History of the Department of Oral Surgery

[From the 1958-1959 Hya Yaka/Yearbook]

Fifty Years of Oral Surgury [sic]

The history of the Oral Surgery and its methods of teaching have gone through some quite radical changes since the turn of the century. As an illustration, there is a story told by Dr. Edgar Paul of a dentist who recalls his student days in the "extracting department" in the late nineties. When an extraction was necessary, a pair of forceps was removed from a nail on the wall and after the operation was completed the forceps were washed off under the tap and replaced on the nail. We have indeed progressed a long way from this horse and buggy type of oral surgery.

Fifty years ago there was no such term as oral surgery. In the present location of the Surgery Department, there were two rooms and the large surgery which comprised the extracting department. The examination room under Dr. Hoskin and the reception area were adjacent to these rooms, in what is now Dr. Johnson's office and the operating room next door.

The equipment was primitive by today's standards and the practical instruction was exceedingly limited. Lectures in Surgery were given by Dr. J. B. Willmott and the first demonstrator who limited his practice was Dr. Henderson. Local anaesthesia was obtained by the use of cocaine for the first few years then novocaine came into regular use. The novocaine was in tablet form and had to be boiled with water in a small porcelain crucible. It was then drawn into a metal or glass luer type syringe with a very short needle. Injections were made by the subperiosteal method close to the gingival border and intraosseous anaesthesia was also very popular. It was not until about 1920 that the use of conductive or block anaesthesia became popular and was taught to students in the schools.

In the field of general anaesthesia which was probably more universally used than it is today, the original method was far from adequate and yet it served a very useful and indispensable purpose. Fifty years ago nitrous oxide was, as today, the basic agent used. It was administered by a machine known as a gasometer, which consisted of a metal cylindrical container full of water into which fitted another inverted container. Gas came from a tank through the water and into the top cylinder. The weight of this, due to gravity, caused the gas to be forced to the patient through a rubber tube and face piece. The nitrous oxide was administered until the patient was asleep and somewhat the colour of mud, then the inhalor was removed and the extractions commenced. The operator had about one-half minute in whcih to remove any teeth. His skill and speed governed the extent of the operation. No doubt this era gave rise to the often quoted expression of "keeping one in the air." It is remarkable to note that the safety record of this type of anaesthesia was extremely good.

Most of the instructional help in the department, with the exception of Dr. Henderson, came from senior students who had a particular aptitude in this department.

Two names stand out in the past fifty years as being synonymous with the teaching of oral surgery. They are, of course, Dr. Edgar Paul and Dr. Joseph Johnson. Dr. Paul was a senior student demonstrator in his final year and developed a keen interest in the field of exodontia. After a few years in general practice, he went into the specialty and spent part time at the college instructing and lecturing in his chosen field. For the next forty years Dr. Paul gave of his time and knowledge in lectures and clinics as Professor of Exodontia and Anaesthesia.

Dr. Johnson, or "Joe" as he is affectionately known, joined the staff of the department on a full time basis in 1930 and for the past few years has been Professor of Dental Oral Surgery and Anaesthesia. Both Dr. Paul and Dr. Johnson have served the cause of organized dentistry with tireless devotion as well as their own specialty.

During the twenties and thirties several specialists served on the staff on a part-time basis. Among them were Dr. Bill Amy, Dr. Frank Jarmyn, Dr. Murray Robb and Dr. Gordon Frawley.

In the early 1930's the Surgery Department was enlarged to its present size and facilities both in staff and equipment improved markedly.

After the second great war, in 1946, the first postgraduate course was inaugurated to confrom with the new regulations of qualified specialization in the field of Dental Oral Surgery. Ontario had led the rest of Canada and indeed many of the states of the U.S.A. in setting forth a minimum requirement for specialization in three fields of Dentistry. The original requirement was one year postgraduate training folowing [sic] a period of general practice. This has since been changed to a three year course involving basic sciences and hospital internship.

Since the post war classes reached their senior year, the Surgery Department has been staffed by a group of specialists who serve part time, so that there is always someone on duty. Patients are checked before, during and after surgery and assistance given where required. Interesting cases and operations beyond the undergraduate level are done by these men with the students assisting and observing.

At the beginning of the 1958 session, Anaesthesia became a separate department under Dr. R. S. Locke who had completed a two year post-graduate course in the subject. Lectures and practical instruction in general and local anaesthesia have been handled on a cooperative basis with the Oral Surgery Department.

In the new school many improvements and changes will be noted. The planning of the department has resulted in a most functional setup for oral surgery that will be second to none on the continent. The space allotted includes six operating rooms, treatment room, one large surgery for general anaesthesia cases, waiting room, seminar room, five staff rooms, sterilizing and storage rooms, recovery and washrooms. All of the operating and recovery rooms are fitted with piped-in central suction and oxygen. There is a ground floor exit from the department. All instruments will be sterilized by autoclave in one room and stored on trays ready for the next case. After use, students will bring the tray to an adjoining "dirty" room where the instruments will be scrubbed and placed on trays again ready for sterilization.

It is felt that the long range planning of the Surgery Department, as with other departments in the school, will provide adequate space and facilities for many years to come. We are a rapidly expanding country and it is gratifying to see that the men who control building funds in the University have seen fit to reward the tireless efforts of the Dean and the dental staff with a very close approximation of the ideal Dental College.

Oral Surgery is the oldest specialty in Dentistry and in reviewing the past fifty years wer feel that much progress has been made. There is more to be accomplished particularly in the field of hospital and health insurance cooperation, and no effort will be spared to bring oral surgery into a recognized position which it truly deserves.

[Dr. D. H. MacDonald]