Prerequisites for Medicine in the Feudal Era
Before the reign of Peter the Great, domestic dentistry developed less rapidly than in European countries. The main catalyst for providing surgical care for facial trauma was large-scale wars and outbreaks of severe epidemics.
The first organized attempts to provide care were recorded in the 14th century in Moscow, where special hospital wards were deployed at eighteen monasteries. Monks performed tooth extraction operations and treated maxillofacial injuries.
Over time, foreign specialists began to be recruited:
- Dmitry Donskoy: the appearance of the first healers from Europe.
- Ivan III: the arrival of professional physicians in the entourage of Sophia Paleologue. Concurrently, self-taught Russian healers practiced.
- Ivan IV (the Terrible): establishment of the Apothecary Chancery, which was responsible for distributing medications to treat toothaches and facial injuries.
- Michael Romanov: practice became divided — ordinary citizens turned to artisan doctors, while complex dental interventions at the court were performed exclusively by foreign doctors.
Regulation and the emergence of instrumentation (18th – 19th centuries)
The era of Peter I marked systematic transformations. By decree of the emperor, the first surgical instrument manufacturing plant in the country was built. An important milestone was the creation by the master Potapov of the first specialized set of instruments designed for tooth extraction.
Gradually, the need for legislative regulation of dental practice arose. In 1858, the Ministry of Internal Affairs published a strict procedure for training in the so-called "dental art" for the first time in its collection of circulars.
Emergence of caries epidemiology and sanitation
It was in the late 19th century that the foundations of the epidemiological approach were laid. Researchers of that time statistically established for the first time that the prevalence of caries among urban residents significantly exceeds similar indicators in the rural population.
A colossal contribution to the development of a scientific approach was made by Professor N.V. Sklifosovsky. He became the founder of the in-depth study of the carious process. Moreover, he was the first in domestic practice to clearly formulate the need for preventive measures and regular oral sanitation.
His ideas were developed by Professor A.K. Limberg, who went down in history as the creator of the system of planned dental sanitation for schoolchildren. In 1891, he successfully defended the country's first odontological dissertation dedicated to the prevention and therapy of "tooth decay."
Formation of professional education
For a long time, personnel were trained through a system of craft apprenticeships. The situation changed in 1881 with the opening of Russia's first dental school (the second in Europe after Paris) at the clinic of the Imperial Philanthropic Society. In January 1884, the first graduation of 23 specialists took place, and over a decade, the school trained 219 dentists.
Subsequently, such institutions began to open en masse in major cities:
- St. Petersburg: Vongel's school of dentistry.
- Warsaw: James-Levy school.
- Moscow: schools of I.M. Kovarsky, V. Greffe, Dr. Izachik, and Doctor of Medicine G.I. Wilga.
- Odessa: I.I. Margolin's school.
The most important legal act was the State Council Regulation of May 7, 1891, "On the Reform of Training in Dental Art." The document officially banned apprenticeship and established two qualification categories: dentist and dental physician. These measures led to a rapid growth in personnel: by 1913, 6,700 specialists were already practicing in the country.
Soviet reforms and the state system (1918–1920s)
After the change in the political regime, the system of odontological education came under the jurisdiction of university medical faculties (according to the decree of November 1918). When the People's Commissariat of Health (Narkomzdrav) of the RSFSR was established, a dental subsection was formed under the leadership of P.G. Dauge.
In the spring of 1920, decrees were issued on the establishment of specialized departments. The dentistry course at the Moscow State University medical faculty was reorganized into a full-fledged department headed by Prof. G.I. Wilga and Prof. L.A. Govseev. Prominent figures began their path here: V.A. Dubrovin, I.G. Lukomsky, I.A. Betelman, A.E. Verlotsky.
In parallel, major research bases were created:
- Institute of Public Dentistry (Petrograd, 1919).
- Odontological Institute (Kiev, 1919).
- State Institute of Dentistry (Moscow, 1922).
Briefly: answers to topical questions
What are the stages of processing and sterilization of dental instruments?
Processing and sterilization of reusable dental instruments include three main stages: disinfection, pre-sterilization cleaning (PSC), and sterilization.
