Dental care in pre-contact was simple. For cleaning, Hawaiians rubbed wood ash or charcoal on and between the teeth and then rinsed their mouths.
Toothache and periodontal disease were treated with the root of the pua kala (poppy,) bitten into and held between the teeth. Teeth were extracted by pulling them out with an olona cord. (Schmitt)
Some extraction was done as part of mourning – prolonged weeping and sorrowful wailing marked the death of a loved one, distress upon the death of a respected leader was demonstrated by knocking out one’s teeth, cutting one’s flesh, tattooing one’s tongue, or cutting a section of one’s hair. (NPS)
It was found that the custom of knocking out the incisor teeth as a sign of grief for the departed was not prevalent, just over 17-per cent (more often resorted to by men than by women, and more prevalent on the island of Hawai‘i than on the other islands. The lower incisors were removed more often than the upper. (Chappel)
When Kalola died (grandmother of Keōpūolani (future wife of Kamehameha,)) Kamehameha and his chiefs entered into mourning for her. Her chiefs and others were full of grief and Kamehameha knocked out a front tooth (as did other chiefs.) (Desha) When Kamehameha died in 1819, Boki knocked out four of his front teeth. (Daws)
Western dentistry apparently started in the Islands with the coming of the missionaries. “Mr B has almost daily calls to extract teeth, let blood, administrate medicine, etc. If the mission should have perfect health, a physician might still be exceedingly useful at this, or any other station on the islands.” (Sybil Bingham Journal, February 14, 1822) (Bingham was a missionary, not a doctor or dentist.)
Just before, Sybil was a patient, “Feb. 5th. I have some confidence in the skill of my dear husband, or I could hardly have been prevailed on to sit down, as I did yesterday, to the extraction of a badly decayed tooth, given up as hopeless, a long time since.” (Sybil Bingham Journal, February 5, 1822)
Shortly thereafter, “Feb. 8th. Much distressed again, night before last, with the tooth ache. The seat of the pain was a large black tooth, so much decayed that I thought I never should have resolution to have it extracted.”
“But encouraged by the good success of Monday, I closed school last night and sat down as before, to the operation. Much to my surprise, like the other, it came safely out. I had taken an opiate–now went to bed–slept and was refreshed, and, today, find myself well and free from pain.” (Sybil Bingham Journal, February 8, 1822)
Hawai‘i’s first professional dentist of record was Dr MB Stevens, who appeared in December 1847 and advertised his services over a twelve-week period, and then dropped out of sight.
Dr. Stevens was followed by George Colburn, who arrived in Honolulu on September 20, 1849 and ran an advertisement in the paper; however, like his predecessor, apparently moved on. (Schmitt)
Hawai‘i’s third dentist, and the first to settle permanently in Hawai‘i, was John Mott Smith. Dr. Smith (who eventually acquired a hyphen between his middle and last names, becoming John Mott-Smith) was a New Yorker who studied dentistry by himself, using the textbooks of a friend who was then attending dental college.
After passing the State dental examinations, he located in Albany and practiced there for three years. He moved to California in 1849 and late in 1850 sailed to Hawai‘i. He arrived early in 1851 and remained an Island resident until his death 44 years later, after a distinguished career as a dentist, editor, and government official. (Schmitt)
Intimate friend of both King Kalākaua and Queen Lili‘uokalani, Dr Mott-Smith was an ardent champion of the monarchy and gave freely of his services to the kingdom
Here is a short video about Dr Mott-Smith, portrayed by Adam LeFebvre at a ‘Cemetery Pupu Theatre, sponsored by Hawaiian Mission Houses:
In 1866 Mott-Smith gave up his dental practice to John Morgan Whitney, the first in Hawai‘i to actually graduate from a dental school. Whitney, MD, DDS, was for more than fifty years regarded as Honolulu’s leading dentist.
“When I first came to my practice in Honolulu it was the custom for the physicians to give instructions to the dentist what to do. This I resented with considerable spirit …”
“… for as I said to them, ‘I have spent as many years in preparing for my specialty as you did for your general practice and under as severe discipline, and it is but commonsense that I should know more about it that you do who did not probably give it an hour of time in your full course.’”
“I had so much of this to contend with that I resolved to see for myself the foundation upon which they built their sense of such superior knowledge.” (Whitney; Pacific Dental Gazette)
Notwithstanding the growth in sophistication regarding dental care, standards for dentists remained low or nonexistent through most of this period. Licensing had been instituted for foreign physicians in 1859 and all physicians in 1865, for example, but until the last decade of the century no restrictions were imposed on the practice of dentistry.
‘An Act to Regulate the Practice of Dentistry in the Hawaiian Kingdom’ was approved on December 19, 1892; a three-member Board of Dental Examiners (one physician and two dentists) was created, and standards for licensing were established.
A new, much stricter ‘Act to Regulate the Practice of Dentistry in the Territory of Hawai‘i’ was approved on April 25, 1903. The new law established a Board of Dental Examiners, consisting of three practicing dentists, to be appointed by the Governor upon the recommendation of the Dental Society of Hawai‘i (formed 3-months earlier.)