In early 19th century Britain, dentistry was still a “trade” practised by three groups:
- A small elite body of educated men who had medical or surgical qualifications and who chose to practise dental surgery.
- Those who paid handsomely to become apprenticed to such leaders but held no formal qualification.
- An assortment of uneducated and unqualified persons who attracted clients by blatant advertising. These were the most numerous.
Although efforts had been made to reform marketplace dentistry it was not until 1858 that the provisions of the Medical Act allowed the Royal College of Surgeons of England to institute the Licentiate in Dental Surgery (LDSRCS Eng.). It was not until 1921 that anyone calling themselves “dentist” or “dental surgeon” had to hold a dental qualification registered with the General Medical Council.
Charles Gaine (1827-1914) was born in Ludlow and became apprenticed to Thomas Bell FRS, FRCS, dental surgeon to Guy’s Hospital London, who did much to raise dentistry to the rank of a profession.[i] By 1840 Gaine had completed his pupillage and was working as an assistant to William Robert Wood (1807-1893) a surgeon dentist of 7, German Place, Brighton where the arrival of the railway in 1839 would soon make the resort the “Queen of watering places” and a ”school town”. Given such a wealthy young clientele it is not surprising that Gaine was soon treating dental irregularities of his young patients and more successfully than elsewhere by employing orthodontic screws for the first time (Figure 1). His principal, William Wood, stated these methods were “… sufficiently novel and important to be illustrated by models and plates which were accepted for, and their merits acknowledged at, the (Great) exhibition of 1851.” Unhappily for Gaine, at the insistence of his influential employer, the records and methods used in these cases were exhibited at the Crystal Palace under Wood’s name “Mine was the invention, his the kudos” (Figure 2). It led to Gaine leaving the practice and setting up on his own in Bath.
First book on orthodontics textbook in English
There is no record of Gaine carrying out any orthodontic treatment in Bath. At that time the wealthy formed a mere 14% of Bath’s population of whom a high proportion were the elderly retired. For the remainder, wages were barely above subsistence and would not have extended to dental treatment of any kind apart from extraction. What little we know of Gaine’s practice at this time comes from the Reverend Kilvert whose diaries recorded his visits from 1871-1878.[ii] For example in October 1878 he mentions “Went to Bath by the 9.45 train (from Chippenham). Had two teeth stopped by Gaine and bought 6 pairs of gloves at Harmer’s for 1/6d”.[iii] However in April 1858, two years after he arrived in Bath, Gaine produced the first orthodontic textbook in the English language which was published by the local Bath entrepreneur and bookseller Charles Oliver of 24, Milsom Street.[iv] (Figure 3). This may well have been to establish that he, and not William Wood, had been the inventor of the orthodontic screw plate as well as to attract patients.
Origin of the RUH Maxillofacial department
The passing of the Medicines Act in the same year must have alerted the unqualified Gaine to the possibility that he might eventually be prohibited from dental practice and so he took the unusual step of undertaking medical training part-time at the Bristol Medical School whilst continuing his dental practice in Bath. By this means he achieved his MRCS in 1862 and was then able to able to apply for the advantageous post of Assistant Surgeon at the General Hospital Bath, an appointment which he gained three years later and held until 1899. He was thus its first qualified dental surgeon and one of the earliest such regional hospital appointments in the UK. Gaine clearly undertook significant maxillo-facial surgery there.[v] He also became Assistant Surgeon to the 2nd Somerset Militia, then based in Bath, which had close links with the General Hospital. Little is known of Gaine’s duties in connection with this military appointment. The only indication of these again comes from the Reverend Kilvert’s diary for May 1871: “Then I went to Gaine’s and had two teeth stopped. He had just come in from ball practice with the militia to whom he is attached. A surgeon is always required to be on the ground during ball practice. He was still in his uniform, black tunic braided, and black trousers with a narrow red stripe, and looked very soldier like”.[vi]
Medically qualified dental colleagues whom Gaine met at Bristol during his medical training included Thomas Cook Parsons and Samuel Hayman, both of whom were also members of the Odontological Society of London and would play key roles in developing dental education in Bristol.[vii] The Western Counties Dental Association, of which they and Gaine were founder members, had been created in 1879 but in 1880 it had voted to merge with the newly formed British Dental Association thereby becoming its first branch. Cook Parsons was the first SW Branch President, Gaine becoming its third in 1883.
Gaine became actively involved in the British Medical Association of which he was elected Branch President in 1886.[viii], [ix] Like his mentor Ball, he was concerned that dentistry should remain a surgical speciality and not become a separate profession.[x] In 1875 Gaine had been made a member of the Dental Reform Committee whose efforts would eventually lead to the passing of the Dentists Act of 1878. However, in April 1877 when it became clear that the exclusive rights of medically qualified surgeons to practise dentistry were to be denied, he and a number of others resigned from the Committee.[xi]
By the time of his death at 1 Norfolk Crescent Bath on 19th December 1914, Gaine’s wife and children had all predeceased him and his former regiment had sailed for duties in India. It is therefore not surprising that the long-retired Charles Gaine had no published obituary apart from a few lines in the Bath Weekly Chronicle. His ashes were scattered near the memorial he had built for his wife and children in Lansdown cemetery (Figure 4).
Article by Prof. Chris Stephens
Edited by Dr Roger Rolls
[i] Obituary: The late Mr. Thomas Bell,FRS.Nature 1880; 21: 499-500.
[ii] Neale R S. Bath 1680-1850 . A social history. Chapter 8. Routledge and Kegan Paul Ltd, London, 1981.
[iii] ibid Vol III, p 428.
[iv] Gaine C. Treatise on certain irregularities of the teeth with cases illustrative of a novel method of successful treatment. Bath: C W Oliver, 1858.
[v] Gaine C. Plastic operation on the palate. Lancet 1862; 80: 205.
[vi] Kilvert R.F. The Kilvert Diaries. Vol 1. Plomer, W (ed) Jonathan Cape, London,1938 ,p.358.
[vii] Saunders C J G. The University of Bristol Dental School and Hospital. p8. Bristol: The Board of Governors of the United Bristol Hospitals, 1964.
[viii] Gaine C. On the effects of dental disease. BMJ 1886; 2: 249.
[ix] Gaine C. A Proposed Dental Section. BMJ 1889; 1: 562.
[x] He had joined the Association of Surgeons Practising Dental Surgery in 1876.
[xi] Gaine C. Dental Reform (Letter). The Lancet 1877; 109: 701-2.