We live in a very privileged age. The world might be more over-populated than ever, but we’re also living longer and staying healthier long into our old age. More importantly, we don’t need to fear the reaper just because we contract a mild infection or require some minor surgery.
If you witnessed dental surgery from a few hundred years ago, you would be shocked and even horrified. It would also make you rethink those dreams of traveling back in time and living like a Roman general or English royalty!
In the past, we’ve taken a deep dive into the history of toothpaste, mouthwash, and toothbrushes on this blog. We have talked about the rudimentary tools that our ancestors used to clean their teeth and we’ve also spoken about the bizarre and downright disgusting ingredients used in toothpowders and pastes. For this guide, we are going to be a little more morbid as we delve into the history of tooth extractions and uncover some bloody and brutal practices.
If you have a weak stomach, this guide is not for you!
Ancient Dentistry
Before we look at dentistry in the Bronze Age, a time when great civilizations were built and medical science advanced leaps and bounds, let’s go a little further back.
Prior to the age of agriculture, when humans settled down in large groups and grew crops to feed their families and the wider community, we were hunter-gatherers. We had very basic tools, nothing was written down, and as we lived in many isolated groups, we didn’t have the means to pass on medical knowledge.
You couldn’t just pop down to the town dentist because there was no town and there definitely wasn’t a dentist. If you had a problem with your health, whether because of tooth decay, bumps and bruises, or broken limbs, you likely visited the equivalent of a shaman. A few magic spells, prayers, and herbs later and you just had to cross your fingers and hope that the problem went away.
The good news is that tooth decay would have been very rare. The human diet consisted mainly of game and whatever fruits, berries, nuts, and seeds that they could forage. They may have eaten insects and likely ate flowers and tubers as well.
Early humans ate what they could get because there was no guarantee they would have food the next day. Also, in nomadic societies, there was very little opportunity to raise herds of animals, which meant no milk, cheese, or butter.
They didn’t consume an abundance of carbohydrates as we do today. There were no refined sugars, and their diet was generally much more tooth-friendly.
Of course, they still encountered issues. For instance, early humans often salvaged as much from slain animals as they could, which means they would eat the organs and use the pelts. They also ate the bone marrow, giving them some of the essential nutrients that they needed to grow.
All of that ripping, tearing, and gnawing would have placed their teeth under great strain and they may have suffered from fractures and toothache every now and then.
They may have even benefited from early dentistry, although it’s hard to say as very few tools have survived from that period.
The Age of Agriculture
For a long time, the earliest proof of dentistry tools came from a dig in Denmark around 3,000 BC. That changed a couple of decades ago when a dig in Pakistan uncovered the oldest dentist drill in the world.
The “drill” was made of wood and tipped with tiny flint heads, before being attached to a bowstring to allow it to revolve rapidly. It rotated around 20 times a second, which is incredibly impressive when you consider that the drill was dated to between 5,500 BC and 7,000 BC.
To put that into perspective, the Great Pyramid of Giza is believed to have been constructed around 2,600 BC. It means that the people who invented and used this drill were as old to the Pyramid builders as those crafty Egyptians are to us.
Scientists didn’t just find a basic tool and then make assumptions about how it was used. They actually tested it and found that it could quickly and expertly drill holes into human teeth.
Excavators also found 300 skeletons at a nearby burial site and discovered that 9 of them had holes in their teeth that had been drilled with the implement. Surprisingly, some of these holes were drilled in the back of the mouth, which means they wouldn’t have been visible. It’s an important footnote, as it means that the holes were drilled for medical reasons and not for aesthetics.
And if you thought that was interesting, there’s more.
The holes were deep enough to expose nerves and excavators believe that the holes may have been filled with some kind of resin or cotton, replicating a modern filling. In other words, the people in this area of Pakistan could have been drilling through decay to remove the problem before filling the exposed area to protect the nerve.
They also noted that drugs could have been used as anesthetics or analgesics. The area is famous for its opium production and that has remained the case for many years, so it’s not a stretch to assume that they used the opium latex to soothe their woes. After all, our ancestors often used flowers and fauna for sustenance and medicine, and if that community had grown up surrounded by opium, they might have figured out its medicinal properties.
Those properties would have been very useful, as well, because while the drill was efficient enough to drill holes in just a couple of minutes, the pain would have been unbearable in that time. The drill would have sent vibrations throughout the skull and a little opium would have made it significantly more tolerable.
Ancient Empires (Greeks, Egyptians, Romans)
In around 5,000 BC, between 500 and 2,000 years after the Pakistan drill was being used to terrify and heal desperate patients, a Sumerian text referred to “tooth worm” as being the cause of dental cavities. It makes sense when you consider that dental caries often present as holes, not unlike the ones that worms leave in the ground and on vegetables.
