Reviewer-nga-wa-natun-eden014 (5-8)

Module 5: Timeline of Dental History: Advances in Science and Education

18TH CENTURY

Before 1800‟s, the practice of dentistry was still a long way from achieving professional status. This was to change in the 19th century - the most significant period in the history of dentistry to date. By 1800 there were still relatively few „dentists' practicing the profession. By the middle of the 19th century the number of practicing dentists had increased markedly, although there was no legal or professional control to prevent malpractice and incompetence. Pressure for reform of the profession increased.

1801

Richard C. Skinner writes the Treatise on the Human Teeth, the first dental book published in America. This book is a short and concise study on the structure and function of teeth. This was published at a time when dentistry, based on local newspaper advertisements of dentists,

was still an itinerant practice. Dentistry was not regulated (first licensing examination was introduced in 1841 the state of Alabama). Richard Skinner‟s book is a milestone in the rise of American dentistry.

1825

Samuel Stockton begins commercial manufacture of porcelain teeth. His S.S. White Dental Manufacturing Company establishes and dominates the dental supply market throughout the 19th century.

1830’s-1890’s

The 'Amalgam War' conflict. The Crawcours (two brothers from France) introduce amalgam filling material in the United States under the name Royal Mineral Succedaneum. The brothers are charlatans whose unscrupulous methods spark the “amalgam wars,” a bitter controversy within the dental profession over the use of amalgam fillings.

What is a dental amalgam?

Dental amalgam is a liquid mercury and metal alloy mixture used in dentistry to fill cavities caused by tooth decay.[1] Low-copper amalgam commonly consists of mercury (50%), silver (~22–32%), tin (~14%), zinc (~8%) and other trace metals

NOTE: Alloy is a metal made by combining two or more metallic elements, especially to give greater strength or resistance to corrosion

1839

The American Journal of Dental Science, the world‟s first dental journal, begins publication.

Charles Goodyear invents the vulcanization process for hardening rubber. The resulting Vulcanite, an inexpensive material easily molded to the mouth, makes an excellent base for false teeth, and is soon adopted for use by dentists. In 1864 the molding process for vulcanite dentures is patented, but the dental profession fights the onerous licensing fees for the next twenty-five years.

NOTE: Vulcanization is a chemical process for converting natural rubber or related polymers into more durable materials via the addition of sulfur or other equivalent curatives or accelerators

1840

Horace Hayden and Chapin Harris found the world‟s first dental school, the Baltimore College of Dental Surgery, and establish the Doctor of Dental Surgery (DDS) degree. (The school merges with the University of Maryland in 1923). On this same year, the American Society of Dental Surgeons, the world‟s first national dental organization, is founded. But the organization dissolves in 1856.

1841

Alabama enacts the first dental practice act, regulating dentistry in the United States. The act called for the assignment of a dentist to the state‟s medical board in order to grant licenses for practicing dentistry in the state, however, the act was never enforced, few dentists are ever assigned a seat on the medical board and only a couple of dental licenses are ever granted during the forty years it was on the books.

1844

Horace Wells, a Connecticut dentist, discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his private practice. He conducts the first public demonstration of its use as an anesthetic in 1845 but the demonstration is generally considered a failure after the patient cries out during the operation. Laughing gas and nitrous oxide are one in the same—a safe and effective anesthetic administered to dental patients through a mask in an oxygen mixture. Laughing gas won’t put you to sleep like general anesthesia. Instead, inhaling this mixture will make you feel a light tingling sensation.

1846

Dentist William Morton (a student of Wells) conducts the first successful public demonstration of the use of ether anesthesia for surgery. The previous year Horace Wells, also a dentist, had conducted a similar demonstration that was regarded a failure when the patient cried out. Crawford Long, a physician, later claims he used ether as an anesthetic in an operation as early as 1842, but he did not publish his work.

1859

Twenty-six dentists meet in Niagara Falls, New York, and form the American Dental Association.

1864

Sanford C. Barnum, develops the rubber dam, a simple device made of a piece of elastic rubber fitted over a tooth by means of weights, which solves the problem of isolating a tooth from the oral cavity.

What is the purpose of rubber dam?

Its purpose is both to prevent saliva interfering with the dental work (e.g. contamination of oral micro-organisms during root canal therapy, or to keep filling materials such as composite dry during placement and curing), and to prevent instruments and materials from being inhaled, swallowed or damaging the mouth. In dentistry, use of a rubber dam is sometimes referred to as isolation or moisture control

NOTE: A dental dam or rubber dam is a thin, 6-inch (150 mm) square sheet, usually latex or nitrile, used in dentistry to isolate the operative site (one or more teeth) from

the rest of the mouth. Sometimes termed "Kofferdam"—from German.

1866

Lucy Beaman Hobbs graduates from the Ohio College of Dental Surgery, becoming the first woman to earn a dental degree.

1867

The Harvard University Dental School, the first university-affiliated dental institution, is founded. The school calls its degree the Dentariae Medicinae Doctorae (DMD), creating a continuing semantic controversy (DDS vs. DMD).

