The Beginnings and the Rise of the Dental Department
By Walter H. Jackson, '76d
Ann Arbor
There is a tendency among the critics to place in the category of myths all the stories handed down by tradition; and to mythology not too much respect is paid. Yet I have been fascinated in searching the past for something relative to the earliest beginnings of the dental department of the University of Michigan, —even among those myths, if you will, that tell us all we know of that stage in its evolution that precedes its written history. Of course, now that the department has come into the strength of its maturity, any of us would be proud to show that his originality, his help and guidance in those earliest times, were potent factors in giving the school its start toward the position it holds today.
The earliest myth that comes down to us is the story of how C. B. Porter and Dr. Corydon L. Ford made the effort to establish a dental school as long ago as 1857.
A second tradition traces the origin of the department back to the year 1865, and to this same C. B. Porter, together with John A. Watling, and George L. Field. Again the development did not pass beyond the simple protoplasmic stage.
Then there is a third word-of-mouth story. In this, Drs. D. C. Hawxhurst and W. H. Jackson began once more to nurture the germ. They called to their aid, also, Dr. E. S. Holmes, of Grand Rapids. By that eternal vigilance which is the price of success they obtained from the dental profession of the state of Michigan barely enough nourishment for the project to keep it alive from year to year. At some of the meetings of the state society, rather than being aided the embryo dental school seemed likely to be killed outright. But at last, in 1875, the profession united its efforts, and prevailed upon the legislature to grant the necessary appropriation, and upon the regents to accept the charge of organizing and maintaining the new department. To the regents and to President Angell the profession of the whole state is under the greatest obligations. Their wisdom in selecting men of ability and of good character to work out the destiny of the department has never been challenged.
For the first four years of its life the school was housed in the northwest "residence building" on the campus, one of the four originally intended to domicile the members of the faculties. The homeopathic department now occupies the rooms in which our school began its career. At the end of four years, when the institution might have been thought to be hardly out of its swaddling clothes, the old home was too small longer to meet its needs. So the southeast residence—the present recitation building of the engineering department — was enlarged, and was given over to the exclusive occupancy of the dental department. In 1891 after the hospital was removed from the campus to the present site, the old building was thoroughly renovated, and at the opening of the school year in the fall, was occupied by the dental school. The department has continued here—badly cramped for room in these later days.
In 1884 owing to the rapid advancement of the profession, it was found necessary to lengthen the course to two years of nine months each. In 1889 came a further lengthening to three years of nine months each, and not with standing, the department still increased in numbers. In 1900, the course was once more made longer; and now to receive the diploma of this institution one must spend four years in study, and in order to gain admission must first have had a preparation equivalent to the ordinary high school course. The entrance requirement is thus the same as for other departments of the University. The four years' course following the high school preparation, will in the future prove itself to be the right thing. This school has never hesitated to take the lead in raising its standards of admission and in increasing the length of time required to gain its diploma.
Its library has grown to 1014 volumes. Its museum has developed wonderfully; the half of its present collection would have made the old boys dance with glee. Its attendance during the last decade was 2314. During the same period its clinical patients have numbered 89,765; and the operations performed, 104,227. It has, since its organization, graduated 1074 persons; of this number, 36 have been teachers of the profession in educational institutions. In 1891-92 the publication of the Dental Journal was begun by the department. This magazine, a bi-monthly, still lives a worthy life.
I wish I might have space to give the names of all the graduates and of all the benefactors of this department. For, as it is honorable to be deemed worthy to receive a diploma from such a school, so it is honor enough for any one to have rendered it a service that places it under obligation to one.
Could I mention only the names of some of the old professors, as Taft, Ford, Watling, Dorrance — and I should not forget Henry, the janitor—it would make some of the older alumni's hearts bound. As for myself I was there just long enough to learn that in time a person tires of working for glory—and nothing added.
The Evolution of the Dental Curriculum
By Will H. Whitslar, 85d
Cleveland, Ohio
Dentistry, like many sciences, has required ages to reach its present degree of perfection. Being a specialty of medico-surgical science, it has a history second only to the general subject of medicine. To study dentistry fully, one must enquire into the life history of the peoples of Egypt, Greece, Italy, Phoenicia, Arabia, China, India, Central America, Europe, and finally of the United States of America.
