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Monday, February 1, 2016

Dental Fads, Fancies and Facts


This set of dental tools was used by Dr. Earle Munson during a practice in Gardner, Massachusetts from 1918 to 1954.  He is the father of Bradford dentist Dr. Philip Munson and grandfather of Dr. Robert Munson. The cabinet pictured below held dental instruments and medications during the Gardner practice.  It is now an ornamental part of the current Dr. Munson's office.   

Some dentists were itinerant and offered services in a number of communities. This also opened the door to quacks who preyed on unsuspecting patients.   Dr. Sebre Gustin Jr. practice dentistry for 35 years until his death in 1883.

Cocaine toothache drops were introduced in 1885 and was very popular for the treatment of toothache pain

in children. This was an example of the use of cocaine as a "miracle cure." It was said that in addition to soothing pain it would put the child in a "better mood."  

In the 1880s tube toothpaste began to replace liquid or powder forms of dentifrice. Colgate became the most popular brand.  This ad was published during World War I.

In 1887 Frank Ritter began to manufacture dental chairs in Rochester, New York.  The one pictured in this 1917 advertisement was the first example of single dental unit equipment. Below is pictured the Ritter chair used by Dr. Earle Munson during his practice.  

In the more than 200 years of American dental history, the profession has made giant strides beyond this kind of dentures manufactured from animal or human teeth.   
“Many are inclined to neglect their teeth until they are past remedy, or have them filled in a diseased condition--making the foolish remark, ‘So long as my teeth don’t trouble me, I won’t trouble them.’”
Dr. R. Kilbourn Green Mountain Freeman, 1848
Most people would rather not find themselves in a dentist’s chair.  But for centuries, those same people have sought relief from the stabbing pain of a toothache or needed replacements for missing teeth. This article describes advances in dental care and how those developments found their way into local practices. 

Dental health was mixed in ancient times. While teeth were often worn by the abrasives in crudely ground flours, many people did not have cavities resulting from a sugar-rich diet.  When dental problems did arise, they were caused by the activity of toothworms.  While the upper classes have consulted physicians or dentatores , others relied on folk prescriptions ranging from donkey’s milk to cloves or turned to blacksmiths, barbers, monks or other “tooth-drawers.”

There is evidence of extractions by forceps and fillings with soft materials that prevented air from reaching exposed roots. There is also evidence of attempts of replacing missing teeth using ivory or using teeth taken from animals or even from other humans. The latter might come from corpses, purchased from the indigent or even stolen by toothnappers.  

For centuries people have used toothpicks made from, depending on their social class,  hog bristles and twigs or precious metals. Powders were used to clean teeth and freshen breath, but overly abrasive powders could damaged enamel. 

French physician Pierre Fauchard is considered to be the founder of modern dentistry. In 1728 he published the first scientific description of dental anatomy, causes and treatment of dental diseases and available dental instruments.  

Colonial America had no professionally trained dentists. As before, those needing assistance would turn to those who did dentistry on the side. Boston engraver Paul Revere was one . His neighbor Isaac Greenwood is considered to be one of the first native- born dentists. 

Greenwood’s son John was also a dentist in 1790 and made one of several sets of false teeth worn by George Washington, which incidentally was not made of wood. John Greenwood also constructed the first known foot powered dental drill. About the same time Josiah Flagg of Hartford, Connecticut constructed the first dental chair.  It was a Windsor chair with an adjustable headrest and an arm modified to hold instruments.

By the 1830’s many were using commercially available tooth-care products and treating pain with a variety of patent medications. One Vermont newspaper in 1836 carried an advertisement for Cambrian Tooth-ache Pills which promised “immediate relief.”  At best, such products usually offered only temporary relief.

Similar advertisements mentioned the availability to dentists of the time-worn “tooth key” for extractions. This instrument was used to turn the tooth out, usually resulting in breaking the tooth and creating excruciating pain. 