1871

A tooth coloured filling material, silicate cement, was introduced. James B. Morrison patents the first commercially manufactured foot-treadle dental engine. Morrison‟s inexpensive, mechanized tool supplies dental burs with enough speed to cut enamel and dentin smoothly and quickly, revolutionizing the practice of dentistry.The American George F. Green receives a patent for the first electric dental engine, a self-contained motor and handpiece.

1877

The Wilkerson chair, the first pump-type hydraulic dental chair, is introduced.

1880’s

Dr. Washington Sheffield of New London, Connecticut manufactured toothpaste in collapsible tube and called it Dr. Sheffield‟s Dentifrice in 1892. Dentifrice had been available only in liquid or powder form, usually made by individual dentists, and sold in bottles, porcelain pots, or paper boxes. Tube toothpaste, in contrast, is mass-produced in factories, mass-marketed, and sold nation-wide. In twenty years, it becomes the norm.It was on the same year that the British Dental Association was founded.

1883

The National Association of Dental Examiners is founded by the members of the dental boards of several states in order to establish uniform standards in the qualifications for dental practitioners, the administration of dental boards overseeing licensing and the legislation of dental practice acts.

1885

The first female dental assistant is employed by C. Edmond Kells, a prominent New Orleans dentist. Her duties include chair-side assistance, instrument cleaning, inventory, appointments, bookkeeping, and reception. Soon “Lady in Attendance” signs are routinely seen in the windows of 19th century dental offices. The American Dental Assistants Association is founded in 1924 by Juliette Southard and her female colleagues.

1895

Wilhelm Conrad Roentgen (1845 - 1923), a German physicist, discovers the x-ray.

1896

In 1896 prominent New Orleans dentist, C. Edmond Kells, takes the first dental x-ray of a living person in the U.S.It was on this same year that Dr. Greene Vardiman Blackor known as “G.V. Black”, a leading reformer and educator of dentistry establishes the principles of cavity preparation. In 1908 he publishes his two-volume treatise: Operative Dentistry.

NOTE: Cavity preparation is the mechanical alteration of a tooth to receive a restorative material, which will return the tooth to proper anatomical form, function, and aesthetics. The procedure is done to remove the defective or friable tooth structure.

1899

Edward Hartley Angle classifies the various forms of malocclusion. Credited with making orthodontics a dental specialty, Angle also establishes the first school of orthodontics (Angle School of Orthodontia in St. Louis, 1900), the first orthodontic society (American Society of Orthodontia, 1901), and the first dental specialty journal (American Orthodontist, 1907).

NOTE: Malocclusion is an imperfect positioning of the teeth when the jaws are closed.

Normal occlusion: The mesiobuccal cusp of the upper first molar occludes with the buccal groove of the

lower first molar.

Class I malocclusion: Same as normal occlusion but characterized by crowding, rotations, and other

positional irregularities.

Class II malocclusion or Retrognathic: The mesiobuccal cusp of the upper first molar occludes anterior to

the buccal groove of the lower first molar. There are two subtypes of Class II malocclusion.

Class III malocclusion or Prognathic: The mesiobuccal cusp of the upper first molar occludes posterior to

the buccal groove of the lower first molar.

19TH CENTURY

1903

Charles Land devises the porcelain jacket crown.

1907

William Taggart invents a “lost wax” casting machine, allowing dentists to

make precision cast fillings.

1908

G. V. Black publishes his monumental two-volume treatise Operative Dentistry, which remains the essential clinical dental text for fifty years. Black later develops techniques for filling teeth, standardizes operative procedures and instrumentation, develops an improved amalgam, and pioneers the use of visual aids for teaching dentistry.

1913

Alfred C. Fones opens the Fones Clinic for Dental Hygienists in Bridgeport, Connecticut, the world‟s first oral hygiene school. Most of the twenty-seven women graduates of the first class are employed by the Bridgeport Board of Education to clean the teeth of school children. The greatly reduced incidence of caries among these children gives impetus to the dental hygienist

movement. Dr. Fones, first to use the term “dental hygienist,” becomes known as the Father of Dental Hygiene.

1938

The nylon toothbrush, the first made with synthetic bristles, appears on the market, introduced by DuPoint.

1937

Alvin Strock inserts the first Vitallium dental screw implant. Vitallium, the first successful biocompatible implant metal, had been developed a year earlier by Charles Venable, an orthopedic surgeon.

1945

The water fluoridation era begins when the cities of Newburgh, New York, and Grand Rapids, Michigan, add sodium fluoride to their public water systems.

1948

The Oral Health unit was established in World Health Organization.

1949

Oskar Hagger, a Swiss chemist, develops the first system of bonding acrylic resin to dentin.

1950’s

The first fluoride toothpastes are marketed.

1955

Michael Buonocore describes the acid etch

technique, a simple method of increasing the

adhesion of acrylic fillings to enamel.

What is an acid etch technique?

