Editing Dentistry (section)

==History==
{{see also|History of dental treatments}}
[[File:A wealthy patient falling over because of having a tooth ext Wellcome V0012058.jpg|thumb|upright|''A wealthy patient falling over because of having a tooth extracted with such vigour by a fashionable dentist'', {{circa|1790}}. History of Dentistry.]]
[[File:Johann Liss 002a.jpg|thumb|upright|''Farmer at the dentist'', [[Johann Liss]], {{circa|1616–17}}]]
Tooth decay was low in [[Paleolithic diet|pre-agricultural]] societies, but the advent of [[Agriculture|farming]] society about 10,000 years ago correlated with an increase in [[tooth decay]] (cavities).<ref>{{cite web |url = https://www.bbc.com/earth/story/20160229-how-our-ancestors-drilled-rotten-teeth |title = How our ancestors drilled rotten teeth |last = Barras |first = Colin |publisher = BBC |date = 29 February 2016 |access-date = 1 March 2016 |archive-url=https://web.archive.org/web/20170519063141/https://www.bbc.com/earth/story/20160229-how-our-ancestors-drilled-rotten-teeth |archive-date=19 May 2017}}</ref> An infected tooth from Italy partially cleaned with flint tools, between 13,820 and 14,160 years old, represents the oldest known dentistry,<ref>{{cite web |url = http://news.discovery.com/history/oldest-dentistry-found-in-14000-year-old-tooth-1507156.htm |title = Oldest Dentistry Found in 14,000-Year-Old Tooth |publisher = [[Discovery Channel]] |date = 16 July 2015 |access-date = 21 July 2015 |archive-date = 18 July 2015 |archive-url = https://web.archive.org/web/20150718211808/http://news.discovery.com/history/oldest-dentistry-found-in-14000-year-old-tooth-1507156.htm |url-status = dead }}</ref> although a 2017 study suggests that 130,000 years ago the [[Neanderthals]] already used rudimentary dentistry tools.<ref>{{cite web |url = https://news.ku.edu/2017/06/23/analysis-neanderthal-teeth-marks-uncovers-evidence-prehistoric-dentistry |title = Analysis of Neanderthal teeth marks uncovers evidence of prehistoric dentistry |publisher = The University of Kansas |date = 28 June 2017 |access-date = 1 July 2017 }}</ref> In Italy evidence dated to the Paleolithic, around 13,000 years ago, points to bitumen used to fill a tooth<ref>{{Cite journal |last1=Oxilia |first1=Gregorio |last2=Fiorillo |first2=Flavia |last3=Boschin |first3=Francesco |last4=Boaretto |first4=Elisabetta |last5=Apicella |first5=Salvatore A. |last6=Matteucci |first6=Chiara |last7=Panetta |first7=Daniele |last8=Pistocchi |first8=Rossella |last9=Guerrini |first9=Franca |last10=Margherita |first10=Cristiana |last11=Andretta |first11=Massimo |last12=Sorrentino |first12=Rita |last13=Boschian |first13=Giovanni |last14=Arrighi |first14=Simona |last15=Dori |first15=Irene |date=2017 |title=The dawn of dentistry in the late upper Paleolithic: An early case of pathological intervention at Riparo Fredian |url=https://onlinelibrary.wiley.com/doi/10.1002/ajpa.23216 |journal=American Journal of Physical Anthropology |language=en |volume=163 |issue=3 |pages=446–461 |doi=10.1002/ajpa.23216 |pmid=28345756 |hdl=11585/600517 |issn=0002-9483|hdl-access=free }}</ref> and in Neolithic Slovenia, 6500 years ago, beeswax was used to close a fracture in a tooth.<ref>{{Cite journal |last1=Bernardini |first1=Federico |last2=Tuniz |first2=Claudio |last3=Coppa |first3=Alfredo |last4=Mancini |first4=Lucia |last5=Dreossi |first5=Diego |last6=Eichert |first6=Diane |last7=Turco |first7=Gianluca |last8=Biasotto |first8=Matteo |last9=Terrasi |first9=Filippo |last10=Cesare |first10=Nicola De |last11=Hua |first11=Quan |last12=Levchenko |first12=Vladimir |date=2012-09-19 |title=Beeswax as Dental Filling on a Neolithic Human Tooth |journal=PLOS ONE |language=en |volume=7 |issue=9 |pages=e44904 |doi=10.1371/journal.pone.0044904 |doi-access=free |issn=1932-6203 |pmc=3446997 |pmid=23028670|bibcode=2012PLoSO...744904B }}</ref> The [[Indus valley]] has yielded evidence of dentistry being practised as far back as 7000 BC, during the [[Stone Age]].<ref>{{cite journal | last1=Coppa | first1=A. | last2=Bondioli | first2=L. | last3=Cucina | first3=A. | last4=Frayer | first4=D. W. | last5=Jarrige | first5=C. | last6=Jarrige | first6=J. -F. | last7=Quivron | first7=G. | last8=Rossi | first8=M. | last9=Vidale | first9=M. | last10=Macchiarelli | first10=R. | title=Early Neolithic tradition of dentistry | journal=Nature | publisher=Springer Science and Business Media LLC | volume=440 | issue=7085 | year=2006 | issn=0028-0836 | doi=10.1038/440755a | pages=755–756 | pmid=16598247 |display-authors=1}}</ref> The [[Neolithic India|Neolithic]] site of [[Mehrgarh]] (now in Pakistan's south western province of [[Balochistan]]) indicates that this form of dentistry involved curing tooth related disorders with [[bow drill]]s operated, perhaps, by skilled bead-crafters.<ref name="bbc" /> The reconstruction of this ancient form of dentistry showed that the methods used were reliable and effective.<ref>{{cite web | title=Dig uncovers ancient roots of dentistry | website=NBC News | date=2006-04-05 | url=https://www.nbcnews.com/id/wbna12168308}}</ref> The earliest [[Dental restoration|dental filling]], made of [[beeswax]], was discovered in [[Slovenia]] and dates from 6500 years ago.<ref>{{cite journal | doi = 10.1371/journal.pone.0044904 | pmid=23028670 | pmc=3446997 | volume=7 | issue=9 | title=Beeswax as Dental Filling on a Neolithic Human Tooth | journal=PLOS ONE | pages=e44904| year=2012 | last1=Bernardini | first1=Federico | last2=Tuniz | first2=Claudio | last3=Coppa | first3=Alfredo | last4=Mancini | first4=Lucia | last5=Dreossi | first5=Diego | last6=Eichert | first6=Diane | last7=Turco | first7=Gianluca | last8=Biasotto | first8=Matteo | last9=Terrasi | first9=Filippo | last10=De Cesare | first10=Nicola | last11=Hua | first11=Quan | last12=Levchenko | first12=Vladimir | bibcode=2012PLoSO...744904B | doi-access=free |display-authors=1}}</ref> Dentistry was practised in prehistoric [[Malta]], as evidenced by a skull which had a [[dental abscess]] lanced from the root of a tooth dating back to around 2500 BC.<ref>{{cite news|title=700 years added to Malta's history|url=https://www.timesofmalta.com/articles/view/20180316/life-features/700-years-added-to-maltas-history.673498|work=[[Times of Malta]]|date=16 March 2018|archive-url=https://web.archive.org/web/20180316111529/https://www.timesofmalta.com/articles/view/20180316/life-features/700-years-added-to-maltas-history.673498|archive-date=16 March 2018|url-status=live}}</ref> The practice of dentistry dates back thousands of years, with evidence of dental procedures such as tooth extraction and fillings found in ancient civilizations like the Egyptians and the Greeks. One notable historical figure is [[Pierre Fauchard]], often referred to as the 'father of modern dentistry,' who wrote the first comprehensive book on the subject in 1728.

