|
|
HOW IT EVOLVED
The General Dentist - Early 1960's
|
| |
The early 1960's were years of transition for the dentist practicing
general dentistry That which began to occur at this time would have
occurred about ten years earlier if it wasn't for the Second World
War. During this period, there were many advances made in science
and technology, which helped win the war. In peacetime these would
have been translated into progress to further private industry and
scientifically oriented professions such as medicine and dentistry.
After the war, many of the advances made were channeled into the
private sector.
The first sixty years of the 20th century were years for the most
part, when the practice of dentistry in the United States remained
basically the same. Dental students were taught by men and women who
themselves were taught in the late 19th or early 20th centuries.
In the 1950's, after the war, although the older generation of
instructors still set the curriculum, a new generation of dentists
came on the scene with new ideas, materials and concepts. Many of
these conceived in the military, resulted in the development of new
techniques, medicines, instruments and equipment.
|
|
Fig. I Standing patient being treated in Europe
by 1611 century practitioner.
|
|
| |
From the beginning of the 21st century to 1960, dentistry was pretty
much business as usual. If one went into a dental office during this
period, it would appear to resemble an office of today there being a
chair, cabinet and after the 1920's an X-ray machine, as well as a
dentist neatly attired. Upon closer examination, one would begin to
see many differences. These we shall point out in this paper.
In the first half of this century, a dentist was a person who for the
most part, was expected to perform most of the duties incumbent upon a
practitioner.
|
|
But in the latter part of this century, with the advent of
specialties, it was realized that one person couldn't know nor do it
all. In other words, with all the changes and advances in dentistry,
there were no Leonardo da Vinci's practicing dentistry. As the later
half of the 20th century began, changes were occurring in all aspects
of the dental profession and continue to occur to the present day that
affect the way dentistry is practiced today.
|
|
| |
Fig. 2 Early 1960's - This dentist is shown working sitting down
in an
office set up for stand-up dentistry. The dentist
could tip his dental chair further back if desired.
|
|
| |
A
young dentist starting out in the early 1960's, first of all, found
himself in a new era of sterility. While many dentists continued
sterilizing their needles and various other instruments by placing
them in boiling water, this new group of dentists began practice using
sterile disposable dental needles, which were first introduced in
1959. Disposable needles were first used during the Second World War.
Besides this, the use of an autoclave increased. Cold sterilization
became commonplace. This replaced the concept that most dental
instruments only had to be as clean as knives and forks. Prior to this
an autoclave was basically used for surgical instruments. It was not
until more than several decades later, that infection control in a
dental office was again upgraded. Disinfection and sterilization after
each patient increased to the level it is today. Currently, there is
not a dental office in the country without an autoclave, and dentists
use of gloves, eye protection, protective uniforms, and surgical masks
have become the standard.
The introduction of high-speed drills in the late 1950's meant that
most dentists in the early 1960's acquired one. Some dentists obtained
belt driven high-speed drills and others air-driven high-speed drills,
which they usually attached to their units. Older dentists, with
existing offices, were inclined to use belt-driven drills, so they did
not have to purchase air-compressors, especially if there was not
enough room for them. On the other hand, dentists just starting out
and first equipping their offices, were able to allow room for
air-compressors.
High-speed drills and the water coolants that accompanied them,
brought about changes in equipment, as well as office design. At
first, portable suction units were either attached to the dental units
or were next to them in mobile cases. Gradually, these units were
placed in either a basement or another room. When high-speed drills,
with their attached water coolants became available, although many
dentists continued to work standing-up, many dentists were more
comfortable working in a sitting position. Thus, the increased use of
the dental stool. At this time, many dentists also realized that it
was healthier for them to work sitting down, rather than standing up,
with the patient in a reclining position. With this in mind, some
dentists tipped their conventional chair backward to work, while
others, primarily dentists starting out who were going into new
offices, purchased the newly introduced dental chairs - some motorized
conventional chairs with motorized backs, while others were true
contour chairs. Still other dentists purchased contour seat adapters
to convert their conventional chairs.
|
|
In
the early 1960's, dentists who were working sitting down began to
realize that their units and cabinets were too high and difficult to
reach. Although a few lower units came on the market, it was, for the
most part, several years before new delivery systems and cabinetry
became available. In the meantime, dentists found it awkward to work,
stretching for instruments and medications. Some dentists began to
practice four-handed sit-down dentistry, but again, it was also
several years before this became the standard.
In the early 1960's, new safer x-ray machines, with better radiation
protection and electronic timers, were replacing the older unsafe '
machines.
In clinical dentistry, advances were also beginning to change the way
the general dentist practiced. With the introduction of new impression
materials, such as rubber base, indirect procedures became
commonplace. As a result of this, the era of the dentist constructing
gold inlays and crowns in his office laboratory was coming to an end
as these procedures were taken over by commercial laboratories.
Dentists could now take impressions, send them to a laboratory, have
the restorations made and insert them. The complex method of using
copper band impressions with compound in conjunction with plaster
impressions, was no longer necessary to construct crowns and bridges.
Also the technique of doing a direct wax-up in the mouth to construct
a gold inlay was eliminated. More time became available to work at the
chair. Dentists no longer had to stay in their offices at night and do
laboratory work. Most laboratory work necessary to construct dentures
had already been taken over by commercial laboratories.
As for operative dentistry - amalgams, gold inlays and silicate
fillings were for the most part still the norm. When preparing
amalgam, excess mercury was removed by the use of a squeeze cloth. It
was some time before pre-filled amalgam capsules were generally used.
The silicate fillings that were placed were known to last on average
only three to four years. Although acrylic filling materials were
available, it would be several years before the concept of bonding,
composite filling materials and bonded composite fillings would become
the standard.
|
|
| |
|
|
|
|
| |
Fig. 3 Four-handed, sit-down dentistry, pediatric dental
clinic of Indiana University School of Dentistry 1962.
|
| |
In the early 1960's, although general dentists had been referring to
orthodontists and oral surgeons for many years, the age of specialty
began to take hold. Although general dentists still practiced oral
surgery, endodontia, and periodontia, as some still do today, many now
referred cases to specialists in these fields. Many general dentists
still continued treating children, but others, as they had for years,
availed themselves of dentists who were specially trained in pediatric
dentistry.
|
|
With the increased number of specialists and general dentists
furthering their education, the quality of dentistry being practiced
in America continued to increase.
In conclusion, we can see that the early 1960's were important years
of transition. Changes were occurring in the practice of general
dentistry that would continue to the |
Low Cost Dental Insurance
|