Acid etching is the use of an acidic substance to prepare the tooth‟s

natural enamel for the application of an adhesive. The acid roughens

the surface microscopically, increasing retention of resin sealant.

1957

John Bordern introduces the high-speed air-driven contra-angle handpiece. The Airotor obtains speeds up to 300,000 rotations per minute and is an immediate commercial success, launching a new era of high-speed dentistry.

1958

A fully reclining dental chair is introduced.

1960’s

Sit down, four-handed dentistry becomes popular. This technique improves productivity and shortens treatment time.

NOTE: Bonding agents (spelled dentin bonding agents in American English) are resin materials used to make a dental composite filling material adhere to both dentin and enamel.

What is four-handed dentistry means?

It simply means that the dental assistant's two hands are assisting the dentist's two hands, helping to reduce the amount of time a dental exam or procedure may take.

1960

The first commercial electric toothbrush, developed in Switzerland after World War II, is introduced. A cordless, rechargeable model follows in 1961.

1962

Rafael Bowen develops Bis-GMA, the thermoset resin complex used in most modern composite

resin restorative materials.

1980’s

Per-Ingvar Branemark describes techniques for the osseo-integration of dental implants.

1989

The first commercial home tooth bleaching product is marketed.

1990’s

New tooth-colored restorative materials plus increased usage of bleaching, veneers, and implants inaugurate an era of esthetic dentistry.

1997

FDA approves the erbium YAG laser, the first for use on dentin, to treat tooth decay.It simply means that the dental assistant's two hands are assisting the dentist's two hands,

helping to reduce the amount of time a dental exam or procedure may take.

NOTE: Osseointegration (from Latin osseus "bony" and integrare "to make whole") is the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant.

Module 6:The Ancient Dental Practices

ANCIENT DENTAL PRACTICES

Long before Dentistry came into our civilized world, man had already been preoccupied with the quality of his smile. They did all sorts of practices that can be interpreted today as strange, like chipping or filing of teeth, blackening them, decorating them with gold and precious stones.

I. Chipping or Filing of Teeth

The practice of filing teeth to points was widely practiced throughout the world from Asia to Africa. There was even an allegation that Australian aborigines filed their teeth to points so they could easily bite on people. The usual instrument used for filing of teeth was whetstone and chisel.

Malaysia

Jakun tribe of Malaysia supplements the different embellishments on his face and body by filing the front surfaces of the six upper anterior teeth to make them concave. Some even colored them black.Batak tribe (a Mid-Sumatran Tribe) were said to have chipped the teeth of their children into the desired shape with the use of chisel. The operation caused agony that the child usually shrieked leaping to his feet.

Indonesia

In Indonesia, filing of teeth has a deep significance as a form of initiation at puberty. When a young girl or boy of a high caste family reaches the age of puberty, a ceremony was held to announce his or her status as an adult. Part of the ceremony was the filing of the upper teeth into an even line done by a specialist, called brahmana.

Why do they have to do this?

The reason was to diminish the six evil qualities of human nature: desire, greed, anger, intoxication, irresoluteness, and jealousy.

In common with the Sumatrans and other inhabitants of the Archipelago and southern part of peninsula, both sexes of the ranks have the custom of filing and blackening the teeth, it was being considered as disgraceful to allow them to remain white like dogs. The Java, however, do not file away the teeth as much as is usual with some of the islanders; nor do they set them in gold, as in the case with the Sumatrans.

In Bali, accordingly, teeth were filed because the natives will not be able to enter the spirit world if their teeth were as long and pointed as the animals. In fact, even corpse’s teeth were filed before cremation so they will not look like a demon in the spirit world.

Africa

It also has to do with prevailing sense of beauty. It was stylish for them to file their teeth like the Efe tribes deep in the rainforests of Africa.

India

Tribes like Kadars and Malavetans of India chipped their teeth in the form of serrated cones.

What is their purpose of doing this?

This they did for the purpose of distinguishing themselves from other tribes who also practiced

filing of teeth.

Philippines

The Aetas used chisel especially made for the purpose and the chipping was done precisely with one swift movement to lessen the agony, after which they bite into a layer of banana trunk to prevent sensitivity.

Health Beliefs and Practices

The Aetas have a superior knowledge of not only the edible fauna and staples in the forest but over a hundred medicinal herbs and their applications. Since one average Aeta only gets to use a dozen or two of these natural remedies in a lifetime, it is obvious that the people take pains to memorize entire canons of local herbs, roots and barks and pass them on to their children.

II. Blackening of Teeth

Dyeing of teeth black had been widely practiced in many Asian countries. The practice of blackening teeth revolved around animalistic rituals with the belief that only animals have white teeth.

Philippines

Tasaday Manube tribe, the Stone Age tribe persisting to these days, practice blackening of teeth, also believing that only animals have white teeth.

Burma (present-day Myanmar)

Ralph Fitch, a merchant adventurer, was the first Englishman to have visited Burma in the kingdom of Pegu in 1586. He reportedly saw the people of Pegu, both men and women with black teeth. Manu ethnic group of Burma stained their teeth black because they wanted their teeth to be like the teeth of the rice grasshopper whose teeth were black.

