How Times Have Changed: Dentistry in the Past 86 Years

September 27, 2018
Dental instrument tray

Photo by Jon Tyson on Unsplash

Dentistry is not alone in having come a LONG way in the past century – most scientific fields have advanced to the point of being unrecognizable by their predecessors. We feel so privileged to have had a unique first hand experience of what this has meant for dental practices. From Dr. Greg Sr., who founded Strobel Dentistry in 1932, to Dr. Dan, who runs the practice today, here are some examples of how Dentistry has improved in three generations.

Dr. Greg Sr. (1932-1982) – Gold

Considered the “gold standard” of dental crowns for centuries (see what we did there?), gold crowns are actually still sometimes recommended today.  A very biocompatible and reliable material, gold can create crowns with minimal tooth reduction that don’t crack like other materials. They do, however, come with an extended lab time, an additional cost and a very obvious appearance.

Dr. Greg Jr. (1975-2013) – Porcelain Fused to Metal

While all-ceramic restorations were available from the late 19th century on, they were prone to cracking and not nearly as strong as all metal restorations. They also were often only available for anterior teeth, since they couldn’t handle the biting pressure of the molars. Porcelain fused to metal crowns were a viable alternative for many years: stronger than all ceramic, and much closer to natural teeth in appearance than gold!  However, the porcelain was prone to chipping due the flexing of the metal base structure.

Drs. Dan (2005 – present) and Isabella (2013 – present) – Porcelain SAME-DAY

The advent of new, synthesized ceramic material, such as Lithium Disilicate and Zirconium, and vastly improved milling technology means that today, we can create a strong, natural looking crown on site in as little as two hours!

Dr. Greg Sr. – amalgam and gold

From the beginning of what we’d call Modern Dentistry (1800s), any type of metal that was readily available and could be softened was a candidate for dental filling material. What you chose usually depended on your income level – tin was common for poorer patients, silver and gold for wealthier ones. During Dr. Greg Sr.’s time, amalgam (silver colored metal blend) and gold were the standards.

Dr. Greg Jr. – amalgam and composite

It’s ease of use, incredible durability and low price tag made amalgam the standard for decades. Dr. Greg placed many a complex amalgam filling earlier in his career that we didn’t have to replace until very recently! However, the mercury levels in amalgam material raised concerns over their health risks after they were introduced. Composite resin (tooth colored material) was introduced in the 60s as an alternative, and by the 90s materials and technique had improved enough for composite to become the material of choice.

Drs. Dan and Isabella – composite and porcelain

Composite is still widely used today; in our office, depending on your needs and the location of the decay, we recommend composite resin or porcelain filling material.

Anesthesia

Dr. Greg Sr. (beginning of his career) – nothing!

Though a number of anesthetics had been introduced by 1932 (ether, nitrous oxide, novocaine), in the early days of Modern Dentistry it was still common to get through dental procedures on sheer force of will. As his career progressed, novocaine was the most commonly used in Dr. Greg’s procedures.

Dr. Greg Jr. – novocaine, lidocaine

Novocaine was the go-to for many years in dentistry, well into the 1950s, and is still a household name when many patients think of getting numb. Since roughly 20% of the population is allergic to novocaine-like anesthetics, its use has gradually diminished. Lidocaine gained popularity in the ‘50s and remains one of the most widely used anesthetics today.

Drs. Dan and Isabella  – lidocaine, septocaine, and sometimes NOTHING!

When we do get patients numb, lidocaine and septocaine are our go-tos. In a sense, though, we’ve come full circle, as our Solea Laser Technology allows us to painlessly perform many procedures using no anesthesia at all!

Dr. Greg Sr.  – slow speed film

Radiographs have been around since their discovery in 1895 – the first dental x-ray was performed by a dentist on himself in 1896, and lasted a whopping 25 minutes!! By Dr. Greg Sr.’s start in 1932, radiography had become well integrated into Dentistry, and bitewing technology had reduced the number of films necessary to get an overall view of the teeth. Film advances had only come so far, however; slow speed film was the standard, which meant overall higher radiation and longer exposures.

Dr. Greg Jr. – high speed film

By the time Dr. Greg Jr. joined the practice, significant improvements had been made to the speed of manual film, reducing radiation concerns for patients. While digital radiographs were first introduced in 1987, it took some time for the technology to improve and become widely adopted in the industry. We began using digital x-rays in our office in 2008.

Drs. Dan and Isabella – digital

Digital radiographs not only represented a HUGE reduction in radiation and exposure time for patients, but less chemical exposure for staff by removing the need to process film. Since we went digital, our office has continued to invest in the latest imaging technology, including most recently our CBCT machine for 3D scans.

What hasn’t changed much?

Surprisingly (or not), dental insurance! The traditional and PPO policies of today have typically the same annual maximum (around $1000) as they did when insurance plans were popularized in the ‘70s. Had they kept up with inflation, a typical maximum would be closer to $10,000. Think of what that would mean for our oral health!!