By Margaret Wilson
In the history of UK dentistry many pages have been written about the evolution of dentistry from an unregulated trade into a profession requiring registration, education and examinations. However, the reform of dentistry would not have occurred without the involvement of some unsung heroes.
In the 1870’s there was no name better known to the dental world in the UK than Sidney Wormald, the dentist from Stockport1, yet his name and contributions have subsequently been overlooked. His activities. which resulted in the Manchester Movement were the driving force that began the reform of dentistry.
Early attempts to reform of the dental profession
In the early part of the nineteenth century there were numerous discussions about the need to regulate the dental profession. Many people who called themselves dentists were untrained; their knowledge had not been tested in an examination and there was no regulation or register of those dentists who had undergone training. Many attempts had been made to address these problems, but all were unsuccessful
The beginning of the Manchester Movement- the first Manchester Meeting 1875
It wasn’t only the well-known dentists in London, Messrs Tomes, Nasmyth and Saunders who were pushing for reform. Others were concerned about the lack of regulation of the profession, and the lack of places to study outside of London.
Although many dentists were concerned about this dilemma, there was no real positive action until October 1874 when Sidney Wormald, an ordinary dentist from Stockport and Frank Huet, a well-known dentist from Manchester attended a distribution of prizes ceremony at the Dental Hospital of London. In their conversation, they remarked about how much studying a young dental student was required to complete in order to pass the examination of the Royal College of Surgeons of England. They also observed that there was little incentive for aspiring dentists to study and take an examination when there was no regulation of the profession and anyone could call themselves a dentist.
They decided there and then to work together to achieve reform2. Frank Huet was also concerned about the lack of dental treatment for the poor. In 1875 he had tried to establish a dental hospital in Manchester, but due to local opposition had to wait until 1883 for this facility to be established3.
True to his word in August 1875, Sidney Wormald called together and personally paid for the notable meeting in Manchester, which started the “Reform Movement”. The reform of dentistry was referred to as “The Manchester Movement” because the first meeting was held at 2.00 pm in the Clarence Hotel, Spring Gardens, Manchester. The meeting was attended by over 75 dentists mostly from towns and cities in the North of England but also dentists from other parts of the country. Sidney Wormald opened the meeting and declared that originally, he had only planned to make the meeting local, with only one representative from the local towns, but the response from interested dentists had been so great he had opened the meeting widely.
A gentleman dentist from London had informed the meeting that he brought good wishes and support from leading professional dentists in London. Sidney Wormald then called on his friend Mr Frank Huet, to propose a chairman for the meeting. Frank Huet was well known in Manchester and had originally been asked to chair the meeting, but when he discovered that Mr Charles James Fox was planning to attend, he stood back in favour of Mr Fox, the editor of the British Journal of Dental Science. The reason behind this change of plan was that it was very clear that the Reform of Dentistry would need to be supported throughout the country and it was thought that Mr Fox would be more widely recognised. By the end of this first meeting, it was agreed that the goals for the reform of dentistry would be that:
- All existing practitioners shall be registered
- No one can recover fees as a dentist unless so registered
- After a fixed date none shall be registered unless he possess a diploma.
A Reform Committee was formed representing all parts of the country to see what steps could be taken to arrest the continual influx into the profession of illegitimate practitioners by the adoption of the principles of registration and compulsory education. The result of the Manchester Meeting was the fusing of provincial and metropolitan forces and the formation of the Dental Reform Committee. It is also without doubt that the reform of dentistry had its origins in Manchester with the impetus of the reform having been originated and then driven by Sidney Wormald.
Over the next years, the Dental Reform Committee met mainly in London and struggled to agree on the terms of reference4. Many of the original supporters of reform held medical or dental diplomas and were insistent that only practitioners who had passed a dental diploma could call themselves dental surgeons. However, the vast majority of established working dentists held no formal qualifications. Resignations from the committee were sent by Messrs Cartwright, Saunders, Fox, Smith and Coleman. As a result, John Tomes, despite his failing health, was persuaded to take the chair. Again, this development was supported by Sidney Wormald. In the Reform meeting of 1877, John Tomes noted that progress for a dental diploma, open to established practitioners, was well advanced in the Irish College and there was no reason why the Edinburgh College could also start awarding dental diplomas.