Did You Know that…

Manu ethnic group stain their teeth with the use of

the bark of Indian Jack trees and the juice of fresh lime?

How did they do it?

They boiled the mixture, let it cool, and for three days, rinsed their mouth with the mixture.

NOTE: Ah-kha ethnic group believed that such practice prevented the onset of tooth decay.

One interesting way of blackening teeth was practiced by the Ah-kha ethnic group of Eastern Burma. They kept sour fruits in their mouths for many hours until the teeth become sensitive, after which, they applied juice from the barks of some trees to their teeth.

Japan

In Japan, the practice of dyeing teeth with black pigment was called “Ohaguro”. The pigment consisted of tannic ferric salt. How to make the pigment was handed down from one generation to the next.

Why did they blackened their teeth with Ohaguro?

It was one of the symbols of female virtue which required a married woman to have their eyebrows plucked; her teeth dyed black; and serve no man.

Accordingly, there seems to have been a custom that when one’s daughter was engaged to a man, the parents called on their neighbor asking for Oha guro solution, thus notifying their neighbor of their daughter’s coming marriage.

It was, therefore, a practice that distinguished married women from single ladies. Later, when it was found that those with blackened teeth reached old age without tooth decay, the men followed the practice.

Malaysia and Indonesia

The Malays believed that blackened teeth were not only good to look at, but were also preserved from the action of decay. They first filed the labial surfaces of with the whetstone to better receive the dye which was usually made up of empyreumatic oil of cocoa nut shell. The practice later evolved in Bali with only the molars blackened, leaving the incisors white.

III. Betel Nut Chewing

The chewing of betel nut was the first gestures of hospitality and main social pastime of the many people of Asia such as Burmese, Indians, Malaysians, Singaporeans, and Filipinos.The tradition could be traced to hundreds of years ago according to a marble inscription “1248 AD” captioned Anata Prinnya, found in Burma.

Is there any dental benefit of chewing betel nut?

Yes! Betel nut chewers had comparatively good teeth.The Malayans were nearly free of tooth decay, though they were fond of sweets and their diet consisted mainly of rice and other starchy food

NOTE: A possible explanation may be that the alkalinity of the lime, the astringent properties of the tannin, gallic acid in the nut acts as prophylactic against decay.

How to prepare betel nut? Did they

just bite the nut directly?

No! The nut is cut into segments dabbed with lime (ground and burnt sea-shell) mixed with water or oil and wrapped in a leaf to form a quid.

Among the nobles of Thailand, the betel container which was called ”xrob” was of gold. In the case of the highest ranks, the container was covered with diamonds or other precious stones, constantly held by a servant who is ready to hand it to the master at the slightest sign of his desire to chew the betel nut preparation.

IV. Ornamentation of Teeth

Common throughout the world is the ancient practices of ornamenting teeth, principally the upper incisors, with inlays of gold and even stones such as jade, turquoise, obsidian, and crystals.

Archaeological evidences such as practice abounded in Mexico, the custom of which was practiced by the Mayans.Antonio Pigafetta mentioned the decorative dentistry among the Visayans. In one of his passages he describes Rajah Siaui (Siawi/Si Awi)/Siagu of Butuan having gold ornamental teeth. “He had three spots of gold on every tooth and his teeth appeared as if bound with gold.”

Early Ming Dynasty (ca. 15th century AD). One of the skulls is the renowned Bolinao Skull where gold scales were observed on the buccal surfaces of the upper and lower incisors and canines.

The dental ornamentation consists of pegging with gold plates in fish scale design or pattern with gold wire rivets.

Module 7:

RELIGIOUS ORAL PRACTICES

While many tribes in Asia and Africa embellished their teeth with gold and precious stones, chipped their teeth, or blackened them, some religions rejected this practice.

Islam

Muslims all over the world rejected such practices as an “alteration of God‟s creation”.

Muhammad, the Prophet, he urged his followers to practice oral prophylaxis: “You shall clean your mouth, for this is the means of praising God” in his Canon Law. Certain rituals were to be observed before a Muslim said his prayers five times a day lest his prayers be considered false. This means that Muslims has to wash his hands, mouth, face, nose, ears, neck and feet three times before each prayer. The prophet said that “a prayer which is preceded by the use of a toothpick was worth 75 ordinary prayers” as “one of the effects of the toothpick is that it makes the devil angry; it is pleasant to God but hated by Satan.”

The toothpick was from the “Arak Tree” (Salvadora persica), also called the “toothbrush tree”. The twigs and sometimes the roots which are used for cleaning the teeth are called “siwak” or “miswak”.

How to use the miswak or siwak?

1. Trim ½ inch off the bark

2. Lightly nibble on the exposed end until it forms bristles

3. If the miswak or siwak is dry, then substrate it in fresh water or rose water for 8 hours

4. Use the miswak or siwak by gently brushing in an up and down motion.

5. Trim the miswak every 3 to 5 days and repeat from step 1 (excluding step 3)

How was siwak made?

