The emergence of a graduate dental profession, 1858-1957

This study grew from a request for information as to the date of establishment of the Bachelor of Dental Surgery (BDS) as the professional qualification for dentists in the United Kingdom. In the process of answering this enquiry it became apparent that there was no simple answer and that university dental education was not covered by the existing literature. It also became clear that, while ubiquitous for new dentists by the late twentieth century, the dental degree had only comparatively recently become the standard path to a dental career. This study emphasises the role of professional education, and particularly university education and research, in the development of the dental profession and dental services. University dental education and research, it is argued, was a major factor in the professionalisation of dentistry, in convincing the government of the importance of dental health and thus in establishing dentistry as an essential part of the National Health Service (NHS). University dental education and research, it is argued, extended the therapeutic potential of dental treatment, promoted understanding of the relationship between oral and systemic disease, of the etiology and pathology of dental disease and of methods of prevention and control. Such was the impact of the new standards thus established, that the whole emphasis of dental treatment would shift within the space of one hundred years, from dental surgery and dental prosthetics to conservative and preventive dentistry. This study shows that, from the mid-nineteenth century, a dental elite campaigned for compulsory professional education and, from the late nineteenth century, for university dental education. By the beginning of the twentieth century professional education for doctors and surgeons, for the degree of MBChB, was carried out in university medical schools. Yet, although the dental curriculum was based on the surgical curriculum, it was not until the mid-twentieth century that the standards pioneered by the dental elite were extended to the majority of candidates for the dental profession. Indeed, the generally low standards which prevailed prior to the retiral of the generation of unqualified "Dentists, 1921" had damaging effects on the oral and general health of the British population. The study also suggests that the dearth of qualified dentists contributed to the delay in achieving legislation to eliminate unqualified practice. Arguably, the low standards of the majority of dentists also contributed to the delay in persuading the government that dental treatment was as important to the health and well-being of the population as any other aspect of health care. Just as the standards advanced by the dental elite ultimately persuaded the government of the relative importance of dental care. This study therefore examines the factors which delayed the achievement of a consistent and high standard of professional dental education for dental practitioners. In so doing the study identifies several factors which contributed to the lack of demand for professional dental education and qualification and thus delayed dentistry's establishment as a graduate profession