March 26, 2024 • 31 mins
Embark on a journey into the heart of Baltimore where the first dental school took root, revolutionizing oral health care. We'll reveal the pivotal moments that sparked the dire need for dental regulation, from sideshow jaw hackers to educated dentistry professionals.
🔧 From Baltimore's Roots to Regal Dentures 🦷
With Scott Swank as our guide, we reveal the pivotal moments that sparked the need for regulation, professional associations, and medical journals, transforming the landscape of dentistry. From extracting teeth from the mouths of the city's poorest to showcasing the most luxurious dental tools fit for royalty, we delve into the stark contrast between the struggles of early dental care and the opulence of elite dentistry.
😁 Teeth, Technology, and Oral Narratives 🧚♂️
Hear the captivating truth behind George Washington's dentures, a tale far removed from the myth of wooden chompers. Get the inside scoop on the intricate craftsmanship of these dental devices, made from materials like hippopotamus ivory, and the exclusive nature of dentures in the 18th century. We pay homage to John Greenwood, Washington's trusted dentist, whose skill with dentures proved indispensable to our nation's first president. Join us as we sift through the complex layers of this historic dental story, from the origins of oral folklore to stem cell innovations in tooth replacement.
🔗 Episode Links:
The Dr. Samuel D. Harris National Museum of Dentistry: www.dentalmuseum.com
Curator's Choice - A podcast for history nerds and museum lovers
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ayla Sparks (00:00):
Why had no idea that Baltimore was so known for
dentistry at all?
Scott Swank (00:05):
First, dental school in the world.
That's crazy Dental college inthe world in Baltimore, the
Average Hall, and there were twoprofessors there who were
teaching what they calledodontology lectures and the
students didn't go.
Sometimes they went, sometimesthey didn't.
The professors thought it wasimportant enough.
They were kind of ahead oftheir time really with this
(00:27):
whole thing about oral healthbeing important to your overall
health and that kind of thing.
So they thought it wasimportant enough at the time
that they petitioned the medicalschool to create a dental
department.
And the medical school was goingthrough some really, really
hard times.
They were arguing with thestate of Maryland about who
(00:48):
owned everything.
They didn't have enough money.
How they survived, I reallydon't know.
So they didn't have thewherewithal at the time to put
in a dental department.
They also didn't have the space.
Dentistry was a completelydifferent method of learning
really at the time.
You went to medical school forthe lectures and you did your
(01:09):
hands-on training at clinics andhospitals and infirmaries and
those kinds of things didn'texist then for dentistry.
So they didn't have the spacein the medical school to put in
the dental facilities for peopleto learn the hand skills.
So they just said no and thetwo professors did a petition in
the state and got enoughsignatures to petition the
(01:29):
legislature for to open a dentalcollege and the legislature
said yeah.
Ayla Sparks (01:35):
So without having any areas to really practice, it
sounds like how different wasdentistry as a profession back
when they first started thefirst dentistry school dentistry
as a profession back when theyfirst started the first
dentistry school.
Scott Swank (01:51):
Well, I mean, in terms of differences you had, I
mean there were a lot ofphysicians that were in private
practice and they had little.
They had small offices anddentists were the same way, but
the medical profession waslicensed a long time before the
dental profession.
And I mean medical schools.
Go back in Europe, you knowforever.
I mean you've got Padua andBologna and Edinburgh and you
(02:11):
know all those places.
So physicians were, you know,professionally trained for a
long long time, but they had alltheir clinical learning came
from hospitals and infirmariesand those things just didn't
exist for dentistry it was acottage industry, small private
practices.
So the students, once thedental college opened, they
(02:34):
didn't even have an infirmarythemselves for a number of years
.
So the students would learn inthe professor's practices, which
is largely how dentistry waslearned anyway.
Ayla Sparks (02:47):
I was wondering if it was like a trade, where you
just go in and be an apprenticeat someone who's already doing
it.
Scott Swank (02:52):
You did.
They called it preceptorshipand that's the way dentists, you
didn't have to do that.
I mean you could buy the.
You didn't even have to buy thebooks.
I mean you could buy theinstruments if you could find
them and just start Just startwhacking away yeah yanking
people's teeth out, basically,and a lot of charlatans did I
(03:12):
mean.
there are any number of images,not portraiture but paintings
that depict, you know, thisperson.
And they've got an assistantwith a, you know, grinding an
organ and they're making allkinds of noise to draw a crowd.
And then they get a person fromthe crowd and they come up,
they extract the tooth and theyhold it up.
(03:33):
And who knows if they hadpracticed with it, had
preceptored under anotherdentist, if they had even read a
dental textbook at that time,who knows?
Ayla Sparks (03:44):
I mean it was a lawless wasteland.
Yeah, it could be Ofshowmanship.
Scott Swank (03:49):
And you know the reason.
I had always wondered whydentistry?
Why the profession kind ofstarted in the mid-1800s and
dentists at that time werestarting to associate form
associations, state associations, local associations.
They knew the profession had tobecome professional, basically.
(04:11):
So in order to do that, theyknew they needed an organization
, which they had been toyingwith for a while.
They needed a journal, and thejournal started in 1839.
And they knew they neededprofessional training.
And I think the real impetus forthat came with the collapse.
There was economic collapse inthe United States in the late
(04:33):
1830s, so a lot of men were outof work and apparently a bunch
of them saw people they knew whowere practicing dentistry and
they were doing pretty well, andthey said, well, heck, I'll
just practice dentistry too.
And the people that had beenpracticing dentistry and were
doing it correctly had learned,you know, from other dentists
(04:55):
and that kind of thing saw thisas a huge problem in terms of
whatever you want to call itwith the population.
I mean, they were, you know,going to see the status of this
profession just drop like a rockand they wanted to take steps
to prevent that.
So I think that was part of thereason the dental school was
founded there as well, gave thata big impetus.
(05:18):
And then you know, practice lawsstarted early on.
The dental school opened in1840.
Started early on.
The dental school opened in1840.
I think Alabama had the firstpractice law in 1841.
Of course, all those practicelaws I think pretty much, if not
all of them, the vast majorityof them grandfathered in people
that had been practicingdentistry for years.