An ancient [[Sumerian language|Sumerian]] text describes a "[[tooth worm]]" as the cause of [[dental caries]].<ref>{{cite web|url=http://www.ada.org/public/resources/history/timeline_ancient.asp |title=History of Dentistry: Ancient Origins |archive-url=https://web.archive.org/web/20070705105101/http://www.ada.org/public/resources/history/timeline_ancient.asp |archive-date=5 July 2007 |work=American Dental Association |access-date=9 January 2007 |df=dmy |url-status=dead }}</ref> Evidence of this belief has also been found in ancient India, [[Egypt]], Japan, and China. The legend of the worm is also found in the ''[[Homeric Hymns]]'',<ref>{{Cite journal|last=TOWNEND|first=B. R.|title=The Story of the Tooth-Worm|date=1944|journal=Bulletin of the History of Medicine|volume=15|issue=1|pages=37–58|jstor=44442797|issn=0007-5140}}</ref> and as late as the 14th century AD the surgeon [[Guy de Chauliac]] still promoted the belief that worms cause tooth decay.<ref>{{cite journal|author=Suddick Richard P., Harris Norman O. |year=1990 |title=Historical Perspectives of Oral Biology: A Series |url=http://crobm.iadrjournals.org/cgi/reprint/1/2/135.pdf |journal=Critical Reviews in Oral Biology and Medicine |volume=1 |issue=2 |pages=135–51 |url-status=dead |archive-url=https://web.archive.org/web/20071218025641/http://crobm.iadrjournals.org/cgi/reprint/1/2/135.pdf |archive-date=18 December 2007 |doi=10.1177/10454411900010020301 |pmid=2129621 }}</ref>