The history of the medical science of the entire world was stored up in the great library at Alexandria in Upper Egypt. In 321 B. C, this collection contained seven hundred thousand volumes making in all a wonderful library and museum of literature, art, and science. Here lived Herophilus, Galen, Etius, and many others, who adorned the annals of medical science. Alas for human frailties and greed! This great library, so resplendent in scientific lore was carried, in part, to Rome by the ambitious Romans. Julius Caesar in relentless war, partially destroyed it by fire, and the destruction was made complete by the Saracens, A. D. 641. By the loss of this library, we are deprived of a vast portion of the records made by humanity from the beginning to beyond the advent of the Son of God. Hence we now find it necessary to turn to the tombs of the ancients for most evidences of early dentistry. These evidences are not entirely wanting.
Moreover the writings of Herodotus, the Greek historian, are available. Herodotus relates that in traveling through Egypt, he found the practice of medicine divided among the priesthood; each applied himself to one class of disease only, some to the head, others to the eye, and others to the teeth, each specialist being for-bidden to enter the field of his colleagues.
Ebers, the Egyptologist, has proved that in the Egyptian medical schools they had special teachers in dentistry, more than three thousand years ago. This is the first evidence of systematic teaching of dentistry. Examples also, of practical work have been found in the mouths of mummies, indicating proficiency in dental art at that time. The use of gold was understood by these ancients. Artificial teeth were made from ivory, bone, and wood; teeth were filled with lead, and, it is believed, fillings were made of gold. The ancient Etruscans, who lived in northern Italy, were also well skilled in mechanical sciences and fine arts. Etruria was a seat of learning, wealth, and power; hence every possible opportunity to embellish dress with ornaments was accepted. Even the teeth were gilded, and gold bridges and attachments for them were made. Unfortunately for history, these people were believers in cremation of the dead; thus they destroyed much of their superior work and left only enough to indicate their extreme skill.
As further indication of a knowledge of dentistry among the ancients, Homer the poet, tells us that Aesculapius the "god of medicine" used a narcotic to produce insensibility when extracting teeth, and also taught the filling of teeth. Hippocrates (450 B. C.), who was regarded by Herodotus as the greatest surgeon that ever lived, wrote intelligently about the teeth and their care, and those who studied dental surgery under him were required to take the Hippocratic oath, which was a code of ethics.
Thus we learn, that even in the earliest times, dentistry was studied and practiced with comparative success.
Reference has been made to the subdivision by the Egyptians of the specialty of medicine. Plutarch speaks also of this, and his description of the barbers of his time, indicates that dentistry was not their art, but was distinctly a specialty of medicine. Barbers have been associated with surgeons and dentists in times past, but by the decrees of Louis XV of France in 1741, and George III of England in 1785, dentistry was instituted a profession by itself. I have indicated here some portions of the early history of dentistry. We must pass through centuries before we find concentration of dental knowledge.
During this passage of time, we note Ambroise Pare, (1509 - l590), John Hunter, (1728-1793), Fauchard, (1680-1761), Berdenmore, the first royal dentist, and Lemaire (both 18th century,) and many other eminent men who have contributed data to the store-house for our subsequent use. This knowledge was largely developed within a hundred years previous to the establishment of the first dental college in the world.
In 1839, Professor Chapin A. Harris organized the Baltimore College of Dental Surgery, thus beginning the first effort at systematic didactic instruction. This was a great event. It had been Professor Harris's fond hope to establish a dental school in connection with a medical college, but because of the mechanical elements required in dentistry, the trustees considered that it should have no place in a medical college curriculum. There were a few who fought bravely to establish their identity as specialists in medicine, asserting that the professional care of the teeth, since they are parts of the human economy and subject to systemic conditions necessitated a complete understanding of the whole body. The fact that out of the fifty-two dental colleges today, more than one half are connected with universities and colleges of medicine, proves the efficiency of Professor Harris's conception. It became necessary, at that time, however, to organize an independent school. The length of the term was only a few months, and four professors composed the faculty. Note the change today. In the fall of 1903 all the colleges will establish a four-year course of no less than seven months in each year.
It must be averred at this point that the instruction in the five independent schools that were established in the twenty years following the organization of the Baltimore college, was largely "mechanical dentistry," based, however, upon an exceedingly good knowledge of anatomy and chemistry. The second dental school to be organized in connection with a university, was established at Ann Arbor in 1875.
