Ancient Foundations
There is evidence of neolithic dentistry, as far back as 13,000 years ago. Early Egyptian society took this further, as did others. Maxillofacial techniques are in 5th century Greek texts, created by the physician Hippocrates.
Arab armies invading the Indian province of Sind in the 8th century, discovered written works which may predate Hippocrates. They describe surgical options, including skin flap surgery to repair facial damage.
The Indian texts were translated into Arabic and Persian, adding to their medical understanding. Later observations by British surgeons in India were shared, which had an influence on European plastic surgery.
Europeans had already recognised the importance of knowledge. Military surgeons accompanied the crusaders, barbers guilds came soon after and more formal medical books in the 16th century.
Ambrose Pare, a French surgeon, published important works to spread knowledge. Others developed surgical tools, or ways to cope with infection and disease, such as the 17th century English doctor, Thomas Sydenham.
The reality is that understanding has grown in many parts of the world and thankfully been shared. Man’s wish to treat such an important part of the anatomy has existed for millennia.
The Modern Era
The term “maxillofacial” came into use in the 19th century, a construct of the Latin maxillo (jaw) and facialis. Although there were exceptions, most early oral and maxillofacial surgeons were doctors, rather than dentists.
Some obtained a dental degree to add to their medical degree, becoming dentally trained oral surgeons. A practice which then became the rule in most countries, where maxillofacial consultants must hold both qualifications.
At the same time as the speciality emerged, anaesthetics improved to widen treatment. Cross profession cooperation began in 1846, a dentist anesthetised a patient, whilst a medical surgeon removed a salivary gland tumour.
Both professions changed to a degree around this time, the first use of the terms “oral surgeon” and “dental surgeon” emerged. The best known treatise on diseases and surgery of the mouth was published in 1869.
Progress continued to be made in the following decades, although technological development and world events would have a significant impact.
The 20th Century
Understanding of the relationship between the teeth, mouth and general health became more established during the early decades of the 20th century.
The first oral surgical hospital intern was appointed in 1937, the science of disease and infection took significant leaps forward. They all made a difference but two world wars would make more.
In the first, doctors began to develop new techniques to deal with blast injuries on a massive scale. To ensure survival and for the first time at a common level, to consider patients future function and appearance.
The second world war saw oral and maxillofacial surgeons emerge as a major speciality. Years of conflict and the aftermath required specialists who could deal with jaw lacerations, fractures, deformity, or dentoalveolar surgery.
Final recognition still took time. Double degree programs began in many countries during the 1970s, or 80s. The British Association of Oral Surgeons became The British Association of Oral & Maxillofacial Surgeons in 1985.
An acceptance of the work leaders in the medical profession had carried out for some time, for their patients and the future of medical science.
Looking Forward
The maxillofacial field has transformed lives and been transformed by technology, from computerisation, to digital imaging. Apart from direct treatment, knowledge and research are shared far faster than in ancient times.
Will we get to the stage where a quick injection of tailored stem cells brings the growth of a fresh body part, or individual genetic analysis provides the perfect personal cure?
The answer to both is probably yes, although history has proven that the time needed to make such dreams reality is longer than expected. Neither are they likely to be divorced from individual knowledge, or offered by robots.
Technology may help with the shortage of maxillofacial surgeons. International research is taking knowledge forward but helping people to return to health works in ways we can not program in.
We believe our consultants will be here to serve you for decades to come. Perhaps the time will come where your face is submerged in a cloud of nanobots, for a surgical clean up but so much more will still be needed.
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Phone – 020 7935 8627
Email – pa@shakib.org