Dentistry

• 1. Introduction

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  Dentistry is older than the written history of humanity. The earliest evidence stretches back tens of thousands of years, with rich traces appearing from 7000 BC onward. One tooth from Italy, partially cleaned with flint tools, dates between 13,820 and 14,160 years old. For a long stretch it stood as the oldest known dentistry on record. Then, in a paper reported in May 2026, the title slipped further back: a tooth showed signs of drilling by Neanderthals at least 49,000 years ago. So how did this branch of medicine, focused on the teeth, gums, and mouth, grow from flint and bow drills into an accredited profession with its own degree? Who decided that a tooth worm was the villain, and who finally proved otherwise? And why does a discipline so ancient now wrestle with mercury vapor, noise damage, and the digital transformation of healthcare? The answers run from Sumerian clay to the dental schools of Ohio.

• 2. The Tooth Worm

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  An ancient Sumerian text named the culprit behind dental caries: a tooth worm. The same belief turns up in ancient India, Egypt, Japan, and China, and it even surfaces in the Homeric Hymns. As late as the 14th century AD, the surgeon Guy de Chauliac still promoted the idea that worms cause tooth decay. The legend proved astonishingly durable across cultures and centuries.

  Recipes for toothache, infections, and loose teeth are scattered through the Ebers Papyrus, the Kahun Papyri, the Brugsch Papyrus, and the Hearst papyrus of Ancient Egypt. The Edwin Smith Papyrus, written in the 17th century BC, may reflect manuscripts as early as 3000 BC, and it discusses the treatment of dislocated or fractured jaws. In the 18th century BC, the Code of Hammurabi referenced dental extraction twice, both times tied to punishment. In ancient Egypt, Hesy-Ra became the first named dentist, a title that translates as greatest of the teeth.

  Greek scholars Hippocrates and Aristotle wrote about the eruption pattern of teeth, treating decayed teeth and gum disease, pulling teeth with forceps, and using wires to steady loose teeth and fractured jaws. The Etruscans in northern Italy used dental appliances, bridges, and dentures from as early as 700 BC, binding human or animal teeth together with gold bands. The Romans likely borrowed the technique by the 5th century BC, and the Phoenicians crafted dentures from gold wire and ivory teeth during the 6th to 4th century BC. Roman writer Cornelius Celsus described oral diseases and treatments including narcotic-containing emollients and astringents.

• 3. Drills And Beeswax

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  The Neolithic site of Mehrgarh, now in Pakistan's province of Balochistan, holds evidence that dentistry was practiced as far back as 7000 BC, during the Stone Age. The work involved curing tooth disorders with bow drills, operated perhaps by skilled bead-crafters. When researchers reconstructed this ancient method, they found it was reliable and effective.

  Bitumen filled a tooth around 13,000 years ago, in evidence dated to the Paleolithic. In Neolithic Slovenia, 6500 years ago, beeswax was used to close a fracture in a tooth, and the same site yielded the earliest known dental filling, made of beeswax. In prehistoric Malta, a skull dating to around 2500 BC had a dental abscess lanced from the root of a tooth. A 2017 study suggested that Neanderthals used rudimentary dentistry tools 130,000 years ago.

  The earliest dental amalgams were documented in a Tang dynasty medical text written by the Chinese physician Su Kung in 659, then appeared in Germany in 1528. During the Islamic Golden Age, dentistry featured in The Canon of medicine by Avicenna and Al-Tasreef by Al-Zahrawi, considered the greatest surgeon of the Middle Ages. Avicenna held that a jaw fracture should be reduced according to the occlusal guidance of the teeth, a principle still valid today. Al-Zahrawi invented over 200 surgical tools resembling the modern kind.

• 4. Barbers And Pelicans

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  During the Middle Ages and through the 19th century, dentistry was not a profession in itself. Dental procedures were often performed by barbers or general physicians, and barbers usually limited themselves to pulling teeth to ease pain and chronic infection. Dental extractions had long been used to treat a variety of illnesses.

  In the 14th century, Guy de Chauliac most probably invented the dental pelican, named for its resemblance to a pelican's beak. It was used to perform extractions until the late 18th century, when the dental key replaced it, and modern forceps replaced the key in the 19th century. Instruments for extraction date back several centuries.

  The first book focused solely on dentistry was the Artzney Buchlein in 1530. The first dental textbook written in English was Operator for the Teeth by Charles Allen in 1685. The English physician Thomas Browne, in A Letter to a Friend, made an early dental observation with humour, noting that Egyptian mummies he had seen kept their mouths gaping, which gave a good chance to view their teeth, in which it was not easy to find any wanting or decayed.

• 5. The Father Of The Trade

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  The French surgeon Pierre Fauchard became known as the father of modern dentistry. Working with primitive surgical instruments in the late 17th and early 18th century, he improvised, adapting tools from watchmakers, jewelers, and barbers that he thought could serve dentistry. He introduced dental fillings as a treatment for cavities. He argued that sugar-derived acids like tartaric acid caused decay, and suggested that tumors around the teeth and in the gums could appear in the later stages of tooth decay.

