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Dentist for President Washington
THE BIG PICTURE History of Dentistry Dentist for President Washington Background.—John Greenwood practiced dentistry in New York City from 1785 until a few years before his death at age 60 years in 1819. He was not only an eminent dentist for the city itself but also treated President George Washington. His procedures and devices demonstrate his ingenuity and mechanical skill, as well as his extensive understanding of the human dentition. Early Life.—John Greenwood was born in Boston on May 17, 1760 and educated at the North Writing School. He was sent to live with his uncle in Falmouth, Massachusetts for 2 years before the Boston Massacre, when British troops fired on Boston inhabitants and killed seven, one of whom had been an apprentice of John’s father and a friend of John. He ran away from his uncle’s home to go to his family in Boston, but ended up enlisting in the Army as a fifer at age 15 years. He served for 20 months, returned to Boston in December 1776, re-enlisted in February 1778, and was discharged in May 1779. He received only 6-month’s pay for his time in the service, but did not seek further payment. After the war, Greenwood made his way to New York City, where he helped repair old quadrants and compasses in the employment of an instrument maker. He also made hickory walking sticks, which was one of his father’s trades. His father also was an ivory turner, billiard ball maker, and a leading dentist in the colonies. He was the first to offer preventive dental care for an annual fee and constantly warned parents that their children’s teeth needed attention and care. John did not learn dentistry from him, but did demonstrate his adroitness and mechanical ability through his work on the first electrical machine made for Benjamin Franklin’s experiments. Innovations in Dentistry.—When Greenwood determined that he would be a dentist is unclear. He spent a couple of years in Pennsylvania where he may have practiced dentistry, but the first advertisement he placed was in the Daily Advertiser in New York City on February 28, 1786. His education included reading The Natural History of Human Teeth by John Hunter of England. In copious notes in his copy he strongly disagreed with much of what Hunter said, noting that Hunter was a surgeon, not a dentist.
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Fig 3.—The lower portion of the next-to-the-last set of dentures made by Greenwood for Washington in 1789. It is carved from hippopotamus ivory, with natural human teeth held in place with gold screws. Washington still had a lower second bicuspid, and Greenwood made a convenient hole for the denture to slip over the tooth to add stability. On the side is the groove for the spring that attached to the upper denture. Washington ultimately lost his last tooth and he graciously gave the denture to Greenwood as a memento. On it the dentist inscribed ‘‘This was the great Washington’s teeth.’’ (New York Academy of Medicine.) (Courtesy of Ring ME: John Greenwood, dentist to President Washington. Calif Dent Assoc J 38:847-851, 2010.). For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.
Greenwood believed that one should not extract a tooth if it can be saved, which was a revolutionary concept at that time. In making dentures for George Washington, Greenwood saw that he still had a serviceable lower second bicuspid and adapted the lower denture so that it would slip over that tooth and be more stable (Fig 3). When faced with a patient with a suppurating disease of the antrum, Greenwood extracted a molar tooth and daily flushed the antrum with a solution of Castile soap suds until it was cured. With respect to full dentures, Greenwood devised a way to take an impression of an edentulous upper jaw using beeswax, then make a die on which he swaged a sheet of gold to create the palatal portion of an upper denture. This technique was used in making the last full set of dentures for President Washington (Fig 4). He was also the first to use spiral springs of gold wire to hold the upper and lower dentures together in the mouth.
accept no payment because it was so important. He also mentions that other dentists also perform this task and should not charge a fee either. He calls himself J Greenwood, surgeon dentist, but did not mention that he was President Washington’s favorite dentist, even though this is less than a year before the president died. He also mentioned that three stores carried his dentifrice, but history shows that he actually blanketed the city with his tooth powders, making them widely available. Fig 4.—The last set of dentures made by Greenwood for George Washington, and with which he was buried. The upper gold palate was swaged between dies, and the teeth, individually carved from ivory, had gold pins that were each soldered to the palate. This method of construction was invented by Greenwood. The lower base is one piece of ivory to which ivory teeth were attached with screws. (Courtesy of Ring ME: John Greenwood, dentist to President Washington. Calif Dent Assoc J 38:847-851, 2010.)
Advertisements.—Even though Greenwood advertised for about 25 years, the ads usually did not repeat themselves. In general, he mentioned his services and reasonable fees, but he usually reworded the ads, even using different titles for himself. In an advertisement dated February 9, 1799 from the Weekly Museum, it is possible to better understand Greenwood’s attitudes toward dental practice and dental prevention measures. He devoted half of the text to preserving children’s teeth, for which he would
Clinical Significance.—The skill and knowledge demonstrated by the dentists of the Revolutionary War times eventually transformed the profession and resulted in the United States having outstanding dentistry. Many of the fundamental techniques and basic operative equipment developed in the late 1800s are still in use today, demonstrating the brilliance of practitioners such as John Greenwood.
