Dentistry

Dentistry is the art of the treatment of teeth and their supporting tissues. The Egyptians, in their papyri dating back to 3500 BC, described dental and gingival ("of the gums") maladies and their management, and evidence of teeth restoration has been found in Egyptian mummies. Documents from the Hebrews, Chinese, Greeks and Romans all refer to aspects of dentistry.

In more recent times, the Frenchman Pierre Fauchard (1678-1761), author of the first classic treatise on dentistry, Le Chirurgien dentiste (1728), has been recognized as the founder of modern scientific dentistry. He was responsible for the separation of the science and art of dentistry from general medicine and surgery.

Physicians and barber surgeons accompanied colonists to America. Although several people advertised that they could extract and replace teeth, they were not trained dentists. They included an ivory turner and umbrella maker, a wigmaker and hairdresser, and Paul Revere, a silversmith. During this colonial period dentistry in N America lagged far behind the advances being made in Europe.

In the early 1800s "dentists" with some skills acquired through apprenticeship immigrated to Canada from the US. They included a Mr Hume, who advertised his profession in Halifax in the Acadian Reporter in 1814; and a Mr L.S. Parmly, who practised in Montréal in 1815, published the first Canadian book on dentistry, The Summum Bonum, and who called himself a dentist and "medical electrician."

On 3 Jan 1867, 9 dentists met in Toronto to form the Ontario Dental Association, and in 1868 the Royal College of Dental Surgeons of Ontario was established. Also in that year, The Canada Journal of Dental Science began publication. After several attempts from 1867 to 1870 to establish a school, the first dental college in Canada was founded, in Toronto, in 1875 by the Royal College of Dental Surgeons of Ontario; it consisted of 2 full-time staff, 5 part-time staff and 11 students. Over the next 100 years dental schools were incorporated into Canadian universities.

In 1888 the Royal College of Dental Surgeons of Ontario became affiliated with U of T and the university agreed to confer the degree of Doctor of Dental Surgery upon students completing the prescribed course of study. The first examination was held after 4 months' instruction in 1889; 25 candidates were successful. These were the first doctorate degrees conferred on dental graduates outside the US.

McGill U Dental School dates from 1905, but its origins can be traced to 1892 when the Association of Dental Surgeons of the Province of Québec was founded in Montréal. A French-speaking school was established at Université de Montréal in 1905. A fourth dental school was opened in 1908 as part of Dalhousie U.

In Western Canada, the first dental school was not established until 1923, when a 4-year program was introduced at U of Alberta; it was followed by one at U of Manitoba (1958) and at UBC (1964). Three further dental schools were introduced during the 1960s and 1970s: at U of Western Ontario (1966), U of Saskatchewan (1968) and Laval (1971). Some 14 749 dentists were practising in Canada in 1993, a dentist to population ratio of 1:1851.

During the 20th century, dentistry evolved from a profession based on empirical methods, through one based on mechanics, to one based on sound research methodology supported by both basic science and clinical research. In 1993, at the annual meeting of the International Association of Dental Research, over 2400 research presentations were given.

Specialization in dentistry in N America began during the early 20th century. W.G. Beers of Montréal (1843-1900) confined his practice to exodontia (oral surgery) and is considered to be the first specialist in dentistry in Canada. The main specialties that subsequently developed were exodontia, periodontia and orthodontia. Other specialities recognized in Canada today are oral radiology, maxillofacial surgery, oral pathology, pediatric dentistry, prosthodontics, endodontics and dental public health.

Several societies and graduate programs related to specializations were established; after many controversial years the Royal College of Dentists of Canada was created in 1964 by federal statute to promote high standards of specialization, to determine qualifications, to establish training programs in Canadian dental schools, and to provide the recognition and designation of dentists who possessed special qualifications. This legislation was supported by all the provincial dental licensing boards, which are responsible for the licensing of dentists and the practice of dentistry in each province.

With the development of the profession of dentistry, it was proposed that a profession of auxiliary dental workers might be established, but the issue was hotly debated. In 1947 the Ontario laws governing dentistry were amended to cover dental hygienists. The first Canadian dental training school for dental hygienists was opened at the Toronto dental school in 1951, and by the mid-1960s most schools and provinces offered similar training programs. Dental hygienists are employed in private dental offices and dental public-health programs, and recently their duties have been extended in several provinces.

Dental mechanics, responsible for the manufacture of dental appliances for dentists, have been allowed in some provinces to work directly with the public to provide dentures. Dental assistants work closely with dentists in the chairside provision of dental care to patients.

Canada has a lower percentage of women dentists than many other countries. The first Canadian woman to graduate from a dental college was Mrs Caroline Louisa Josephine Wells, who completed her training at the Royal College of Dental Surgeons of Ontario in 1893.

Dental associations have been established in each province, but the national voice is the Canadian Dental Association. In many countries dental care falls under government health-care programs, but in Canada only selected groups, eg, children and the elderly, have benefited from subsidization for dental expenses, and then only in some provinces.