Tuesday, 26 April 2011

Brief History of Dental Profession in Ontario

The following timeline and facts are taken from Gullett's A history of dentistry in Canada (1971) unless otherwise noted. This post is meant to provide a brief overview of the establishment of the dental profession in Ontario. The books, ads and pictures mentioned below were retrieved from digitized and print sources available at the University of Toronto Libraries’ Dentistry Library, the Thomas Fisher Rare Books Library and Media Commons, as well as the Toronto Public Library.


Early dentistry (pre-1859)

Pierre Fouchard

Dentistry was not an established profession in Canada. Tooth extraction was a part-time service performed by barber-dentists, gunsmiths, barrel makers, candy shops owners and other tradesmen, whom often manufactured their own instruments. Europe was more advanced in the field of dentistry compared to the Americas. Pierre Fauchard (1678-1761) is considered the father of dentistry in Europe and his book Le chirurgien dentiste (Fauchard, 1786) is historically important, as it is one of the first books to describe dental procedures and equipment during his time. This two-volume work is found at the Thomas Fisher Rare Books Library. In this work, Fauchard aims to create guidelines and tips for dental procedures, prevention of tooth decay, and describes dental instruments that he used. You can view the table of contents for both Volume 1 and Volume 2.


John Hunter's The natural history of human teeth (1771) is known to have established the anatomical basis of dentistry. Although Hunter writes in detail about anatomy and the art of dentistry, it was not until later that it was accepted as a profession.
Summum Bonum
In Canada, some dentists began to discuss the establishment of the profession, but found obstacles in moving forward. Levi S. Parmly is open about this issue in the book The Summum Bonum, the first dental book published in Canada:
“The veil of mystery which still hangs over Dentistry, renders it not only conjectural, but even a suspicious art. This has long ago been removed from the other sciences, which induces many to believe that Dentistry is a mere trick….Dentistry, however, needs only to be better known in order to secure the esteem of mankind” (Parmly, 1815).

A reprint of this book was published in 1970 by the Canadian Academy of Periodontology to mark the first meeting between the American and the Canadian Academies of Periodontology. It can be found at the Thomas Fisher Rare Books Library. A microform version of the original, published in 1815, is available at the Media Commons library and here it is online, courtesy of the Toronto Public Library's CIHM's collection.
It was common to extract decayed teeth, but not much was done in terms of prevention. However, one early work on oral health is Eleazar Parmly's book An essay on the disorders and treatment of the teeth (1822), where he expresses his belief on educating the public about keeping the teeth and mouth clean to prevent decay. The Parmlys were a dental family who contributed much to dentistry in North America. (Sanoudos, M. & Christen, A. G., 1999; Shklar, G., & Chernin, D., 2003).

jbcurio, 2009
Advertising dental services in the local newspaper was a common way to attract patients. It was also popular for tooth extractions to take place in public places for entertainment, and these shows continued to occur until much later (Gullett, 1971). However, it was this type of behaviour that acted as a catalyst for dentists to meet together and form associations and standards for the profession.




Dental apprenticeships increased in the 1840s, but training was not standard and the apprentices relied on the trainers’ willingness to share experiences. Indentureships developed from an informal arrangement to legal contracts, but even these had negotiable guidelines and differed. In the 1840s Aldis Bernard of Montreal introduced a bill for the incorporation of the College of Physicians and Surgeons of Lower Canada with clauses pertaining to dentistry, but this did not go forward.



Birth of the Ontario Dental Association (1860-1869)


The discussion to establish Dentistry as a profession continued and was actively planned. In 1860, Charles Brewster of Montreal sent a letter to all known dentists in Canada asking “What is your opinion as to incorporating the dentists by Act of Parliament and obliging all those who in future may wish to practice in Canada, to pass a proper examination before a Board of Dentists?”(Gullett, 1971). He received many replies in favour of this matter, but could not go forward to Parliament as it was considered provincial jurisdiction.


Gullett, 1971, p.41

In the fall of 1866, Barnabas W. Day, the father of dentistry in Ontario, also sent a letter to all practicing dentists in the province, inviting them to a meeting in Toronto on January 3rd, 1867 to discuss the establishment of an association. This was the first dental meeting in Canada and is considered the birth of the Ontario Dental Association. The meeting was attended by 8 dentists and Day was appointed Chairman of a committee to draft the constitution and bylaws for a new association, which was passed officially on July 2nd, 1867 (Shosenberg, 1992). Further discussion and planning led to the adoption of the Act Respecting Dentistry on March 4, 1868 and gave the Board of the Directors of the Royal College of Dental Surgeons of Ontario the standards to control the unregulated profession (Crawford, 2002) and the authority to establish a dental school This was the first dental act in the worldA copy of the signed petition for the Act, presented to the Legislative Assembly of Ontario can be found on pages 279-282 in Gullett (1971). 
The first official meeting of the Ontario Dental Association occurred on April 14, 1868, just over a year from the first dental meeting in Canada.

In this same year, Dr. William George Beers, a stakeholder in the establishment of dental education and the profession in Quebec and Canada, launched the first known Canadian dental periodical Canada Journal of Dental Sciences with his own financial resources. Beers along with C.S. Chittenden and R. Trotter were editors of this publication and published the first issue in 1869.







