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Tuesday, May 21, 2013

Management of Jaw Injuries in the American Civil War

By Richard A. Pollock, M.D., University of Kentucky College of Medicine, Lexington, Kentucky
 
James Baxter Bean published a series of articles in the Southern Dental Examiner in 1862 describing his work with “plaster and its manipulations.” This early experience included a new way of managing jaw fractures, with customized splints uniquely based on pretraumatic occlusion. Bean's oral splints and their method of construction, using an articulator, became the standard of care in the Atlanta region during the American Civil War and, by 1864, throughout The Confederacy. In short course, Bean's approach also swept The Union, following in large part the efforts of a colleague in the North, T.B. Gunning. Thus, what began in the early 1860s in a dental laboratory in the southeast swept the continental United States and revolutionized management of jaw-fractures during, and immediately after, the American Civil War.
 
Bean was born July 19, 1834, in eastern Tennessee, attended Washington College in Limestone (in the tri-cities area of the State), and in 1860 graduated from the Baltimore College of Dental Surgery. He briefly practiced in Micanopy, Florida (south of Gainesville), and it was from there that he authored articles on “Plaster and its [Dental] Manipulations.” While awaiting publication of his four-part series in the Southern Dental Examiner in 1862, Bean moved to Atlanta, Georgia, to be closer to the South's only dental supply house, Brown & Hape, and to enjoy the stability of transactions in Georgia currency or in gold-and-silver coin.
 
After the fall of Atlanta to Union forces, the management of jaw injuries was relocated to a dedicated ward at the Blind School Hospital in Macon, some 90 miles south of Atlanta. Personnel and the resident dentist there were already versed in the ways of Bean.
 
IMAGE: The Bean splint
 

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