Page 18 - Pharmacy History 29 July 2006

Dental considerations
Dennis B. Worthen. PhD
Lloyd Library and Museum Cincinnati, Ohio
Dentistry of the pre-fluoride era was very different
from the practice of dental medicine today. Before the use
of fluoride as prophylaxis against dental caries, the most common
task of the dentist was to fill cavities when the patient reluctantly sought treatment for a toothache. Drilling was usually performed without the benefit of procaine HCl (novocain), and whether a toothache was more painful than the dentist’s drill was debatable. Teeth that couldn’t be saved were extracted; orthodontics and periodontics were specialties of the future. As a result, many of us grew up with a fear of the annual trip to the dentist’s surgery.
A brief history of
dental hygiene
Dental hygiene (cleaning the teeth and mouth) was a well-established practice in the ancient civilisations of China, Egypt, Greece and Rome. Ancient dentifrices were made of all sorts of ingredients such as shells, animal parts, and honey. Toothaches caused by tooth decay were probably the most common dental problems. However, as late as the end of the 1700s, tooth pain was still thought to be caused by the lack of humoral balance, and Buchan1 stated that ‘we must first endeavor to draw off the humors from the part affected. This may be done with mild purgatives, scarifying the gums, or applying leeches to them, and bathing the feet frequently in warm water.’ Buchan also recommended induced vomiting and the use of blistering plasters, but the ultimate therapy was to remove the offending tooth. In the United States, the barber was identified early on as the ‘go to’ professional for tooth extractions. In Australia even the local blacksmith was called on to pull a painful tooth, although many pharmacists also practised dentistry
and had a dental chair and other equipment in a room adjacent to their dispensary.
Even with the advent of the dental professional and the more common practice of filling cavities with a number of compounds, including gold foil, extraction was the normal cure for toothaches caused by
badly decayed teeth. Pharmacists compounded a number of dentifrice formulas as powders or pastes that often contained chalk, pumice,
or soap as the main ingredients (see formulas 1 1896). Placing oil of cloves on a piece of cloth and inserting the treated cloth into the oral cavity was a well-established treatment for toothaches.
In the 19th century, a common treatment was the application of compound of tincture of benzoin
to the aching tooth or chewing Spanish pellitory (pyrethrum). The berries of Aralia spinosa (prickly ash, toothache tree), which were used as a treatment for toothache, were placed
directly into a hollow tooth when
it was aching or were macerated in wine or spirits to make a tincture.(4) Extraction was still the only sure cure for toothache, but even that carried some risk. Pregnant women with a toothache were usually warned not have the tooth extracted during her pregnancy, unless she was prepared to run the risk of worse suffering than even the offending tooth caused her. A tooth extracted during this period has been known to produce an abortion!
Toothpowders and the advent of toothpaste
As long ago as 5000 BC the Egyptians were making a tooth powder consisting of the powdered ashes of ox hooves, myrrh, powdered and burnt eggshells and pumice. Directions were given about relative quantities that should be mixed, but no instructions are available as to how the powder was to be used. It
is assumed that it was rubbed onto the teeth using the fingers as the toothstick, the fore runner of the toothbrush, was not in use at that time.
The Greeks and then the Romans improved the formulas for these toiletries by adding abrasives such as crushed bones and oyster shells to clean debris from the teeth.
Various tooth powders
18 ■ Pharmacy History Australia
volume 3 ■ no 29 ■ JuLY 2006