The local dental clinic did not just pop out of the ground fully formed. From the start of the dentist in Brentwood it was a long journey with many up and down’s. Pre-19th dentistry was more established than you might think. There has always been a pressing need as anyone with dental distress will tell you. A healthy set of teeth has always been prized; there was a compensation rate set across the Roman empire for those who knocked out the tooth of a free man.
The important changes of the 19 century were the increase in income of the general population, giving them access to high-sugar food and the disposable income to pay for dental treatment.
The work of ‘operators for the teeth’ as they were referred to, was a trade learned from a long apprenticeship, with no official license to practice. The result was a highly variable quality of care and competence. There was little recourse in the event of malpractice and even the length of the apprenticeship was totally up to the masters of the practices.
The first respectable institution to take dental education seriously was Guy’s hospital, starting intermittent lectures in the last few years of the 18th century. With the dental hospital of London and the National Dental Hospital founded in the 1850s, both provided private care for the wealthy but had integrated surgeries who would carry out free treatment for those in need.
In 1860 the Royal College of surgeons wrote the first Licentiatiates in Dental Surgery (LDS). This had no legal power but complying with the licentiates was a source of prestige when competing for wealthy patrons. LDS diplomas could be obtained by surgical colleges across Great Britain by the 1870s, showing that graduates had a grounding in all the basic techniques to practice.
The start of law and regulations in dentistry
None of the qualifications associated with the fledgeling industry was mandated, and qualified practitioners were a rare sight outside of Harley Street. The majority of people would see an apprentice but these days were numbered with the calling of the dental reform committee of 1870. The committee was charged by Parliament to write legislation on the practice of dentistry.
This formed The Dentists Act of 1878 which forced the adherence to the LDS and registration for practitioners to refer to themselves as dentists.
This did not have the desired effect. Rather than raising the quality of care, it divided it into two camps. The Dentist, fully qualified with an LDS surgery, who would provide a high-quality service for the rich and powerful minority, versus the ‘not-dentists’ who had gained their experience from apprenticeships, but were affordable and served the vast majority of the population. Generally, it was seen as a triumph and parliament saw no need for further legalisation.
March of progress
Only after the first world war did the era of the un-qualified practise come to an end with The Dentists Act of 1921. Today, you can look up the license of any dental practitioner if you wish on the General Dental Council’s website.