At the start of the 21st century, Melbourne's population enjoys better dental health than ever before. The decay rate in children's teeth has fallen significantly over the past 30 years and people are keeping their own teeth for longer, so that the expectation of being edentulous in old age is no longer valid.
In the late 19th century there were many improvements in dental technology and materials, mainly emanating from the USA. The activities of the Odontological Society of Victoria, the 'Odonto' (1884) - the first of its kind in Australia - helped in the passing of the Dentists Act 1887, which provided for formal professional registration. But unregistered dentists were not barred from practice until 1910. Odonto members helped to establish the Melbourne (later Royal) Dental Hospital in Lonsdale Street (1890). Formal dental training, as opposed to private apprenticeship, began in 1897 at the Australian College of Dentistry (ACD), which affiliated with the University of Melbourne in 1904. From 1907 the ACD and the Melbourne Dental Hospital shared premises in Spring Street, relocating to a new building on the site of the old Haymarket in 1963. The ACD was wound up in 1967 and the Royal Dental Hospital moved again, this time to Swanston Street, Carlton, in 2003.
Dental health has been historically poor in industrialised societies, particularly among working-class children, due to cheap sugar products and refined flour. In the first half of the 20th century, dental fillings were slow, expensive and painful and general and local anaesthesia were mostly reserved for extractions. It became common practice to have all teeth removed and dentures made in young adulthood. The theory of focal sepsis, whereby infected teeth and gums were said to cause many other illnesses, gave medical respectability to such treatment.
After World War II the numerically inadequate dental profession disavowed the theory, although the public's expectation of full dentures took longer to dispel. The invention of the air-turbine drill in 1957 made the filling of teeth faster, less traumatic and relatively cheaper. At the same time the Australian Dental Association began lobbying for fluoridation of the water supply to reduce the incidence of dental caries and hence the need for treatment from the under-resourced private and public sectors of the profession.
In the 1970s Melbourne's water supply was fluoridated, two-year trained dental therapists began treating primary-school children, advanced dental technicians were able to make dentures for the public and the number of dentists on the Dentists Register increased. All these had a gradual but profound effect on dental health and people's expectations of it. Another significant factor has been the introduction of fluoridated toothpaste. Since the 1970s there has been an increase in the number and nature of dental specialists, following a similar trend in medicine, and in 1989 dental hygienists, who clean teeth and gums and instruct in oral health, were permitted to work in Victoria. The creation of a Bachelor of Oral Health course at the University of Melbourne and regulatory changes have further enhanced their roles.
Today dental aesthetics has become as important as dental function and this concept has been fostered by television, film and commercials. The focus of dentistry has therefore changed from the repair or replacement of broken-down dentitions to that of enhancing appearance and function and maintaining healthy dental and oral tissues for a lifetime.