Ring ME: John Greenwood, dentist to President Washington. Calif Dent Assoc J 38:847-851, 2010 Reprints not available
Periodontal Treatment Growth factors for periodontal regeneration Background.—Several decades ago it was discovered that some cells migrating to or present in toothsupporting periodontal defects have the ability to regenerate lost periodontal tissues. Research has produced moderate success to take advantage of this capability. The materials investigated were chosen as those most likely to contribute properties linked to wound healing, wound repair, and/or periodontal tissue regeneration and can inhibit or modulate immune responses, epithelial cell down growth, bacterial invasion or growth, and bone-tooth ankylosis. A biocompatible delivery system for the agents is also needed so they can be delivered with sensitivity to spatial and temporal cell requirements and generate the appropriate response. Growth Factor Agents.—Human recombinant basic fibroblast growth factor (FGF)-2 plus hydroxypropyl cellulose and a surgical procedure has been introduced as an attractive growth factor for reconstructing periodontal
tissues. FGF-2 offers angiogenic and proliferative properties and the ability to promote the expression of activity transcript factor 4, which is required for osteoblast maturation. A 24-hospital, randomized, double-blind, placebo-control, dose-response study in Japan covering a 2.5-year period focused on moderate periodontal disease treated with FGF-2. This factor promoted the regeneration of lost periodontal tissues in ways similar to those of other agents that have been investigated. Bone quality was not measured, and bone height was limited past the alveolar crest level found at surgery, meaning complete regeneration has not been achieved. Many growth factors now used clinically have endured rigorous clinical trials to achieve Food and Drug Administration (FDA) approval. Bone mineral proteins have achieved impressive results when used in regenerating bone mineral protein defects and for sinus floor augmentation. The drawback to using growth factors for recombinant tissue
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2011
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Dental Abstracts
Fig 3.—The lower portion of the next-to-the-last set of dentures made by Greenwood for Washington in 1789. It is carved from hippopotamus ivory, with natural human teeth held in place with gold screws. Washington still had a lower second bicuspid, and Greenwood made a convenient hole for the denture to slip over the tooth to add stability. On the side is the groove for the spring that attached to the upper denture. Washington ultimately lost his last tooth and he graciously gave the denture to Greenwood as a memento. On it the dentist inscribed ‘‘This was the great Washington’s teeth.’’ (New York Academy of Medicine.) (Courtesy of Ring ME: John Greenwood, dentist to President Washington. Calif Dent Assoc J 38:847-851, 2010.). For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.
Greenwood believed that one should not extract a tooth if it can be saved, which was a revolutionary concept at that time. In making dentures for George Washington, Greenwood saw that he still had a serviceable lower second bicuspid and adapted the lower denture so that it would slip over that tooth and be more stable (Fig 3). When faced with a patient with a suppurating disease of the antrum, Greenwood extracted a molar tooth and daily flushed the antrum with a solution of Castile soap suds until it was cured. With respect to full dentures, Greenwood devised a way to take an impression of an edentulous upper jaw using beeswax, then make a die on which he swaged a sheet of gold to create the palatal portion of an upper denture. This technique was used in making the last full set of dentures for President Washington (Fig 4). He was also the first to use spiral springs of gold wire to hold the upper and lower dentures together in the mouth.
accept no payment because it was so important. He also mentions that other dentists also perform this task and should not charge a fee either. He calls himself J Greenwood, surgeon dentist, but did not mention that he was President Washington’s favorite dentist, even though this is less than a year before the president died. He also mentioned that three stores carried his dentifrice, but history shows that he actually blanketed the city with his tooth powders, making them widely available. Fig 4.—The last set of dentures made by Greenwood for George Washington, and with which he was buried. The upper gold palate was swaged between dies, and the teeth, individually carved from ivory, had gold pins that were each soldered to the palate. This method of construction was invented by Greenwood. The lower base is one piece of ivory to which ivory teeth were attached with screws. (Courtesy of Ring ME: John Greenwood, dentist to President Washington. Calif Dent Assoc J 38:847-851, 2010.)
Advertisements.—Even though Greenwood advertised for about 25 years, the ads usually did not repeat themselves. In general, he mentioned his services and reasonable fees, but he usually reworded the ads, even using different titles for himself. In an advertisement dated February 9, 1799 from the Weekly Museum, it is possible to better understand Greenwood’s attitudes toward dental practice and dental prevention measures. He devoted half of the text to preserving children’s teeth, for which he would
Clinical Significance.—The skill and knowledge demonstrated by the dentists of the Revolutionary War times eventually transformed the profession and resulted in the United States having outstanding dentistry. Many of the fundamental techniques and basic operative equipment developed in the late 1800s are still in use today, demonstrating the brilliance of practitioners such as John Greenwood.
Ring ME: John Greenwood, dentist to President Washington. Calif Dent Assoc J 38:847-851, 2010 Reprints not available
Periodontal Treatment Growth factors for periodontal regeneration Background.—Several decades ago it was discovered that some cells migrating to or present in toothsupporting periodontal defects have the ability to regenerate lost periodontal tissues. Research has produced moderate success to take advantage of this capability. The materials investigated were chosen as those most likely to contribute properties linked to wound healing, wound repair, and/or periodontal tissue regeneration and can inhibit or modulate immune responses, epithelial cell down growth, bacterial invasion or growth, and bone-tooth ankylosis. A biocompatible delivery system for the agents is also needed so they can be delivered with sensitivity to spatial and temporal cell requirements and generate the appropriate response. Growth Factor Agents.—Human recombinant basic fibroblast growth factor (FGF)-2 plus hydroxypropyl cellulose and a surgical procedure has been introduced as an attractive growth factor for reconstructing periodontal
tissues. FGF-2 offers angiogenic and proliferative properties and the ability to promote the expression of activity transcript factor 4, which is required for osteoblast maturation. A 24-hospital, randomized, double-blind, placebo-control, dose-response study in Japan covering a 2.5-year period focused on moderate periodontal disease treated with FGF-2. This factor promoted the regeneration of lost periodontal tissues in ways similar to those of other agents that have been investigated. Bone quality was not measured, and bone height was limited past the alveolar crest level found at surgery, meaning complete regeneration has not been achieved. Many growth factors now used clinically have endured rigorous clinical trials to achieve Food and Drug Administration (FDA) approval. Bone mineral proteins have achieved impressive results when used in regenerating bone mineral protein defects and for sinus floor augmentation. The drawback to using growth factors for recombinant tissue
Volume 56
Issue 3
2011
123