Recipes for the treatment of toothache, infections and loose teeth are spread throughout the [[Ebers Papyrus]], [[Kahun Papyri]], [[Brugsch Papyrus]], and [[Hearst papyrus]] of [[Ancient Egypt]].<ref name="blomstedt">{{cite journal |author = Blomstedt, P. |year = 2013 |title = Dental surgery in ancient Egypt |journal = Journal of the History of Dentistry |volume = 61 |issue = 3 |pages = 129–42 |pmid = 24665522 }}</ref> The [[Edwin Smith Papyrus]], written in the 17th century BC but which may reflect previous manuscripts from as early as 3000 BC, discusses the treatment of dislocated or fractured jaws.<ref name="blomstedt" /><ref>{{cite web |archive-url=https://web.archive.org/web/20071226035425/http://students.ou.edu/D/Andrew.J.Dunlevy-1/episode1.html |url=http://students.ou.edu/D/Andrew.J.Dunlevy-1/episode1.html|title=Ancient Egyptian Dentistry |website= University of Oklahoma |accessdate= 15 December 2007|archive-date= 26 December 2007}}</ref> In the 18th century BC, the [[Code of Hammurabi]] referenced dental extraction twice as it related to punishment.<ref>{{cite web |last1 = Wilwerding |first1 = Terry |title = History of Dentistry 2001 |url = http://www.dentalofficesantaclarita.com/history2001.PDF |access-date = 3 November 2014 |archive-url = https://web.archive.org/web/20141103094821/http://www.dentalofficesantaclarita.com/history2001.PDF |archive-date = 3 November 2014 |url-status = dead }}</ref> Examination of the remains of some [[History of ancient Egypt|ancient Egyptians]] and [[Greco-Roman]]s reveals early attempts at dental [[prosthetic]]s.<ref>{{cite web |url = http://www.arabworldbooks.com/articles8c.htm |title = Medicine in Ancient Egypt 3 |publisher = Arabworldbooks.com |access-date = 18 April 2010 }}</ref> However, it is possible the prosthetics were prepared after death for aesthetic reasons.<ref name="blomstedt" />

