dentistry, development of. Practical dental treatment in medieval and early modern Britain was generally restricted to cleaning and extracting teeth, and applying dressings or prescribing mouthwashes to relieve pain. Cleaning by scraping or application of acids was carried out by barbers, who were also legally permitted to extract teeth. Extractions were the due of tooth-drawers, an independent trade group since at least the end of the 13th cent., but were undertaken also by surgeons, blacksmiths, and itinerants at markets and fairs. The emergence of restorative dentistry in mid-17th-cent. London was enhanced by the arrival of skilled immigrant surgeons from the continent and the early stirrings of consumerism, although contemporary satirists saw the provision of artificial teeth as no more than cosmetic vanity. As anatomical and technical knowledge slowly improved throughout the 18th cent., gold or lead fillings appeared, while artificial teeth became increasingly sophisticated, though affordable only by the wealthy. ‘Operators for the teeth’ gave way to ‘dentists’, who began to seek business not only in London but in provincial towns. By the mid-19th cent., dentistry was developing into a profession, with scientific journals and professional societies, then qualifications and a register (1878), though still under the control of the General Medical Council. Apprenticeship and informal parental or casual training were superseded by dental schools which had developed out of earlier dental dispensaries and hospitals. The profession was closed by the Dentists Act of 1921, but did not become independent of the GMC until 1957. The inclusion of dental treatment within the National Health Service (1948) generated an unforeseen demand for treatment, but also revealed a shortfall in practitioners, services, and standards. Expansion of dental schools and reduction in caries rates after the advent of fluoridation have since improved the nation's dental health, but many practitioners have recently returned to independent practice, and the future of the NHS dental service has become questionable.

A. S. Hargreaves