(05:39):
I think if you didn't have acomplaint against you with
anybody you were grandfatheredin, but of course people that
were new had to be licensed atthose points.
Ayla Sparks (05:52):
Back in the 40s.
I am curious was it just if youhad a toothache you'd go to the
doctor and they'd yank thattooth out, or was it a little
bit more like a medical approach?
Scott Swank (06:02):
For a physician.
A lot of physicians diddentistry because they had to.
There weren't any dentistsaround, so if they had, you know
, a patient that ended up withtoothache, they many times took
it out themselves.
Now, if there was a dentistaround they would have done that
and they had the instrumentsfor it.
It was a lot cruder than it isnow and of course, there wasn't
(06:25):
any anesthesia.
Ayla Sparks (06:27):
I was gonna say it's just a jug of whiskey,
right.
Scott Swank (06:44):
Well, yeah, until the advent of vulcanite as a
material to use as a denturebase, which is basically cured
rubber, and that process wasdiscovered in 1853, I believe.
So it wasn't until after that.
Pretty much I would say.
There probably aren't that manyvulcanite dentures made
(07:06):
pre-Civil War.
Then you know, of course theCivil War happens and everything
kind of goes haywire and thenthings settle down after that.
So really, you know, denturesdidn't really become a thing
until after the Civil War, Iwould say.
Ayla Sparks (07:20):
Speaking of dentures, you have one from
probably the most recognizableperson from US history George
Washington's dentures.
Scott Swank (07:30):
I mean it's way cool, because you know, first
president, in his mouth he, Imean it's such a personal thing,
right, I mean it's a denture,it's not like your shoe, it's
not like a belt, it's not like asword.
I mean you know, this was inhis mouth.
Ayla Sparks (07:49):
I was there when he was giving speeches.
Scott Swank (07:51):
Yeah, it was probably the reason that you
know his second inauguraladdress was the shortest in
history, because if you see it,you'll understand that you
didn't, you wouldn't, want thatin your mouth.
It couldn't be comfortable.
Ayla Sparks (08:08):
For his teeth is it kind of?
He had one set of dentures thathe used throughout his life.
Scott Swank (08:10):
He did not.
Ayla Sparks (08:10):
Or were there multiples?
Scott Swank (08:12):
Multiple dentures.
We know there are one, two,three, four.
There are four dentures, partof a denture or a denture set,
extant.
So the Royal London HospitalMuseum and Archives has one half
(08:33):
of one denture.
It has been described as halfof an upper.
I don't believe it.
We've got a model of it in themuseum and I think it's half of
a lower.
The New York Academy ofMedicine owns a lower denture, a
full lower.
It's not I say full,technically it's not a full
(08:54):
denture.
There's a hole in it that thedenture went over Washington's
last remaining tooth.
So it was what modern dentistrywould call an over denture.
But it was basically a fulldenture, the upper to that set.
I don't know where that wouldhappen the upper to the set that
(09:14):
London owns have no idea whathappened.
The Mount Vernon LadiesAssociation has at Mount Vernon
Washington's estate.
They have a full set ofdentures.
They have an upper and a lower.
So that's the third.
We have a lower.
The upper to that set did exist.
We have no idea where it is nowbecause it disappeared and then
(09:38):
it is rumored that Washingtonwas buried with a set.
So that would be the fifth setthat we know of and I think
there probably were other setsor parts of sets on top of that.
Washington was always he wasnever satisfied with his dentist
.
He was always complaining aboutthe, about the, privately about
(10:00):
the person, more publicly aboutthe dentures, more publicly
about the dentures.
He utilized at least eight, theservices of eight different
dentists.
John Greenwood ended up beinghis favorite in terms of
dentures.
We believe there may have beena set made for Washington by
James LaMayer and nobody knowswhere that set is, and
(10:25):
Washington described a set ofdentures as being unwieldy, too
large and too clumsy to use.
We think that set may have beenmade by La Meilleur.
But once Washington kind ofdiscovered Greenwood, he stuck
with him.
Like I said, washington had oneremaining tooth.
Washington lost that tooth justbefore he was inaugurated
(10:48):
president for the second time.
So Greenwood had to makeanother set, which we think was
the London set, and I think itwas all one piece.
The lower was all one piece ofivory, the base and the teeth.
They were not differentsections and I think Washington
dropped it and broke it.
That's why only half of itexists.
Ayla Sparks (11:09):
So Greenwood had to make another entire set, and
that's the set we own.
Rumors kind of abound when itcomes to George Washington's
teeth, because you know, we'veall heard the wooden teeth.
And they were actually enslavedindividuals' teeth and then
that they were ivory teeth.
So can you let us know what'sgoing on with these rumors?
Scott Swank (11:24):
Let's go with wood first.
No wooden dentures in theUnited States or Europe.
So the people that wereGreenwood was an American and
had been trained in the US as adentist.
Some of the other folks hadcome over from France because
France, during thatrevolutionary time period for
(11:44):
the US, was the place puttingout dentists.
I mean, they were dentistrycentral for Europe at that point
and some of those fellows cameover with different groups
during the revolution.
They were assigned to differentmilitary groups or to the Navy,
(12:05):
on a ship, that kind of thing,and they ended up staying, which
is really kind of where USdentistry got its start.
So they had no background inwooden dentures.
They weren't making woodendentures in Europe so they
didn't make them here, I thinkprimarily because the woods, the
(12:25):
actual woods, were different.
They did make wooden denturesin Japan but they used a very
dense, very oily wood.
Ayla Sparks (12:34):
I was going to say the wood would swell in your
mouth.
Scott Swank (12:38):
I'm not so sure the oil would help with the
swelling, but the splinters youknow, you can actually finish it
smooth so that it didn't stickyou.
And I also think that Europe hadaccess to a huge amount of
ivory.
I think there was just ivorycoming out of Africa like you
wouldn't believe, and notnecessarily elephant ivory that
(13:01):
was going into, you know, intothe fancy trades, but there was
a huge amount of hippopotamusivory coming out of Africa and
that's what they were usingprimarily in the fabrication of
dentures in both Europe and theUnited States.
And you have to understand thatdentures at that time were all
(13:21):
handmade and hand-fitted to aplaster impression.