[[Ancient Greece|Ancient Greek]] scholars [[Hippocrates]] and [[Aristotle]] wrote about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with [[forceps]], and using wires to stabilize loose teeth and fractured jaws.<ref name="History Of Dentistry">{{cite web |url = http://completedentalguide.co.uk/history-of-dentistry/ |title = History Of Dentistry |work = Complete Dental Guide |access-date = 29 June 2016 |url-status=dead |archive-url = https://web.archive.org/web/20160714150814/http://completedentalguide.co.uk/history-of-dentistry/ |archive-date = 14 July 2016 |df = dmy-all }}</ref> Use of dental appliances, [[bridge (dentistry)|bridges]] and dentures was applied by the [[Etruscans]] in northern Italy, from as early as 700 BC, of human or other animal teeth fastened together with gold bands.<ref>{{cite web |url = http://edwardmoondds.com/history-of-dentistry-research-group/ |title = History of Dentistry Research Page, Newsletter |publisher = Rcpsg.ac.uk |access-date = 9 June 2014 |archive-url = https://web.archive.org/web/20150428045701/http://edwardmoondds.com/history-of-dentistry-research-group/ |archive-date = 28 April 2015 |url-status=dead }}</ref><ref name="donaldson">{{cite journal |author=Donaldson, J. A. |year=1980 |title=The use of gold in dentistry |url=https://link.springer.com/content/pdf/10.1007/BF03216551.pdf |journal=Gold Bulletin |volume=13 |issue=3 |pages=117–124 |doi=10.1007/BF03216551 |pmid=11614516 |s2cid=137571298 |doi-access=free}}</ref><ref name="Becker1999">{{cite book |last=Becker |first=Marshall J. |url=http://medlib.yu.ac.kr/eur_j_oph/ijom/IJOMI/ijomi_14_19.pdf |title=Ancient "dental implants": a recently proposed example from France evaluated with other spurious examples |date=1999 |publisher=International Journal of Oral & Maxillofacial Implants 14.1}}</ref> The [[Ancient Rome|Romans]] had likely borrowed this technique by the 5th century BC.<ref name="donaldson" /><ref name=":4">{{Cite web |last=Malik |first=Ursman |title=History of Dentures from Beginning to Early 19th Century |url=https://exhibits.library.utoronto.ca/exhibits/show/history-dentures/references |access-date=2023-05-03 |website=Exhibits}}</ref> The [[Phoenicia|Phoenicians]] crafted dentures during the 6th–4th century BC, fashioning them from gold wire and incorporating two ivory teeth.<ref>{{Cite book |last1=Renfrew |first1=Colin |title=Archaeology: Theories, Methods, and Practice |last2=Bahn |first2=Paul |publisher=Thames & Hudson |year=2012 |isbn=978-0-500-28976-1 |edition=6th |pages=449}}</ref> In ancient Egypt, [[Hesy-Ra]] is the first named "dentist" (greatest of the teeth). The Egyptians bound replacement teeth together with gold wire. [[Ancient Rome|Roman]] medical writer [[Cornelius Celsus]] wrote extensively of oral diseases as well as dental treatments such as narcotic-containing [[emollients]] and [[astringents]].<ref>{{cite web |url = http://www.dentaltreatment.org.uk/history.html |archive-url = https://web.archive.org/web/20091201213847/http://www.dentaltreatment.org.uk/history.html |archive-date = 1 December 2009 |title = Dental Treatment in the Ancient Times |publisher = Dentaltreatment.org.uk |access-date = 18 April 2010 }}</ref> The earliest [[amalgam (dentistry)|dental amalgams]] were first documented in a [[Tang dynasty]] medical text written by the Chinese physician Su Kung in 659, and appeared in Germany in 1528.<ref>{{cite journal |author = Bjørklund G |title = The history of dental amalgam (in Norwegian) |journal = Tidsskr Nor Laegeforen |volume = 109 |issue = 34–36 |pages = 3582–85 |date = 1989 |pmid = 2694433 }}</ref><ref>{{cite journal |last = Czarnetzki |first = A. |author2 = Ehrhardt S. |title = Re-dating the Chinese amalgam-filling of teeth in Europe |journal = International Journal of Anthropology |date = 1990 |volume = 5 |issue = 4 |pages = 325–32 }}</ref>

During the [[Islamic Golden Age]] Dentistry was discussed in several famous books of medicine such as [[The Canon of Medicine|The Canon in medicine]] written by [[Avicenna]] and Al-Tasreef by [[Al-Zahrawi]] who is considered the greatest [[surgeon]] of the [[Middle Ages]],<ref>{{Cite book|title=Medieval Islamic Civilization: An Encyclopedia (Routledge Encyclopedias of the Middle Ages)|last=Meri|first=Josef|publisher=Psychology Press|year=2005|isbn=978-0-415-96690-0}}</ref> Avicenna said that jaw fracture should be reduced according to the occlusal guidance of the teeth; this principle is still valid in modern times. Al-Zahrawi invented over 200 surgical tools that resemble the modern kind.<ref>{{cite book |last1=Friedman |first1=Saul S. |title=A history of the Middle East |date=2006 |publisher=Mcfarland |location=Jefferson, N.C. |isbn=0786451343 |page=152}}</ref>