In the sixties, colleges announced an extension of the course of study, and October 17, 1866, five college representatives met in New York to form an organization of the colleges of dentistry, "for the advancement and elevation of our profession, and for a higher standard of education and professional attainments." Professor Taft represented the Ohio college at this meeting. Practically a reorganization of this body occurred in 1884, and it is now known as the National Association of Dental Faculties. Its object is to promote dental education. This has been accomplished in fixing requirements of admission to colleges, length of time of instruction, and courses of study with recommendation of suitable text-books. This association has established these conditions, and thereby has advanced the profession more than any other means.
In 1893 at Chicago, during the World's Columbian Exposition, there appeared another epoch making organization, the National Association of Dental Technics. This association was organized to further a certain line of dental teaching, but has become a mighty factor in the quality of education taught. It is a veritable training school, since here the various specialists in dental teaching give out ideas that result in the material advancement of education. Two years ago, the name of the association was changed to correspond with its purpose; and it is now known as the National Institute of Dental Pedagogics.
The dental curriculum of the early colleges consisted of only four or five subjects; in the colleges of to-day, it includes twenty or more. The modern course of dental study embraces chemistry, both quantitative and qualitative, metallurgy, applied physics, electro-therapeutics, ceramics, jurisprudence, general and special histology, microscopy, embryology, biology, physiology, bacteriology, general anatomy, including dissections of the whole body, materia medica and therapeutics, general and special pathology, physical diagnosis, neurology, special dental anatomy, comparative odontology, dental hygiene, prosthetic dentistry, including technics and clinics, operative technics and operative dentistry with clinics, crown and bridge work with technics, steel technics, anesthetics, and oral surgery, thus offering sufficient work to fill four years' time of the average student. The advance is due, we must say, to the efforts of the two organizations just mentioned.
Coincident with the growth of the colleges, dental periodicals and various dental societies have contributed not a little towards the evolution of the science and its mode of study.
There is now beginning another chapter in the history of dental education; namely the unification of the curriculums of the schools of this and foreign countries. Two international meetings have been held and the relative merits of educational systems are being considered. In time we hope for unanimity of instruction throughout the world and a consequent benefit to humanity.
I have thus given the general scope of dental education with a view to showing that, while dentistry has existed for thousands of years, it has remained for the dentists of the United States largely to establish definite means of obtaining a systematic and orderly arrangement of dental knowledge.
In this connection it is most desirable to say that this article would not be complete if personal reference to Professor Jonathan Taft were not made in connection with the develop mint of the college curriculum. I do not know of any one who has been identified more closely with the evolution of colleges and their courses of study. He has been pre-eminent in this as in other matters of dental education, and his cool judgment has had a refining influence throughout.
The alumni of the dental department of the University of Michigan are everywhere augmenting the dental knowledge of the world.
The Extension of the Dental College Course
By Jonathan Taft
Ann Arbor
For several years the dental faculty has been impressed with the conviction that three years, even of nine months each, made too short a period for giving a proper training in both the principles and practice of dentistry.
During the year 1900 the subject of extension of the term was often discussed by the faculty and frequently with members of the Board of Regents, with the President, and other officials of the University. With scarcely an exception these all concurred in the proposed extension of the course, at least after being informed upon all the points involved. The President from the beginning was decidedly in favor of the movement, and gave it hearty support. The regents, after giving the matter full consideration by thought and discussion, established the four years' course by a unanimous vote. Of those who were most active in securing this advance, the name of Dr. Hermann Kiefer, a former member of the Board, stands prominent. He recognized at once the value of this movement, and said that if the faculty was ready for the change it ought to be made at once. And when there was suggested the importance of raising the entrance requirements at least to graduation from a high school, he at once concurred. He proposed that both advances be made at the same time and further-more that two subjects, physics and comparative odontology, be added to the curriculum, and that more time be given to study and work in some of the branches that compose the curriculum. A surgical clinic was also inaugurated and made a required course.
This college was the first to move in this direction, and the first with one exception, viz., the dental department of the Detroit College of Medicine and Surgery, to take up and put into operation these changes.
The schedule of study and work was rearranged in a manner feasible for the most profitable employment of the time to be devoted to the course.
No movement of so pronounced a character has ever been made in dental education that received so general and hearty approval by the dental profession as this; and indeed approval comes from all who are informed on the subject. So generally was the movement approved by those engaged in, the dental college work of this country that the National Association of Dental Faculties at its annual meeting in 1901, after due consideration passed the following resolution by an almost unanimous vote: —
Resolved: That attendance upon four full courses of not less than seven months each in separate academic years shall be required before examination for graduation for all students matriculating after the session of 1902-03.