  Fauchard pioneered dental prosthesis and invented many methods to replace lost teeth, proposing substitutes carved from blocks of ivory or bone. He introduced dental braces, at first made of gold, after discovering that teeth would follow the pattern of the wires and could be corrected. Waxed linen or silk threads fastened the braces. His 1728 work Le chirurgien dentiste, or The Surgeon Dentist, covered basic oral anatomy and function, dental construction, and operative and restorative techniques, and it effectively separated dentistry from the wider category of surgery.

  After Fauchard, the study expanded rapidly. British surgeon John Hunter published Natural History of Human Teeth in 1771 and Practical Treatise on the Diseases of the Teeth in 1778. In 1763 he began collaborating with the London dentist James Spence, and he theorised about transplanting a tooth from one person to another. He realised the odds of success improved if the donor tooth was fresh and matched in size to the recipient, principles still used in organ transplantation. The donated teeth never properly bonded, yet one patient said three of his lasted six years, a remarkable result for the period.

• 6. From Trade To Profession

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  John M. Harris started the world's first dental school in Bainbridge, Ohio, and it opened on the 21st of February 1828. Today the building is a dental museum. The first dental college, the Baltimore College of Dental Surgery, opened in Baltimore, Maryland in 1840. The Ohio College of Dental Surgery followed in Cincinnati in 1845, then the Philadelphia College of Dental Surgery in 1852. In 1907, Temple University accepted a bid to incorporate that school.

  In the United Kingdom, the London School of Dental Surgery and the Metropolitan School of Dental Science both opened in London in 1859. The British Dentists Act 1878 and the 1879 Dentists Register limited the titles dentist and dental surgeon to qualified and registered practitioners, though others could still call themselves dental experts or dental consultants. The 1921 Dentists Act required the registration of anyone practising dentistry. The British Dental Association, formed in 1880 with Sir John Tomes as president, helped prosecute dentists practising illegally. In 1879, Francis Brodie Imlach became the first dentist elected President of the Royal College of Surgeons in Edinburgh.

  Dentists in many countries complete between five and eight years of post-secondary education before practising. Degrees include the Doctor of Dental Surgery and Doctor of Dental Medicine in North America, and the Bachelor of Dental Surgery in the UK and Commonwealth countries. The Royal Commission on the National Health Service reported in 1979 that the UK then had more than twice as many registered dentists per 10,000 population as it had in 1921.

• 7. Hidden Hazards

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  Sound levels above 90 dBA can damage the delicate structures of the inner ear, leading to noise-induced hearing loss and tinnitus. The Occupational Safety and Health Administration sets the permissible exposure at 90 dBA, while the National Institute for Occupational Safety and Health sets its limit at 85 dBA. Exposures below 85 dBA are not considered hazardous, and OSHA allows 8 hours at 85 dBA before damage. In dentistry, most cleaning tools such as piezoelectric, sonic, and ultrasonic scalers stay under 75 dBA, yet years of exposure can still cause hearing loss or tinnitus, and few dentists report using hearing protection.

  Elemental mercury makes up approximately 50% of conventional dental amalgam, combined with an alloy powder of silver, tin, copper, and other trace metals. The mercury binds the alloy particles into a durable, moldable mass, but it can release toxic vapor during placement and removal. Chronic exposure has been linked to neurological, renal, and immunological effects, with symptoms including tremors, memory impairment, fatigue, and mood changes.

  Methyl methacrylate, an acrylic resin used in dentures, temporary crowns, and retainers, can irritate the eyes, skin, and respiratory tract, and long-term exposure can cause occupational asthma or allergic contact dermatitis. NIOSH recommends keeping concentrations below 100 ppm over an 8-hour time-weighted average. Disinfectants pose their own risk: research shows around 10.9% of dental professionals may test positive for an allergic reaction to glutaraldehyde, compared with 2% in non-dental control subjects.

• 8. Evidence And Pixels

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  Gordon Guyatt and the Evidence-Based Medicine Working Group at McMaster University in Ontario, Canada introduced a new paradigm for medical education in the 1990s. It asked practitioners to apply current scientific evidence to decisions about a patient's oral and medical health. Evidence-based dentistry sits within the larger movement toward evidence-based medicine, guiding choices on manual tooth conservation, fluoride water treatment, fluoride toothpaste, and the handling of diseases like tooth decay and periodontitis.

  Gum disease has been associated with an increased risk of diabetes, heart disease, and preterm birth. Conditions in the mouth may also signal systemic diseases such as osteoporosis, diabetes, celiac disease, or cancer. This link between oral and overall health is referred to as oral-systemic health, and it is part of why the World Health Organization treats oral diseases as major public health problems, hitting disadvantaged groups hardest.

  Computer-aided design and manufacturing systems, combined with 3D printing, artificial intelligence, and electronic health records, are reshaping how patients are treated. Research shows larger dental centers adopt these tools more rapidly, and younger dentists who attend digital training programs show greater willingness to use them. Financial constraints and a lack of comprehensive training remain the major barriers, even as the work of forensic odontologists, prosthodontists rebuilding faces after head and neck tumors, and veterinary dentists keeps widening what the profession covers.