Pierre Fauchard, Dentistry, and Urine in the 18th Century

French physician Pierre Fauchard is widely credited as being the “father of modern dentistry.” He joined the navy in the late seventeenth century and quickly became interested in dental ailments due to scurvy affecting most sailors on ships. After leaving the navy, he began to practice at the University of Angers Hospital where he pioneered scientific oral and maxillofacial surgery, so that by the first decade of the 1700s Fauchard was considered one of the most skilled surgeons among his peers.

Fauchard published Le Chirurgien Dentiste (“The Surgeon Dentist”) in 1728. His book was the first of its kind. It consisted of fragmented medical and dental ideas that he gathered together. He also added his own ideas and borrowed ideas from previous writers. His book described basic oral anatomy, operative dental methods, periodontal disease, tooth transplantation, and orthodontics, and as dentistry was still a relatively a new field, Fauchard quickly started a dental revolution with his forward thinking ideas.

To further his ideas, Pierre Fauchard quickly discovered he needed proper dental tools, as they were lacking. This resulted in him creating various dental tools, many of which he adapted or improved from tools used by watchmakers, barbers, and jewelers. Among items he devised was needle-nose pliers used in prosthodontics, various tools for filling teeth, and the pelican forceps used for extracting teeth. 

Fauchard also provided exacting instructions to extract teeth. This was accomplished using “an elevator, pelican, or pincers.”[1] In addition, he suggested that while undergoing treatment, people use a dental chair as people had been sitting on the floor with their head between the dentist’s legs. For extractions, he devised the following:

“The tooth was first loosened with an elevator and then the claw of the pelican was pushed down on the root as far as possible. The end of the handle [was] then brought into line with it and placed on the gum … [enabling] the operator to grip the tooth while it was rocked until movement was felt, a process he called ‘shaking.’”[2]

In Fauchard’s book, he also devoted an entire chapter on how to straighten teeth. He maintained that the “Bandeau,” a horseshoe-shaped piece of metal, could expand the arch and correct the position of teeth and this is what was used on Marie Antoinette‘s teeth to beautify them. He also asserted that based on the size of a tooth’s root, children’s teeth would move quicker and easier than adult teeth because adult’s had larger roots. Therefore, he suggested that even babes on their mother’s breast with irregular teeth could be placed in a Bandeau. (I can only imagine the pain a mother would have undergone when suckling a baby with metal braces.)

Whereas most dentists at the time extracted decayed teeth, Pierre Fauchard attempted to treat them. In fact, he introduced the idea of dental fillings as a way to treat cavities and suggested using amalgams, such as lead, tin, or sometimes gold for the fillings (an idea also previously suggested by Italian Johannes Arculanus, a professor of medicine and surgery in the fifteenth century). Fauchard also asserted cavities were caused by sugar derivate acids, such as tartaric acids, and encouraged people to have their teeth periodically cleaned by a dentist.

Years later, at the Fourth International Dental Congress in 1904, a paper titled, “A propos of a Portrait of Pierre Fauchard” by a Dr. George Viau of Paris was presented to the conference. Several other doctors also spoke about Fauchard’s groundbreaking ideas. Among them was a Dr. J.E. Greevers from Holland who mentioned Fauchard’s book and noted how his ideas were still relevant when he addressed the audience stating:

“His chapter on artificial teeth is very interesting, and you find in this book what is now called crown and bridge work and pivot teeth. The disease of the teeth were closely watched by him at that time, and his descriptions of the many observations on dental disease are worth reading.”[3]

Besides his creative ideas related to tooth extractions, braces, and cavities and fillings, Pierre Fauchard refuted many old world theories about teeth. For instance, for as long as anyone could remember people believed a worm caused caries and periodontal disease. He searched in vain for the worms before putting this theory to rest: He did so by looking in a microscope where he discovered no worms. At the time, some dentists also believed teeth did not have roots and were spontaneously generated. Fauchard disproved the theory of spontaneous tooth generation, arguing that first teeth, which are called milk teeth, separated themselves from their roots.

For all Pierre Fauchard’s forward thinking, however, there is one idea he supported that might astonish you. From medieval times urine was widely thought to be helpful for a wide variety of diseases. He believed urine was beneficial to patients suffering from toothache. Thus, he advised patients to rinse their mouths, both morning and night, with spoonfuls of their own urine. It worked. Apparently, one of the chemical compounds in urine is ammonia, something unidentifiable at the time but also the reason for the patient’s beneficial results.

References:

• [1] Atkinson, H.F., “Some Early Dental Extraction Instruments Including the Pelican, Bird or Axe?,” in Australian Dental Journal, 2002, p. 90.
• [2] Ibid.
• [3] The Dental Cosmos, Volume 46, 1904, p. 1026.