teeth were made of ivory, hippopotamus or human bone, or metal (brass or lead). Starting in 1851 they were replaced by a new technology, vulcanized rubber, invented by Charles Goodyear, an American, who succeeded in hardening the resin of the rubber tree. An American dentist émigré to Paris, Thomas Evans, first used it as a denture base in 1848.
Toothpaste was invented in 1850. The first toothpaste was based on a formulation of powder or pumice. The invention of modern toothpaste is attributed to the American dentist Dr. Washington Wentworth Sheffield, who came up with the patent in 1878. He is also credited with placing it into collapsible tubes. The idea came to him while in France observing the tubes used by Parisian painters.
Foot-Pedal Dental Drill
The dental drill was a major breakthrough in speeding up removal of decayed tissue. The use of a drill on teeth dates back 6,500 years. The use of modern dental drills started with George F. Green, an American dentist who in 1868 invented the foot pedal-operated pneumatic drill and seven years later patented the electric drill.
Caries investigation was significantly advanced when a German-educated, American scientist, Dr. Willoughby D. Miller, described the Acid Dissolution Theory in 1890. Until that time, caries, the most common infectious disease affecting humans, was thought to be caused by worms. Using experimental approaches learned from Dr. Robert Koch, a German physician and pioneering microbiologist, Miller reproduced caries in an environment that simulated the oral cavity while working at the Free University of Berlin. Miller, who is recognized as the first oral microbiologist, was influenced to become a dentist by Dr. Frank P. Abbott, dean of New York College of Dentistry from 1911 to 1924, who was Miller’s partner in Berlin and his father-in-law.
WATER FLUORIDATION PROJECT
First Major Water Fluoridation Project
The discovery of the role that fluoride plays in caries prevention is an achievement that the CDC ranks among the 10 greatest public health advances of the 20th century. Fluoride research had its beginning in 1901, when a young dental school graduate, Frederick McKay, left the East Coast to open a dental practice in Colorado Springs, Colorado. When he arrived, McKay was astounded to find scores of residents with grotesque brown stains on their teeth and began research, in collaboration with renowned dental researcher Dr. G.V. Black, that led to recognition of fluoride’s preventive capabilities, and, 30 years later, to the knowledge that water-borne fluoride can prevent cavities.
Under the leadership of Dr. H. Trendley Dean at the NIH, the first major public water fluoridation project began in in Grand Rapids, Michigan, in 1944. The project, which lasted 15 years, showed that the caries rate among Grand Rapids children born after fluoride was added to the water supply dropped more than 60 percent. As a result of their efforts, McKay, Dean, and others helped to transform dentistry into a prevention-oriented profession.
One of the most significant advances in modern dentistry derives from the use of dental sealants to prevent dental decay. In the mid-1960s, Drs. Michael Buonocore and E. I. Cueto introduced the first commercial sealant. The product was based on Dr. Buonocore’s work on the development of materials to prevent occlusal caries in posterior teeth. In 1974, Drs. J.W. McLean and A. D. Wilson introduced the glass ionomer cement currently used for fissure sealants.
Digital dentistry refers to a wide scope of technologies and devices - introduced in the past several decades - that incorporate digital or computer-controlled components in contrast to mechanical or electrical devices alone. The digital technologies that might be used in the dental office include CAD/CAM (computer-assisted design, computer-assisted manufacture), cone beam CT, digital X-rays, intra-oral camera, dental lasers, and optical scanners, among them.
One of the most recent technological advances is Invisalign®, a system that creates a series of computer-generated clear plastic orthodontic realigners to correct slight malocclusions. Invisalign® "democratized" orthodontics by making the system available to general practitioners. The 1997 invention is attributed to Zia Chishti and Kelsey Wirth.
More recently, a new technology developed at the NYU College of Dentistry has been shown to significantly decrease the amount of time required for a patient to wear braces. The process is called micro-osteoperforation (popularly known as "faster braces"), which involves poking small holes into the patient’s gums using a special plastic drill called a Propel. The controlled injury allows porous bone tissue to form, and, as a result, braces can move the teeth faster. The NYU team that developed this technology, introduced in 2013, was led by Drs. Cristina Teixeira and Mani Alikhani.