WHAT IS DENTISTRY?
Dentistry is a branch of Medicine that deals with prevention, and treatment of dental diseases, disorders and related soft tissue in the mouth.
A Dental Surgeon (UK) or a Dentist (USA) educates, diagnoses and treats patients with most dental problems and refers them to dental specialties as needed. A qualified dentist goes to a minimum of 4 years of dental schooling, many times with a pre degree course. The last 2 years of the training include clinical practice and is further supplemented by internship.
Mentioned below are some clinical specialties where dentists undergo special training for 2 years or more to obtain a higher qualification.

ORTHODONTIST specializes in correcting “malocclusion” or irregular teeth arrangement by using ‘Braces’.

ORAL & MAXILLOFACIAL SURGEON specializes in doing special surgeries of the mouth and treats fractures of the jaws including the TM Joint

PROSTHODONTIST specializes in replacing missing teeth and surrounding tissues, either by fixed or, removable dentures or artificial teeth. Some of the newer treatment methods used are porcelain fused to metal restorations (Ceramics) and Dental Implants. MAXILLO-FACIAL PROSTHETICS is a further subspecialty.

RESOTRATIVE / CONSERVATIVE / ENDODONTIST specialize in root canal treatment and larger restorations of teeth.

DENTAL RADIOLOGY & DIAGNOSIS specialists assist in the accurately diagnosing the problem.

PERIODONTIST specializes in treating surrounding gum and bone disease

PEDODONTIST specializes in treatment of children’s dental needs.

Old Chair 1850

Old Dental Chair Around 1850's

HISTORY:
Historically from about 2500 BC, the Egyptian days, there is sufficient evidence to show that people took care of their teeth. Removal of teeth though crude, was done and so were replacements of teeth. Decorative procedures on the front teeth and shaping them were considered ‘beautiful. A Dental operator was any one skillful in removing teeth.

In the middle ages, a section of barbers were trained to ‘surgical intervention’ and around 1500, the first book (Artzney Buchlein) dedicated to dentistry was published in Germany, and later by Ambrose Pare, known as the father of Surgery in France. Ambrose’s book included information on extractions, treatment of tooth decay and jaw fractures.

The famous Pierre Fauchard in 1720, also known as the Father of Dentistry published his book, The Surgeon Dentist, A Treatise on Teeth, which covered several aspects of dentistry in a formal way.

John Greenwood, in 1790, constructed the first known dental foot engine. He adapts his mother’s foot treadle spinning wheel to rotate a drill.

Formal Training of Dentists began with the opening of The First Dental College in 1840 at Baltimore, and the second one at Philadelphia in 1863, USA.

The chartering of The Baltimore College of Dental Surgery, Dental School, University of Maryland on February 1, 1840 represented the culmination of the efforts of Dr. Horace H. Hayden and Dr. Chapin A. Harris, two physicians who recognized the need for systematic formal education as the foundation for a scientific and serviceable dental profession. Together, they played a major role in establishing and promoting formal dental education, and in the development of dentistry as a profession.v Gradually the profession got more organized with a scientific approach. On must remember that there was no ‘anesthesia’ to ‘numb’ the area and dentistry was painful. Also then the drilling procedures were slow and time consuming.

Horace Wells a Connecticut dentist in 1844 discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his private practice.

In October 1846, Thomas Green Morton demonstrated the first successful use of Ether as an anesthetic for a tumor removal. Surgery and treatment becomes ‘civilized’ with control or absence of pain.

The nylon toothbrush, the first made with synthetic bristles, appears on the market around 1940.
THE LOCAL ANESTHETIC:
A temporary, reversible, ‘numbness’ can be achieved in a localized part of the body when certain type of drugs is used judiciously. This ‘deadening’ of an area allows a surgeon to perform painless surgeries on the body in selected areas. ‘Local anesthetics’ as they are called is widely used in dentistry all over the world.
The use of Cocaine was the first step. Isolated in 1860, it was used for skin and eye procedures. However, it was quite potent and it was a boon when Procaine, a derivative of Cocaine was developed around 1904. But the real convenience came to dentistry with the development of Xylocaine (lidocaine) in 1940. Generally speaking the number of people allergic to this is very low.
DENTISTRY IN INDIA:
The scenario in India was that dentists were trained as ‘apprentices’ while working with another dentist and where serving the public, purely based on the skills they had learnt, but did not have a formal dental education. Many of the earlier apprentices were trained by the British dentists. For a time Chinese dentists were popular probably because they were good at the art of making false teeth. Much of the dentistry then consisted of removal of bad teeth and replacement with an artificial set of removable made dentures. These were made of vulcanite first and then later out of acrylics when they were introduced.

The first dental college in India was started at Calcutta in 1948. Dr.R.Ahmed was instrumental and is generally recognized as the ‘father’ of dentistry in India. Subsequently other government dental colleges were started in major cities like Mumbai, Chennai and Bangalore.

Later on the splurge for starting more dental colleges began and currently we have about 145 dental colleges in India. In Karnataka State we have around 40 and each college passes out some 25 dental graduates in a year, approximately 1000 in number.

A point to note is that while the number of dentists has increased over the years, there has not been a corresponding increase in the number of dental laboratory technicians and dental assistants. However, the manufacturing segment of dental equipments has made a tremendous stride. Availability of materials, information and training has made the Indian dentist as well performable as any of his counterpart in the world. Considering all of these, dentistry is still less expensive.

Dramatic Changes:
Over the years, these are some dramatic changes that have had a palliative effect on dental treatment:

Use of dependable local and general Anesthesia
Introduction of pneumatic high speed drills
Diamond and advanced drill bits ‘burs’
Newer Restorative materials
Dental Ceramics, or Porcelain Fused to Metal Restorations
Use of Lasers
Introduction of Branemark Titanium Dental Implants
Radiography and Digital Radiography
Ultrasonic devices
Autoclaves and sterilization procedures
Fine gauge inject able needles
Effective and safer Local anesthetics
Disposable syringes
Change of dental equipment design;
Stand up dentistry to sit-down
Use of suctions
Better Impressing materials
Dental Laboratory equipments techniques
Supportive: improved medication; air-conditioning; Optical etc.
CONCEPTS IN TREATMENT:
Essentially every trained dentist around the world would like to save your teeth. Gone are the days (excepting perhaps in developing countries) where a dentist is viewed as a ‘tooth-puller’. Exodontias or removal of teeth are done, only in hopeless situations.

Dentistry as a profession views that everyone in the population must have healthy, neatly arranged, good looking teeth for life and strives towards this goal. The profession knows that artificial teeth are only second best to nature and are fabricated only as a second choice to correct the nature’s anomaly.

 
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