An Appropriate Abode: Housing the Middle-Classes in Victorian Bloomsbury

Guest post. This week I’m pleased to welcome Alison Kay to the blog, who has written a fascinating piece on the history of Bloomsbury and the housing market. Read more

‘For God’s sake, make haste and ease me’: Dentistry in 1830s London

‘I called at the dentist today, according to my appointment. He recommends passing a thread of silk between my teeth every day and brushing my decayed teeth with spirits.’

A polished brass plate and a fashionably decorated treatment room awaited the well-to-do dental patient of the 1830s, but at the time Anthony Evans braved the perennial advice to floss, there were no guarantees about the quality of treatment. Dentistry was unregulated, and any enterprising fellow could set up shop without having pulled a tooth in his life. For the more skilled practitioner, who would normally have qualified as a surgeon before specialising in teeth, these untrained people were unwelcome rivals. Not only did they give dentistry a bad name (which some surgeons were quite capable of doing themselves!) but they possessed the self-promotional effrontery to earn a lot of money.

Surgeon-dentist C. Bene, writing to The Lancet in 1833, relates an anecdote about a baronet plagued with toothache. ‘Sir D. H. B.’ stopped his curricle at a smart house on the New Road, where ‘Teeth Extracted‘ gleaned in gold lettering in the window. He entered, seeking relief from his pain.

‘The “dentist”, after some fidgeting and shuffling about the room, took a survey of the decayed tooth, but it was not until he had been frequently spurred on by the importunities of his patient, “Come, come, for God’s sake, make haste and ease me,” that he commenced the apparently important operation.’

The extraction complete, the dentist ‘began to jump about the shop like one overjoyed at some fortunate event‘. He admitted that he had started his business that very day, and the baronet’s tooth was the first he had ever drawn.

Conscientious dentists despaired at the extent of quackery, but those who expressed their opinions in the medical journals were isolated voices in a fragmented profession. Although dentistry had emerged as a sole occupation, ‘surgeon-dentists’ (a title that could be adopted by anyone) were still relatively few in number. Tooth extraction also formed part of a general surgeon’s role, an extra service offered by chemists, or a sideline to unrelated occupations. New inventions and methods did not take hold on a wide scale – individuals guarded them as a way of enhancing reputation and income. In addition, surgical proficiency did not make someone capable of crafting artificial teeth, while mechanical dentists from an artisan background might create good dentures but have no surgical training. Little solidarity existed between, or even within, these groups.

Some notable practitioners, however, were well aware of these problems, and during the 1840s, individuals such as George Waite, James Robinson and John Tomes (pictured above) called for organisation and official qualifications. Although these attempts met with little success, the issues became open for public discussion. The first British dental journal appeared in 1843 – it was short-lived, but its successor, Forceps, campaigned for regulation, lamenting that,

‘In this country any quack who chooses to place a brass plate on his door, some artificial masticators in his window, and advertises his list of charges in the papers, is a dentist to all intents and purposes.‘

The anecdote from Mr. Bene might have been fictionalised to support his views, but it illustrates a factor in the success of inexperienced dentists – the urgency of agony. Toothache is equally excruciating for baronet or pauper, and the desperate individual could not spare days comparing the qualifications and experience of various practitioners. If you can’t eat because a pulsating tooth abscess is driving you insane, the long-term ideal of a unified dental profession is not your first priority.

Although pain is a great leveller, social status did make a difference to dental health. John Gray, who published a tract on Dental Practice in 1837, observed that the teeth of the upper classes were worse than those of labourers. He attributed this to their habit of visiting fashionable dentists, who became fashionable through chutzpah rather than ability:

‘In the higher ranks of society it is scarcely possible to find a person of the age of twenty-four who has not lost some teeth, and so many of the remainder are so stopped with hold, that their mouths have some resemblance to the window of a jeweller’s shop.’

Gray condemned the practice of treating young people’s overcrowded teeth by filling between them – a process that destroyed the enamel and caused food to get trapped in the gaps, leading to sensitivity and decay.

While the poor did not necessarily go around with full sets of pearly-white gnashers, the lack of such interference at least gave their teeth a chance of remaining sound for longer. But when emergencies arose, dental services were accessible even to those with little money. Some dentists allocated part of their working day to the treatment of the poor, and in 1839 the charitable London Institution for Diseases of the Teeth was established. Extractions were also available at chemist’s shops and from itinerant practitioners, who either focused on dentistry or used their speedy tooth-drawing skills to attract an audience to a medicine sales pitch.

Anthony Evans’ dental appointment came at a time when a dentist could be a proficient and well-educated practitioner, a charlatan trying out a new money-making scheme, or anything in between. Change, however, was brewing. Over the next decade, reputable practitioners would agitate for the formalisation of their profession, and dentistry took to the chair to undergo an agonisingly long-drawn-out process of reform.

About the Author: Caroline Rance is the author of the popular medical history blog,  The Quack Doctor. Her debut novel, Kill-Grief, was published by Picnic Publishing in April 2009. You can also follow Caroline on Twitter, here.