Muslims frayed the sticks of fibers by immersing them in water for twenty dour hours and applying to the teeth just like toothbrushes. After days of its use, the fibers get soft and all one had to do was cut off the bristles and use the fresh end.

Buddhism

The Japanese culture was greatly influenced by Buddhism from India and Confucianism from China. The influence included the oral habits of Japanese people in the 13th century, the time that a Buddhist monk by the name of Dogen lived and write “Shobogenzo” or “The Treausry of the True Darma of Eye”. The book was the crystallization of Dogens religious philosophy and it devoted chapters on such practical behaviors as “cleaning” and “face-washing”. These chapters explained how to clean oneself or wash one’s mouth, quoting fromthe sutras that for one master the True Way of Buddha, he must be clean both inside and outside.

Dogen encouraged his followers to use tufted wooden brush in cleaning their teeth. Tooth brushing instruction first spread among the priests teaching Buddhism and then the elite of the society, then the masses. A prayer was usually chanted before brushing: “When you use a wooden brush, you should pray to the masses, and polish the teeth with crunching desire in order to achieve the real Buddhism.”

The importance of teeth in Buddhist religion is greatly manifested in

their veneration of Gautama Buddha’s tooth.

Hinduism

Both medicine and religion in India have done much to focus attention to the teeth. Hindus consider the teeth as „gateway of the body” insisting that they be kept scrupulously clean. No Hindus would take breakfast without cleaning his teeth first, the tongue and the whole mouth, believing that body ailments were caused by bad breath.

CURING DENTAL AILMENTS

Chinese

The Chinese were making remarkable contributions to human progress since ancient times, and it is not surprising that Dentistry in China had an early start as evidenced by their use of arsenic in relieving toothache about the 2nd century AD. They developed silver amalgam for fillings long before Dentistry in the West discovered its use. Early writings indicated that full dentures were being constructed by the Chinese during the 12th century.The earliest report of cleft lip operation was in an ancient monograph; the operation was performed during the Ch’in dynasty.

But despite their long history, the Chinese are still being treated by traditional doctors using the principle of Yin and Yang. This theory of diseases and their cures is skin to the Hippocratic Theory of the cardinal humors and their relation to the disease process. The Chinese rely upon the vital principle of Ch‟i or spirit which could be drawn out or replenished with the use of acupuncture needles, much like the Greek practice of drawing out blood..

What is Yin and Yang principle?

In Chinese philosophy, Yin-yang, which translates into “dark-bright,” describes the notion that everything in nature consists of two paradoxical phases or energies.

NOTE:

MOXIBUSTION (cautery)-supplement acupuncture. From Japanese word “mogusa” or “mo kusa” meaning “burning herb”. This is a form of heat therapy in which dried plant materials called “moxa” are burned on or very near to skin surface.

Charted in the body are more than 360 pressure points or acupoints thought to be directly linked to the internal organs; and 116 of these are believed to be connected to the teeth and other

oral structures. This method of acupuncture is said to be effective in the treatment of practically all oral ailments.

To supplement acupuncture, moxibustion is also employed whereby inflammation in the mouth is localized such as that brought about by cautery. The rationale is that fire used being Yang, it will counter the excess of Yin.

Mainstay in Chinese (including the Koreans) traditional medicine is the herbs, the most popular of which is ginseng. Believed to be effective in treating various ailments, the aromatic roots of ginseng is dispensed in a form of teas, powders and pills, to be taken in combination with other herbs.

Indian

Traditional Indian medicine is based on the notion there are 700 vessels in the body that carry the three basic principles, and any derangement of these principles will result into disease. Indian surgeons recommended bloodletting with leeches because they believed that bad blood caused disease of the mouth.But there are also other remedies to toothache like scarification, enemas, use of mouthwashes, ointments, and sneeze-inducing materials.

A surgeon, Vagbhata, who lived about 650 AD, described killing the "tooth worm" to which toothache was attributed, with the use of wax. The cavity was filled with wax and with the use of a heated probe, the wax burned out in the cavity. If the pain still persisted, he recommended extraction with specially designed forceps; the beak of which was shape like an animal's head.

Japanese

Japanese dentists who travelled the country were said to have been experts in extracting teeth using only fingers. Very interesting is the manner by which these travelling dentists were trained.

How were these dentists trained?

In a plank of soft wood, a number of holes were made and into each hole a plug of wood simulating a tooth was forced. The plank of wood was then placed on the ground, and the student was told to seize with the thumb and the first finger of his right hand the plugs and pull them out one by one without moving the plank. After practicing for several times in the soft plank wood, a harder wood with plugs more tightly placed was substituted. When the student succeeded with the last test, he was deemed fit to practice Dentistry.