This restriction will be in operation in all colleges, which have membership in the Faculties Association. There will be some variation in the length of annual session. The resolution above makes a minimum time of seven months. Some colleges have annual sessions of eight and a few of nine months. It is quite probable that some of the schools that have the short sessions will in the near future extend the time to eight or nine months.
This movement will tend to unify and harmonize the educational work of the dental colleges everywhere, and especially in this country. It is the expectation and hope of many that this action will impart to our professional interests a stimulus and uplift that will be prophetic of larger and better things for the future.
Europe as a Field for American Dentistry
By William Mitchell, 78d
London, England
Why do American dentists find a good field abroad There are many factors, which have conduced to this end, and which to a certain extent, still do so.
That history works in cycles we have almost an everyday illustration. It has been a strange reversal of the order of things, that the earliest exponents of modern dentistry of their time in America were English and French. The reason for this is not far to seek; the advanced spirits in our profession, in its then infant condition, men of progressive ideas, ambitious to excel in their calling, and with a desire to exploit new fields of labor, would naturally turn to a new country where they would soon become leaders through the dearth of home talent. This principle applies likewise to the advance guard of American dentistry in Europe.
The good seed sown in America by the pioneers from Europe, found a congenial soil and surroundings for its rapid fruition. The progressive spirit which has ever been rife there, developed schools and institutions of learning for the study of our profession which at once placed themselves in the van, and have ever since remained the pattern to be copied by the schools of other countries.
The progress of dentistry the world over has always been, and must necessarily be, a question of education. In this, America has never for one moment faltered in its line of progress. Its best teachers have invariably been men of advancement and education, of not only national, but of international reputation. This combination of attainments gathered in the pioneer schools an earnest class of students—men devoted to their work. Many of them stimulated by the success of their teachers have gone abroad, and have there made names for themselves, and by their earnestness and thoroughness have shed lustre upon their schools and profession.
It was not long before leaders in our profession in America demonstrated that while dentistry was undoubtedly a specialty of medicine—or to be more correct, of surgery—it had a distinct field to occupy. In Europe, the reverse of this condition existed for many years; and in many countries today, a very peculiar opinion, to say the least, is still held respecting the position that dentistry should occupy. To show that those who believe the doctor of medicine competent to practice dentistry are wrong, we have but to refer to the degree of success in dentistry attained by the general practitioner of medicine or surgery. In only a very few isolated cases do we know—certainly in the last twenty-five years—of a medical man, or a surgeon, minus a dental education, who has made even a reasonable success in our calling. That the pattern set the dental world, by those responsible for dental education in America, has been a good one; there can be no doubt. The opinion held by the traveled and thinking portion of the public in the various countries abroad, regarding the American dentists who have settled in those lands, is one of the best possible proofs of this. In many instances, the American dentist ranks side by side, in his specialty, with the physician and the surgeon. There are names that might be mentioned in connection with American dentistry abroad, but this would possibly be invidious, and it seems to me unnecessary. Many of these men who have been before the general and professional public in their respective localities abroad for many years, and who have acquitted themselves honorably alike to their patients and their profession, have been accorded social and titular preferment in a most marked degree. Their honors have not been brought them by any favoring circumstances, nor by their taking advantage of lucky opportunities, but have been attained through the quality of their early instruction and their individual appreciation and application of it to the needs of the community where they have settled.
The foregoing not only applies to the native American dentist, but also in many instances to Europeans who have had the courage to break loose from their circumscribed surroundings, who after learning all they could at their own institutions and fulfilling all the requirements there, have been progressive enough to go to the United States, and avail themselves of the facilities and instruction afforded only by the institutions and instructors of that country—afterwards returning home to demonstrate to their patients the benefits and advantages thus received.
Education broadens views and I believe that the generous spirit in which dental meetings are held, papers discussed, and methods demonstrated, in America, has had not a little to do with the advancement of our profession in that country. The benefits of this spirit are reflected in every community where the American graduate is practicing. There are many men in Europe today who refrain from discussing methods and means of practice. They perpetuate error and crudity by selfishly retaining to themselves those benefits, which as members of a supposed liberal profession they should proffer to their colleagues. These men are narrow-minded and unworthy a place in a profession. Thank God, a more progressive element is growing up abroad, which will surely work, out, for the benefit of the people, a standard that will compel the European dentists as a class to come up to a much higher level than they have heretofore attained.