So you had to take a piece ofivory and start carving it and
keep fitting and carving and oh,this spot's too high, I'll
carve that.
Now, this spot's too high, I'llcarve that.
So in terms of what a denturecost then would probably be in
(13:41):
the neighborhood of just over$100,000 today.
So only the elite of the elitescould afford to have a denture
made for them.
Now, slave teeth on one ofGeorge Washington's denture.
I'm not so sure.
The New York Academy ofMedicine denture has some human
teeth on it.
(14:01):
I'm not sure any of them wouldhave been from Washington's
slaves, for the reason thatdentists were acquiring human
teeth to use on dentures fromvarious places and Greenwood
made the denture.
And Greenwood would have nothad access to Washington's
(14:23):
slaves, but he would have hadaccess to the population of New
York City and there were a lot,a lot of poor, very, very poor
people in large metropolitancities like London, paris, new
York, all those kinds of places,and dentists would actually pay
(14:44):
people for their teeth.
Oh, that is so sad.
Yeah, sad story, but true.
And you were hoping to getteeth from younger people
females especially because youwanted teeth that looked good.
You couldn't use a rotten toothon a denture, you had to use
teeth that looked good.
So that's primarily where theteeth were coming from.
Ayla Sparks (15:07):
The dark dentistry trade.
Scott Swank (15:11):
Yeah, dentists would just pay or they would
keep teeth that they.
You've got to understand thatperiodontal disease was just as
bad as decay at the time.
So you're getting teeth thatneed to be taken out, not
because they're decayed butbecause there's no bone left to
hold them in.
So Greenwood had an entire boxfull of teeth that he, you know,
(15:34):
he could choose from to make tomake to put on dentures.
So I think the chance of thehuman teeth that are on the New
York Academy denture being fromWashington Slaves is very, very
remote.
They used a lot of calves teeth,bovine teeth.
You could.
Apparently they were nice andwhite.
You could carve them easily,especially for, like the larger
(15:54):
anterior front teeth on theupper.
Yeah, you could carve themeasily.
The teeth that were on ourdenture, they were all ivory.
The upper ones used individualpieces of ivory, the lower ones
used sections of ivory that arecarved to look like individual
teeth.
But it's actually like three orfour teeth in a row and then
(16:17):
they hold on, they're onto thedenture.
That way the Mount Vernondenture has all kinds of stuff
on it.
It has what one person thinksis an elk's tooth used as one of
the molars.
Ayla Sparks (16:31):
Because elk do have ivory in there.
Scott Swank (16:34):
Yeah, elk have vestigial tusk.
Yeah, they call it elk ivories.
Yeah, and one of them,apparently one of the teeth came
off and it was repaired, andthe repair was made with a nut.
Yeah, I don't know what kind of, you know what kind of chestnut
, or yeah, I don't have any idea, but it's, you know, it's got a
couple X's in it and it's inone of the posterior teeth, so
(16:56):
yeah, so that denture's got allkinds of stuff on it.
Ayla Sparks (17:00):
So if someone were to come and visit the museum,
what can they expect to see?
What kind of exhibits do youguys have?
Scott Swank (17:07):
Well, the exhibits at the dental museum kind of run
the gamut.
I mean it starts out with teethin popular culture.
Kind of run the gamut.
I mean it starts out with teethin popular culture because we
were really trying to get awayfrom that whole idea of
dentistry and pain.
Those two have been associatedfor way too long, and so the
(17:27):
first part of the museum talksabout teeth in popular culture,
different cultural traditionswith teeth, smiles, toys, films,
commercials, that kind of thing.
And then it goes intoprevention.
We've got information onfluoride when that first came
out and the controversy you knowthe big controversy about
(17:48):
putting fluoride in water andthat kind of thing.
We've got Queen Victoria'sdental instruments oh wow, and
that kind of thing.
Got Queen Victoria's dentalinstruments oh wow, during the
Victorian era, if you werewealthy enough, you had your own
personal dental scalers thatyou took to the dentist who then
used them to scale your teeth,as opposed to the scalers he
(18:11):
owned or she owned mostly hethat he owned to scale teeth, so
that you weren't having yourteeth scaled by instruments that
had scaled somebody else'steeth, which at the time
probably wasn't the worst ideain the world.
I mean, we assume that theinstruments were being cleaned.
(18:32):
I don't think there was reallyanything, nothing antiseptic
going on.
I mean, there wasn't evenanything antiseptic going on at
that time in hospitals.
Ayla Sparks (18:40):
And probably just wiped off on the apron and then
next patient.
Scott Swank (18:43):
Yeah, so if you could afford your own, you took
them.
So of course Queen Victoriacould afford her own, so she had
her own.
Ayla Sparks (18:51):
I'm sure they were gold encrusted or something.
Scott Swank (18:54):
They're quite fancy , they're plated silver, gold
plated silver, when mother ofpearl handles, quite nice.
I've seen a fancier set,pictures of a fancier set.
Apparently one of the queens ofspain had a very similar set,
but on the crowns each of queenvictoria's has a crown at the
end of the handle, and wherethere would be gems on a real
(19:17):
crown are just, you know, likebumps in the gold, whereas the
spanish queen had little, teeny,tiny pieces of gemstones put
there, like sapphires and rubiesand that kind of thing.
Ayla Sparks (19:30):
So I was slightly hoping it was going to be the
bones of conquered foes, butyeah, no, I don't think so.
Scott Swank (19:37):
But um, so we've got queen and, uh, prince
albert's personal dental scalerswere just up for auction not
long ago.
Yeah, that was something we wedidn't didn't have the funds to
bid on, but it would kind ofbeen nice to have them both
together.
And his weren't as fancy ashers.
Ayla Sparks (19:56):
I'm also curious in your opinion over the course of
dentistry in its entirety.
What are some of the mostinfluential or important?
Either discoveries orinventions have been made that
kind of revolutionized thedentistry game.
Scott Swank (20:13):
Well, dentistry for a long, long time was basically
extractions.
Now you go back to the late1700s and things are getting
more complicated in terms ofextractions, fillings, dentures,
surgeries to remove differentthings, even to deal with some
(20:34):
periodontal disease.
But the things and theinstrumentation was relatively
simple.
