Yeshiva University Journal of Medicine and Dentistry

Abstract

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Over the course of time, a multitude of intraoral technologies have been invented, modernized, and improved in order to create the advanced modern technology that is used in dental practices today. Since the time of the earliest dentist in the 1830’s, there have been tremendous global improvements in the intricate details of dental equipment. The advancement of technology from photography to radiography to ultrasounds has developed dentistry into a prominent, impactful industry.1 Ultrasounds have proven to be a unique area of dentistry with the potential to transform the future of the dental industry. Technological advancements regarding X-rays have had a high rate of growth in the last decade and have only continued to improve with the new technology of ultrasounds within the field of dentistry. 

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Introduction

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The technological era began in the eighteenth century. This time period was a revolution as the development of machines were invented and the way life was lived began to shift. This time period coincided with modern dentistry as it too began in the eighteenth century. Pierre Fauchard was the first dentist to record modern practices of dentistry in his book “The Surgeon Dentist, A Treatise on Teeth.” Although the technologies used back then were not the same as common practices today, it was the foundation in developing knowledge on what future dentists would eventually use to improve dental medicine.

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First Intraoral Photograph

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In 1839, the Paris Academy of Sciences introduced the process of photography, and thus, the first intraoral photograph was taken. Later that year, Alexander S. Wolcott paired with John Johnson and created a small business that produced optical and medical instruments. In 1840, Wolcott and Johnson designed and patented the first camera-based model known as the ‘mirror camera.’As the creation of the camera was fascinating, many dentists started searching for photographic devices to obtain intraoral images. However, there was one major issue that presented itself: there was no clear way to get light from the camera’s flash within the dark crevices of the mouth. Despite using many types of close-up focused lenses, the images taken were unclear. The challenges that were encountered in early intraoral photography opened up pathways and research to discover more advanced techniques for oral photography.2

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Discovery of X-rays

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After over three decades of dental research and unsuccessful inventions, in 1895, German engineer, Wilhelm Röntgen, discovered X-rays. This was a scientific breakthrough as the world had never before seen the inside of an animal or human before. Later that year, Dr. Otto Walkoff, a German dentist, invented the first dental radiograph. The radiograph, produced by X-rays, took twenty-five minutes of exposure while having the patient lay on the floor with specified glass receptors within their mouth. The following year, Dr. C. Edminds Kells from New Orleans was the first to actively use an X-ray on dental patients. Thus, he is given the title of ‘the father of dental radiography.’ This new invention had an enormous influence on the world of dentistry which opened many doors for research.3 At the age of eighteen, Dr. Frank Van-Woert invested his time in research in oral and maxillofacial radiology. He established a practical demonstration of dental radiography and presented it before the New York Odontological Society. Dr. Van-Woert discovered the first dental X-ray film, which used less radiation. This technology was groundbreaking and implemented into practices for the next one hundred years. 

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Advancement in X-ray Imaging

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In 1987, Dr. Francis Mouyen advanced X-ray imaging by decreasing the X-ray image size. He introduced the new technology of digital imaging to the dental world by inventing a way to employ fiber optics in order to create a smaller-sized X-ray. The mechanism he used was a device called the CCD, the charge coupled device, which operates as an image sensor chip. This sensor enhanced the visualization of unseen areas that other X-rays did not have the ability to photograph. This would impact dentistry as the X-ray imaging was safer, since it emitted less radiation, and the new capabilities of fitting into a person’s mouth which would make it easier to identify hard to reach crevices. Later that year, Fuji Optical Systems of California produced the first intraoral camera. This resembled what current video cameras are like today. Due to the hard work of dentists and researchers, the advancement of dentistry globally has impacted radiography, X-ray technology, and intraoral photography.4

With Dr. Mouyen’s technological advancement of the new X-ray, there were a multitude of processes that took place. The multi-step process required a dark room due to the chemicals that were present during the process and in order to decrease the exposure from film light. After the X-rays were placed in a dark room, they were laid on a light box in order to ensure better visualization of the X-rays. Past technologies included many harmful chemicals, time-consuming processes, wasted space, and low quality images. The process took up much space within the patient's files and was a waste of time and materials, concluding the time-consuming process with an unclear appearance of an X-ray. In order to improve these faculties, new technology such as digital X-rays have come about in recent years (Figure 1). These technologically advanced products include 3-D technology, which enhanced the imagery on the tooth anatomy, clearly revealing bone decay, bone infections, gum diseases, abscesses, and any development of abnormalities. ​