The universal medicine for treating toothache is the oil of cloves. Its use dates back to the 3rd century BC and continues to be used today in the form of eugenol mixed with zinc oxide powder. Cloves are dried flower buds of a tree in the myrtle family that grows in the Moluccas islands of Indonesia. It reaches up to forty feet high and produces tiny bright red flowers, the oil of which when distilled induces magical relief to toothache.

NOTE: Zinc oxide-eugenol cement (IRM) is a low-strength base used as a temporary cement filling in the event that the patient will return at a later date for a semi-permanent

restoration.

Module 8:

ERAS OF PHILIPPINE DENTAL HISTORY

As in other ancient countries, the dental practitioners among the early Filipinos were the barbers, herbolarios (herbsman) and the tribe chieftains. They treated toothache either bypulling out the tooth, or by alleviating the pain. The extraction of the tooth was done with the

finger with or without the aid of strings.

PRE SPANISH ERA (900-1521)

Early Filipinos, even before the advent of the Spaniards had been practicing some crude form of dentistry. Barbers doubled up as dental practitioners. They used queer methods of treating

toothaches. They used their fingers and sometimes nail-pliers for extracting teeth.

Chinese Traders

The Chinese introduced the chew stick, a plant stem frayed on one end used for cleaning of the teeth. The chew stick is said to be the forerunner of the modern toothbrush invented by the Chinese in 1498 (Bamboo stem as handle embedded with turfs of swine bristle). For thousands of years the Chinese used acupressure and acupuncture. The latter included 388 points of puncture, 116 of which were used as remedy for toothache with 6 others for curing

pain in the gums. The puncture points were then cauterized. The Chinese brought with them various medicines extracted from minerals, herbs, tree parts, seaweeds animal parts. It is believed that Chinese introduced into the country the duckbill forceps (dubbed by the Spanish as “Boca y Pato”.)

Seafarers from the Middle East

Seafarers from the Middle East the Arabians headed by religious leaders the Imams. Primarily their coming is to propagate the faith of Islam. Trade and commerce is only secondary. Their culture is so closely interrelated with the precepts of their religion. The virtues of the Koran urge their Father to live in healthful ways of living, observe regular ablution along with oral

hygiene.

Japanese traders

Long before the Spanish conquistadores set foot on Philippine soil least known in history in the shoreline of Agoo, La Union is a place called Puerto de Japon. This is a settlement of Japanese who came to do trade and commerce. In time their group swelled a settled, interaction with the people was positive led them to inter-marry with the local folks.

The shoreline of Agoo is known to be rich in gold mixed with the sand. This explains why they have gold miners among them artisans, iron smith, carpenters, fishermen, track gardeners and

more importantly the healers. Their medicine men may have applied their healing craft with the local folk of Agoo or even shared their medical and dental knowledge. Like the Chinese the Japanese have an array of medicinal herbs, processed sea products, pafts of trees, extracts from animal, minerals prepared as medicines. For trade the Japanese brought silk, art pieces, porcelain ware, tea and others.

Minions of the Madjapahit Kingdom, India

Ayurvedic medicine that developed and flourished in India over the millennia steadily advanced over the years.The ayurvedic concept of the healing art deals generally with the health of the body and the treatment of illness. Some sections teach on the treatment of illness in the oral cavity. The Madjapahit empires of lndia at some point ruled over Indonesia and by extension of their power with political influence over the Philippines. Minions, officials of the empire

and travelers from Indonesia who came to settle may have advocated ayurvedic medicine in the healing of illness among our people. Not much is known about remedies that treats dental disease.

Who were the dental practitioners in the pre-Spanish era Philippines?

They are those who had been acknowledged with the strength and courage, skills and knowledge in the art of healing for illness and pain in the oral cavity. They were the: Hilots (Midwife) / Albularios (Medicine men) / Babaylan (Medicine men or women); Mandakdaoat of the Kankan-i tribe of La Union; and Mumbaki of the Cordilleras

Dental treatments

These were some of the treatments used by the early Filipinos during pre-Spanish Era to treat their dental ailments: prayers, rituals and incantations, herbal medicines, animal sacrifice, leech therapy, vinegar in the temple, minced garlic, mouth rinses made from herbs.

SPANISH ERA (15215-1898)

1880

It was during this year that there were reading materials from Hispanic communities that trickled to the masses through a translator. This later leads to an opening of the medical course at the Pontifical University of Santo Tomas.

Practice of dentistry during Spanish time was not a legally established profession, for there was no law promulgated by the Spanish government, nor any royal decree from Spain enforced in the Islands governing the practice of dentistry. No license was required to entitle one to practice as a sacamuela or tooth puller without rendering himself liable for illegal practice of dentistry.

So who were considered as dental practitioners during Spanish era?

a. Sacamuelas (tooth pullers)

b. Licenciado en Medicina (graduate of a course from UST or a Doctor of Medicine degree from Europe)

c. Cirjuanos Ministrantes (male nurse)

d. Cirjuanos Ministrantes Practicantes (who finished observation “courses”)

Dentistry was practiced in the Philippine Islands during the Spanish time. In those days, practice of dentistry was popularly known as the profession of sacamuelas or tooth-pullers. Dentist in Manila and the provinces earned the reputation of tooth-pullers, because these could no longer

be saved. Before the establishment of the special course in the University of Santo Tomas (UST) as Licenciado en Medicina (Licentiate in Medicine) or a graduate from Europe with the degree of Doctor or Medicine, the sacamuelas practiced dentistry.

