A Glimpse at the Evolution of Cosmetic Dentistry Over the Last Century in a Few Words
Cosmetic dentistry has undergone a profound metamorphosis over the last century, transforming from its rudimentary stages into the sophisticated landscape we witness today. This essay covers the evolution of cosmetic dentistry, navigating through the currents of technological advancements, evolving aesthetic preferences, and an increasingly patient-centred care approach, cementing its status as an essential and dynamic aspect of modern dental practice.
According to Cleveland Clinic, “Cosmetic dentistry focuses on improving the appearance and aesthetics of your smile. Common cosmetic dental procedures include teeth whitening, dental bonding, and veneers” (“Cosmetic Dentistry: What It Is, Procedures & Types”). The historical roots of cosmetic dentistry trace back to ancient civilizations, notably the Etruscans and Romans, who explored primitive implants, bridges, and rudimentary teeth-whitening techniques. In ancient China, civilizations utilised silver or gold wire to fill cavities, marking early attempts at dental restoration. The Mayans, around 600 AD, showcased ingenuity by hammering shell pieces into the jaw as dental implants (often executed post-mortem), laying the groundwork for cosmetic dentistry (Abraham).
Throughout the 1900s, dentists attempted to use various materials for dental implants, but none of them achieved long-term results. “In 1913, Dr. E.J. Greenfield tried to use 24-karat gold as an implant. Then, two brothers, Drs. Alvin and Moses Strock tried to use fixtures made from Vitallium after observing the material being used in hip bone implants. These fixtures were more long-lasting, and the brothers were recognized as the first people to place an implant into the jawbone successfully” (“The Evolution Of Dental Implants Throughout History”). Later on, in 1952, orthopaedic surgeon and research professor Dr Per-Ingvar Brånemark made a groundbreaking discovery. “During a study on bone healing and regeneration, he implanted a piece of titanium into a rabbit’s femur. He was not able to remove it because the titanium had fused with the bone. He accidentally discovered that implants made from titanium had a better success rate and theorized this technology could be useful in dental implant applications and similar fields” (“The Evolution Of Dental Implants Throughout History”). The introduction of titanium implants has significantly enhanced patients’ quality of life, allowing them to avoid the side effects associated with other implant materials and prolonging their durability. Titanium and its alloys are widely used in dentistry due to their exceptional biocompatibility, superior mechanical properties, osseointegration, and resistance to wear and corrosion (“Titanium and titanium alloys in dentistry: current trends, recent developments, and future prospects”). The remarkable compatibility between titanium and human bone has been a catalyst for further exploration and innovation in the field, leading to various techniques and materials enhancing aesthetics and overall dental experiences. As the 20th century progressed, cosmetic dentistry continued to evolve, maintaining a focus on improving mouth aesthetics and enhancing the overall dental experience. Today, dental implants remain a popular choice, providing a durable and functional solution for missing or damaged teeth.
As stated by Dentistry.co.uk, “A boom in cosmetic dentistry took place in the 1990s as the ‘cosmetic dentist’ became differentiated from the regular high street dentist. At that time, tooth whitening and veneers became normalised. There was also a drive to achieve beautiful smiles that looked natural” (“The history of cosmetic dentistry over the last 25 years — Dentistry”). Veneers are ultra-thin shells meticulously crafted from porcelain or composite resin meant to cover only the front side of the anterior teeth, which are usually only placed on if the patient would like to change the aesthetics of their smile. Although veneers were first invented in 1928 by California dentist Charles Pincus (Rashid and Ayoub 1), they marked a groundbreaking innovation in late 20th-century cosmetic dentistry, with the refinement of their design and application during this period elevating their status, addressing durability concerns and delivering natural-looking results. This differed from earlier practices that often involved less durable and aesthetically inferior materials, such as resin-based compounds, acrylics, or rudimentary ceramics. The introduction of high-quality veneers revolutionized smile enhancement, setting a new standard for long-lasting aesthetic appeal. Similarly, the procedure known as “bonding,” recognised as another pivotal technique, gained prominence for its versatility in correcting dental imperfections with a minimally abrasive/invasive approach. Applying tooth-coloured composite resin to the affected area of the tooth, bonding stands out as a minimally invasive yet highly effective approach in a cosmetic dentist’s toolkit. However, dental bonding is not as resistant to stains and is less durable compared to crowns, veneers, or fillings. The bonding material can easily chip and break off the tooth, and its longevity is relatively short-lived. Due to these limitations, some dentists consider dental bonding best suited for small cosmetic changes, short-term correction of cosmetic problems, and correcting teeth in areas of very low bite pressure (Brennan).
