From Paul Revere to AI: 250 Years of Dentistry in America

When we tell schoolchildren the story of Paul Revere, we usually leave out the detail that puts him in just about every dental textbook: he was Boston's most aggressive advertising dentist. In 1768 — eight years before the Declaration of Independence — Revere ran newspaper notices promising to "fix Teeth as well as any Surgeon-Dentist who ever came from London." He fitted dentures from hippopotamus ivory wired to remaining teeth with gold. And after the Battle of Bunker Hill in 1775, he identified his fallen friend Joseph Warren's body from a wired bridge he'd installed two years earlier — the first verified forensic dental identification in American history.

So American dentistry began the same year America did, and the same silversmith made both possible. In the 250 years since, dentistry in this country has gone from a tradesman's side gig to a science with its own postdoctoral specialties, biological research arms, and an annual revenue larger than Disney's. Here is the story in five chapters.

The trade era — barbers, silversmiths, and George Washington's teeth (1776–1840)

For most of the colonial and early federal era, dentistry was a side practice. Barbers pulled teeth between haircuts. Silversmiths like Revere made dentures because they had the metalworking skills. Traveling "tooth pullers" set up at county fairs alongside livestock auctions.

The most famous early American dental patient was, of course, George Washington. He lost his first tooth at twenty-two, and by the time he was inaugurated in 1789 he had a single natural tooth remaining. He owned four sets of dentures across his life. None were wooden — that's a persistent myth. They were made of human teeth (some bought from poor donors, possibly enslaved), cow and horse teeth, hippopotamus and elephant ivory, gold wire, and lead. The wooden-teeth story comes from staining: ivory dentures absorbed wine and food and darkened with grain-like streaks that, in candlelight, looked like wood. His dentures hurt to wear, distorted his lower face, and made eating difficult — which is why portraits from his presidency show that famously tight, unhappy mouth.

The first native-born American dentist with formal training was Josiah Flagg of Boston, who practiced in the 1790s and is credited with designing the first dental chair — a wooden contraption with a headrest and an adjustable arm for instruments. Until Flagg, patients were treated standing, leaning, or on whatever stool the practitioner had handy.

What set American dentistry apart in this era was geography. In Europe, dentistry was beginning to develop as an offshoot of medicine, regulated by guilds. In the new United States, with no central licensing and a sprawling frontier, anyone could practice. The quality varied wildly. A patient might be lucky enough to find a Revere or a Flagg, or unlucky enough to find a traveling charlatan who promised extractions with "no pain" and meant it only in the sense that the pain came after.

The profession is born — schools, anesthesia, X-rays (1840–1900)

If there is a single year when American dentistry became a profession, it is 1840. That year, two Maryland dentists, Horace Hayden and Chapin Harris, founded the Baltimore College of Dental Surgery — the first dental school anywhere in the world. They had tried to add dental training to the University of Maryland's medical school and been refused on the grounds that dentistry was a mechanical trade, not a medical one. So they built their own school, granted the first dental degrees in history, and accidentally exported the model. Every dental school in the world today descends from that 1840 Baltimore decision.

In 1844, in Hartford, Connecticut, a dentist named Horace Wells watched a public demonstration of nitrous oxide for entertainment — laughing gas — and noticed that one of the participants gashed his leg without realizing it. The next day, Wells had a colleague extract his own tooth while he breathed the gas. He felt nothing. Wells took the demonstration to Massachusetts General Hospital, but the audience heckled and the surgical anesthesia movement passed him by. Two years later, his former student William Morton successfully demonstrated ether anesthesia at the same hospital and went down in history as the inventor of surgical anesthesia, while Wells, who had introduced the principle, died in obscurity. The first practical use of inhaled anesthesia in American medical history was for a dental extraction.

The American Dental Association was founded in 1859 in Niagara Falls, New York — a curious choice for a professional headquarters that reflected just how new and informal the field was. The ADA's founding members took stances that look strikingly modern: minimum standards for dental education, a code of ethics that forbade quack remedies, and the recognition that dentistry was distinct from but cooperative with medicine.