Dentistry should be a liberal profession. Unfortunately, in many respects it is not. In America, the crass stupidity of those responsible for the laws regulative of dental practice in the various states has made dental legislation in the United States "confusion worse confounded." This condition of affairs has enabled narrow minds—the possessors of which un-fortunately in many instances have access to the ear of those in high places—sometimes effectually to prevent practice of their profession by Americans abroad. Laws have been framed compelling American graduates to qualify for practice by taking the courses prescribed at the behest of pseudo public benefactors in their respective countries. But with passing time many such men toward whom, in days gone by, a certain respect was accorded, have now become impotent through insistence upon the importance of their antiquated ideas.
In recent years, the good name of American dentistry abroad has suffered much from the unscrupulous in methods of such men as Huxmann, and others of his ilk, who have availed themselves of the elasticity of the laws in some of the states, and have granted dental degrees upon insignificant and worthless acquirements. The public abroad being unable, in many instances, to differentiate between degrees granted by the good college and those by a bogus one, have sometimes condemned all. In their very sweeping denunciation of American schools they have overlooked the fact that invariably the possessor of a bogus diploma was one of their own countrymen, and never an American citizen. In a way, these spurious dentists pay a real compliment to American institutions. Imitation as a form of flattery rates high. The dental advertising quack and charlatan of Europe is invariably an "American dentist, "though he may not be able to convey an idea in English. Even he—debased and degraded as he is, and unable to attain to professional dignity either naturally or by training—would avail himself of the public's opinion of American methods as taught in American schools.
Dentists abroad, unless they be American dentists, have little or no standing socially, in the communities in which they practice. It is not uncommon now to hear people speak of "Mr." as "only a dentist," thus indicating that he was not considered as having any standing in the community, though his professional attainments might be great. To illustrate this fact, I give a story told me by a patient, a friend of whom had been attending a social function one evening, where she had met a well-known American dentist, a very entertaining and intellectual man. She expressed her surprise, when inquiring later who he was, she found him to be a dentist. The man in question is well known on both sides of the Atlantic.
It may sound boastful to speak of the foreign world's estimation of American dentists abroad, and to do so would be in bad taste were it not the truth. This good opinion has been promoted by the best citizens—who are almost invariably the traveled public of the various communities. That American dentists abroad have the most select practices in every respectable community I believe will admit of no argument. This preference has been brought about by no ephemeral sentiment on the part of the public whom they serve, but by the way they have served that public. It is owing to their earnestness to benefit their patients, their deportment in their communities, combined with their natural qualities for adapting themselves to their surroundings, that they have done so much towards carrying far afield the names of their institutions; and toward demonstrating to the public the quality of the education obtainable in those schools.
It may be interesting to note that it is to a graduate of the dental department of the University of Michigan, that the distinction belongs of being the first American citizen to pass the preliminary and final professional examinations to qualify as a dental practitioner in France. The test had to be accomplished in the language of that country. And it was a graduate of the University of Michigan who succeeded in his year in taking nearly all the honors at the London Dental Hospital — including a scholarship for the best all-around man; this too, after some of the conditions had been arranged upon a most exacting basis.
The following list of graduates of our department who are now practicing outside North America and United States territory is illustrative of the demand for American dentists in foreign fields. Out of the total number of 955 living graduates listed in the general catalogue of 1841-1901, 61 are given as residing outside of America or American territory. Foreign residents among the dental graduates thus constitute about 6 1/2 percent of the total; the proportion is many times larger than among the graduates of any other department.
William Mitchell, '78, London, England.
Evelyn Pierrepont, '80, London, England.
Denton E. Peterson, '81, Tientsin, China.
Alban V. Elliott, '81, Florence, Italy, (deceased since publication of catalogue).
Maximilian E. Chapalay, '83, Hyeres, France.
John W. Gale, '83, Cologne, Germany.
Charles M. Cunningham, '84, Belfast, Ireland.
Louis J. Mitchell, '84, London, England.
Hervey C. Merrill, '85, Cologne, Germany.
Robert Nicol, '85. Keith, Banffshire, Scotland.
Herbert Cox, '86, Auckland, New Zealand.
Felipe Gallegos, '86, Cartago, Costa Rica.
Mrs. Hervey C. Merrill, '87, Cologne, Germany.