Time often lagged between celebrated inventions and their appearance in local communities.   In 1825 Samuel Stockman began the commercial manufacturing of porcelain teeth.  By the mid-1830s advertisements began to appear in Vermont newspapers for porcelain replacements, a lucrative, if not always successful, product. At least one Vermont dentist still offered animal teeth as an alternative. 

Some dentists filled cavities with metal foil as mercury amalgam paste was available but unstable. The Crawcour Brothers were charlatans known for using unstable silver paste on anyone willing to pay.  At the same time there was a controversy within the dental profession over the use of amalgam fillings.

In 1836 Charles Goodyear invented vulcanized rubber and in 1864, Vulcanite was patented as an excellent base for false teeth. In 1867 a Chelsea dentist advertised that “he was fully authorized” to  insert teeth into this hard rubber base. Dentures underwent a number of innovations during the years that followed. One of many patents was awarded in 1875 to Dr. J. N.  Clark of Bradford.    

 In 1846 Vermont dentists announced the use of sulphuric ether for painless extractions. In 1848 chloroform became available for dental use. By March of that year, one Brattleboro dentist using this anesthesia was “literally thronged with patients.” In 1876 the Vermont Phoenix reported, “It is needless to dilate on the inestimable boon which anesthesia in its various useful applications has conferred on mankind.”  

In 1892 a Boston dentist invented “Vegetable Vapors” as a substitute for “ether, chloroform or all dangerous substitutes used to destroy pain.” The only notice of its local use was in a series of ads in The United Opinion from 1897-1899. It was being used by Dr. W. H. Talbot of Haverhill who promised “painless dentistry.”    

Two advertised product available to Vermonters in the 1830’s were “The British Antiseptic Dentifrice Tooth Powder and “Jones’s Amber Tooth Paste.”The latter guaranteed to “render the foulest teeth delicately white and make the breath pure and sweet.”Baking soda was also a popular dental cleaner. 

In the 1880’s tube toothpaste began to replace the liquid or powder forms of dentifrice, with Colgate being the most popular brand. Thanks to mass marketing it became used widely within 20 years. 

Since ancient times some form of toothbrushes were used to clean teeth. In 1857 H. N. Wadsworth received the first toothbrush patent. While toothbrushes were mentioned in Vermont newspapers prior to that time, advertisements for them began to appear in 1860.
Over the next 40 years, a number of innovations changed dental practice. In 1871, a patent was given for the first commercially manufactured foot-treadle dental engine.  This invention revolutionized drilling of teeth. In 1877 the Wilkerson pump-type hydraulic dental chair was introduced

In 1890 Willoughby Miller reported on plaque as the basis of dental decay. This resulted in a heightened awareness of oral hygiene. Nevertheless, it was still rare for individuals to visit a dentist until there was a problem.  It was rarer still  for a child to visit a dentist as most felt that primary teeth did not need special care as they would soon fall out. 
Dental x-ray was introduced in 1895.It was first mentioned in The United Opinion in 1896 and after 1914 was included in dental advertisements in both states. Dental offices became electrified in Vermont after 1893. Charles Land devised the porcelain jacket crown in 1903.The local anesthetic Procain was introduced in 1905, later marketed as Novocain.

After an unsuccessful attempt to establish dental nurseing as a practice, the first dental hygienists were graduated from formal training in 1913. It would be another seven years before a license was granted to a dental hygienist in Vermont. Dental assistants involved in four-handed dentistry were not certified in Vermont until 1962.

 Records from the late 1770’s indicate there were no local dentists. As communities and the profession expanded, dentists began to offer their services. About 1840 Dr. Abram Dickey established a practice in Lyme and was still listed in 1867 along with Samuel Hale of Orford.

 In 1852 Alvah Cummings was listed as a Topsham dentist and Edwin Kilbourne practiced in Bradford. Twenty-five years later the New England dental directory listed two dentists in Thetford, three in Groton, at least four in Bradford and one each in Lyme, Orford, Woodsville, Topsham, Newbury and West Fairlee.  Some communities had no dentists. By 1919 there were four dentists in Woodsville.  They included Dr. Edward Miller of Ryegate and Dr. H. G. Darling. 