Three innovations from the late nineteenth century are still in every modern dental operatory. In 1864, a New York dentist named Sanford Barnum invented the rubber dam — the thin latex sheet that isolates the tooth being worked on from saliva and the rest of the mouth. It is still used in 2026, essentially unchanged. In 1871, James Beall Morrison patented the foot-treadle dental drill, freeing both of a dentist's hands and dramatically improving precision. And in 1895, in New Orleans, a dentist named C. Edmund Kells took the first dental X-ray in America — within months of Wilhelm Röntgen's discovery in Germany. Kells went on to develop dental radiography as a clinical specialty. He also worked unprotected with X-ray tubes for thirty years, lost his hand and then his arm to radiation cancer, and eventually took his own life in 1928. The trade-off between imaging and exposure was only understood after men like Kells paid for it.

The standardization era — G.V. Black, hygienists, and a wartime crisis (1900–1960)

Greene Vardiman Black, a self-educated Illinois dentist whose formal schooling ended at seventeen, became "the father of operative dentistry" by writing the textbook that standardized cavity preparation, amalgam alloy chemistry, and the classification of restorations. Black's six-volume Operative Dentistry, published in 1908, is the document that turned a thousand different techniques into one shared craft. Dentists in Maine and Texas began, for the first time, doing essentially the same procedure for the same kind of cavity.

In 1913, a Connecticut dentist named Alfred Civilion Fones invited an assistant in his Bridgeport practice to attend training in a new role he was inventing: dental hygienist. The first class graduated, and by 1917 Connecticut had licensed the profession. Within twenty years, every American dental practice had hygienists handling cleanings and prevention — a division of labor that today is so embedded it's hard to imagine how recently it was invented. The routine gum check at the start of every cleaning, the twice-yearly visit, the fissure sealants in elementary school: all of it descends from Fones's 1913 idea.

Then came the war. When the United States began drafting men for the Second World War, the Selective Service rejected an astonishing percentage of recruits for missing teeth — the standard required six opposing molars to chew Army rations. By 1942 the military had quietly lowered the standard because it could not field an army otherwise. This was the country's first national reckoning with dental health as a public-health issue. Postwar federal investment in school dental programs, fluoridated water, and Medicare-Medicaid dental coverage followed directly from what the draft revealed.

Grand Rapids, Michigan became the first city in the world to add fluoride to its municipal water supply in January 1945. The trial was scientifically rigorous: dental researchers tracked Grand Rapids children's cavity rates against those of a control city (Muskegon) for eleven years. The result — roughly a 60 percent reduction in cavities among Grand Rapids children born after fluoridation — converted skeptical city councils across the country. By 1960, more than fifty million Americans drank fluoridated water. It remains, in the CDC's words, one of the ten greatest public health achievements of the twentieth century. (For more on how this still affects your routine care today, see our piece on who actually needs fluoride treatments.)

The technology era — the air turbine, the implant, the laser (1960–2000)

In 1957, the introduction of the air-driven turbine drill changed what dentistry felt like more than any single innovation before it. The slow belt-driven drills of the previous half-century vibrated, ground, and were unmistakably terrifying. The air turbine spun at 250,000 rpm, cut quickly and cleanly, and made a high whine that — for the first time — wasn't accompanied by the bone-conducted rumble that had haunted every patient's memory of the dental chair. Adoption was rapid and complete; by 1965 the belt drill was a museum piece.

In the 1980s, a Swedish orthopedic surgeon's research project arrived in the United States and changed dental restoration permanently. Per-Ingvar Brånemark had discovered in 1952 that titanium, in living bone, did something no other metal did: it fused. The bone grew into the titanium's microscopic surface and locked it in place. Brånemark called the phenomenon "osseointegration," and by the 1980s American dentists were placing the first titanium dental implants — small screws set into the jaw to anchor a crown. A patient who lost a tooth no longer had to choose between a bridge that wore down the teeth next to it or a removable partial. They could have a tooth back. Implant dentistry, today a multi-billion-dollar specialty, did not exist in any practical form before that decade.

The other 1980s revolution was cosmetic. Composite resin — tooth-colored filling material — improved enough to replace silver amalgam for visible cavities. A dentist named Charles Pincus had cemented porcelain veneers onto Hollywood actors' teeth as early as the 1930s, but the durable bonded veneers of today's cosmetic dentistry come from the late 1980s and early 1990s. The "smile makeover" entered the patient's vocabulary.