So you really have to get intoa more, almost a more modern
time to really see things.
That revolutionized dentistry Imean anesthesia, revolutionized
(20:56):
dentistry, I mean anesthesia,of course, revolutionized
dentistry and general anesthesiain terms of ether, nitrous
oxide, chloroform, they all.
Nitrous oxide was first in 1842, then you had ether in 1844.
And chloroform came right closeto that, maybe another two or
four years after that.
That's extremely important.
(21:16):
But other than, you know,taking out teeth that are
difficult to get out, you reallydon't want to put people out
with ether and chloroform.
They're dangerous, especiallyether in terms of the transition
from being unconscious tonon-breathing and dead.
It's very small with ether,which is why chloroform took
over, you know, as soon as theyshowed that it would work.
(21:38):
But local anesthesia isn'tdiscovered and proven until 1895
.
So that's, you know, like 50years before you get local
anesthesia, which is whatdentistry revolves around today.
I mean right, so we've gotlocal anesthesia in 1895.
And then in the early 1900s DrGV Black perfected the
(22:03):
formulation for dental amalgamand that revolutionized
restorative dentistry in termsof being able to cut a tooth so
that you get out all the decayand then fill it with a material
that's going to last a whileand isn't injurious.
You know that kind of thing.
And the problem with earlysilver amalgams was, upon
(22:27):
setting, you know, getting hard,they expanded instead of shrunk
.
So you were having thesecharlatan guys going around and
they would.
They weren't even really takingthe decay out of teeth.
If a tooth had a hole in it.
They would mix up this, youknow silver paste and put it in
a tooth and they would be in youknow a city this week and gone
the next and by the time thefillings had set and expanded
(22:51):
and cracked the tooth and madeit worse than it was before they
started they were gone.
So you know, the scientificformulation for amalgam coming
out in the early 1900srevolutionized that part of
dentistry.
And then hand pieces.
The first rotary driven handpiece that was commercially
(23:14):
available didn't come out untillike 1877.
So before that if you wanted toput a hole in a tooth or take
decay out of a tooth, they hadcome up with all kinds of
mechanical means to do that.
None of them really worked thatwell.
Ayla Sparks (23:28):
I'm picturing those old egg beaters.
They did do that.
Scott Swank (23:31):
Yeah, we've got one of those at the museum.
They came up with a like aclock mechanism.
You wind it up and the spring,you know, turned the, turned the
burr.
Um, that was really heavy, thatdidn't work well.
Bow drills, oh you know, likeyou've seen, you know, um, you
know naked and afraid with her?
Yeah, exactly and and you'retrying to start a fire with them
(23:53):
.
Ayla Sparks (23:54):
Yeah.
Scott Swank (23:54):
Well, they use those to put you know
preparations in teeth.
Ayla Sparks (23:57):
It sounds very precise.
Scott Swank (23:58):
They're difficult to use, of course, and you can't
get them.
You know they're very hard touse in the back teeth.
So the foot treadle dentalengine that had a handpiece with
a small burr, that you actuallymade move with your foot,
revolutionized dentistry.
That made cutting teeth.
I mean the time savings andability to cut tooth was just
(24:22):
remarkable.
Ayla Sparks (24:23):
Oh, that's cool too .
Is there anywhere in the museumthat you touch on the tooth
fairy?
Scott Swank (24:28):
We used to.
We put in a big exhibit.
We changed exhibits years ago.
We took out the information onthe tooth fairy and then we had
another exhibit.
That was an exhibit basicallyon children's dental literature,
but of course that had booksand things on tooth traditions
for children and that includedthe tooth fairy.
But the tooth fairy is just anEnglish thing.
Ayla Sparks (24:51):
So the Tooth Fairy is particularly popular in
Western folklore, but it is notvery well documented as the true
origins.
However, one of the earliestreferences to a tooth deity
similar to the tooth fairy canbe found in Norse mythology.
So in Norse culture, childrenwould offer their lost baby
(25:13):
teeth to the Norse god, odin,and it was believed that Odin
would then bless the children inreturn for their teeth.
There are many other toothtraditions throughout the world,
like in most Hispanic countriesthere's a small mouse who comes
and takes your teeth and leavescandies.
In Asia, especially in Japan,there's a tradition where if
(25:35):
your child loses an upper tooth,then you're supposed to throw
the tooth somewhere on theground.
If they lose a bottom tooth,you're supposed to throw them
somewhere high, like up on aroof, and the reasoning behind
that is whatever direction youthrow that tooth is the
direction it's going to grow in.
So if you want them to havenice straight teeth you do the
(25:56):
top ones should grow straightdown on the floor, vice versa
with the roof.
So, at the risk of showing offhow macabre my mother and I were
while I was growing up, I haveall of my baby teeth and I even
have my adult teeth that hadbeen removed, like my wisdom
teeth.
I kept them all.
I was even able to keep some ofmy puppy's baby teeth, which
(26:20):
was remarkable to find.
I was lucky enough to find themon the floor.
But when I was telling this toScott, he told me that I am not
the only one.
He discovered that somescientists are actually doing
the same thing, but perhaps fora much nobler reason.
Here's Scott.
Scott Swank (26:37):
But now the bioengineering exhibit.
I don't know if it brings thisout specifically, but while we
were doing that exhibit it cameup that they're working on the
ability to usesemi-differentiated stem cells,
so not pluripotent stem cellsthat you would obtain from an
(26:58):
embryo, but there are other stemcells in the body that are what
they call semi-differentiated.
So for teeth, there are stemcells that will produce any kind
of tooth.
I mean, you can't get an entireorganism out of them, but
they'll produce a tooth.
So scientists have been workingon the ability to grow teeth
(27:25):
from these partiallydifferentiated stem cells.
Wow, and you can get them frombaby teeth.
Ayla Sparks (27:33):
That is incredible.
Scott Swank (27:34):
Especially baby teeth, molars.
Ayla Sparks (27:37):
So this is making me sound actually more of a
scientist than a crazy personwho saved all of my teeth.
Yeah, I'm really thinking ahead, actually Way ahead of the time
.
Scott Swank (27:49):
And I did not read in putting that exhibit together
, I didn't read anything aboutlongevity.