Dr. Oscar H. Stevens is one dentist who devoted his entire career to serving the area. Born in Corinth in 1843, he was in practice in Bradford in 1868 and continued until about 1905. His advertisement that year offered patients a newly patented “improved dental plate.” In 1876 he, along with fellow dentist J. N. Clark, were described as “well known and highly esteemed dentists, in the use of all modern improvements.” By that time his advertisements noted he had fashioned over 300 sets of teeth.

Those modern improvements included his use of the “Electric Vibrator” for the extraction of teeth “without being tortured and without the least danger.” In 1891 he offered his services to the citizens of St. Johnsbury and Barton as a visiting dentist.  To those who needed his services he advertised, “Now is your time.” 
Other established dentists offered services in neighboring towns. In the mid-19th century, a dental surgeon from Chelsea, Dr. Sebre Gustin, Jr. advertised that he was available in Thetford and Corinth along with other Orange County towns. In 1888 Dr. A. Clark of Montpelier advertised his services in Groton, Waits River and West Fairlee  for a week at a time. In 1902 Dr. Walter Cole of Bradford offered to see patients in Orford and Lyme three day each month.

Dentists were even known to make house calls. Farmer Henry Martin of Bradford had his remaining teeth pull while sitting on the running board of his vehicle in his front yard. He then went to milk the cows. 

As dentistry training became an established expectation, the profession saw the advantages of both licensure and organization. The American Dental Association was organized in 1859. In 1877 both the Vermont State Dental Society and the New Hampshire Dental Society were organized. Within a year New Hampshire adopted a licensing requirement with a board of dental examiners. Vermont did the same in 1882.  
 The profession tried to protect the public from quacks, especially those who arrived in town, performed procedures and then disappeared, leaving suffering patients behind. In 1905 the St. Johnsbury  Caledonian reported a case in which a quack extracted teeth from a  Bethel patent under the promise of no pain. His quick exit left behind a girl who experienced “80 hours of terrible pain and a badly swollen jaw.”

Advertising by dentists was another issue and in the early decades of the 20th century, the profession began to take a stand against it. It was only after court cases against the prohibition in 1977 that advertising again appeared.

During World War II millions of servicemen received dental care, many for the first time. This helped to increase dental awareness in the general public in the years following the war. For many the idea of a “family dentist” became a reality.  
The following is a roster of local dentists from the past 80 years. Dr. Byron Bayley was practicing in Bradford in the 1930’s. Dr. Leonard Abbadessa began his practice in Bradford in 1942 and Dr. Perley Speed opened his office in Woodsville in 1944. Dr. Philip Munson joined Dr. Bayley in 1948, and after leaving for service in the Navy, returned to practice from 1953 until 2002. Dr. Peter Saladino had an office from 1963-1993. Dr. James Barton began practicing in 1964 and retired in 2010. 

Dr. James Brown practiced in Haverhill from 1989 until his retirement before 2008. Dr. James Gold had his practice in East Thetford from 1977until 2008 and then sold it to Dr. Alicia Willette who still operates it. 

Other current practitioners include Dr. Robert Munson who joined his father’s practice in 1984 and Barton’s son Dr. Charles Barton who began his dental career in 1994. His wife Dr. Khang Bui joined her husband in 2006, the first female dentist in the area. Dr. Ralph Falvotico opened office in Bath in 2000. 

Drs. James Barton and Robert Munson recently listed what, to them, were the most important changes in dentistry during their careers in Bradford. Both agreed that implants, changes in composites, fluoride additives, and root canal procedures were major changes. Dr. Barton spoke about the importance of high speed drills, an innovation at the beginning of his practice. Both felt that dental education and care for children had improved dramatically.  
My wife Carolyn worked for many years as a dental assistant for both Drs. Munson and for Dr. James Barton. In fact, I met her for the first time as I sat in Barton’s dental chair in 1967. When Jim left the room temporarily he asked her to talk with me.  At the end of the procedure, I asked her for a date. Over the years I have had a close connection with dentists and their staffs and have not in those years regretted my history of sitting in a dentist chair.