Ancient illustration of the reduction of a dislocated mandible which appeared in one of the commentaries of Hippocrates written by the great physician, APOLLONIOS of Kition in Cyprus, in the 1st Century, B.C.

While the attendant holds the head of the seated patient, the surgeon thrusts his thumbs into the patient's mouth as his fingers grip the man under the chin. This firm hold enabled the surgeon to quickly force the mandible back into place.

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The reduction of mandibular dislocations is still accomplished in the same manner today as illustrated here. Fortunately, this accident is rarely sustained today. Until after world war I, however, dislocated mandibles frequently occurred during dental extractions and other procedures. Newer methods, anesthetics and instruments have all but eliminated this complication of dental manipulation.

Etching by LUIGI GUIDOTTI, Kupferstich, 1625, Kupferstich Cabinet, BERLIN.

 This etching shows a violent depiction by Guidotti which shows the patient seated below the Dentist.

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It is not difficult to conceive of this as a double operation------ The epilation of the patient's long locks and the extirpation of his Molars.

Apparently the most effective and comfortable position assumed by the dentist at that time was above and behind the patient. This afforded the dentist maximum leverage, with the available instruments, in the contest of strength between him and the erring tooth.

Today, many edentulous individuals give a history of neglected gingival inflammation with consequent gum recession inflicting the loss of all the teeth.

The successful treatment of gingival inflammation, bleeding gingivae and other periodontal conditions that result in gum recession and loss of teeth, depends not only upon the removal of all calculus or other operations, but also upon the adjunctive cooperation of the patient at home.

THE LIQUIDATION SALE- "Illustration from Pictorial History of Dentistry- Testimonies of 5000 Years" By: CURT PROSKAUER/ FRITZ H. WITT.

A sure and interesting method to discover the mores of a people who lived in a different era of time and custom is to examine the literature and art of the period. There you will find described and illustrated the dress, customs, habits and intimate details of life as they lived it. 

Here, from the early 19th century, is a sketch of the liquidation sale of an inventory of over 1,000,000 artificial teeth of first quality and 100% perfect.... (Is it possible they are preparing for next year's model?) There is no reason to doubt that this is a true picture of the event with crowds of people clamoring to lift a toothy bargain from the sales table.

Today there are no bargain sales of 1,000,000 artificial teeth. Every effort is made to save the natural teeth. However, there are many instances where this is not possible. The patient must then be fitted with a prosthesis.

The sudden change from natural to artificial teeth is one of the thousand natural shocks that the flesh may become heir to. Among the new tribulations are abrasions and wounds which cause inflammation, soreness and pain.

ASEPSIS IN THE 18TH CENTURY

The artist has a very low conception of asepsis in dental procedures as performed in the 18th century. To emphasize this sad state of surgical asepsis he has deliberately exaggerated the conditions in this drawing.

In this satirical fantasy, he reveals his contempt by transforming the dental office into a blacksmith shop; the instruments are the tools of the horse- shoeing trade; the dental assistant is the blacksmith's helper with his unclean hands in the mouth of the patient; the floor and the surroundings are as filthy as those usually found in a place where horses are shod and treated. Even an inquisitive pig has his snout through the opening of the locked door...... perhaps he is symbolic of the next patient.

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This is a satirical version of things as they were before Doctor Lister*. New techniques, new modern anesthetic agents and procedures have changed all these. Today patients visit their dentists regularly without foreboding.

*Joseph Lister, 1st Baron Lister (1827–1912), British surgeon and pioneer of antiseptic surgery.