So, in terms of and how daywhere you actually save those
teeth on purpose, and then, ifyou lose a tooth for some reason
(28:12):
, perhaps you'll be able to usestem cells obtained from those
teeth to grow a new one.
Ayla Sparks (28:18):
That's amazing.
Scott Swank (28:19):
Yeah, that would be amazing.
That would be the ultimatetooth replacement is if you
could replace your own teethwith your own teeth.
Ayla Sparks (28:27):
Well, I have learned a lot about dentistry
that I had no idea about.
Tooth replacement is if youcould replace your own teeth
with your own teeth.
Well, I have learned a lotabout dentistry that I had no
idea about Some really darkthings, some really exciting and
new things.
So thank you so much formeeting with me.
No-transcript.
Why had no idea that Baltimore was so known for
dentistry at all?
Scott Swank (00:05):
First, dental school in the world.
That's crazy Dental college inthe world in Baltimore, the
Average Hall, and there were twoprofessors there who were
teaching what they calledodontology lectures and the
students didn't go.
Sometimes they went, sometimesthey didn't.
The professors thought it wasimportant enough.
They were kind of ahead oftheir time really with this
(00:27):
whole thing about oral healthbeing important to your overall
health and that kind of thing.
So they thought it wasimportant enough at the time
that they petitioned the medicalschool to create a dental
department.
And the medical school was goingthrough some really, really
hard times.
They were arguing with thestate of Maryland about who
(00:48):
owned everything.
They didn't have enough money.
How they survived, I reallydon't know.
So they didn't have thewherewithal at the time to put
in a dental department.
They also didn't have the space.
Dentistry was a completelydifferent method of learning
really at the time.
You went to medical school forthe lectures and you did your
(01:09):
hands-on training at clinics andhospitals and infirmaries and
those kinds of things didn'texist then for dentistry.
So they didn't have the spacein the medical school to put in
the dental facilities for peopleto learn the hand skills.
So they just said no and thetwo professors did a petition in
the state and got enoughsignatures to petition the
(01:29):
legislature for to open a dentalcollege and the legislature
said yeah.
Ayla Sparks (01:35):
So without having any areas to really practice, it
sounds like how different wasdentistry as a profession back
when they first started thefirst dentistry school dentistry
as a profession back when theyfirst started the first
dentistry school.
Scott Swank (01:51):
Well, I mean, in terms of differences you had, I
mean there were a lot ofphysicians that were in private
practice and they had little.
They had small offices anddentists were the same way, but
the medical profession waslicensed a long time before the
dental profession.
And I mean medical schools.
Go back in Europe, you knowforever.
I mean you've got Padua andBologna and Edinburgh and you
(02:11):
know all those places.
So physicians were, you know,professionally trained for a
long long time, but they had alltheir clinical learning came
from hospitals and infirmariesand those things just didn't
exist for dentistry it was acottage industry, small private
practices.
So the students, once thedental college opened, they
(02:34):
didn't even have an infirmarythemselves for a number of years
.
So the students would learn inthe professor's practices, which
is largely how dentistry waslearned anyway.
Ayla Sparks (02:47):
I was wondering if it was like a trade, where you
just go in and be an apprenticeat someone who's already doing
it.
Scott Swank (02:52):
You did.
They called it preceptorshipand that's the way dentists, you
didn't have to do that.
I mean you could buy the.
You didn't even have to buy thebooks.
I mean you could buy theinstruments if you could find
them and just start Just startwhacking away yeah yanking
people's teeth out, basically,and a lot of charlatans did I
(03:12):
mean.
there are any number of images,not portraiture but paintings
that depict, you know, thisperson.
And they've got an assistantwith a, you know, grinding an
organ and they're making allkinds of noise to draw a crowd.
And then they get a person fromthe crowd and they come up,
they extract the tooth and theyhold it up.
(03:33):
And who knows if they hadpracticed with it, had
preceptored under anotherdentist, if they had even read a
dental textbook at that time,who knows?
Ayla Sparks (03:44):
I mean it was a lawless wasteland.
Yeah, it could be Ofshowmanship.
Scott Swank (03:49):
And you know the reason.
I had always wondered whydentistry?
Why the profession kind ofstarted in the mid-1800s and
dentists at that time werestarting to associate form
associations, state associations, local associations.
They knew the profession had tobecome professional, basically.
(04:11):
So in order to do that, theyknew they needed an organization
, which they had been toyingwith for a while.
They needed a journal, and thejournal started in 1839.
And they knew they neededprofessional training.
And I think the real impetus forthat came with the collapse.
There was economic collapse inthe United States in the late
(04:33):
1830s, so a lot of men were outof work and apparently a bunch
of them saw people they knew whowere practicing dentistry and
they were doing pretty well, andthey said, well, heck, I'll
just practice dentistry too.
And the people that had beenpracticing dentistry and were
doing it correctly had learned,you know, from other dentists
(04:55):
and that kind of thing saw thisas a huge problem in terms of
whatever you want to call itwith the population.
I mean, they were, you know,going to see the status of this
profession just drop like a rockand they wanted to take steps
to prevent that.
So I think that was part of thereason the dental school was
founded there as well, gave thata big impetus.
(05:18):
And then you know, practice lawsstarted early on.
The dental school opened in1840.
Started early on.
The dental school opened in1840.
I think Alabama had the firstpractice law in 1841.
Of course, all those practicelaws I think pretty much, if not
all of them, the vast majorityof them grandfathered in people
that had been practicingdentistry for years.
(05:39):
I think if you didn't have acomplaint against you with
anybody you were grandfatheredin, but of course people that
were new had to be licensed atthose points.
Ayla Sparks (05:52):
Back in the 40s.
I am curious was it just if youhad a toothache you'd go to the
doctor and they'd yank thattooth out, or was it a little
bit more like a medical approach?
Scott Swank (06:02):
For a physician.
A lot of physicians diddentistry because they had to.
There weren't any dentistsaround, so if they had, you know
, a patient that ended up withtoothache, they many times took
it out themselves.
Now, if there was a dentistaround they would have done that
and they had the instrumentsfor it.
It was a lot cruder than it isnow and of course, there wasn't
(06:25):
any anesthesia.
