A Remembrance by Monsieur Jean Claude de Vaux
I’ll begin with the beginning of Modern Dentistry:
It was between 1650 and 1800 that the science of modern dentistry developed. And in 1728 Pierre Fauchard, who was widely acknowledged as the « Father of Modern Dentistry » published « Le Chirurgien Dentiste »( Lee Shee Roo Gee-Au- Don Teets) which contained detailed information about all aspects of contemporary dentistry. It was his lead that encouraged others, and for example, before the end of the century in England the distinguished surgeon, John Hunter, had published his book entitled »The Natural History of the Human Teeth »., and the first course of dental lectures was established at Guy’s Hospital in London.
The 1770s saw many advances in all areas of science, technology and medicine. Dentistry was blessed with a number of great French scientists and practioners who laid the foundation for modern dental practice, and not the least of which is Pierre Fauchard.
So lets travel back now in time to the 17th century, and I would like to have my colleague and close friend now speak to you about Monsieur Pierre Fauchard.
Bonjour! My name is Jean de Vaux, I am a general surgeon and was a close friend of Pierre’s for many, many years. In fact, Pierre and I are the same age and we studied together. We were both self educated, he to be a Dental Surgeon, I to be a General Surgeon.
Monsieur Fauchard is no longer with us, and oh, what a loss. Even if had been able to be present, he would share with you all , all of his accomplishments , for he was a very modest man. But at the same time, very proud of his accomplishments and his profession.
If I can remember correctly,(for my memory is not as good as it used to be, maybe some of you have the same problem), Pierre was born in Brittany in 1678 in a very modest home. In 1693 he joined the French Navy at the age of 15, much to his families distress, and came under the influence of Alexander Poteleret, a surgeon major, who had spent considerable time studying the diseases of the dental organs. I naturally saw very little of Pierre until he returned from the Navy in 1696. We spent many hours talking about his wonderful experience’s of the past three years. He came back with skill and knowledge not usually found in someone so young. He was a voracious reader and his enthusiasm to learn and share with others was endless. I was envious , but felt so fortunate to be one of his close friends, and to have him share with me all he knew. He told me of the navy personnel who on long voyages suffered severely from disorders of the teeth, particularly scurvy and how Major Poteleret inspired and encouraged him to read and carefully investigate the findings of his predecessors in the healing arts. He said he wanted to acquire and disseminate sound knowledge based on actual practice.
I was very sad when Pierre told me he was going to open a practice in Angers, a University Center, because it meant I would not see as much of him, and I was learning so much from talking to him. However we did stay very close friends. In Angers, his is credited as being the first to describe himself as a »Chirurgien Dentiste ». In English this is surgeon dentist. All other dentists were call » Dentateurs ». There were very few dentists, and they mainly did extractions of the teeth. However as many of you might know, the barber also extracted teeth. That same barber also was a expert in using leeches for bleeding. (That is the reason for the red in the Barber’s pole).
Pierre was a remarkable man who had great manual dexterity and was ambidextrous, as most dentists were in our day. And even though he was using primitive instruments, he became recognized throughout the surrounding area, all the way to Paris, for his skills. He not only removed teeth but filled carious teeth, removed tartar from around the teeth and benign tumors of the gum.
He shared freely with all of us his skills in dental prosthesis, one of his specialties. He told me that the loss of teeth was very unfortunate, but that art and science can replace them. He bragged that he had made many artificial prosthesis and had discovered methods to replace the loss of a few teeth or all of them, and these substitutes, made artificially, had become as useful as the natural ones. If you read his book(as I suggest you do) you will see how he made imitations of human teeth, carved from blocks of ivory or bone, or used human teeth and held them in place by tying them to the remaining solid teeth, using waxed thread or gold wire. He told me that teeth or artificial pieces which are fastened by pivots or gold wires remain in place for 15 or 20 years without becoming displaced, while pieces fastened by means of waxed linen or silk threads which are usually employed to fasten them, last only a short time.
Pierre told me that he did not regard it as being undignified to use information or adapt tools for use in dentistry from such ancillary trades as those of watch maker, jeweler or barber. It was obvious to me that he was a true genius, having a inquiring mind and he used good judgment at all times.
It was around 1716 to 1718 that I noticed that Pierre was away from his home and office, often for long periods of time. He told me he was observing and studying with other surgeons and dentists, and consulting with patients who had heard of his skills. His reputation in the whole of western France was now at its highest. So in 1718 he moved to Paris ( ah the city of lights and beautiful Madames, and excellent restaurants, one of which is Fouguet’s on the Avenue Champs Elysees a favor of mine and Pierre’s, what delightful times we spent there), while in Paris he was called on by eminent general surgeons for dental related consultations and referrals. He was now recognized as he most outstanding dental surgeon in all of France!
Pierre now realized that there were no good text book’s on dentistry and that a teaching book an encyclopedia on dentistry you might say, was needed.