In time, the cirujanos ministrantes joined the rank for regular dental practitioners. About the year 1898, San Juan de Dios Hospital engaged men called cirujanos ministrantes to work as helpers to medicos or physician. These helpers are equivalent to our present day male nurses. These cirujanos ministrantes were given facilities and privileges to observe in the offices of dentists, after which they could put up their own dental offices, and they are now called cirujanos ministrantes practicantes.

The Faculty of Medicine (Facultad de Medicina) of the University of Santo Tomas, seeing the need of some definite training of these helpers, started a special course of two years for cirujanos ministrantes under Dr. Antelo, a director of Hospital de San Juan de Dios, assisted by Dr. Valle. The subject taught were the rudiments of those given to medical student in the first two years. Graduates of this course were called cirujanos dentistas. They were also appointed as health officers in places where there were no physicians or medicos has been practicing the profession of sacamuelas or tooth-pulling.

Pioneer Filipino Dentists

Like any other profession, practice of dentistry in the Philippines has a humble beginning. Dental practice in this country began more than one hundred years ago in the district of Quiapo City, Manila.

Capitan Jose “Cheng cheng” Arevalo

He was generally considered as the first Filipino dentist. By occupation he was a sculpture, a very skilled one. It is said that he established his dental office at Villalobos Street in Quiapo and had for his assistant his first wife, who came from a family of jewellers and goldsmith and was herself skilled in gold craftsmanship.

Monsieur M. Fertri

About 1850’s, a French dentist from Hong Kong, Monsieur M. Fertri, came to Manila. Not long after his arrival in this city, he set up a dental office in Quiapo, at the corner of B. Hidalgo and Barbosa Streets. His practiced covered practically every phase of dentistry, but an able dentist a s he was; he was not a good prosthetist. This handicap compelled him to look to an assistant who could make artificial teeth. In Capitan Chengcheng, Fertri found a proficient prosthetist.

In no time, Capitan Chengchneg became indispensible to Fertri that the latter had no other recourse but to take Capitan Chengcheng as his partner in the profession. The joint practice of these two unassuming dentists marked the birth f dentistry in the Philippines and became the precursor of professional dentistry in the country.

AMERICAN ERA (1898-1946)

1899-1903

This year marked the beginning of state supervision of the dental practice of the country. Major General Elwell Otis (Military Governor of the Philippines) authorized the Provost Marshall General to determine the fitness of dental practitioners in the islands. Examinations were given and licenses subsequently issued this time.

1903

On January 10, 1903, by authority of the United States the Philippine Commission put into effect Act 593 (An Act Regulating the Practice of Dentistry in the Philippines). This Act empowered the Commissioner of Health, Major E. C Carter of the United States Medial Department, to appoint the members of the first Board of Dental Examiners. Accordingly, he named Dr. Robert Oliver, Dr. Wallace Skidmore and Dr. Antonino Vergel de Dios on this board on February 16, 1903.

1908

Founding of Sociedad Dental de Filipinas with Dr. Bonifacio Arevalo as president

1924

Founding of the National Dental Association of the Philippine Islands with Dr. Francisco

Tecson as president

1945

Unification of the two dental associations into the Philippine Dental Association with Dr. Joaquin C. Ladao, Sr. as 1st president.

Prominent Dentists

A few of the Filipino pioneers in Dentistry entitled to a rank of distinction in the history of dentistry in the Philippines can be mentioned. They were:

1. Dr. Antonino Vergel de Dios

- Formerly was an appointed maestro municipal or municipal teacher in his town at San Rafael, Bulacan for 14years.

- He graduated with the degree of Doctor of Dental Surgery (DDS) at University of Pennsylvania, USA and thus become the first Filipino dentist who graduated in Dentistry abroad.

- He specialized in Root Canal Therapy at Universidad Central de Madrid, Spain and was conferred by the University the degree of Doctor en Odontologia.

-Later established an office in Paris, France, where he made a name as a dentist and obtained another degree of Doctor of Dental Surgery (DDS). With this degree, he earned the distinction of being the first Filipino to have held the degree of Doctor of Dental Surgery from three foreign universities in the 1980’s.

-When the first Board of Examiners were appointed pursuant to Act No. 593, Vergel de Dioswas the only Filipino member appointed to the Board, the other two being Americans. He served in the Board for eleven years and during the incumbency he was ever alert to improve a lot of Filipino dentists.

2. Dr. Gregorio R. Mateo

- Father of Philippine Dentistry

- He graduated with the degree of Doctor of Dental Surgery (DDS) at University of Washington, USA

- He introduced the infiltration of technique of anesthesia delivery. Before the introduction of this method of anesthesia, general anesthesia in which ether chloroform or ethyl chloride had been employed by dental practitioners in Manila.