The complete cycle consists of the following steps:
- Disinfection — soaking instruments in a disinfecting solution.
- Pre-sterilization cleaning — rinsing under running water, soaking in a detergent solution, and mechanical or ultrasonic cleaning.
- Packaging — packing and preparation for sterilization.
- Sterilization — processing using physical or chemical methods.
- Efficacy control — checking the quality of sterilization.
- Delivery — storing sterile material and delivering it to the site of operation.
How are dental handpieces disinfected and sterilized?
Disinfection and sterilization of dental handpieces are carried out manually or by machine methods, taking into account their complex internal structure.
- Manual disinfection — wiping twice with 70% alcohol or a 3% chloramine solution before and after use, then passing the handpiece through a burner flame.
- Machine disinfection and PSC — using "Assistina" systems (supplying disinfectant solution and oil under pressure) or "Terminator" (express processing in 3 seconds).
- Sterilization of dental handpieces — boiling in vaseline oil followed by centrifugation.
- Sterilization of surgical handpieces — steam processing at a temperature of 140 °C.
What classes of medical waste are generated in a dental office?
In a dental office, medical waste is classified by degree of hazard into classes A–D.
- Class B — waste contaminated with sputum, including masks, handkerchiefs, wipes, and containers.
- Class C — waste from patients with COVID-19.
Sources do not provide the full composition of classes A, G, and D as applied to a dental office.
How is the quality control of pre-sterilization cleaning of dental instruments carried out?
Quality control of pre-sterilization cleaning (PSC) is carried out using qualitative chemical tests to detect residues of occult blood and detergents.
The volume of control is 1% of simultaneously processed items of the same name, but not less than three units. The following tests are used:
- Azopiram test — a mixture of azopiram and a 3% hydrogen peroxide solution is applied to the instrument.
- Amidopyrine test — a mixture of alcohol, amidopyrine, hydrogen peroxide, and acetic acid is used.
Cleaning is considered ineffective if a blue-violet coloration appears within 1 minute, which then turns pink-lilac or brownish.
What are the requirements for surface treatment in the dental office after each patient?
After treating each patient in the dental office, mandatory disinfection of furniture surfaces, medical devices, and door handles is required. Constant access to disinfectants must also be ensured.
Before the start and after the end of the work shift, sanitary treatment of the procedural table, the table for storing sterile instruments, dental chairs, sinks, and sink faucets is carried out by wiping twice with a cloth moistened with a 1% chloramine solution, followed by turning on a germicidal lamp.
To memorize the pioneers of prevention: Sklifosovsky — Sanitation (laid the groundwork for the very idea of healthcare improvement), Limberg — Treatment (introduced mass planned treatment/sanitation for schoolchildren).
Class and exam questions
Who in Russia was the first to express the idea of the need for oral sanitation?
Professor N.V. Sklifosovsky was the first to substantiate the need for regular oral sanitation and the implementation of preventive measures. He is also the pioneer in the study of dental caries.
When was training to become a dentist through apprenticeship officially abolished?
Training personnel through individual apprenticeships was banned on May 7, 1891, with the issuance of a special State Council Regulation reforming the teaching of dentistry.
What is the main contribution of A.K. Limberg to odontology?
Professor A.K. Limberg was the creator of the system for planned oral cavity sanitation in school-age children. In 1891, he also defended the first domestic dissertation on the prevention and treatment of caries.
What decisions were made at the 1st All-Russian Odontological Congress in 1896?
At the congress held in Nizhny Novgorod, issues of personnel training were discussed, the question of a final ban on handicraft apprenticeships was raised, and the idea of mass sanitation of students was formulated.
What else to study on this topic
- Functions and structure of the Apothecary Order in providing maxillofacial surgery.
- Evolution of dental instruments: from Potapov's kit to factory production.
- Activities of the first scientific societies and specialized journals ("Zubovrachvestnik", "Odontologicheskoye obozreniye").
- Formation of the first odontological privat-docent positions (Military Medical Academy and Higher Women's Courses).
- Structure and tasks of the Institute of Public Dentistry, founded in Petrograd in 1919.
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Other topics in "Chapter 1. Introduction to the Specialty of Dentistry"
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