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Historical Events
In the Beginning

Early Dental Journals
Early Textbooks
References

Scurvy was a deadly scourge for sailors, producing huge gingival enlargement
(scroll down for photo credit and text fromTwo years before the mast ).

"The scurvy had begun to show itself on board. One man had it so badly as to be disabled and off duty, and the English lad, Ben, was in a dreadful state, and was daily growing worse. His legs swelled and pained him so that he could not walk; his flesh lost its elasticity, so that if pressed in it would not return to its shape; and his gums swelled until he could not open his mouth. His breath, too, became very offensive; he lost all strength and spirit; could eat nothing; grew worse every day; and, in fact, unless something was done for him, would be a dead man in a week, at the rate at which he was sinking. The medicines were all, or nearly all, gone, and if we had a chest-full, they would have been of no use, for nothing but fresh provisions and terra firma has any effect upon the scurvy. This disease is not so common now as formerly, and is attributed generally to salt provisions, want of cleanliness, the free use of grease and fat (which is the reason of its prevalence among whalemen), and, last of all, to laziness. It never could have been from the last cause on board our ship; nor from the second, for we were a very cleanly crew. It was probably from having none but salt provisions, and possibly from our having run very rapidly into hot weather, after our having been so long in the extremist cold."

Photo and text: Dana RH Jr. Two years before the mast – a personal narrative of life at sea.
Norwalk, Connecticut; Easton Press, 1969, p. 305 (First edition, 1840).

In the
Beginning

In the
Beginning

In the
Beginning

In the
Beginning

In the
Beginning

In the
Beginning
 

The 1900s.

Oral Pathology as a specialty of dentistry is traditionally presumed to have its origin in the 1930s and 1940s, perhaps commencing with Bunting's Textbook of Oral Pathology, Thoma's Oral Pathology, or the first issues of the Archives of Clinical Oral Pathology, and Oral Surgery, Oral Medicine, Oral Pathology.  The American Academy of Oral Pathology and the American Board of Oral Pathology were formed during this time period, preceded slightly by the first organizations devoted exclusively to Oral Pathology, the New York Institute of Clinical Oral Pathology and the American Dental Association's Registry of Dental and Oral Pathology. An even earlier landmark was Bloodgood's 1915 "everything-you-need-to-know" review of oral lesions in the second volume of the Journal of the American Dental Association.

It all began in the first "Golden Age" of Dentistry: 1835-1860.

The first professorship of "Dental Pathology", however, originated much earlier, with the 1840 establishment of the Baltimore School of Dental Medicine.  The first text dedicated to Oral Pathology as we know it today was published shortly thereafter by Bond and, of course, Fouchard, Jordain, Hunter, Bell and others had reported even earlier on a variety of tooth anomalies.  In reality, it appears that the mid-nineteenth century was the time of the true birth of both Oral Pathology.  The age that saw an unprecedented, world-wide "mental stir" in consequence also saw the emergence of "modern" or organized dentistry. This first "Golden Age" of dentistry, 1835-1860, began with dentistry "not a whit more respectable than the barber-surgeons of old times" and concluded with its establishment as an organized, science-based health profession with techniques and therapeutic successes not unlike those of the twentieth century.  The face of dentistry was absolutely changed to something unrecognizable from that which came before.

Who started it all?

A fascination for pathologic processes was an integral part of modern dentistry at its inception, as was a strong and apparently new belief that information should be openly and widely shared.  Approximately half of all "scientific" articles in the first volume of the earliest published dental journal were related to pathologic conditions of the mouth and jaws, and the first truly comprehensive text for the dental profession in the United States, Bell's 1829 classic, dealt extensively with pathologic processes, including first reports of numerous oral diseases. Lester Cahn believed that Sir Jonathan Hutchinson was the earliest Oral Pathologist, but the chairman of Baltimore's Department of Special Pathology, Thomas Bond, more correctly holds that distinction. Bond's insight was so remarkable that he was able to hypothesize etiologies and pathophysiologies which are still valid today.

Koecker, although a less influential dental surgeon, was the first professional to actually be designated a "dental pathologist" in print. He published a general text on dentistry, Principles of Dental Surgery, as early as 1822.   Interest in pathology continued to grow as dentistry became a strong and independent health profession, and by 1860 many of today's well-established oral lesions had been reported in the various dental journals then publishing. These accounts frequently anteceded the usually quoted "first reports" by several generations. Oral pyogenic granulomas, for example, were not well understood until the 1951 analysis by Kerr, yet Simon P. Hullihen, the "father of oral surgery", described one succinctly in an 22 year-old pregnant woman as early as 1844. Hullihen documented a recurrence of his patient's gingival "aneurysm" with her second pregnancy. During the same year Westcott described pregnancy gingivitis under the diagnosis of "uterine irritation;" Harris had described it earlier as "hemorrhoidal discharge in dysmenorrhea."

It was primarily an American phenomenon.

Oral pathology papers frequently begin with historical reviews of the lesion or disease under discussion, usually mentioning the first cases identified. It seemed appropriate, therefore, to document the first actual dental journal reports of such entities. The attempt to do so is considerably facilitated by the fact that American dentistry, through its free exchange of innovative technology and scientific inquiry, its journals, national organizations, and its schools of dentistry, dominated the profession throughout the nineteenth century. Consequently, virtually all of the earliest journals were published in English and almost always in the United States. While individuals from other countries published occasional textbooks of exceptional quality and insight, other countries lacked the cooperative spirit needed to assure a rapid expansion of professional knowledge. This first Golden Age of dentistry was a truly remarkable and uniquely American phenomenon, as declared in 1851:

"dental surgery, as at present practiced, is almost an American creation, for although operations upon the teeth have been practiced since the days of the Pharaohs, and probably before, yet the rude and simple character of the early manipulations hardly give them a claim to be regarded among the effects of scientific art, and until comparatively lately, but very little improvement seems to have been made in this department of surgery."

Dr. Bouquot's connection.

It is presumed that, because of this American dominance, references in early American dental journals are among the first reasonably accurate references to oral pathologic entities.  Because of this, Dr. Bouquot has undertaken an ongoing research into the earliest dental journals and textbooks, i.e. those from the 1830s through the 1870s. These web pages are the result, but summaries of his published papers can be found at www.maxillofacialcenter.com.

Gorlin

R. J. Gorlin
Registry of
Historical
Oral Pathology
 

The R. J. Gorlin Registry of Historical Oral Pathology is a collection of reports of oral and maxillofacial lesions and diseases published in the dental literature from the first dental journal in 1839 to 1870. More recent papers are also in the Registry, as are texts and reports of oral diseases in the medical literature. While much of the Registry is completed, it is not yet in a form to place on the web. If you have a specific request for old references, or wish to contribute a reference to the Registry, please contact Dr. Bouquot at MFCenter@aol.com.
 

 * last year of publication is unknown by authors
** incorporated into Journal of American Dental Association in 1936

First textbook devoted to diseases of the mouth

First journal report of oral pathologic entity (dilaceration)

First emphasis on systemic effects on oral tissues

First report of hereditary effect on oral tissues

First use of term "dental pathologist" (For L. Koecker)

First report of specific systemic effect (menstruation) on oral lesion (pulp polyp) 

First professorship of dental pathology (Baltimore)

First continuing education course in oral pathology

First text devoted to head and neck tumors

First report of racial predilection for an oral disease

First text devoted to dental/oral medicine

First use of term "oral medicine"

First literature review in oral pathology

First microscopic description of a lesion in dental journal

First dental pathology lectureship in a U.S. medical school

First discussion of a differential diagnosis

First series report of an oral pathologic entity