Dentistry

The people of the Middle Ages may have lacked germ theory, but they could pull a tooth!

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Dentistry is medicine of the teeth, gums, and mouth. Professional practitioners of dentistry, called dentists, may recommend preventative behaviors (like tooth-brushing) to avoid disease and decay in this region of the body. Alternatively, they might intervene with an anesthetic-filled^[1] procedure once you have gone and fucked that up.

In the Western countries, this profession evolved from the barber-surgeons of the Middle Ages who treated soldiers (and had oral health as one of their several duties).^[2] That's probably why they like sharp stuff, and making people sit uncomfortably still.^{[citation NOT needed]} Within the medical fields, modern dentistry is one of those professions that has had a somewhat peculiar evolution, even beyond its descent from barber-surgeons.^[2]

The profession especially seems to have grown apart from the rest of medicine during the 1800s — traditionally explained as part of a schism occurring in 1839–1840 as medical schools rejected integration with dentistry.^[3][4][2] In recent decades, this has become less the case, as dentistry has gradually moved in the direction of reintegration.^[5][3][4] Though, in many places, such as southern Europe, the seclusion from the broader medical world simply never happened.^[5]

History[edit]

Early roots[edit]

Dentistry has been practiced in some form since ancient Egypt where written records have been found,^[5] and even back then they realized the importance of oral health to health in other parts of the body.^[6] The earliest evidence of tooth fillings dates back 13,000 years, when bitumen was used on two teeth in what is now Italy.^[7]

Modern dentistry[edit]

Pierre Fauchard is considered an early pioneer to modern dentistry.^[8] He denounced quackery in the field all the way back during the 1700s, although ironically some of his own solutions (like swishing one's own fresh urine through one's own teeth) would be considered as such today as well (by reasonable minds, anyhow).^[9] In 1778, the King of England's surgeon, John Hunter, wrote about the importance of oral health in The Natural History of the Human Teeth.^[6]

Seclusion and integration[edit]

In many of the Western countries (excepting some places such as southern Europe), it is the case that dental medicine and mainstream medicine were separated from one another.^[5][2] They had their own educational institutions, licensing programs, regulations, etc.^[3]

This has caused, or helped exacerbate, some problems today.^[3] Those include: gaps in health insurance coverage,^[3][4] gaps in the compatibility of health records,^[2] a misconception that oral health is supplemental,^[4] and a general lack of necessary collaboration between dentists and other sorts of doctors. Due to this historical evolution apart, it is unfortunately not that uncommon for patients to end up in a hospital emergency room with a dental problem, surrounded by professionals who can't address the issue.^[4][10]

Nonetheless, there have been efforts to increase collaboration between dentistry and the rest of medicine. Thus it can be seen that dentistry is on a (rather slow) trajectory to integrate into the broader medical field.^[5][3][4] As for why such progress has been slow: existing financial incentives and perceived threats to professional autonomy have been unhelpful factors.^[2] Although dentists are often not certified as "MDs",^[11] they will typically receive an education with many similarities to what is taught in medical school (perhaps even studying alongside medical students), though with limitations.^[12][3]

Looking back, there have been real pushes to integrate dentistry with the rest of the medical and scientific world since at least the 1920s, with William John Gies.^[5][4] Scientific advances have helped to drive specialization in dentistry,^[5] and in such a way that it even encourages further integration with medicine.^[11] One of the most significant improvements has been the addition of anesthesia to the dentist's toolbelt, as without it there would be a whole lot more pain in the world.^[1] More recently, there have been more advanced additions, such as that of the polymerase chain reaction (PCR).^[5]

Evidence-based dentistry[edit]

There has been a suggestion that dentistry is not sufficiently evidence-based — this appeared in an article for The Atlantic in 2019.^[13] One dentist, H. Grant Ritchey Jr., wrote for the medical blog Science-Based Medicine to rebut this (not least to point out that the claim dentistry overall is focused on "procedure rather than prevention" is ludicrous), explaining some basic foundations of evidence-based dentistry,^[12] although he concedes there are occasional issues in the field of dentistry with "grifty", profit-oriented behavior among some practitioners. In that vein, he added: "we need a little bit of a watch guard here."^[14]

We regret that there's no strong case for avoiding the dentist's pointy little metal tools.

See also[edit]

• Dental woo
• Psychoanalysis — isolated from mainstream psychiatry, though maybe it should be

External links[edit]

• The Center for Evidence-based Dentistry
• Dental Watch
• Evidence-Based Dentistry (journal)
• Posts tagged "dentistry" at Science-Based Medicine
• "Is Dentistry Science?", UCSF School of Dentistry
• See the Wikipedia article on Dentistry.

Further reading[edit]

• "Should dentistry play a larger role in general medicine". South African Dental Journal (The South African Dental Association) 78 (3). April 2023. 
• Mark Grossman (January 31, 2020). "Holistic Dentistry; Full of …… Wholes". Office for Science and Society. McGill University.
• Michael Reddy (May 6, 2019). "Is Dentistry Science?". UCSF School of Dentistry.
• John Dodes (September 5, 2011). "The Tooth About Dentistry". Point of Inquiry.
• Dodes, John E. (Fall 1986). "Dentistry and Pseudoscience". Skeptical Inquirer 11 (1): 51–53.  (May be a bit outdated; makes for historical background reading if nothing else.)

References[edit]