An increase in practising dentists
During the first fifty years, there was a marked increase in the number of practising dentists, partly due to the expansion of the middle class.
Most practitioners learnt their trade through an apprenticeship but there was no control to prevent malpractice or incompetence and the standards of apprenticeship varied greatly.
Occasional lectures in dentistry began at Guy's Hopsital at the end of the 18th century.
The Dental Hospital of London was founded in 1858 and the National Dental Hospital the following year, both with teaching schools attached.
The Royal College of Surgeons created the first Licentiates in Dental Surgery (LDS) in 1860.
By 1879 LDS diplomas were also granted by the surgical colleges of Glasgow, Edinburgh and Ireland.
Formation of the Dental Reform Committee
In the 1870s, leading dentists including Sir John Tomes and Sir Edwin Saunders (one of Queen Victoria’s dentists) formed the Dental Reform Committee.
This Committee campaigned for the first legislation to regulate dentistry.
The Dentists Act of 1878 required all dentists to undertake the LDS and register in order to call themselves a dentist.
Initially this was a setback for the women who were practising as dentists. The dental schools refused them entry and so they could not qualify and register.
It was not until 1895 that the first woman in the UK qualified; Lilian Murray qualified in Edinburgh, where they did allow women to study.
It was nearly another 20 years before an English dental school admitted women on to an LDS course.
Inequalities in oral health
Despite the improvement in dentists' education, the nation's teeth actually got worse during the 19th century: a study of two graveyards found that there were more caries amongst those buried in the second half of the century than in the first half.
Most families were lucky if they even had one toothbrush to share between them and often could not afford dental treatment, even if there was a dentist in their neighbourhood.
Technological developments in dentistry
For those who did visit the dentist scientific developments did, at least, help to make the experience more pleasant: general anaesthetic was introduced in the 1840s and local anaesthetic 40 years later.
The foot-operated drill made the process of filing much quicker and for those in need of dentures, the development of vulcanite dentures in the middle of the century ensured a much better fit.
Most of those who did visit dentists, however, were still visiting unqualified practitioners, as unregistered dentists still outnumbered the qualified at this time.
This was because the 1878 act had protected the term dentist, not the practice of dentistry.
The Dentists Act of 1921 finally restricted practice to qualified persons only.