The history of dental care – from tooth puller to modern clinic

Tooth pain is as old as humanity, but the profession that treats it is relatively young. For most of history, teeth were pulled from people without special training, without anesthesia, and without the hygiene we today take for granted. As a dental assistant, you stand at the end of a long development that has made dental treatment precise, gentle, and safe work — and your profession plays a major role in that development.

§Tooth pullers and barbers

In the Middle Ages and far into more recent times, teeth were pulled by the same barber-surgeons who also cut hair and performed minor procedures. In markets and villages, travelling tooth-pullers also appeared, who with pliers, hot coals, string and 'miracle cures' promised fast and painless treatment. The truth was usually different: broken jaws, bleeding and infections often followed. For most people, treatment equalled having the tooth pulled out — saving or repairing a tooth was rarely an option.

§The birth of the dentist trade

A decisive shift came in the 1700s. The French surgeon Pierre Fauchard (1678–1761) published in 1728 the work Le Chirurgien Dentiste — the first scientific book solely about teeth. Fauchard systematically described diseases fillings instruments and treatment and he is considered the founder of modern dentistry. With him dental treatment began to become a true profession based on knowledge rather than sleight-of-hand and potions. Still it was for a long time limited to the wealthy while ordinary people continued to seek the tooth puller.

§How the key players work together to solve a patient's problems

Before modern times tools were crude and pain relief was nearly absent. Anesthesia was not common in dentistry before the mid-1800s, so a procedure meant real pain. The early drill was hand-operated – Fauchard described a drill driven by a string wound around a cylinder – and later came foot-operated drilling machines where the dentist pedaled like an old-fashioned sewing machine. Fillings were made from metals like tin, lead, and gold. The hygiene we base the entire profession on today was virtually nonexistent.

• 01Pliers, elevators, and hand tools for extraction – rarely to save the tooth.
• 02Hand drill and later foot-operated drill instead of electric and pneumatic equipment.
• 03Fillings of tin, lead and gold.
• 04No routine anaesthesia and almost no sterilization.

§The dental assistant emerges

The dental assistant profession itself is almost a hundred and fifty years old. The commonly recognised starting point is that American dentist C. Edmund Kells in 1885 in New Orleans employed the first actual female clinic assistant. That did several things at once: treatment became faster because two pairs of hands worked together and the clinic became a safer place to come — not least for female patients who now sought the dentist in far greater numbers. The idea spread quickly and 'chairside assistance' gradually became a trade in itself with its own training.

§The technical revolution

20th century transformed the clinic. X-rays, discovered in the late 1800s, made it possible to see holes and bone the eye cannot reach — and over time led to the entire radiation protection field. Modern anaesthesia made treatment tolerable. The real breakthrough in drilling came in 1957, when the air-driven high-speed turbine (Borden Airotor) reached several hundred thousand revolutions per minute and made drilling fast and gentler. Together with the autoclave and systematic infection control, it laid the foundation for the clinic you work at today.

§The dental assistant today

Today dental clinic assistant is an independent profession with formal education and a central place in the clinic. Where the assistant's role was once an extra hand it is now a professional pillar: infection hygiene according to national guidelines sterilization in autoclave assistance in four-handed technique X-ray and radiation protection record keeping and confidential handling of patient data according to GDPR. The long development from the tooth-puller's pliers to the modern sterile clinic is above all about two things: making treatment safe and making it safe for the patient — and both are core tasks in your profession.

“From the marketplace's tooth puller to the modern clinic, the history of dental care is the story of safety, hygiene and security – and that is exactly what the dental assistant protects every day.”