Historically, dental extractions have been used to treat a variety of illnesses. During the [[Middle Ages]] and throughout the 19th century, dentistry was not a profession in itself, and often dental procedures were performed by barbers or general [[physician]]s. [[Barber]]s usually limited their practice to extracting teeth which alleviated [[pain]] and associated chronic tooth [[infection]]. Instruments used for dental extractions date back several centuries. In the 14th century, [[Guy de Chauliac]] most probably invented the dental pelican<ref>{{cite web|url = http://en.dmd.co.il/antique-dental-instruments/antique-dental-pelican/|title = Pelican|author = Gregory Ribitzky|access-date = 23 June 2018|archive-date = 25 January 2020|archive-url = https://web.archive.org/web/20200125120211/http://en.dmd.co.il/antique-dental-instruments/antique-dental-pelican/|url-status = dead}}</ref> (resembling a [[pelican]]'s beak) which was used to perform [[dental extraction]]s up until the late 18th century. The pelican was replaced by the [[dental key]]<ref>{{cite web|url = http://en.dmd.co.il/antique-dental-instruments/antique-dental-toothkey-2/|title = Toothkey|author = Gregory Ribitzky|access-date = 23 June 2018|archive-date = 23 June 2018|archive-url = https://web.archive.org/web/20180623085108/http://en.dmd.co.il/antique-dental-instruments/antique-dental-toothkey-2/|url-status = dead}}</ref> which, in turn, was replaced by modern forceps in the 19th century.<ref>{{cite web|url = http://en.dmd.co.il/antique-dental-instruments/antique-dental-forceps/|title = Forceps|author = Gregory Ribitzky|access-date = 23 June 2018|archive-date = 23 June 2018|archive-url = https://web.archive.org/web/20180623093608/http://en.dmd.co.il/antique-dental-instruments/antique-dental-forceps/|url-status = dead}}</ref>

[[File:Device-teeth-fauchard.jpg|thumb|upright|Dental [[needle-nose pliers]] designed by Fauchard in the late 17th century to use in [[prosthodontics]]]]

The first book focused solely on dentistry was the "Artzney Buchlein" in 1530,<ref name="History Of Dentistry" /> and the first dental textbook written in English was called "Operator for the Teeth" by Charles Allen in 1685.<ref name="bdatimeline">{{cite web |url=http://www.bda.org/museum/the-story-of-dentistry/timeline.aspx |title=The story of dentistry: Dental History Timeline |archive-url=https://web.archive.org/web/20120309235717/http://www.bda.org/museum/the-story-of-dentistry/timeline.aspx |archive-date=9 March 2012 |website= British Dental Association |accessdate= 2 March 2010}}</ref>

In the United Kingdom, there was no formal qualification for the providers of dental treatment until 1859 and it was only in 1921 that the practice of dentistry was limited to those who were professionally qualified. The [[Royal Commission on the National Health Service]] in 1979 reported that there were then more than twice as many registered dentists per 10,000 population in the UK than there were in 1921.<ref>{{cite book |title = Royal Commission on the NHS Chapter 9 |date = July 1979 |publisher = HMSO |isbn = 978-0-10-176150-5 |url = http://www.sochealth.co.uk/national-health-service/royal-commission-on-the-national-health-service-contents/royal-commission-on-the-nhs-chapter-9/ |access-date = 19 May 2015 }}</ref>

===Modern dentistry===

[[File:Microscope,The Dental cosmos (1907).jpg|thumb|right|A microscopic device used in dental analysis, {{circa|1907}}]]

It was between 1650 and 1800 that the science of modern dentistry developed. The English physician [[Thomas Browne]] in his ''[[A Letter to a Friend]]'' ({{circa|1656}} pub. 1690) made an early dental observation with characteristic humour:

{{Blockquote|quote=The Egyptian Mummies that I have seen, have had their Mouths open, and somewhat gaping, which affordeth a good opportunity to view and observe their Teeth, wherein 'tis not easie to find any wanting or decayed: and therefore in Egypt, where one Man practised but one Operation, or the Diseases but of single Parts, it must needs be a barren Profession to confine unto that of drawing of Teeth, and little better than to have been Tooth-drawer unto King Pyrrhus, who had but two in his Head.}}

The French surgeon [[Pierre Fauchard]] became known as the "father of modern dentistry". Despite the limitations of the primitive surgical instruments during the late 17th and early 18th century, Fauchard was a highly skilled [[surgeon]] who made remarkable improvisations of dental instruments, often adapting tools from [[watchmaker]]s, [[jeweler]]s and even [[barber]]s, that he thought could be used in dentistry. He introduced [[dental filling]]s as treatment for [[dental cavities]]. He asserted that [[sugar]]-derived acids like [[tartaric acid]] were responsible for [[caries|dental decay]], and also suggested that tumors surrounding the teeth and in the [[Gingiva|gums]] could appear in the later stages of tooth decay.<ref name="Besombes">{{cite book |url = https://books.google.com/books?id=2RRqAAAAMAAJ |title = Pierre Fauchard (1678–1761): The First Dental Surgeon, His Work, His Actuality |author = André Besombes |author2 = Phillipe de Gaillande |publisher = Pierre Fauchard Academy |date = 1993 }}</ref><ref name="Weinberger">{{cite book |url = https://books.google.com/books?id=2wtqAAAAMAAJ |title = Pierre Fauchard, Surgeon-dentist: A Brief Account of the Beginning of Modern Dentistry, the First Dental Textbook, and Professional Life Two Hundred Years Ago |author = Bernhard Wolf Weinberger |date = 1941 |publisher = Pierre Fauchard Academy }}</ref>

