Chew on this: Dentures may be on way out

9/3/2001

Dentures are becoming rarer, thanks to better ways of preventing and treating dental disease, wider availability of dental insurance coverage, and a big change in public attitudes about the teeth.

People once expected to lose all their natural teeth. “Another year, another tooth.” That was the accepted wisdom for many people in their 20s, 30s, and 40s. And sure enough, many people reached age 50 without a single natural tooth in their mouths.

Now more people want to avoid losing their teeth, and consider them permanent possessions.

Nevertheless, about 25 million Americans wear full dentures. Some have dental implants, with their dentures attached securely to posts imbedded in the jaw bone. Most, however, wear regular dentures. They know that even artificial teeth made from modern plastic and ceramic materials aren't a good substitute for natural teeth.

Dentures were among the first artificial replacements for human body parts lost to disease and accidents. It's amazing to glance backwards and see the improvements that have occurred in the most common replacement for a natural body component.

The Etruscans, who lived in ancient Italy, had the best dentists and denture makers in the ancient world. By 700 B.C., they were making partial dentures from human teeth held together with bands of gold. The bands were soldered to fit securely around the inserted human teeth, and then anchored to sound teeth in the patient's mouth.

Never make the mistake of thinking that medical science and other technology in the ancient world was backward. Those Etruscan dentures are among many examples of ancient technology that far surpassed anything available for centuries in modern times, which began in 476 A.D. with the fall of the Western Roman Empire.

With the decline of learning in the Dark Ages, dentists never made dentures to match the Etruscans until the 19th century.

In the 1800s, the best dentures were made the Etruscan way, with human teeth - rather than whalebone or ivory. George Washington's famous dentures had human teeth and teeth made from hippopotamus ivory.

Bone had a big drawback. It lacks the tough outer enamel layer found on teeth. When used in dentures, and exposed to acids produced by mouth bacteria, bone decays quickly.

Talk about bad breath. Nothing could match the stench from a person with a mouthful of rotting whale-bone dentures. The fashion for fans developed not because people wanted to act coy. Fans were used to hide bad teeth and unsightly dentures, and to shield other people from bad breath.

“Waterloo dentures” were the most prized dentures in the 1800s. Denture makers had only a few sources for the human teeth - poor “volunteers” who sold their teeth, mortuaries, or battlefields.

Napoleon's defeat at the Battle of Waterloo in 1815 left 50,000 casualties and a bonanza of teeth that were shipped all over Europe and even to the United States. Dentists advertised “Waterloo teeth” at bargain prices, and consumers snapped them up.

Sadly, the practice of removing battlefield teeth continued, even into the Civil War in the United States - despite the great 1837 innovation of London dentist Claudius Ash. He perfected the first dentures made from porcelain. Porcelain avoided the use of dead people's teeth, and opened the era in which decent dentures eventually were widely available at reasonable prices.

Society may be closing the curtain on the denture era itself as dentistry makes progress against tooth decay and gum disease, and more people keep their teeth for a lifetime.

Michael Woods is the Blade's science editor. His column on health and medical issues appears each Saturday. Email him at mwoods@theblade.com.