Diplomas for existing practising dentists – the second Manchester Meeting May 1877
The need for formal dental education and an examination to test that knowledge before awarding a qualification had been generally accepted. Young dentists could attend formal courses and enter for the LDS examination held by the RCS Eng. Since 1859, permission had been given to RCS Eng. to examine and confer a licence upon dental practitioners. The first sitting of the LDS was in 1860. However, that did not help the many dentists who were working around the country, who had not been unable to receive any formal education, could not be resident in London for two years and who now had well established practices. There were also dentists who had not bothered to sit formal examinations as there was no register of dentists so little incentive to sit for a qualification.
The problem was that the RCS Eng. would not allow those existing practicing dentists who had not had formal education to sit their examination. Without a qualification these dentists could not be registered and would find it difficult to distance themselves from quacks and opportunists.
It was known that there would soon be legislation in the form of a Dentist’s Act which would require all dentists to be on the register and to have a qualification. There was a need for urgent action. Once again Sidney Wormald called a meeting of dentists, again in the Clarence Hotel Manchester, on 6th May 1877. The objective of the meeting was to consider the best methods of providing a qualification which would be within the reach of existing reputable practitioners. John O’Duffy of Dublin reported the efforts being made by the dental profession in Dublin to induce the Royal College of Surgeons in Ireland to institute a dental diploma. A committee was set up by Sidney Wormald to collect subscriptions and the names of gentlemen desirous of possessing the diploma. Sidney Wormald became the Hon treasurer of the newly formed Dental Diploma Committee.
“The College in London had, with true British dignity, long since closed its doors except to pupils per curriculum-, and with real British obstinacy practically refused every appeal for a re-opening. Again, our honest friend at Stockport solved the problem, and in Manchester, in May, 1877, to awaken some interest in this matter, applied himself bravely to the task. Another meeting was called and endeavour, if possible, to induce the College of Surgeons in Ireland, or one of the other licensing bodies of Great Britain, to appoint an examining board for dentists, and issue licence5.”
The Dental Diploma Petition Committee
After Sidney Wormald’s meeting in Manchester in May 1877, the Dental Diploma Petition Committee held a series of meetings all over the country. The venues were: Leeds, Bristol, Edinburgh and Norwich. The committee was particularly concerned at the lack of qualified dentists in the provinces. The objectives of the meetings were to inform dentists about the resolution of the meeting in Manchester and of the efforts being made in Ireland to establish a Diploma which could be taken by established dentists6. The meetings were addressed by Sidney Wormald and Dr W H Waite of Liverpool. At the meeting in Leeds on June 30th 1877 Dr Waite reminded dentists that no substantial improvement in the position of dentists would be effected” “until we provincials who are in reality the great majority in the profession, roused ourselves and took vigorously in hand the great work of Dental Reform, The English diploma was meant to benefit the whole of the profession, but this has failed”6.
Dr Waite considered this as failure because at that time there were 2000 men practising dentistry in Great Britain and Ireland. The RCS Eng. Diploma began in 1859. Between 1859 and 1863, 240 men were admitted to the Diploma on payment of the fee and passing a formal examination. From 1863, 129 students had followed the curriculum and taken the Diploma, making a total of 369 gentlemen who had the Dental Diploma. Of these 172 lived in and around London with only 197 in the provinces. Sidney Wormald described the situation in Manchester where there were over 220 dentists but only five held the LDS, two by curriculum and five by grace. When you also included all the towns between Macclesfield and Rochdale, there were 310 dentists but only seven had LDS. Clearly the restrictions for entry into the Diploma of the RCS Eng. were detrimental and had an even greater adverse effect on dentists living outside London.
In July, 1878, the ” Dentist’s Act ” passed both houses of Parliament and received the Royal assent. ” From and after the first day of August, 1879, a person shall not be entitled to take or use the name or title of dentist (either alone or in combination with any other word or words), or of dental practitioner, or any name, title, or description, implying that he is registered under this act, or that he is a person specially qualified to practice dentistry, unless he is registered under this Act.”
The LDS RCS in Ireland
After all the deliberations, it was the Royal College of Surgeons in Ireland (RCS I) that set up a diploma that established dentists with no formal education other than an apprenticeship could take. The title of the examination was to be the Licentiate in Dental Surgery of the Royal College of Surgeons in Ireland7. In September 1878 at the RCS I in Stephen’s Green. Some of the best-known dentists of England, Ireland, Scotland and the Channel Islands obtained the LDS RCS I. As reported in the Irish Times, it was stated that “the RCS in Ireland conferred a very great boon upon the Englishmen who had been debarred from obtaining a qualification or degree in their own country”.