[[File:Panoramic radiograph of historic dental implants.jpg|thumb|Panoramic radiograph of historic dental implants, made 1978]]

Fauchard was the pioneer of [[Prosthodontics|dental prosthesis]], and he invented many methods to replace lost teeth. He suggested that substitutes could be made from carved blocks of [[ivory]] or [[bone]]. He also introduced [[dental braces]], although they were initially made of gold, he discovered that the teeth position could be corrected as the teeth would follow the pattern of the wires. Waxed [[linen]] or [[silk]] threads were usually employed to fasten the braces. His contributions to the world of dental science consist primarily of his 1728 publication Le chirurgien dentiste or The Surgeon Dentist. The French text included "basic oral anatomy and function, dental construction, and various operative and restorative techniques, and effectively separated dentistry from the wider category of surgery".<ref name="Besombes" /><ref name="Weinberger" />
[[File:A_dental_chair_in_a_dentist_clinic_in_North_Carolina,_United_States.jpg|left|thumb|A modern dentist's workspace]]
After Fauchard, the study of dentistry rapidly expanded. Two important books, ''Natural History of Human Teeth'' (1771) and ''Practical Treatise on the Diseases of the Teeth'' (1778), were published by British surgeon [[John Hunter (surgeon)|John Hunter]]. In 1763, he entered into a period of collaboration with the London-based dentist James Spence. He began to theorise about the possibility of [[tooth transplant]]s from one person to another. He realised that the chances of a successful tooth transplant (initially, at least) would be improved if the donor tooth was as fresh as possible and was matched for size with the recipient. These principles are still used in the transplantation of [[internal organ]]s. Hunter conducted a series of pioneering operations, in which he attempted a tooth transplant. Although the donated teeth never properly bonded with the recipients' gums, one of Hunter's patients stated that he had three which lasted for six years, a remarkable achievement for the period.<ref>{{cite book |author = Moore, Wendy |author-link = Wendy Moore |title = The Knife Man |url = https://books.google.com/books?id=DKInoTPFrBoC |access-date = 8 March 2012 |date = 30 September 2010 |publisher = Transworld |pages = 223–24 |isbn = 978-1-4090-4462-8 }}</ref>

Major advances in science were made in the 19th century, and dentistry evolved from a trade to a profession. The profession came under government regulation by the end of the 19th century. In the UK, the Dentist Act was passed in 1878 and the British Dental Association formed in 1879. In the same year, [[Francis Brodie Imlach]] was the first ever dentist to be elected President of the Royal College of Surgeons (Edinburgh), raising dentistry onto a par with clinical surgery for the first time.<ref>{{cite news|url=http://historyofdentistry.co.uk/index_htm_files/2004Apr2.pdf |title=A pioneering history: dentistry and the Royal College of Surgeons of Edinburgh |first=Helen |last=Dingwall |date=April 2004 |work=History of Dentistry Newsletter |issue=14 |url-status=dead |archive-url=https://web.archive.org/web/20130201191323/http://historyofdentistry.co.uk/index_htm_files/2004Apr2.pdf |archive-date=1 February 2013 |df=dmy }}</ref>

