With the demise of the western Roman Empire about the year 475 CE, medicine in Europe declined into a torpor that would last for almost a thousand years. About the only places where medicine or surgery was practiced were monasteries, and monks were aided in their surgical ministrations by the local barbers, who went to the monasteries to cut the monks’ hair and shave the monks’ beards. In 1163 a church council at Tours, France, ordered that henceforth no monks or priests were to practice any surgery, since it was felt that the shedding of blood was incompatible with the holy office of the clergy. Thus, the only people who had any rudimentary knowledge of surgery were the barbers, and they stepped into the breach, calling themselves barber-surgeons. They practiced simple dentistry, including extractions and cleaning of teeth. In the 1600s a number of barber-surgeons began restricting their activity to surgery and dropped the word “barber,” simply calling themselves surgeons. In England, Henry VIII granted a charter to a combined group of barbers and surgeons, which ultimately evolved into the Royal College of Surgeons.
In 1530 the first book devoted entirely to dentistry was published in Germany and was written in German instead of Latin. It addressed barber-surgeons and surgeons, who treated the mouth, rather than university-trained physicians, who ignored all diseases of the teeth. Subsequent to this publication, other surgeons published texts incorporating aspects of dental treatment.
By the 1700s in France, a number of surgeons were restricting their practice to dentistry, and in 1728 a leading Parisian surgeon, Pierre Fauchard, gathered together all that was then known about dentistry in a monumental book, The Surgeon Dentist, or Treatise on the Teeth. In it he discussed and described all facets of diagnosis and treatment of dental diseases, including orthodontics, prosthetics, periodontal diseases, and oral surgery. Fauchard effectively separated dentistry from the larger field of surgery and thus established dentistry as its own profession. Fauchard is known today as the father of modern dentistry. Other surgeons in Germany and France, who made notable contributions to the field of dentistry, readily followed his lead.
English dentistry did not advance as far as French dentistry in the 18th century. The guild that had united the barbers and surgeons was dissolved in 1745, with the surgeons going their own way. Some barbers continued their dental ministrations and were designated “tooth drawers.” A second group, as a result of the French influence, referred to themselves as “dentists,” while those who did all manner of dentistry were called “operators for the teeth.” The first English book on dentistry, The Operator for the Teeth, by Englishman Charles Allen, was published in 1685; however, no other works on English dentistry were published until Thomas Berdmore, dentist to King George III, published his treatise on dental disorders and deformities, in 1768. In 1771 English surgeon John Hunter, famed as the father of modern surgery, published The Natural History of the Human Teeth, an outstanding text on dental anatomy. Hunter also pioneered the transplantation of teeth from one individual to another, and, because of his tremendous reputation, this practice was widely adopted. Although tooth transplantation between individuals did not prove successful, it was nevertheless the first attempt to transplant human tissue from one person to another. In 1806 English dentist Joseph Fox, who served on the staff of Guy’s Hospital in London, offered the first observations on what is today recognized as the “rejection phenomenon” of transplants.