Caroline A. Magness, '86, Liverpool, England.
Clifford F. Snyder, '86, Berlin, Germany.
Harriet A. P. Brierly, '88, London, England.
James E. Harris, '88, London, England.
Homer E. Parshall, '88, Berlin, Germany.
William H. Woodburn, '88, Glasgow, Scotland.
Albert E. Anderson, '89, Maidstone, England.
H. Fielden Briggs, '89, Bristol, England.
George B. Hayes, '89, Paris, France.
Griffith P. Terry, '89, Milan, Italy.
Ernest Catt, '90, Scarborough, England.
Norman K. Cox, '90, '92m, Timaru, New Zealand.
Fred D. Fisher, '90, Skipton, England.
George Northcroft, '90, London, England.
Henry T. Osborne, '90, London, England.
Rokus C. Devries, '91, Valparaiso, Chili.
Frederick W. Fleming, '91, London, England.
William Williams, '91, Liverpool, England.
Eli M. Conard, '92, Sydney, New South Wales.
James A. Milliken, '92, London, England.
Henry Milling, '92, Dublin, Ireland.
Arthur F. Leuty, '93, Alexandria, Egypt.
Robert D. McBride, '93, Dresden, Germany.
Ethelwyn Phillips, '93, Wigan, England.
Fred M. Prettyman, '93, Sao Paulo, Brazil, S. A.
Louis N. Seymour, '93, London, England.
Henry M. Bridgman, '94, Kirnberley, S. Africa.
Charles D. Cassidy, '94, Dublin, Ireland.
Charles P. Haselden, '94, Montreux, Switzerland.
Mary Linde, '94, Hanover, Germany.
Douglas Anderson, '95, Maidstone, England.
Fred E. Dodge, '95, Vienna, Austria.
Edmund Dubuis, '95, Geneva, Switzerland.
John F. H. Kuyper, '95, Semarang, Java.
Joseph Merckens, '95, Cologne, Germany.
Harry B. Respinger, '95, Basle, Switzerland.
Joseph H. Stromier, '95, Glasgow, Scotland.
Mrs. Friedrich von Widekind, '95, Berlin, Germany.
Friedrich von Widekind, '95, Berlin, Germany.
Ernest F. Day, '96, London, England.
Henry W. C. Bodecker, '97, Berlin, Germany.
Joseph T. Davies, '98, '91m, Cape Town, S. Africa, now at Grahamstown.
Carl H. Lebert, '99, Stuttgart, Germany.
Harry W. Sheldon, '99, Paisley, Scotland.
Edward J. Anderson, '00, Maidstone, England, now at Grahams-town, S. Africa.
Elsa Schultz-Hopf, '00, Hamburg, Germany.
Lee A. Watling, '00, Dresden, Germany.
Ottilie Borck, '01, Stettin, Germany.
What Modern Dentistry Does
By Charles Morehead Briggs, '00d
Ann Arbor
I Fear there are many people to whom the practice of dentistry implies merely the filling or extraction of teeth. But to know how to fill or "pull" teeth is to understand but a very small part of the modern dentist's work.
Present day dentistry demands of its practitioners that they shall possess, first, the basic principles of medicine. The splitting of medical and surgical practice into specialties has many times been deprecated and discouraged by the corporate bodies, which charge themselves with the maintenance of the educational standard and the public reputation of the profession. It may be noted, however, that those most strenuous in their denunciations of specialization, resort in their own cases to the practitioner who is looked upon as the highest authority in the peculiar ailment in question. Treatment of diseases of the teeth constituted a specialty of medicine among the ancient Egyptians. This branch of the parent tree has so grown that today it is itself breaking up into specialties.
There are many diseases that wholly, or in part, show their existence by certain manifestations in the mouth, and the dentist daily saves the world untold suffering and misery by his timely treatment of such cases, or after discovering such condition, by referring them to the physician for treatment. In the matter of treating; facial neuralgia, to take one example, modern dentistry deserves a high position; for this disease is now in the great majority of cases successfully treated by the dentist. We have seen many cases of neuralgia, of from five to fifteen years standing, that have baffled the skill of medical specialists, yield to the skilful treatment of the dentist. The dentist is now expected and required to reduce fractures of the jaw. The ordinary medical practitioner is at a loss to know how to proceed; but the dentist makes appliances and directs the treatment; the jaws unite quickly, in normal position, without those awful contortions of the face, sometimes seen where the work has been performed by some one not perfectly familiar with the teeth and their environment.
