Pierre Fauchard

Pierre Fauchard (born 1678 in Brittany; died March 22 1761 in Paris) was a significant French physician, he is credited to be the "father of modern dentistry". He is widely known for his book, Le chirurgien dentiste, "The Surgeon Dentist" 1728, where he described the basic oral anatomy and function, signs and symptoms of oral pathology, operative methods for removing decay and restoring teeth, periodontal disease (pyorrhea), orthodontics, replacement of missing teeth, and tooth transplantation. His book is said to be the first complete scientific description of dentistry. Fauchard's text was followed by others that continued to expand the knowledge of the dental profession throughout Europe.

Early years
Pierre was born in a very modest home. In 1693 he joined the French Royal Navy at the age of 15, much to his families distress, and came under the influence of Alexander Poteleret, a surgeon major, who had spent considerable time studying the diseases of the dental organs.

During that time, Fauchard learned that navymen personnel who were on long voyages suffered severely from disorders of the teeth, particularly scurvy. Eventually Major Poteleret inspired and encouraged him to read and carefully investigate the findings of his predecessors in the healing arts. He said he wanted to disseminate the knowledge he learned all those years at sea based on actual practice. This idea led Fauchard to become a combat medic as Alexander's protégé.

Life as youth dentist
Once Pierre left his duties on the navy, he shortly settled down in Angers, where he did much of his medical practice at the University of Angers Hospital. In Angers, he started much of the revolutionary medical work we know today, he was the pioneer of scientifical oral and maxillofacial surgery, Pierre often described himself as a "Chirurgien Dentiste" (Surgical dentist) a term very rare at the time as dentists in the 17th century only focused in the treatment of tooth decay by extracting them.

Although the limitations of the primitive surgical instruments during the late 17th and early 18th century, Fauchard was considered a highly skilled surgeon by many of their colleagues at Angers University Hospital. Pierre made remarkable improvisations of dental instruments, Fauchard often adapted tools from watch makers, jewelers and even barbers, that he thought they could be used in dentistry.

Pierre introduced, dental fillings as treatment for dental cavities. He stated that sugar derivate acids like tartaric acid were responsible of dental decay, and also suggested that tumors surrounding teethgum in later stages of tooth decay appeared as an effect of it.

Fauchard was the pioneer of dental prosthesis, he discovered many methods to replace the loss of teeth, and stated that substitutes could be made from carved blocks of ivory or bone and those artificially-made dental pieces would be useful as the natural ones. One of this methods stated that the artificial teeth could be held them in place by tying them to the remaining solid teeth by pivots, using waxed thread or gold wire. Pierre 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.



From Angers to Paris and his revolutionary book
During 1716 to 1718, Pierre's career gained a great prestige. During that time Fauchard spend long periods away from home studying and sharing his medical practice to other surgeons across France.

In 1718, Fauchard moved to Paris. Jean Claude de Vaux a close friend of him said that Pierre enjoyed the beautiful restaurants located on Avenue Champs Elysees.

During his staying in Paris. Pierre realized that many medical libraries lacked of good textbooks on dentistry and that an encyclopedia teaching book of oral surgery was needed, so he took the decision to write a professional dentist's treatise that could be based on his medical experience.

For many months Fauchard gathered many medical research books as he could, interviewed many dentists he met, and reviewed his personal dairies during his years at Angers to write his manual, finally in 1723, at the age of 45, he completed the manuscript for "Le Chirurgien Dentiste" (roughly translated as "The surgical dentist"). The manuscript was meticulously reviewed and the it was published in 1728 in two volumes. The book was well received in European medical community, an elarged edition in French language was published in 1746 and a German translation was available in 1773. The book was very advanced for its time and was considered to be the origin of scientific dentistry.

"The surgical dentist"
The book consisted of 38 chapters in volume 1 and 26 chapters in volume 2. Both volumes contained 42 plates depicting surgical instruments and appliances. Many of the ideas introduced in the book were totally new to dentistry.

Highlights

 * Pierre's suggested that German tooth worm theory attribuited to dental decay, many of his observations through the microscope never gave positive to worms.
 * Fauchard also said the cause of dental caries was sugar, and people should limit it their daily foods.
 * Pierre disproved the spontaneous teeth generation, he said that the first teeth, which are called milk teeth, separate themselves from their roots. Some dentists at Fauchard's time believed they didn't have roots.
 * Fauchard introduced dental fillings as treatment for dental cavities, he suggested amalgams like lead, tin and sometimes gold, he also said that teeth should be cleaned periodically by a dentist.
 * Pierre said that braces should be used to correct teeth's possitions and that children's teeth was easier to move and faster than older people's teeth he suggested the cause was based on the size of the teeth roots.
 * Fauchard was ahead of his time on medical care and he described the way how the patient should be greeted by the doctor and in what particular position the patient should take sit.
 * Pierre recommended that the dentist should stand behind the patient to avoid create fear on them and introduced the concept of dentist's chair light.



Human urine as a medical treatment
Pierre Fauchard engraved on his books many of his inventions of many instruments made for oral surgery such as the obturator and the now famous dentist's drill. The drill Fauchard developed was manual and powered by a catgut twisted around a cylinder. He also suggested on his book that olive oil should be prescribed for cloves and cinnamon for pulpitis.

One of the ideas introduced by Pierre Fauchard that brought the attention of modern science historians was that Pierre recommended the use of human urine in the treatment of early stages of caries. A chemical compound that Pierre was not able to identify in urine at the time was ammonia, which was responsible of the "beneficial result" of urine. Although urine was used for this purpose since the ancient times to Middle Ages, the idea of use it for the treatment got the aversion of many physicians and patients as well.

Final days
On his book and during all his life Fauchard denounced how many patients were victims of quackery by dental charlatans. Pierre encouraged his students and friends that the highly injurious techniques used by charlatans should do not be taken seriously. He warned his medical readers that nitric acid and sulfuric acid on teeth to remove tartar used by charlatans are potentially dangerous and said how to identify their false dental fillings.

Doctor Fauchard became a model for all dentists to come, he died at the age of 83 in Paris, France on March 22 1761.

Legacy
Fauchard's work influenced many youth medical minds in the age of enlightenment in France, Robert Bunon (1702-1748) dentist like Pierre, spend many years of his life in the enamel hypoplasia research.

Bourdet (1722-1789), whom is said to be one of the France's best dentists after Fauchard, based his work mainly on dental prosthesis (a concept introduced by Pierre), he also improved the way how the amalgams should be made and was the first physician to do gingivectomy on their patients when required.

The American 19th century dentist Chapin A. Harris often quoted him and said that "considering the circumstances and limitations of his time, he will always be remembered as a pioneer and founder of modern dentistry."

Trivia

 * Although Doctor's Fauchard famous dental treatise on dentistry was published on the 18th century, it wasn't until the 20th century when Hilian Lindsay a medical science historian made a translation to English language.


 * Fauchard was considered one of the firsts physicians to denounce medical malpractice in dentistry he alleged to a tribunal that many dentists in France didn't have a degree or experience.