Ayla Sparks (06:27):
I was gonna say it's just a jug of whiskey,
right.
Scott Swank (06:44):
Well, yeah, until the advent of vulcanite as a
material to use as a denturebase, which is basically cured
rubber, and that process wasdiscovered in 1853, I believe.
So it wasn't until after that.
Pretty much I would say.
There probably aren't that manyvulcanite dentures made
(07:06):
pre-Civil War.
Then you know, of course theCivil War happens and everything
kind of goes haywire and thenthings settle down after that.
So really, you know, denturesdidn't really become a thing
until after the Civil War, Iwould say.
Ayla Sparks (07:20):
Speaking of dentures, you have one from
probably the most recognizableperson from US history George
Washington's dentures.
Scott Swank (07:30):
I mean it's way cool, because you know, first
president, in his mouth he, Imean it's such a personal thing,
right, I mean it's a denture,it's not like your shoe, it's
not like a belt, it's not like asword.
I mean you know, this was inhis mouth.
Ayla Sparks (07:49):
I was there when he was giving speeches.
Scott Swank (07:51):
Yeah, it was probably the reason that you
know his second inauguraladdress was the shortest in
history, because if you see it,you'll understand that you
didn't, you wouldn't, want thatin your mouth.
It couldn't be comfortable.
Ayla Sparks (08:08):
For his teeth is it kind of?
He had one set of dentures thathe used throughout his life.
Scott Swank (08:10):
He did not.
Ayla Sparks (08:10):
Or were there multiples?
Scott Swank (08:12):
Multiple dentures.
We know there are one, two,three, four.
There are four dentures, partof a denture or a denture set,
extant.
So the Royal London HospitalMuseum and Archives has one half
(08:33):
of one denture.
It has been described as halfof an upper.
I don't believe it.
We've got a model of it in themuseum and I think it's half of
a lower.
The New York Academy ofMedicine owns a lower denture, a
full lower.
It's not I say full,technically it's not a full
(08:54):
denture.
There's a hole in it that thedenture went over Washington's
last remaining tooth.
So it was what modern dentistrywould call an over denture.
But it was basically a fulldenture, the upper to that set.
I don't know where that wouldhappen the upper to the set that
(09:14):
London owns have no idea whathappened.
The Mount Vernon LadiesAssociation has at Mount Vernon
Washington's estate.
They have a full set ofdentures.
They have an upper and a lower.
So that's the third.
We have a lower.
The upper to that set did exist.
We have no idea where it is nowbecause it disappeared and then
(09:38):
it is rumored that Washingtonwas buried with a set.
So that would be the fifth setthat we know of and I think
there probably were other setsor parts of sets on top of that.
Washington was always he wasnever satisfied with his dentist
.
He was always complaining aboutthe, about the, privately about
(10:00):
the person, more publicly aboutthe dentures, more publicly
about the dentures.
He utilized at least eight, theservices of eight different
dentists.
John Greenwood ended up beinghis favorite in terms of
dentures.
We believe there may have beena set made for Washington by
James LaMayer and nobody knowswhere that set is, and
(10:25):
Washington described a set ofdentures as being unwieldy, too
large and too clumsy to use.
We think that set may have beenmade by La Meilleur.
But once Washington kind ofdiscovered Greenwood, he stuck
with him.
Like I said, washington had oneremaining tooth.
Washington lost that tooth justbefore he was inaugurated
(10:48):
president for the second time.
So Greenwood had to makeanother set, which we think was
the London set, and I think itwas all one piece.
The lower was all one piece ofivory, the base and the teeth.
They were not differentsections and I think Washington
dropped it and broke it.
That's why only half of itexists.
Ayla Sparks (11:09):
So Greenwood had to make another entire set, and
that's the set we own.
Rumors kind of abound when itcomes to George Washington's
teeth, because you know, we'veall heard the wooden teeth.
And they were actually enslavedindividuals' teeth and then
that they were ivory teeth.
So can you let us know what'sgoing on with these rumors?
Scott Swank (11:24):
Let's go with wood first.
No wooden dentures in theUnited States or Europe.
So the people that wereGreenwood was an American and
had been trained in the US as adentist.
Some of the other folks hadcome over from France because
France, during thatrevolutionary time period for
(11:44):
the US, was the place puttingout dentists.
I mean, they were dentistrycentral for Europe at that point
and some of those fellows cameover with different groups
during the revolution.
They were assigned to differentmilitary groups or to the Navy,
(12:05):
on a ship, that kind of thing,and they ended up staying, which
is really kind of where USdentistry got its start.
So they had no background inwooden dentures.
They weren't making woodendentures in Europe so they
didn't make them here, I thinkprimarily because the woods, the
(12:25):
actual woods, were different.
They did make wooden denturesin Japan but they used a very
dense, very oily wood.
Ayla Sparks (12:34):
I was going to say the wood would swell in your
mouth.
Scott Swank (12:38):
I'm not so sure the oil would help with the
swelling, but the splinters youknow, you can actually finish it
smooth so that it didn't stickyou.
And I also think that Europe hadaccess to a huge amount of
ivory.
I think there was just ivorycoming out of Africa like you
wouldn't believe, and notnecessarily elephant ivory that
(13:01):
was going into, you know, intothe fancy trades, but there was
a huge amount of hippopotamusivory coming out of Africa and
that's what they were usingprimarily in the fabrication of
dentures in both Europe and theUnited States.
And you have to understand thatdentures at that time were all
(13:21):
handmade and hand-fitted to aplaster impression.
So you had to take a piece ofivory and start carving it and
keep fitting and carving and oh,this spot's too high, I'll
carve that.
Now, this spot's too high, I'llcarve that.
So in terms of what a denturecost then would probably be in
(13:41):
the neighborhood of just over$100,000 today.
So only the elite of the elitescould afford to have a denture
made for them.
Now, slave teeth on one ofGeorge Washington's denture.
I'm not so sure.
The New York Academy ofMedicine denture has some human
teeth on it.
(14:01):
I'm not sure any of them wouldhave been from Washington's
slaves, for the reason thatdentists were acquiring human
teeth to use on dentures fromvarious places and Greenwood
made the denture.