Beyond the Dental Reform Committee and the formation of the BDA
With the passing of the Dentist’s Act in 1878, the Dental Reform Committee had completed its role. But there was a need for a national dental association, similar to the British Medical Association, to represent both provincial and London dentists. In March 1879 a meeting of dentists was held in London, chaired by John Tomes. It was resolved the Dental Reform Committee should become the Representative Board of a new organization called the British Dental Association which was established in 1880. At the formation of the Midland Branch of the BDA, Sidney Wormald became its treasurer, a post he held for 10 years scarcely missing a single meeting1.
Sidney Wormald 1823 (about)- 1898
Born in about 1823 he was the son of a blacksmith. As a dentist he had a considerable practice in Stockport especially in mechanical dentistry (prosthetics), even before the introduction of vulcanite. In the 19th century, Stockport was a town south of Manchester in Cheshire. To this day the town is dominated by a large brick viaduct, built in 1840 to carry the main line railway from Manchester to Birmingham and London. The arrival of the railway in Stockport gave Sidney Wormald the opportunity to travel throughout Great Britain addressing gatherings of dentists on matters relating to Reform, Education, Examination and Registration.
Sidney Wormald’s education in dentistry would have been as an apprentice. His first mention in Stockport was in White’s 1860 Directory of Cheshire where he is listed under the category Surgeon Dentist at 30 Wellington Road South, Stockport. The problems he faced when trying to obtain a qualification and registration were that he had no formal education had not taken an examination and he had advertised himself as a dentist in the local newspapers, some of the adverts being more than just a name and address.
In 1876 Sidney Wormald wrote to the Journal of Dental Science, stating that he had applied for an LDS at the RCS Eng.- only to be refused as he had advertised 11 years previously. He was very annoyed by this refusal and vowed to change the system for himself and other dentists in the same predicament. Despite being rejected by the RCS Eng., as were many other practicing dentists who wished to be registered, he turned his attention to persuading the RCS I to establish an examination for existing dentists without any formal education.
Sidney Wormald entered the first sitting the LDS of the Royal College of Surgeons in Ireland. In the Dentists Register of 1879, he is recorded as having the qualification Licentiate in Dental Surgery of the Royal College of Surgeons in Ireland dated 1878. When Sidney Wormald and his colleagues passed their LDS examination in Ireland it was on the distinct understanding that they had not advertised for the past two years and would not advertise in future8.
Sidney Wormald was an ordinary dentist working in a northern town. He was a successful practitioner and easily could have just continued working in his dental surgery. Instead, and despite the fact he had no formal education, he saw the need for dentists to distance themselves from the rogues and quacks who were preying on the unsuspecting public. He had the foresight to realise that formal training and examination leading to a recognised qualification resulting in registration of the profession was the way forward. He knew that there were many other established dentists who wished to be registered and rather than sit back and do nothing he started the Manchester Reform Movement.
After the initial meetings he travelled all around the country at his own expense, meeting dentists and gathering support for the need for education and training leading to registration. Then when faced with rejection from the RCS Eng. he turned to RCS in Ireland for help. When he achieved this goal, he was in the first group of dentists to subject himself to the new examination.
Having succeeded in these objectives he remained loyal to the institutions that had supported dentistry and was a supporter of efforts to establish dental schools in Dublin and Edinburgh. He was present at the inception of the British Dental Association and when the Midland Branch of the BDA was formed, Sidney Wormald became its treasurer, a post he held for 10 years. He was a true hero of our profession and someone that dental history must not forget.
- Waite WH, Br Dent J 1898; 19:701-702.
- Dental Reform, Registration and Compulsory Education, Brit J Dent Sci 1875;18:467-494.
- Wilson M, The establishment of a Dental Hospital and a Dental School in Manchester Dental Historian 2009; 49: 24-32.
- Dental reform Committee J Dent Sci 1877; 386-400.
- Journal of the BDA 1898; 19: 701-702
- Meeting of the Dental Diploma Committee in Leeds, J Dent Sci 1877; 367-386.
- Dental Cosmos 1878; 20: 687.
- J Dent Sci 1878 :500.