History of Periodontics
History of Periodontics
History of Periodontics
• Gingival and periodontal diseases have afflicted humans since the dawn of history. Studies
in paleopathology have indicated that destructive periodontal disease, as evidenced by bone
loss, affected early humans in such diverse cultures as ancient Egypt and early pre-
Columbian America.
• Almost all early writings calculus and systemic disease were frequently postulated as causes
of periodontal disorders
• However, methodic and carefully reasoned therapeutic discussions did not modern
treatment, with illustrated text and sophisticated instrumentation, did not develop until the
time of Pierre Fauchard during the eighteenth century
CONTENTS
• Early Civilizations
• The Classical World
• The Middle Ages
• The Renaissance
• The Eighteenth Century
• The Nineteenth Century
• The Twentieth Century
EARLY CIVILIZATIONS
• Periodontal disease was the most common of all diseases found in the embalmed bodies
of the ancient Egyptians
• The Ebers papyrus contains many references to gingival disease and offers a number of
prescriptions for strengthening the teeth and gums
• The medical works of ancient India and China devote significant space to oral and
periodontal problems and oral hygiene and they describe gingival inflammations,
periodontal abscesses, and gingival ulcerations
THE CLASSICAL WORLD
• Hippocrates (460 BC-377 BC), the father of modern medicine, discussed the function and
eruption of the teeth and the etiology of periodontal disease
• Believed that inflammation of the gums could be caused by accumulations of “pituita” or
calculus, with gingival hemorrhage occurring in cases of persistent splenic maladies
• Among the Romans, Aulus Cornelius Celsus (25 BC-50 AD) referred to diseases that
affect the soft parts of the mouth and their treatment, including oral hygiene
• Paul of Aegina (625 AD-690 AD) wrote that tartar deposits must be removed with either
scrapers or a small file and that the teeth should be carefully cleaned after the last meal of
the day
THE MIDDLE AGES
• Albucasis (936-1013), his 30-volume medical encyclopedia, called al-Tasrif, had a clear
understanding of the major etiologic role of calculus deposits, and he described the
techniques of scaling the teeth with the use of a set of instruments that he developed,
splinting loose teeth with gold wire, and filing gross occlusal abnormalities
•
THE RENAISSANCE
• During the Renaissance, with the rebirth of classical scholarship, the development of
scientific thought and medical knowledge, significant contributions were made to
anatomy and surgery
• During the fifteenth century by the Turkish author Serefeddin Sabuncuoglu (1385-1468),
who included illustrations of the surgical removal of hypertrophic and swollen gingiva
and lingual frenum. Drug treatment should be initiated if there are swollen gums, mobile
teeth, and pus formation. If there is no response, surgical treatment should be performed.
A tube is placed on the gums. A hot cautery is inserted into the cannula, and the gingival
tissue is cauterized. If this is correctly applied, the adjacent teeth will be warm.
• Paracelsus (1493-1541) developed an interesting and unusual theory of disease: “the doctrine of calculus”,
Paracelsus recognized the extensive formation of tartar on the teeth and related this to toothache. He
considered toothache to be comparable to the pain produced by calculus in other organs, such as the kidney
• For the treatment of periodontitis, Eustachius recommended both the scaling of calculus and the curettage of
granulation tissue so that actual reattachment of the gingival and periodontal tissues could take place
• Frenchman Ambroise Paré (1509-1590) was the outstanding surgeon of the Renaissance, and his contributions
to dental surgery included gingivectomy for hyperplastic gingival tissues. He also understood the etiologic
significance of calculus and used a set of scalers to remove the hard deposits on the teeth
• Italian physician, mathematician, and philosopher Girolamo Cardano (1501-1576) appears to have been the
first to differentiate among the types of periodontal disease, he mentions one type of disease that occurs with
advancing age and leads to progressive loosening and loss of teeth as well as a second very aggressive type
that occurs in younger patients
• Anton van Leeuwenhoek (1632-1723), used it to discover
microorganisms, cellular structure, blood cells, sperm, and various
other microscopic structures, including the tubular structure of dentin,
using material from his own mouth, Leeuwenhoek first described oral
bacterial flora, and his drawings offered a reasonably good presentation
of oral spirochetes and bacilli
• He even performed antiplaque experiments involving the use of strong
vinegar in his own mouth and in vitro on bacteria in a dish
THE EIGHTEENTH CENTURY
• Leonard Koecker (1785-1850), he mentioned the careful removal of tartar and the need for oral
hygiene by the patient, recommending that it be performed in the morning and after every meal
with the use of an astringent powder and a toothbrush, with care taken to place “the bristles …
into the spaces of the teeth”, also Koecker was an early advocate of the “odontogenic focal
infection” theory, and he recommended the extraction of all severely involved teeth and roots, to
prevent systemic infection
• Levi Spear Parmly (1790-1859), who is considered the father of oral hygiene and the inventor of
dental floss
• John W. Riggs (1811-1885), seems to have been the first individual to limit his practice to
periodontics and therefore can be considered the first specialist in this field, also periodontitis
was known as “Riggs' disease”
• American Willoughby D. Miller (1853-1907), in his classic book, “The Microorganisms
of the Human Mouth”, which was published in 1890, he described the features of
periodontal disease and considered the role of predisposing factors, irritational factors,
and bacteria in its etiology, he believed that the disease was not caused by a specific
bacterium but by a complex array of various bacteria that are normally present in the oral
cavity, “the nonspecific plaque hypothesis”
• In 1901, possible role of trauma from occlusion and bruxism in periodontal disease by
Austrian dentist Moritz Karolyi (1865-1945), who also recommended its correction by
grinding occlusal surfaces and preparing bite plates
NECROTIZING ULCERATIVE GINGIVITIS
• Earlier NUG was described when Greek soldiers were affected with “sore mouth and
foul-smelling breath.”
• Hyacinthe Jean Vincent (1862-1950), a French physician working at the Pasteur Institute
in Paris, and Hugo Carl Plaut (1858-1928) in Germany described the spirillum and
fusiform bacilli associated with what later became known as Vincent's angina. In 1904,
Vincent described the presence of these organisms in ulceronecrotic gingivitis
THE TWENTIETH CENTURY