===Hazards in modern dentistry===
{{main|Occupational hazards in dentistry}}
Long term occupational noise exposure can contribute to permanent hearing loss, which is referred to as [[noise-induced hearing loss]] (NIHL) and [[tinnitus]]. Noise exposure can cause excessive stimulation of the hearing mechanism, which damages the delicate structures of the inner ear.<ref>{{cite web|title=Noise-Induced Hearing Loss|url=https://www.nidcd.nih.gov/health/noise-induced-hearing-loss|website=NIDCD|date=18 August 2015}}</ref> NIHL can occur when an individual is exposed to sound levels above 90 dBA according to the [[Occupational Safety and Health Administration]] (OSHA). Regulations state that the permissible noise exposure levels for individuals is 90 dBA.<ref>{{cite web|title=Occupational Safety and Health Standards {{!}} Occupational Safety and Health Administration|url=https://www.osha.gov/pls/oshaweb/owastand.display_standard_group?p_toc_level=1&p_part_number=1910|website=Osha.gov}}</ref> For the National Institute for Occupational Safety and Health ([[NIOSH]]), exposure limits are set to 85 dBA. Exposures below 85 dBA are not considered to be hazardous. Time limits are placed on how long an individual can stay in an environment above 85 dBA before it causes hearing loss. OSHA places that limitation at 8 hours for 85 dBA. The exposure time becomes shorter as the dBA level increases.

Within the field of dentistry, a variety of cleaning tools are used including piezoelectric and sonic scalers, and ultrasonic scalers and cleaners.<ref>{{cite journal|last1=Stevens|first1=M|title=Is someone listening to the din of occupational noise exposure in dentistry|journal=RDH|date=1999|issue=19|pages=34–85}}</ref> While a majority of the tools do not exceed 75 dBA,<ref>{{cite journal|last1=Merrel|first1=HB|title=Noise pollution and hearing loss in the dental office|journal=Dental Assisting Journal|date=1992|volume=61|issue=3|pages=6–9}}</ref> prolonged exposure over many years can lead to hearing loss or complaints of tinnitus.<ref>{{cite journal|last1=Wilson|first1=J.D.|title=Effects of occupational ultrasonic noise exposure on hearing of dental hygienists: A pilot study|journal=Journal of Dental Hygiene|date=2002|volume=76|issue=4|pages=262–69|pmid=12592917}}</ref> Few dentists have reported using personal hearing protective devices,<ref>{{cite journal|last1=Leggat|first1=P.A.|title=Occupational Health Problems in Modern Dentistry: A Review|journal=Industrial Health|date=2007|volume=45|issue=5|pages=611–21|doi=10.2486/indhealth.45.611|pmid=18057804|url=https://researchonline.jcu.edu.au/2690/1/2690_Leggat_et_al...2007.pdf |archive-url=https://web.archive.org/web/20190427125357/https://researchonline.jcu.edu.au/2690/1/2690_Leggat_et_al...2007.pdf |archive-date=2019-04-27 |url-status=live|doi-access=free|bibcode=2007IndHe..45..611L }}</ref><ref>{{cite journal|last1=Leggat|first1=P.A.|title=Occupational hygiene practices of dentists in southern Thailand|journal=International Dental Journal|date=2001|volume=51|issue=51|pages=11–6|doi=10.1002/j.1875-595x.2001.tb00811.x|pmid=11326443|doi-access=free}}</ref> which could offset any potential hearing loss or tinnitus.

===Evidence-based dentistry===
{{Main|Evidence-based dentistry}}
There is a movement in modern dentistry to place a greater emphasis on high-quality scientific evidence in decision-making. [[Evidence-based dentistry]] (EBD) uses current scientific evidence to guide decisions. It is an approach to oral health that requires the application and examination of relevant scientific data related to the patient's oral and medical health. Along with the dentist's professional skill and expertise, EBD allows dentists to stay up to date on the latest procedures and patients to receive improved treatment. A new paradigm for medical education designed to incorporate current research into education and practice was developed to help practitioners provide the best care for their patients.<ref>{{cite journal|title=Evidence-based medicine. A new approach to teaching the practice of medicine|journal=Journal of the American Medical Association|year=1992|volume=268|issue=17|pages=2420–2425|pmid=1404801|author1=Evidence-Based Medicine Working Group|doi=10.1001/jama.1992.03490170092032}}</ref> It was first introduced by [[Gordon Guyatt]] and the Evidence-Based Medicine Working Group at [[McMaster University]] in [[Ontario, Canada]] in the 1990s. It is part of the larger movement toward [[evidence-based medicine]] and other [[evidence-based practices]], especially since a major part of dentistry involves dealing with oral and systemic diseases. Other issues relevant to the dental field in terms of evidence-based research and evidence-based practice include population oral health, dental clinical practice, tooth morphology etc. 
[[File:Dental Chair UMSOD.jpg|thumb|A dental chair at the University of Michigan School of Dentistry]]