And Greenwood would have nothad access to Washington's
(14:23):
slaves, but he would have hadaccess to the population of New
York City and there were a lot,a lot of poor, very, very poor
people in large metropolitancities like London, paris, new
York, all those kinds of places,and dentists would actually pay
(14:44):
people for their teeth.
Oh, that is so sad.
Yeah, sad story, but true.
And you were hoping to getteeth from younger people
females especially because youwanted teeth that looked good.
You couldn't use a rotten toothon a denture, you had to use
teeth that looked good.
So that's primarily where theteeth were coming from.
Ayla Sparks (15:07):
The dark dentistry trade.
Scott Swank (15:11):
Yeah, dentists would just pay or they would
keep teeth that they.
You've got to understand thatperiodontal disease was just as
bad as decay at the time.
So you're getting teeth thatneed to be taken out, not
because they're decayed butbecause there's no bone left to
hold them in.
So Greenwood had an entire boxfull of teeth that he, you know,
(15:34):
he could choose from to make tomake to put on dentures.
So I think the chance of thehuman teeth that are on the New
York Academy denture being fromWashington Slaves is very, very
remote.
They used a lot of calves teeth,bovine teeth.
You could.
Apparently they were nice andwhite.
You could carve them easily,especially for, like the larger
(15:54):
anterior front teeth on theupper.
Yeah, you could carve themeasily.
The teeth that were on ourdenture, they were all ivory.
The upper ones used individualpieces of ivory, the lower ones
used sections of ivory that arecarved to look like individual
teeth.
But it's actually like three orfour teeth in a row and then
(16:17):
they hold on, they're onto thedenture.
That way the Mount Vernondenture has all kinds of stuff
on it.
It has what one person thinksis an elk's tooth used as one of
the molars.
Ayla Sparks (16:31):
Because elk do have ivory in there.
Scott Swank (16:34):
Yeah, elk have vestigial tusk.
Yeah, they call it elk ivories.
Yeah, and one of them,apparently one of the teeth came
off and it was repaired, andthe repair was made with a nut.
Yeah, I don't know what kind of, you know what kind of chestnut
, or yeah, I don't have any idea, but it's, you know, it's got a
couple X's in it and it's inone of the posterior teeth, so
(16:56):
yeah, so that denture's got allkinds of stuff on it.
Ayla Sparks (17:00):
So if someone were to come and visit the museum,
what can they expect to see?
What kind of exhibits do youguys have?
Scott Swank (17:07):
Well, the exhibits at the dental museum kind of run
the gamut.
I mean it starts out with teethin popular culture.
Kind of run the gamut.
I mean it starts out with teethin popular culture because we
were really trying to get awayfrom that whole idea of
dentistry and pain.
Those two have been associatedfor way too long, and so the
(17:27):
first part of the museum talksabout teeth in popular culture,
different cultural traditionswith teeth, smiles, toys, films,
commercials, that kind of thing.
And then it goes intoprevention.
We've got information onfluoride when that first came
out and the controversy you knowthe big controversy about
(17:48):
putting fluoride in water andthat kind of thing.
We've got Queen Victoria'sdental instruments oh wow, and
that kind of thing.
Got Queen Victoria's dentalinstruments oh wow, during the
Victorian era, if you werewealthy enough, you had your own
personal dental scalers thatyou took to the dentist who then
used them to scale your teeth,as opposed to the scalers he
(18:11):
owned or she owned mostly hethat he owned to scale teeth, so
that you weren't having yourteeth scaled by instruments that
had scaled somebody else'steeth, which at the time
probably wasn't the worst ideain the world.
I mean, we assume that theinstruments were being cleaned.
(18:32):
I don't think there was reallyanything, nothing antiseptic
going on.
I mean, there wasn't evenanything antiseptic going on at
that time in hospitals.
Ayla Sparks (18:40):
And probably just wiped off on the apron and then
next patient.
Scott Swank (18:43):
Yeah, so if you could afford your own, you took
them.
So of course Queen Victoriacould afford her own, so she had
her own.
Ayla Sparks (18:51):
I'm sure they were gold encrusted or something.
Scott Swank (18:54):
They're quite fancy , they're plated silver, gold
plated silver, when mother ofpearl handles, quite nice.
I've seen a fancier set,pictures of a fancier set.
Apparently one of the queens ofspain had a very similar set,
but on the crowns each of queenvictoria's has a crown at the
end of the handle, and wherethere would be gems on a real
(19:17):
crown are just, you know, likebumps in the gold, whereas the
spanish queen had little, teeny,tiny pieces of gemstones put
there, like sapphires and rubiesand that kind of thing.
Ayla Sparks (19:30):
So I was slightly hoping it was going to be the
bones of conquered foes, butyeah, no, I don't think so.
Scott Swank (19:37):
But um, so we've got queen and, uh, prince
albert's personal dental scalerswere just up for auction not
long ago.
Yeah, that was something we wedidn't didn't have the funds to
bid on, but it would kind ofbeen nice to have them both
together.
And his weren't as fancy ashers.
Ayla Sparks (19:56):
I'm also curious in your opinion over the course of
dentistry in its entirety.
What are some of the mostinfluential or important?
Either discoveries orinventions have been made that
kind of revolutionized thedentistry game.
Scott Swank (20:13):
Well, dentistry for a long, long time was basically
extractions.
Now you go back to the late1700s and things are getting
more complicated in terms ofextractions, fillings, dentures,
surgeries to remove differentthings, even to deal with some
(20:34):
periodontal disease.
But the things and theinstrumentation was relatively
simple.
So you really have to get intoa more, almost a more modern
time to really see things.
That revolutionized dentistry Imean anesthesia, revolutionized
(20:56):
dentistry, I mean anesthesia,of course, revolutionized
dentistry and general anesthesiain terms of ether, nitrous
oxide, chloroform, they all.
Nitrous oxide was first in 1842, then you had ether in 1844.
And chloroform came right closeto that, maybe another two or
four years after that.
That's extremely important.
(21:16):
But other than, you know,taking out teeth that are
difficult to get out, you reallydon't want to put people out
with ether and chloroform.
They're dangerous, especiallyether in terms of the transition
from being unconscious tonon-breathing and dead.
It's very small with ether,which is why chloroform took
over, you know, as soon as theyshowed that it would work.
