History of Dentistry and Stomatology in Gipuzkoa

In 1901, the degree in dentistry was made official in Spain.(1) In 1944, the medical speciality of stomatology was created, replacing the previous degree in dentistry.(1) In 1987, the degree in dentistry was created again, for which it is not necessary to have a degree in medicine.(1) The University of the Basque Country followed the model of the other schools of stomatology in Spain and became the faculty of dentistry.(2)

Historical background

Prior to the 20th century, there were no official academic qualifications for the practice of dentistry. Dental health was in the hands of a conglomerate of professionals such as dental surgeons or dental mechanics who were trained mainly by learning from each other.(1) Their work consisted mostly of extractions and in some cases fitting dentures.

In 1901, the degree in dentistry was made official and was structured in two theoretical years in common with the degree in medicine and another two or three clinical years in the dental office.(1) Despite the emergence of the new degree, and given the lack of professionals, there was still a large contingent of untrained professionals who worked in patients' mouths. This situation gradually disappeared throughout the 20th century.

In 1944, a change was made to the profession by creating the medical speciality of stomatology and eliminating the degree in dentistry.(1) One particularity in Gipuzkoa was that, given the proximity of the neighbouring country and the existing shortage of professionals, many people crossed the border to be treated in Lapurdi.

Until 1980, most of the dentists who practised in Gipuzkoa came from the school of stomatology at the Complutense University of Madrid.

In 1979, the School of Stomatology was created at the University of the Basque Country in Leioa, which became the professional reference centre in Gipuzkoa, its first director being Professor José María Rivera. In the 1980s there was a great professional plethora among medical graduates, which made it difficult for them to enter Spanish schools. In the mid-1980s, as many as 500 doctors registered for the MIR exam for 50 places at the Leioa school. Faced with this situation, many doctors went to French hospitals 1983 and 1987 to specialise in stomatology. From then on, France became more restrictive and many professionals went to the Dominican Republic, a country that had agreements with Spain for the validation of the new dentistry degree.(3)

1984 and 1992 there was a similar number of new dentists with foreign qualifications as Spanish in Gipuzkoa. The majority of dentists who joined the profession from 1992 onwards were dentistry graduates trained in Spain, with stomatology being an extinct speciality. At the beginning of the 21st century, private dental schools were created in the State, which led to a plethora of professionals with a dentist/population ratio much higher than that recommended by European dental associations.(4) This fact led to a change in professional organisation with the emergence of large corporations that share their space with traditional dental practices.

The coexistence and cooperation professionals of different qualifications and origins was excellent in the province.

Historical milestones in Gipuzkoa

The corporate trend began in 1903 with the creation of the Gipuzkoa Dental Society. Twelve dentists from Gipuzkoa founded this Society, chaired by Hipólito Lobato.(5) Subsequently, in 1929, the Gipuzkoa Dental Association was created. It was made up of 36 of the 45 dentists in the province and its president was Hipólito Lobato.(5) Following the impulse of the association, in 1930 the official College of Dentists of Gipuzkoa was created.(5)

A notable milestone in the history of dentistry in Gipuzkoa was the one that took place in Donostia-San Sebastián at the beginning of 1938 during the Spanish Civil War. The number of wounded maxillofacial patients was enormous, so the military hospital of Donostia-San Sebastián was established as the reference hospital in the rearguard. The first maxillofacial surgery service in Spain was created in this hospital, for which the American surgeon Joseph Eastman Sheehan (1885 - 1951) and the British anaesthetist Robert Reynolds Macintosh (1897-1989) were hired. These doctors formed a team in which the dental and prosthetic speciality was led by Carmelo Balda.(6) At the most critical moments, the number of patients treated reached 700, especially after the battle of the Ebro.(6) The less serious patients were housed in private homes. Eastman wrote in an interview in the New York Times that ‘There were as many mutilated faces in the rebel army as there were in the British army at the end of World War I.’(7) He described the horror as follows: ‘The most frequent facial injuries were from shrapnel, truly impressive. These poor, shrapnel-wounded men in the face were horrifying; real monsters, without faces; a hanging mass of flesh and skin, breathing with their eyes out of their sockets because the bony mass of the face had disappeared; no nose or lip; no mouth or teeth; no chin; their tongues bruised, swollen, drooping over their chests. Full of flies, blowing a bloody foam, suffocating, one must imagine that a huge axe cut off the whole face with a violent sideways blow."(7)

At the end of the war, in 1941, the service was transferred to the Gómez Ulla hospital in Madrid and Carmelo Balda continued with his private practice in Donostia-San Sebastián. It was not until 1989 that José Antonio Arruti (8) created the maxillofacial surgery service at the Nuestra Señora de Aránzazu Health Care Residence (currently the Donostia University Hospital). In the foundation of the School of Stomatology of the University of the Basque Country in 1979, several dentists from Gipuzkoa collaborated and taught there, such as Imanol Irigoyen (9), a pioneer of implants in Spain, and Ramón Antín, who trained in the United States with Peter K. Thomas. Thomas in the United States.

1960 and 1980, different dental subspecialities were developed. Some dentists from Gipuzkoa participated in the creation and development of the different scientific societies in Spain, such as José Luis Zuriarrain (10) in orthodontics, Javier Gorostegui in endodontics or Antxon Lasagabaster (11) in paediatric dentistry.

The Basque Government implemented oral public health measures that resulted in an improvement in the dental condition of the population. The first was to fluoridate drinking water 1988 and 2022 with a consequent reduction in caries.(12) The second measure was the creation of the P.A.D.I. It is a free dental care programme for children 7 and 15 years of age. Its creator was the Biscayan dentist Federico Simón (13).

References

Auñamendi Eusko EntziklopediaFund Bernardo Estornés Lasa

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