Modern dentistry removes facial deformities and restores losses of normal features. Dentists are required to make appliances that will restore the normal contour of the face, in cases where the whole, or part, of the facial bones may have been removed by disease or accident. Artificial noses and lips, as well as the strictly dental appliances, are attempted by none other than the dental specialists. They restore by artificial means the roof of the mouth, when this portion is missing by reason of disease, or when cleft palate afflictions have not been treated surgically during childhood. The dentist in these cases makes appliances that render the mouth capable of performing its duties, bringing about normal breathing and restoring the speech, so that to-day many persons wearing these appliances are not only able to masticate their food with perfect ease and comfort, but are able to enunciate so perfectly as to defy detection, and in many instances to earn their living, not by the sweat of the brow, but by the use of the voice in oratory. There are incurable diseases affecting the bones of the face, and the dentist is called upon to restore artificially parts that are lost, and to do it with appliances that can be easily removed for the purposes of cleansing and medication.
With all the advance made in medicine and surgery within the past few years, it has fallen to the lot of modern dentistry, to originate and perfect a method of surgical treatment for congenital cleft palate, whether simple or accompanied by harelip, single or double. This treatment is practically perfect, and children with dreadful deformities, when taken young enough, are so changed—made over, we may say—that upon arriving at the age of twelve or fifteen, they are not only able to perform all the functions of mastication and speech, but in many cases, (in fact in most cases), have lost even the slightest traces of the deformity.
Rude mechanical contrivances have been used as substitutes for the natural teeth almost from time immemorial. Teeth filled, teeth wired together to be used as substitutes for lost teeth, and crowns pivoted on to roots, are to be seen in the Egyptian mummies. Dental disease, therefore, is not wholly a privilege of this age and civilization.
Modern dental science is of European birth, but American growth. It is indeed both a science and an art. It involves much that is purely mechanical ; and judging by the results we often see, there is too often more of empiricism than of science, and more of bungling mechanism than of art. From a mechanical standpoint, the dentist should be capable of making any instrument he uses; or to devise and make special instruments for special operations. He is required to make delicate and beautiful appliances, the workmanship of which would put to shame the most skillful jeweler, not to mention the thousand and one mechanical operations in his usual practice.
With the ancient Greeks, all works, which exhibited skill, were called "works of art," and are today included in art in the broad significance of the word. The fine or ideal arts include poetry, music, painting, and sculpture. Poetry stands at the head of the fine arts, with music a close second, both taking precedence over painting and sculpture. It is not the intention here to put forth the claims of the several fine arts for precedence, but to claim for dentistry a high place in sculpture. Sculpture finds its grandest achievements in depicting in the human form all gradations of intelligence, affection, sentiment, action or passion, sublime, heroic or tender, and in all orders of beings from the exalted supernatural to the gradations bordering on the brutal. There are types of beauty; and the harmonious relations of one feature with another must be fully comprehended, if it is to be possible to re-store a lost part in all its perfection by a knowledge of what is demanded by the remaining features. In portrait sculpture, the mouth, of all others, is the feature denoting the soul. Neither to the eyes, nose, forehead, ears, chin, nor all combined, is given in full the power of conveying that of which the mouth is capable. It portrays every emotion: love, anger, pride, scorn, contempt, joy, and sorrow. Every tooth has an individual character and expression, not only in harmony with every other of the same mouth, but by the same divine law, in harmony with the features and the character of the creature, man or animal.
One of the greatest aids to the dentist in preserving or restoring this harmony, is porcelain art, so-called. It occupies a conspicuous place in the curriculum of all the leading dental colleges, and many successful practitioners give their entire time to its practice. Modern dentistry rebuilds broken-down teeth, restoring them to usefulness by means of a porcelain crown so constructed as to give absolute protection to the root, and to have great strength and beauty. These crowns are shaped to correspond with the remaining teeth, and colored exactly to shade, and are even supplied with blemishes, such as stains or abrasions, to make them so nearly resemble the remaining teeth as to defy detection, except possibly by the trained eye of the dentist, and then only upon close examination. In the total replacing of lost teeth, also, porcelain art does seemingly wonderful things. Not only can the dentist bridge a space made vacant by the loss of teeth, but he can so make up the loss as to restore the normal facial lines about the mouth, whose expression, if natural, is the key to the character. His work is so constructed that all display of metal is avoided, and the finished piece so resembles the remaining teeth in color, stains, etc., and the lost teeth in shape, size and color, as to pass unnoticed, or to defy detection, even when one is advised of its existence.