(21:38):
But local anesthesia isn'tdiscovered and proven until 1895
.
So that's, you know, like 50years before you get local
anesthesia, which is whatdentistry revolves around today.
I mean right, so we've gotlocal anesthesia in 1895.
And then in the early 1900s DrGV Black perfected the
(22:03):
formulation for dental amalgamand that revolutionized
restorative dentistry in termsof being able to cut a tooth so
that you get out all the decayand then fill it with a material
that's going to last a whileand isn't injurious.
You know that kind of thing.
And the problem with earlysilver amalgams was, upon
(22:27):
setting, you know, getting hard,they expanded instead of shrunk
.
So you were having thesecharlatan guys going around and
they would.
They weren't even really takingthe decay out of teeth.
If a tooth had a hole in it.
They would mix up this, youknow silver paste and put it in
a tooth and they would be in youknow a city this week and gone
the next and by the time thefillings had set and expanded
(22:51):
and cracked the tooth and madeit worse than it was before they
started they were gone.
So you know, the scientificformulation for amalgam coming
out in the early 1900srevolutionized that part of
dentistry.
And then hand pieces.
The first rotary driven handpiece that was commercially
(23:14):
available didn't come out untillike 1877.
So before that if you wanted toput a hole in a tooth or take
decay out of a tooth, they hadcome up with all kinds of
mechanical means to do that.
None of them really worked thatwell.
Ayla Sparks (23:28):
I'm picturing those old egg beaters.
They did do that.
Scott Swank (23:31):
Yeah, we've got one of those at the museum.
They came up with a like aclock mechanism.
You wind it up and the spring,you know, turned the, turned the
burr.
Um, that was really heavy, thatdidn't work well.
Bow drills, oh you know, likeyou've seen, you know, um, you
know naked and afraid with her?
Yeah, exactly and and you'retrying to start a fire with them
(23:53):
.
Ayla Sparks (23:54):
Yeah.
Scott Swank (23:54):
Well, they use those to put you know
preparations in teeth.
Ayla Sparks (23:57):
It sounds very precise.
Scott Swank (23:58):
They're difficult to use, of course, and you can't
get them.
You know they're very hard touse in the back teeth.
So the foot treadle dentalengine that had a handpiece with
a small burr, that you actuallymade move with your foot,
revolutionized dentistry.
That made cutting teeth.
I mean the time savings andability to cut tooth was just
(24:22):
remarkable.
Ayla Sparks (24:23):
Oh, that's cool too .
Is there anywhere in the museumthat you touch on the tooth
fairy?
Scott Swank (24:28):
We used to.
We put in a big exhibit.
We changed exhibits years ago.
We took out the information onthe tooth fairy and then we had
another exhibit.
That was an exhibit basicallyon children's dental literature,
but of course that had booksand things on tooth traditions
for children and that includedthe tooth fairy.
But the tooth fairy is just anEnglish thing.
Ayla Sparks (24:51):
So the Tooth Fairy is particularly popular in
Western folklore, but it is notvery well documented as the true
origins.
However, one of the earliestreferences to a tooth deity
similar to the tooth fairy canbe found in Norse mythology.
So in Norse culture, childrenwould offer their lost baby
(25:13):
teeth to the Norse god, odin,and it was believed that Odin
would then bless the children inreturn for their teeth.
There are many other toothtraditions throughout the world,
like in most Hispanic countriesthere's a small mouse who comes
and takes your teeth and leavescandies.
In Asia, especially in Japan,there's a tradition where if
(25:35):
your child loses an upper tooth,then you're supposed to throw
the tooth somewhere on theground.
If they lose a bottom tooth,you're supposed to throw them
somewhere high, like up on aroof, and the reasoning behind
that is whatever direction youthrow that tooth is the
direction it's going to grow in.
So if you want them to havenice straight teeth you do the
(25:56):
top ones should grow straightdown on the floor, vice versa
with the roof.
So, at the risk of showing offhow macabre my mother and I were
while I was growing up, I haveall of my baby teeth and I even
have my adult teeth that hadbeen removed, like my wisdom
teeth.
I kept them all.
I was even able to keep some ofmy puppy's baby teeth, which
(26:20):
was remarkable to find.
I was lucky enough to find themon the floor.
But when I was telling this toScott, he told me that I am not
the only one.
He discovered that somescientists are actually doing
the same thing, but perhaps fora much nobler reason.
Here's Scott.
Scott Swank (26:37):
But now the bioengineering exhibit.
I don't know if it brings thisout specifically, but while we
were doing that exhibit it cameup that they're working on the
ability to usesemi-differentiated stem cells,
so not pluripotent stem cellsthat you would obtain from an
(26:58):
embryo, but there are other stemcells in the body that are what
they call semi-differentiated.
So for teeth, there are stemcells that will produce any kind
of tooth.
I mean, you can't get an entireorganism out of them, but
they'll produce a tooth.
So scientists have been workingon the ability to grow teeth
(27:25):
from these partiallydifferentiated stem cells.
Wow, and you can get them frombaby teeth.
Ayla Sparks (27:33):
That is incredible.
Scott Swank (27:34):
Especially baby teeth, molars.
Ayla Sparks (27:37):
So this is making me sound actually more of a
scientist than a crazy personwho saved all of my teeth.
Yeah, I'm really thinking ahead, actually Way ahead of the time
.
Scott Swank (27:49):
And I did not read in putting that exhibit together
, I didn't read anything aboutlongevity.
So, in terms of and how daywhere you actually save those
teeth on purpose, and then, ifyou lose a tooth for some reason
(28:12):
, perhaps you'll be able to usestem cells obtained from those
teeth to grow a new one.
Ayla Sparks (28:18):
That's amazing.
Scott Swank (28:19):
Yeah, that would be amazing.
That would be the ultimatetooth replacement is if you
could replace your own teethwith your own teeth.
Ayla Sparks (28:27):
Well, I have learned a lot about dentistry
that I had no idea about.
Tooth replacement is if youcould replace your own teeth
with your own teeth.
Well, I have learned a lotabout dentistry that I had no
idea about Some really darkthings, some really exciting and
new things.
So thank you so much formeeting with me.
No-transcript.
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On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!