Formal Education 1870-1889


Gullett, 1971, p.94
On November 3, the School of Dentistry was established in Toronto, also known as the Royal College of Dental Surgeons. Dr. James Branston Willmott and Dr. Luke Teskey acted as administrators and instructors of the dental school in Ontario. Dr. Tesky, a medical doctor, taught anatomy and performed administrative tasks for over 15 years. Dr. Willmott acted as dean of the school from 1875 until his death in 1915. They were both key players in getting the School to be affiliated with the University of Toronto in 1888. This event was crucial to increasing the academic standards of dentistry. The school moved several times to accommodate space and financial needs. It occupied different locations in Toronto, one of which, 93 College Street, is featured in the picture above. The school moved to the present location at 124 Edward in 1959.

With the expansion of dental organizations and dental education in Canada, dental literature followed with the Dominion Dental Journal superseding the Canada Journal of Dental Sciences in 1889 until it was replaced by the Journal of the Canadian Dental Association in 1935.
Materials used in dentistry also developed. Beers wrote a book on amalgam, inspired by an amalgam war taking place at the time.

Fees for dental procedures have somewhat increased over the years, a copy of an account with common dental procedures from the 1880s is displayed here (Gullett, 1971).




Further developments 1890-1899

Equipment in the dental office developed in a significant way. Dental chairs were being altered to improve the experience of the patient. The Morrison chair and the Favourite Dental Chair are two examples of such innovative technologies. Dental products were also being produced and marketed, such as the Hutax powder, which was the first toothpowder manufactured by dentists. Other toothpowders at the time had a significant amount of sugar and were very abrasive.

The father of public health dentistry is John Gennings Curtis Adams, who operated a free dental hospital for children of low income families in Toronto from 1874-1899 (Gullett, 1971). In 1896 he published the first dental public health book in Canada, School children’s teeth: Their unhealthy and neglected conditions (Adams, J. G., 1896). He focused on the preservation of natural teeth by educating parents and dentists on how to care for them. Adams’ hospital was later closed by the City of Toronto due to back taxes. Copies of the letters he wrote pleading for funding to the City of Toronto and Provincial Board of Health are found in Shosenberg (1992).


Gullet, 1971, p.87


In 1892 the first dental school in Quebec was established, the Dental College of the Province of Quebec, with the notable Dr. George Beers as Dean. Women also became interested in the dental art and in 1893 Caroline Louisa Josephine Wells become the first woman the graduate from the School of Dentistry in Toronto.









National Organization 1900-1911

The dental community was saddened by the loss of Dr. George Beers in December of 1900. He is remembered for his dedication and contribution to all aspects of Dentistry, especially his attempts to create a national organization. Shortly after his death, Dr. Eudore Dubeau sent a letter to all practicing dentists in Canada inviting them to a meeting in Montreal on September 16-18, 1902. Three hundred and fifty dentists attended the meeting in Montreal (Crawford, 2002) at which the Canadian Dental Association was formed. At this meeting the first item on the agenda was to create a Code of Ethics, in an effort to abolish showman 'dentists'.

In Ontario, dentistry continued to expand and in 1911 the first issue of Oral Health, the journal of the Ontario Dental Association was published with Wallace Seccombe as editor. The contents for Volume 1 are presented. As a tribute to the 100th anniversary of Oral Health, here are the biographies of its editors.




References


Adams, J. G. C. (John G. C.). (1896). School-children's teeth : Their universally unhealthy and neglected condition : The only practical remedy: Dental public school inspection and hospitals for the poor.


Crawford, P. R. (2002). The canadian dental association : A century of service, 1902-2002. Ottawa: Canadian Dental Association.


Dominion Dental Journal (1909). Canadian Dental Directory. Toronto: Dominion Dental Journal.

Fauchard, P. (1786). Le chirurgien dentiste,: Ou, traité des dents : Où l'on enseigne les moyens de les entretenir propres & saines, de les embellir, d'en réparer la perte & de remédier à leurs maladies, à celles des gencives, & aux accidens qui peuvent survenir aux autres parties voisines des dents : Avec des observations & dens réflexions sur plusieurs cas singuliers : Ouvrage enrichi de quarante-deux planches en taille douce (Troisieme edition, revue, corrigée & considérablement augmentée. -- ed.). A Paris: Chez Servieres.


Ghent, P. (1937). A sleigh ride in 1833: Through the quaint town that became the city of toronto. Toronto: Bond.


Gullett, D. W. (1971). A history of dentistry in canada. Toronto: Published for the Canadian Dental Association by University of Toronto Press.

Hunter, J. (1771). The natural history of the human teeth : explaining their structure, use, formation, growth, and diseases. London: J. Johnson.

Parmly, E. (1822).  An essay on the disorders and treatment of teeth. New York : Henry Durell and Co.
jbcurio. "Vintage Ad #814: The Mentha Dental Lady Still Smiles." May 13, 2009. Online image. Flickr. 27 April 2011. http://www.flickr.com/photos/jbcurio/3529346192/ (Taken from the Toronto Daily Star, November 16, 1901)

Parmly, L. S. (1970). The summum bonum. Montreal: Paradis-Vincent.

Sanoudos, M. & Christen, A. G. (1999). Levi spear parmly : The apostle of dental hygiene Levi Spear Parmly : L'apôtre de l'hygiène dentaire. Journal of the History of Dentistry, 47(1), 3-6.

Shklar, G., & Chernin, D. (2003). Eleazar Parmly: Clinician, educator, poet. Journal of the History of Dentistry, July 01, 51(2), 51-55. 

Shosenberg, J. W. (1992). The rise of the ontario dental association : 125 years of organized dentistry. Toronto: Ontario Dental Association

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