While it is not within the province of this paper to enter into a discussion of the relative advantages of the several materials used for filling teeth, yet under the head of porcelain art should be mentioned porcelain inlays; these are cavities in the teeth filled with porcelain. This branch of dentistry requires great skill and artistic taste. The progress in the preparation of porcelains and enamels has rendered it possible to insert fillings that a real most unnoticeable; in fact it is many times a difficult matter to make the observer at only a few feet distant believe that a filling has been inserted. These fillings are so prepared and inserted that the patient is required to be in the dentist's chair only a fraction of the time required for a similar filling of gold.
The molding of faces into an ideal form, is not alone the work of the sculptor, neither is the only material inanimate clay. The living subject in the hands of the dentist may often be changed by his skilful art from repulsive deformity into beauty and loveliness. The bones of the face determine its type, and the beauty of the face is dependent upon their shape. In the growth of the face, the excessive development of the jaws and associated parts contributes more to brutality of countenance than the exaggeration of any other feature. Judged by any standard of beauty, great depth of face, from forehead to chin, is a deformity. Protruding jaws and large teeth, with lips that find difficulty in covering them, or a receding lower jaw and retreating upper lip, take from the mouth its intellectual character and dignity. In the mouth and immediate surroundings carricaturists find the greatest scope for their pencils. Go where you will, in the village street, the crowded avenues of the city, in churches or theaters, or wherever humanity congregates, and you will be confronted by these deformities, in greater or less degree, in such numbers that you will be amazed at their prevalence.
One of the greatest advancements made in dentistry within the past few years has been in the correction of such irregularities of the teeth. This is one of the most difficult and exacting branches of dentistry, and is one of the most important of the connecting links between medicine and dentistry. When these deformities occur in the child, modern dentistry not only moves into correct positions the teeth that are crowded or jumbled, but it also reshapes all of the face below the forehead, changing at will the outline and expression of the whole countenance. Have you ever noticed a face that would be beautiful but for a protruding chin, or protruding upper teeth, and no chin at all Especially in a girl's or woman's face, like this, note the sad expression of the eyes, the lack of spirit, the seeming shunning of society. She feels that every one notices her; her deformity is literally blighting her whole life. In contrast see the same face after it has undergone successful treatment; we find a sparkling eye, a smile, all the features in harmony, with joy and thanksgiving written in every line.
In children the service of the dentist is especially valuable; for facial development can be checked here, or forced there, until harmony is secured in all the elements of the countenance. The complete transformation of the features, restoring their power of expression, with its inestimable value to the individual and society at large is one of the crowning glories of dentistry.
The modern dentist makes use of modern methods for overcoming pain incident to the many operations he is called upon to perform, and in no other branch of medicine is the operator required constantly to use so many anesthetics and obtundents as in dentistry. By the use of general anesthetics, such as chloroform, ether, nitrous oxide, and oxygen, and the local anesthetics and obtundents, the dentist is able to perform many of his operations with absolutely no pain, and all his operations with a diminution of pain. By the discovery and introduction of the first general anesthetic, dentistry has done a most remarkable service to the real happiness of mankind.
Modern dentistry has not been backward in utilizing electricity; in fact that force has become indispensable to the dentist, not only mechanically, but therapeutically. Besides its use for furnishing power for the engine and lathes, it is used for annealing the precious metals and for obtaining high heats. This last use has been a boon to dentists, making possible the perfect results obtained in porcelain art. The greatest use of electricity to the dentist, however, lies in its use therapeutically, in drying and sterilizing delicate root canals, in destroying or stimulating the growth of tissue, and in modifying the action of drugs. The X-ray is also extensively used in dentistry, in connection with diseases of the face and jaws. Notwithstanding its many uses at the present time, electricity is destined to play a far more important role in both the science and the art of dentistry in the future. Hence the modern dentist is required to have a thorough knowledge of electricity; indeed, the entire subject of physics is one of great interest and importance to dentistry.
The advancement made in dentistry in the past few years has caused the leading dental colleges to lengthen their course of study from three years to four. The student, it would seem, should find his time fully occupied in trying to master the many branches of his subject in the four short years he is in college.
The Michigan Alumnus
Jan 1903, page 143-155