He told me he wanted to share his knowledge and use his actual case as examples. And if all of this was put into a book, he thought that others could become as knowledgeable and proficient as he. He was determined to raise dentistry to a new height, and to establish it as a science of its own. He worked diligently for a few years, and in 1723, at the age of 45 he completed the manuscript for « Le Chirurgien Dentiste »
( Lee Shee/ Roo/ Gee Au don teets) . Even though he had a very demanding and busy practice, he was determined that the book should be as complete and accurate as possible. The manuscript was meticulously reviewed. How honored I was when he asked me to review the manuscript along with two other surgeons. We made very few recommendations, because he had done such a thorough job. This book, in two volumes was finally published in 1728. It was translated into German in 1773 and a revised and enlarged edition in French in 1746. I believe that this book is the origin of scientific dentistry. It changed the practice of dentistry forever! It was the bible for the dentists for the next century or longer. For those of you who are here today and have not had the opportunity to read the book, I will share with you some of its highlights.
It has 38 chapters in Volume 1and 26 chapters in Volume 2. In all there are 42 plates depicting chiefly instruments and appliances. I know our time is limited,so I will mention a few of his ideas that I feel are important. You must not forget that these ideas were totally new to dentistry. He(Pierre) said:
1. The German tooth worm theory is probably wrong. I have looked through a microscope many times and have found no worms.
2. Sugar is detrimental to both gums and teeth. We should limit it in our daily foods.
3. The first teeth, which are called milk teeth, separate themselves from their roots without anyone knowing just what becomes of them. Some dentists say they have no roots, but they are wrong.
4. If you fill teeth after removing the caries, it will strengthen the teeth. I recommend lead, tin and sometimes gold. Richard has told me you are now using silver and plastic type materials, I know Pierre would approve.
5. Teeth should be cleaned periodically by a dentist. However again Richard has told me of a supporting profession of Dental Hygienists that has helped the dentists in maintaining the patients dental health. This is wonderful.
6. When teeth are irregular I straighten them by using files to make space between them, forceps to loosen the teeth, and wires to hold the teeth in their new position until firm. I have observed that the teeth of young persons are much easier to straighten than those of grown up persons. Because you see in young persons the roots are not as large, and partly because the parts surrounding them are softer. When persons of some years undertake this operation the use of considerable time is required before success can be attained.
7. If a tooth is knocked out it can be replanted and used for many years.
He certainly was ahead of his time, and had some many new almost revolutionary ideas, LIKE:
1. He was the first to describe how a patient should be seated in a comfortable chair to have dentistry done. Up until this time the patient and dentist usually sat on the floor with the patient’s head between the dentists legs, holding on to the dentists knee’s for support. He felt that this was most inappropriate for women, especially those who were expecting a child. He also recommended that the dentist stand behind the patient, not in front of them because it created fear and also blocked out the available light.
2. He invented instruments for:
a. Filling teeth and the pelican’s forceps for removing teeth.
3. He constructed obturator’s to fill in the roof and back of the mouth that had been removed because of disease, now the patient could eat and speak. Complete dentures were carved out of solid blocks of bone or ivory, fastened upon frames of gold or silver with band springs between them to force the prosthesis against the upper and lower jaws.
4. He figured out how to enamel false teeth to match a patient’s existing teeth.
5. He prescribed oil of cloves and cinnamon for pulpitis.
6. He described an improved drill. Its rotary movement was powered by catgut twisted around a cylinder, or a jeweler’s bowstring.
However, I must tell you that it astonished readers that such a learned and enlightened person should record that he relieved many cases of toothache, arising from extensive caries by the use of urine. Urine had been used in the mediaeval times, and was regarded as a panacea for a wide range of diseases. Pierre would advise a sufferer, if otherwise healthy, to rinse his / her mouth morning and evening with several spoonfuls of their own urine. He realized that such a remedy would not meet with universal acceptance, so he added that although aversion to its use might be natural, one ought to appreciate the resulting benefits! I must admit I could not bring myself to use this remedy for many reasons, the least was because of the effect it would have on my friends.
Fauchard was a relentless antagonist of all dental charlatans. In his book, he exposed not only their highly injurious techniques,but also their subterfuges. He told of their placing nitric acid and sulfuric acid on teeth to remove tartar, and how it ate away the tooth, resulting in unnecessary extractions. Or how these charlatans would place a thin layer of gold over tin or lead fillings to make the poor patient think they had received a gold filling, that was very expensive. I think that you can now realize what a remarkable person Pierre Fauchard was. It was obvious that he created order out of chaos and established a profession from a craft. My good friends and colleagues, Monsieur Fauchard had a very active life and practice dentistry for many years. He passed on March 22nd in 1761 at the age of 83. I do miss him!
I can tell you that Pierre Fauchard’s book and his teachings were used for the next 100 years
On the 13th of November in 1880, at the inauguration of the Dental School in Paris, Dr. Louis Thomas expressed himself thus in an address on the History of Odontology « I have spoken of Pierre Fauchard , remember well that name, gentlemen, for with him opens a new era in the History of your Profession. »
Dr. J. Menzeis Campbell, honorary lecturer on Dental History from the University of Edinburgh wrote that » The name of Pierre Fauchard, upon whom the title The Father of Modern Dentistry, has justly been bestowed, will endure when generations of dental pygmies will be entirely forgotten. By having so altruistically and successfully raised the practice of Dentistry from an indifferent trade to a dignified profession, he has achieved everlasting renown. He ranks high in the gallery of the immortals ».
This article posted by the Pierre Fauchard Academy to give insight into the character and work of Pierre Fauchard, Father of Modern Dentistry