In 1985, a Swiss inventor named Werner Mörmann demonstrated a system that scanned a prepared tooth with a small camera and milled a ceramic crown from a block while the patient waited. It was called CEREC, for "Chairside Economical Restoration of Esthetic Ceramics." For decades it was an expensive curiosity. In 2026 it is everywhere — the same-day crown that didn't exist when most current patients' parents had their first one.

The digital era — 3D imaging, clear aligners, AI in the chair (2000–2026)

The first cone beam computed tomography (CBCT) scanner appeared in an American dental office in 2001. It replaced the two-dimensional X-rays of the previous century with a three-dimensional reconstruction of the jaws, sinuses, and nerve pathways. For implant dentistry the change was enormous: where surgeons had previously placed implants by feel and experience, CBCT made the procedure measurable to within fractions of a millimeter. Wisdom-tooth extractions became safer. Root canals could be planned around the actual anatomy of a patient's nerves.

Invisalign — clear aligner therapy invented by a Stanford MBA named Zia Chishti in 1997 — entered general orthodontic practice in the early 2000s. Within a decade, an entire generation of adults who had refused braces in their teens were straightening their teeth on lunch breaks. The product also changed dentistry's relationship to general consumers: it was the first dental treatment most patients learned about from a television ad rather than from their dentist's mouth.

Digital impressions arrived in the 2010s. A small intraoral camera replaced the goopy, gag-inducing impression trays of the previous century. The data flowed directly to a milling unit or implant lab. Patients who hadn't seen a dentist in twenty years sometimes came in expecting the worst part of the visit and discovered it had been quietly retired.

In the last few years, AI-assisted dental radiology has begun showing up in practices across the country. Software analyzes X-rays for cavities, bone loss, and other patterns the human eye can miss in the half-second a clinician spends per image. Used well, it catches problems earlier. Used badly, it generates false positives. The technology is settling into the role of a second opinion rather than a diagnosis — a senior colleague always reading over the dentist's shoulder.

What it took to get from there to here

When a Jupiter patient sits down for a smile-makeover consultation in 2026, the consultation itself draws on every era described above. The bonded veneers are descended from Charles Pincus's 1930s Hollywood experiment, refined by 1990s composites. The titanium implant supporting the back molar is Brånemark's accidental Swedish discovery. The 3D scan is C. Edmund Kells's X-ray plus seventy years of computer engineering. The hygienist who cleaned the patient's teeth before the appointment is doing the job Alfred Fones invented in Bridgeport in 1913. And the dentist who designs the smile stands on a chain of teachers reaching back, eventually, to Hayden and Harris arguing with the University of Maryland medical faculty in 1840.

Two hundred and fifty years. Five generations of practitioners. One continuous improvement in what a smile is allowed to be. Happy Fourth.

Frequently asked questions about American dental history

Did George Washington really have wooden teeth?

No. His dentures were made from human teeth (some purchased from poor donors), cow and horse teeth, hippopotamus and elephant ivory, gold wire, and lead. The wooden-teeth myth comes from how ivory dentures stained with food and wine, taking on dark, grain-like streaks that resembled wood in candlelight.

Who founded the first dental school?

Horace Hayden and Chapin Harris opened the Baltimore College of Dental Surgery in 1840 after the University of Maryland's medical school refused to add dentistry to its curriculum. It was the first dental school in the world, not just the United States. Every dental school today traces its institutional lineage back to that decision.

When did Americans start getting twice-yearly cleanings?

The dental hygienist profession was invented by Alfred Fones in 1913 in Bridgeport, Connecticut. By the 1930s, twice-yearly cleanings had become the standard recommendation across American dental practice — a model that has changed remarkably little in the ninety years since.

When was fluoride added to American water?

Grand Rapids, Michigan was the first city in the world to fluoridate its municipal water supply, in January 1945, as part of a controlled scientific study. The eleven-year trial reduced childhood cavity rates by roughly 60 percent, and fluoridation spread rapidly to most major American cities over the following two decades.

Why do dental implants exist?

Per-Ingvar Brånemark, a Swedish orthopedic surgeon, discovered in 1952 that titanium fuses to living bone — a process he called osseointegration. Modern dental implants are an outgrowth of that discovery, first placed in American patients in the 1980s. It remains the only metal we know of that does this reliably.