The evolution of prosthetic dental crowns reached new heights with the introduction of zirconia and CAD/CAM milling E-MAX crowns in the 2000s (“A brief history of a great invention”). Renowned for their durability, aesthetic appeal, and natural-looking results, these crowns surpassed traditional dental amalgams, which combined mercury with metals like silver, tin, and copper for tooth restorations. Zirconia crowns, with their strength and biocompatibility, became an ideal choice, while E-MAX crowns, crafted from a single block of lithium disilicate ceramic, offered superior strength and precision in replicating the natural tooth structure (Kemp and Taneja). These advancements marked a significant departure from less aesthetically pleasing materials used in the past.
The future of cosmetic dentistry is expected to be shaped by various factors, including technological advancements, patient demand for minimally invasive procedures, and the development of new materials and technologies. Emerging trends indicate a growing demand for procedures such as teeth whitening, veneers, and dental implants. The use of advanced technologies like artificial intelligence (AI), 3D printing, and lasers is poised to enhance the precision and effectiveness of cosmetic dental procedures. However, the cost of these procedures remains a significant factor affecting the growth of cosmetic dentistry, as many are elective and not typically covered by insurance. As these conditions continue to evolve, the future of cosmetic dentistry is expected to see an increase in demand for minimally invasive procedures and the continued development of new materials and technologies (“9 Technologies That Will Shape The Future Of Dentistry”).
The field of cosmetic dentistry has undergone significant evolution, particularly over the last century. This evolution has been driven by technological advancements, novel materials, and innovative techniques, transforming cosmetic dentistry into a dynamic and patient-centred field. From the development of porcelain veneers in 1928 to the establishment of universal anatomy and physiognomy in recent years, the evolution of aesthetic dental materials and techniques has significantly improved the ability to create natural-looking smiles and enhance the overall dental experience for patients.
Works Cited
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Brennan, Robert. “Learn More About Dental Bonding for Teeth.” WebMD, 2 April 2023, https://www.webmd.com/oral-health/dental-bonding. Accessed 15 December 2023.
“A brief history of a great invention.” Dentist & Dental Technician Blogs | Ivoclar US, 24 August 2015, https://www.blog.ivoclar.com/lab/en/dental-ceramics-a-brief-history-of-a-great-invention. Accessed 15 December 2023.
“Cosmetic Dentistry: What It Is, Procedures & Types.” Cleveland Clinic, 27 July 2022, https://my.clevelandclinic.org/health/treatments/23914-cosmetic-dentistry. Accessed 10 December 2023.
“The Evolution Of Dental Implants Throughout History.” Hiossen® Implant, http://hiossen.com/dental-implants/the-history-of-dental-implants/. Accessed 10 December 2023.
“The history of cosmetic dentistry over the last 25 years — Dentistry.” Dentistry.co.uk, 9 June 2022, https://dentistry.co.uk/2022/06/09/the-history-of-cosmetic-dentistry-over-the-last-25-years/. Accessed 10 December 2023.
Kemp, Karen, and Sukriti Taneja. “Emax Crowns Price, Materials, and Pros and Cons.” Dentaly.org, https://www.dentaly.org/us/dental-crown-information/emax-crowns/. Accessed 12 December 2023.
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“9 Technologies That Will Shape The Future Of Dentistry.” The Medical Futurist, https://medicalfuturist.com/the-amazing-future-of-dentistry-and-oral-health/. Accessed 15 December 2023.
Rashid, Raisa, and Waseem ul Ayoub. “Veneers: Modern Approach of Dentistry-A Review.” International Journal of Advance Research, Ideas and Innovations in Technology, vol. 3, no. 5, 2017, p. 5. Google Scholar, https://d1wqtxts1xzle7.cloudfront.net/55561182/Veneers_Modern_Approach_of_Dentistry-A_Review-libre.pdf?1516184355=&response-content-disposition=inline%3B+filename%3DVeneers_Modern_Approach_of_Dentistry_A_R.pdf&Expires=1702629398&Signature=KWN6KDw~bZQ0MVLgE. Accessed 29 November 2023.
“Titanium and titanium alloys in dentistry: current trends, recent developments, and future prospects.” NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640965/. Accessed 15 December 2023.