Formation of the Specialty and Scientific Connections
As an independent medical branch, dentistry emerged only in the 1920s, making it one of the youngest disciplines. Its foundation was the unification of two previously separate fields:
- Maxillofacial surgery, which historically developed within general surgery.
- Dentistry (historically *tooth-drawing* / *tooth-healing*), which existed separately until the 17th century, with care predominantly limited to the extraction of diseased teeth.
Today, the work of a dentist is inextricably linked with many other sciences. Successful practice requires an understanding of related clinical specialties (otorhinolaryngology, ophthalmology, neurology, internal medicine, surgery, radiology). In addition, dentistry relies on natural sciences (biology, physics, chemistry) and fundamental medicine (anatomy, physiology, pathomorphology, immunology, genetics, microbiology). The development of this field is always directly dependent on the economy, culture, science, and social structure of society.
Emergency Care in Dental Practice
The most crucial aspect of working in a dental office is preparedness for critical situations. A physician of any profile must immediately arrest life-threatening conditions that may arise during an appointment. These include:
- Shock, circulatory collapse, syncope (fainting), and comatose states.
- Acute respiratory and heart failure.
- Myocardial infarction and hypertensive crisis.
- Immediate-type allergic reactions.
- Status epilepticus.
- Acute trauma (including thermal injuries).
- Poisoning and snake bites.
An absolutely mandatory surgical skill for every dentist is the ability to perform a tracheotomy to ensure airway patency.
Historical Background: The Ancient East and Egypt
The history of attempts to treat teeth goes back to deep antiquity (3500–3000 BC).
In the Sumerian civilization (city of Nippur), researchers discovered hieroglyphic records with prescriptions for dental remedies, as well as the world's oldest gold toothpick.
The medicine of Ancient Egypt left a rich heritage. Ornate toothpicks and clay tablets describing gum massage techniques have been found in pyramids. Examination of mummies revealed traces of surgical intervention (drilled jawbones) and teeth fastened (splinted) with gold wire. Dating to approximately 2550 BC, a wooden dental prosthesis was found in a pharaoh's tomb. The most valuable written source of that era (3000–2000 BC) is considered to be the Ebers Papyrus, which features an entire chapter dedicated to the treatment of gum and dental diseases with detailed drug regimens.
Antiquity and the East: From China to Greece
In Ancient China around 2500 BC, the physician Hwang Phi created a medical treatise detailing pathologies such as gingivitis and oral abscesses, and mentioned the use of pain relievers and the first dental prostheses.
In Ancient India, dentistry was considered an integral part of surgery (physicians were already performing trepanations and facial plastic surgery). The Ayurveda treatise (9th–3rd centuries BC) offered hygienic advice: chewing licorice to clean teeth and stimulate salivation, and massaging the gums with coconut oil and drinking lemon water for bleeding gums. The famous Indian physician Sushruta (6th–5th centuries BC), who used hashish and henbane for anesthesia, described 65 oral diseases, 23 of which directly pertained to the teeth. He also systematized over 100 surgical instruments, including tooth extraction forceps.
In Ancient Greece, the outstanding thinker and physician Hippocrates (5th century BC) laid down the basic principles of maxillofacial surgery, describing in detail methods for treating jaw fractures and techniques for reducing mandibular dislocations.
The Middle Ages, Rus', and the Birth of Scientific Dentistry
During the Middle Ages in Europe, no significant breakthroughs occurred in dentistry. Classical physicians avoided surgical manipulations, attempting to treat toothache exclusively with internal remedies.
In Ancient Rus, healing long remained the domain of folk healers who used incantations and remedies of animal or plant origin. Due to the absence of a national system of medical education, practice was mostly carried out by foreigners. The medical community was divided into doctors (who treated internal diseases) and surgeon-barbers, who were subordinate to the doctors.
A real turning point occurred in France. In 1700, the title of "dental surgeon" was officially established. The rise of scientific dentistry is associated with the name of Pierre Fauchard. His contribution is colossal:
- Developed artificial crowns made of gold.
- Introduced cavity filling with silver amalgam.
- Invented the use of special springs to secure complete removable dentures.
- Began manufacturing pivot teeth (carving them from bone or using natural teeth).
Subsequently, the specialty developed rapidly: dental drills were invented, and in 1836 arsenic was used for the first time for pulp necrosis.
Briefly: answers to topical questions
What SanPiN (Sanitary Rules and Norms) requirements apply to the minimum area of a dental office per single chair?
The basic area of a dental office for a single physician's chair must be at least 14 m². When installing an additional chair, 7 m² is added to the area standard, and when installing an additional universal dental unit, 10 m². For an operating room in a surgical department, the baseline area with a single dental chair or operating table is at least 23 m².
What instruments are included in the standard oral examination kit?
The mandatory standard kit for oral examination includes three main instruments.
- Dental mirror — used for visual examination of the teeth, sublingual region, and palate.
- Explorer (dental probe) — used to detect carious cavities, probe crown defects, gingival papillae and margins, and to perform percussion.
- Dental tweezers — necessary for determining tooth mobility and performing percussion.
Additionally, the sterile instrument tray may include a spatula, a blunted probe, a Baumann probe, a head mirror, as well as nasal and ear specula.
What types of dental handpieces are used for the preparation of hard dental tissues?
Three main types of dental handpieces are used for preparing hard dental tissues.
- High-speed turbine handpieces — provide high rotation speed using compressed air, used with diamond burs primarily for preparing enamel and unaffected dentin.
- Contra-angle handpieces — low-speed mechanical handpieces, used with carbide burs for preparing necrotic tissues.
- Straight handpieces — low-speed instruments attached to micromotors connected to the dental unit drive.
What sterilization methods are used to process reusable dental instruments?
Physical, chemical, and combined sterilization methods are used for processing reusable dental instruments.
- Thermal methods — include dry heat sterilization, steam sterilization (autoclaving), glass bead (bead sterilizer) method for small instruments, and boiling.
- Chemical methods — soaking in solutions or low-temperature gas exposure for instruments that cannot withstand thermal stress.
- Ozone sterilization — keeping the object in an ozone atmosphere.
- Plasma sterilization — bombardment with plasma atoms and molecules.
Class and exam questions
Which fields formed modern dentistry?
Dentistry emerged in the 1920s through the merger of maxillofacial surgery and traditional tooth-pulling.
What life-saving surgical skill must every dentist master?
Every dentist is obliged to be able to perform a tracheotomy to restore airway patency.
What was Pierre Fauchard's contribution to the development of the specialty?
Pierre Fauchard laid the foundations of scientific dentistry: he developed gold crowns, silver amalgam fillings, pivot teeth, and springs for removable dentures.
What else to study on this topic
- Methodology and technique of emergency tracheotomy
- Algorithms for managing anaphylactic shock in dental practice
- The development of dentistry in Russia after the 18th century
- The evolution of dental instruments from antiquity to the invention of the dental drill
Master the entire topic in the «Propaedeutics of Dentistry» course
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- The complete textbook on "Dental Office Organization" and 868 more pages on the subject
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Other topics in "Chapter 1. Introduction to the Specialty of Dentistry"
Entire section "Chapter 1. Introduction to the Specialty of Dentistry"Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.