- He also introduced gold porcelain fixed bridge which became popular among the rich people.

NOTE: Infiltration anesthesia consists of 1-2% of procaine hydrochloride and adrenaline.

3. Dr. Juanito Arevalo

- He was the grandson of Capitan Chengcheng

- He studied Dentistry in Hong Kong

- A few years later, he returned to the Philippines bringing American and English books on dentistry to the country

4. Dr. Miguel Ochoa

- He took up the two year special course for Cirjuanos ministrantes at the Pontifical University of Santo

Tomas in Manila

-He enrolled and graduated with a degree of Doctor of Dental Surgery (DDS) at Philippine Dental

College. The following years he taught Prosthetic Dentistry and Crown and Bridgework in his alma

mater and was eventually appointed as a Director of the same school.

- He specialized in Prosthetic Dentistry, particularly in full and partial dentures.

- Before the last world war, he was appointed as chairman of the Board of Dental Examiner, with Pedro

Diaz and Eungenio as members.

5. Dr. Antonio de Asis

- He studied medicine and graduated with a degree of Doctor of Medicine (MD) at Universidad Central de Madrid, Spain.

- After returning to the Philippines, he began to practice dentistry. He practiced as medico-dentista (physician dentist) specializing in exodontia only.

-He had his first dental office at Ongpin Street and later at Sampaloc, Manila. After liberation he established his office in Quezon City.

- He introduced “Somnigen” a general anesthesia that produces sleep which he administered to his patient submitting for tooth extraction.

NOTE: The word somnigen literary means a “substance which produces sleep” is derived from the prefix somni- (meaning sleep) and the suffix –gen (meaning that which

produces).

6. Dr. Catalina Arevalo

-she was the first Filipino Lady Dentist

THE JAPANESE OCCUPATION (1942-1945)

During World War II, the Philippines was occupied by the soldiers of the Japanese Empire from 1942 to

1945. Only a few number of dentists in the Philippines practiced their profession during the war and the

occupation, often using resourcefulness due to insufficient availability of dental supplies. Ten years

before the war, there was a steady supply of dental materials and equipment from the United States.

Curricula for schools, including those that are for dental schools, were modified by the Japanese

occupiers according to their military propaganda. After the war, dentists in the Philippines who survived

the occupation returned to practicing their profession.

INDEPENDENT PHILIPPINE REPUBLIC ERA (1946- PRESENT)

Dentists began to actively practice the profession again. The Journal of the Philippine Dental Associationbegan its publication in 1948.

Advancements in Dental Research

Dr. Victorino G. Villa

- dentino enamel cuticle and published articles in the US

Dr. Luz C. Macapanpan

- oral histology

- first lady president of the PDA (1961-1962)

1945-1957

- the professionals’ growth in dental schools and influx of foreign literature

- there were increase in the number of dentists coming from the US

- efforts of organized dentistry in conducting regular scientific meetings and the conventions held annually by the Philippine Dental Association

1998- implementation of CMO No. 06 series of 1998: Updated Policies and Standards for Dental Education

2001- implementation of CMO No. 05 series of 2001: Updated Policies and Standards for Dental Education

2006- implementation of CMO No. 33 series of 2006 : Policies, Standards and Guidelines for Dental Education

2018- implementation of the new dental curriculum through the release of the Commission on Higher Education Memorandum Order No. 03 series of 2018

First Dentist Congressman

Dr. Ricardo Y. Ladrido

- R. A. No. 480 (An act raising the original rank of dentists joining the military service to grade of 1st Lieutenant

- R. A. No. 481 (creation of the AFP Dental Corps)

- R. A. No. 768 (The Philippine Dental Hygienist Law)

- R. A. No. 951 (An Act to provide Dental Services in Private Schools)

- R. A. No. 1054 (Amending R. A. No. 239, providing free emergency dental treatment for employees of Industrial, Commercial and Agricultural establishments

- R. A. No. 1082 (Strengthening the dental services in the rural areas by

providing a Public Health Dentist

- R. A. No. 2620 (An Act Nationalizing the Medical and Dental Services in Public Schools)

- R. A. No. 3814 (An Act Creating the Bureau of Dental Health Services)

Dental Laws

1949– signing of Republic Act No. 417 (Philippine Dental Act of 1949 or An Act to Regulate the Practice

of Dentistry in the Philippines and for Other Purposes)

1965 – signing of Republic Act No. 4419 (Philippine Dental Act of 1965)

2007 – signing of Republic Act No. 9484 (Philippine Dental Act of 2007)

Dental Schools

1946 - Southwestern Colleges – College of Dentistry

- Southwestern University PHINMA – College of Dentistry

1947 - Iloilo City Dental College

- PHINMA University of Iloilo

- College of Dentistry is already closed

1948 - Philippine College of Dental Medicine

- University of the East – College of Dentistry

1953- University of San Agustin – College of Dentistry (the College of Dentistry is already closed)