The Making of the "Dentiste," c. 1650-1760 (review)

Roger King. The Making of the "Dentiste," c. 1650-1760. The History of Medicine in Context. Aldershot, U.K.: Ashgate, 1998. xi + 231 pp. Ill. $84.95 (1-84014-653-2).

Roger King has produced a convincing account of a significant development in the largely underresearched history of dentistry. In the early eighteenth century, the chirurgien dentiste emerged in France. He was neither a mountebank, an empiric tooth drawer, nor an expert in tooth-drawing. The first, according to King, caricatured rather than practiced tooth-drawing. The other two did take out teeth but were considered inferior to the barber-surgeons, who also practiced forms of dentistry, though the expert was brought within the official regulation of medicine through a formal examination process.

The modern dental expert, argues King, came out of the ranks of the surgeons. That is, unlike the expert who had isolated knowledge of one area of the body, the dentiste-surgeon knew about general surgery and then became an expert specialist in the care and treatment of teeth. There are three elements to this argument. First, surgical texts had always dealt with teeth in the head-to-toe listing of surgical conditions. Second, from the mid-seventeenth century surgery was becoming a learned science or body of knowledge based on principles and precepts (here King is too restricted in his view: the enterprise of making surgery learned had been under way in the Middle Ages and Renaissance). Third, the writings of Pierre Fauchard demonstrate the existence of the chirurgien-dentiste in the early eighteenth century. Fauchard's Le chirurgien dentiste (1728) emphasized how the chirurgien-dentiste worked not only with his hands but also with his mind: his was a learned discipline founded on principles based upon theory and experience, while allowing for ingenuity in the solution of new problems. Le chirurgien dentiste expanded the number of surgical dental conditions, and provided a series of case studies that exemplified Fauchard's practice.

By the middle of the eighteenth century the term chirurgien-dentiste was relatively common, and specialized works were appearing that discussed dentistry alone. This separation from general surgery marks the point, argues King, when dentistry had become a true specialty in the modern sense.

The Making of the "Dentiste" also considers the social as well as the intellectual factors that gave birth to this specialty. A learned science of dentistry had more social cachet than one associated with empirics. Moreover, in the courts of Louis XIV and his successors, where the nobility had lost real power (here King follows Norbert Elies), appearances were all-important: the chirurgien-dentiste's ability not only to treat teeth, but also to improve their appearance if they were misaligned, broken, or discolored, spoke to the needs of the nobility. Moreover, the ennoblement of royal chirurgien-dentistes in 1745 and 1767 gave the official seal of approval to the discipline, just as the ennoblement of a royal accoucheur had done for the surgical specialty of man-midwifery.

King's book echoes Adrian Wilson's The Making of Man-Midwifery: Childbirth in England, 1660-1760 (1995): in both, large-scale social history is skillfully drawn upon to make sense of what are marginal events in general history, if not in the history of medicine. This has the merit of integrating the history of medicine into social history, but it can also hide a paucity of firsthand evidence. Although King provides some evidence from the customers of the chirurgien-dentistes, it is by no means clear why these customers chose to use their services rather than those of other dental operators. As with Wilson's arguments for why English women chose to use men-midwives, King has provided a social context and analogical reasons for the social acceptance of the chirurgien-dentistes, but this is not the same as firsthand testimony from their customers.

Nevertheless, this volume is a model...