Much Ado About Dentistry

Aesthetically at least, I guess I have a reasonable set of gnashes. I’ve always brushed them regularly, flossed sporadically, and have recently discovered the wonders of a tongue scraper. However, beyond the, er, veneer, dark secrets take the form of mainly ghastly silver fillings — sometimes fillings around fillings — which may, or may not, be partly down to the love — and medical ignorance — of my dear, departed grandmother.


Until I was about six, my mum and I lived at my grandparents’ house, and my mother, quite rightly, forbade me from eating sweets. My nan considered this tantamount to child abuse, and, what feels like every time my mum’s back was turned, would spread butter across white bread, sprinkle it with sugar, and hand it to me with glee. After my granddad died and my milk teeth had long been replaced by adult ones, my nan would regularly come to stay with us instead, and most evenings there would be something sweet to rot my teeth — along with the occasional couple of gold coins, or even a five-pound note — tucked lovingly under my pillow, which of course I’d devour immediately before drifting off to sleep. It’s a wonder I didn’t wind up with diabetes.


So anyway, I’ve spent more than my fair share of hours in a dentist’s chair, and, aside from the occasional scratch of the anesthetising needle, in my near-38 years, I’ve rarely ever felt more than a niggle. Oh, apart from the time while backpacking around Australia a dentist attempted to extract an infected tooth and I nearly launched us both into the ether.


But at least I wasn’t one of Jacobus van Nierop’s patients, a Dutchman who, in 2016, was dubbed the ‘dentist of horror’ and sentenced to eight years in a French jail for carrying out unnecessary procedures for self-gratification that resulted in injuries such as broken jaws, recurrent abscesses and septicaemia. The BBC reports that one of his patients had eight of her teeth extracted in one sitting leaving her “gushing blood for three days” and with “no teeth for a year and a half”. It’s a story that echoes the almost comical exploits of Canadian mouth doctor Edgar Randolph ‘Painless’ Parker who founded his dental practice in 1892, after begging his college dean to pass him (according to Smithsonian, Parker was a “terrible student”).


After nearly two months without a patient, Parker began advertising ‘painless’ procedures, carried out after injecting his charges with a solution of watered down cocaine that didn’t always work. In 1913, the extraverted ‘surgeon’ set up a travelling dental circus around the US where he took to the stage in a top hat and tails complemented by a necklace of human teeth. Parker’s show consisted of him calling a plant from the audience from whom he would seemingly extract a tooth with little pain or fuss as a brass band and dancers performed alongside. With the procedure complete he would then invite real patients on to the stage to have their teeth pulled, and as he did so, the band would play louder to drown out the screams leaving the audience none the wiser as to his ruse. Parker was sued several times, and eventually did a runner back to Canada, with the American Dental Association labelling him “a menace to the dignity of the profession”.


Until the Victorian age, for most, extraction was pretty much the only way to guarantee the end of an aching tooth, even though dentistry is actually one of the oldest medical professions — known to have been conducted as far back as 7000 BC in the Indus Valley (the first recognised dental practitioner was Ancient Egyptian writer Hesy-Re, and other notable ancients to have dabbled in dentistry include the Greeks Hippocrates and Aristotle). Around 2000 years later, a Sumerian text claimed dental worms to be the cause of tooth decay — a theory that astonishingly stood until the 18th century, when dentistry was finally being seriously considered as a profession.


Though the first tooth tome — The Little Medicinal Book for All Kinds of Diseases and Infirmities of the Teeth —was written in 1530, it would be nearly 200 years more before ‘Father of Modern Dentistry’, Pierre Fauchard of France published the first comprehensive dental textbook Le Chirurigen Dentiste (The Surgeon Dentist) in 1728. Fauchard first recognised that sugar causes tooth decay, and came up with the idea of fillings and prosthesis.


Across the English Channel, former doctor John Hunter published another revolutionary dental book in 1771, Natural History of the Human Teeth, that detailed names for each individual tooth — all still used today. He also proposed the notion of dental implants — not of false teeth, but those from other people. Trading of teeth for a time became so well rewarded that they were robbed from graves and the wealthy even paid the destitute to give up theirs. Trained dentists, however, were few and far between, so barbers and even blacksmiths would often double as dental surgeons using pliers to pull and the patient’s jaw for extra leverage. One of the earliest ‘toothpastes’ was crushed oyster shells, but they wore away at the enamel and exposed the nerves, leading to the development of gentler options such as soot or brick dust. The arrival of the first mass marketed toothbrush of pig bristle in 1780 by William Addis helped greatly, but they were beyond the means of most ordinary folk so were usually shared. Many still opted to have all their teeth pulled out rather stand the agony of them rotting.


Various cleaning powders were developed through the 1800s, but Colgate were the first to offer a mass-produced, fresh tasting toothpaste, in 1873. The dental drill was, around this time, going through various stages of development, allowing practitioners to remove sections of decay rather than the entire tooth. However, the pain was searing so medics experimented with relief such as chloroform or laughing gas (nitrous oxide) though often got the doses wrong and many patients died. Injections of cocaine, such as those used by ‘Painless’ Parker were deemed far less risky.


The addition of fluoride to both toothpastes and drinking water would further reduce cases of decay, and more recently, silver diamine fluoride, an antimicrobial gel, has been shown to further stop the rot. But it is stem cells that likely represent the future of dentistry, with scientists working on ways to regenerate teeth thus eliminating the need for injections — but, alas, not for drilling, as dentists will still need to remove the decay.


Words: Jamie Christian Desplaces