The idea that cavities were caused by worms persisted for thousands of years and was mentioned by Indian and Egyptian writers. It was even believed on the other side of the world, in China and Japan. Even Homer—the great Greek poet who penned the earliest books in Western literature—wrote about worms that caused toothache.
Some of the treatments for getting rid of tooth worms included rinsing medicinal concoctions and inhaling smoke made from seeds and herbs.
Thankfully, this wasn’t a view that was shared by everyone and it began to fade during the enlightening period that was the Bronze Age, where information, ideas, and even dentists/doctors spread across the Mediterranean.
Some of the biggest changes occurred several hundred years later during the age of Hippocrates, a man often dubbed the Father of Medicine and one who lived during Greece’s Classical age.
Hippocrates believed that tooth decay came from within the tooth, likening it to similar processes of decay within the body. Of course, he wasn’t to know that the decay was triggered by unseen forces both outside and inside the body, but his beliefs were revolutionary, nonetheless, and it meant that he saw rotten teeth as a problem that needed to be removed.
Hippocrates and his students used forceps to remove the teeth, ripping them out with force and then hoping that the body healed free from infection. On the plus side, Hippocrates understood the need to keep patients clean and to ensure that the healing process was gentle and kind. This was long before doctors knew anything about germ theory, and Hippocrates’s belief system led to him focusing more on “balancing the humors” than curing symptoms.
But there were still some herbs and medicines that he could use to keep them clean and sterile while easing their pain, including copious amounts of alcohol.
The Greeks also used metal wires to stabilize the jaw following fractures and they even fashioned prosthetics. They weren’t the first to use these tools as the earliest known dental prosthetics came from the Etruscans, an Italian civilization that predated the Romans.
Speaking of the Romans, when it came to dental treatments and tooth extractions they did what the Romans did best and copied everything from the Greeks. Of course, they added their own spin as well and used some of their medical knowledge to make extractions a little less painful and more manageable.
Aulus Cornelius Celsus, a Roman medical writer born in 25 BC, wrote about dentistry in his book De Medicina. The book goes into detail about ancient medicines, treatments, and nutrition, and is one of the oldest (and best) surviving medical encyclopedias. A lot of what we know about the Romans and their medicinal practices comes from Celsus.
He wrote about narcotics and other strong drugs, including opiates, and he also recorded his attempts at oral surgery. It’s likely that teeth were still being pulled as soon as they were cracked or showed serious signs of decay, but at least doctors had some kind of pain relief to give their patients.
Celsus also wrote about his attempts to fix misaligned teeth, scribbling away in his book as he used his patients like guinea pigs for the betterment of doctors everywhere.
Not only does the book provide historians with a lot of information from the turn of the millennium, but it was also used by doctors for nearly 1,000 years after Celsus’s death.
The Bloody and Barbaric Middle Ages
When you think of barbaric and bloody tooth extractions, your mind probably goes to the middle ages. As noted above, brutal tooth extractions were a thing long before the dark ages and even the classic age, but things certainly took a turn for the worse during these times.
Europe was constantly at war. Disease and poverty were rife, and populations were booming. There wasn’t a lot of time for sentimentality—if you had a problem, it had to be removed.
For many years, monks would assume the role of makeshift dentists and perform tooth extractions. They acquired the skills and experience needed to perform many dental treatments and as they were men of god, they were trusted to perform them expertly, combining medicine and spirituality to create treatments perfectly suited for such god-fearing people.
Eventually, the job shifted to barbers. They were skilled with tools. They were used to working closely with patients, and so they seemed like the perfect fit. Also, the men at the top didn’t want monks getting their hands dirty with the blood of their subjects.
But barbers were far from skilled surgeons. In fact, tooth extractions were performed with heavy iron pliers, similar to the ones being used by the blacksmiths of the time.
The iconic barber pole actually stems from this profession. The red represented blood and the white represented bandages. It wasn’t a reference to dental work and actually came from bloodletting, another role assigned to barbers during the middle ages, and one that was used to treat a host of diseases and ailments.
By this time, the average diet had shifted considerably and while sugar was still very rare, bread and other starches were more common. Many citizens had rotten teeth and were in dire need of treatments, and so barbers would often advertise their services and make all kinds of grand claims.
They would often promise a “pain-free” solution, only to deliver one of the most torturous experiences of the individual’s life.
Even if the tooth was extracted without issue, it wasn’t the end of the patient’s woes as infections were common. They didn’t know anything about germs back then and they weren’t the cleanest, either. In fact, cleanliness had taken a nosedive since the ancient Greeks and Romans and even doctors didn’t care too much about being clean and sterile.
You needed a little luck to escape an infection after having a tooth pulled, and the pain and consequences of that infection were often a lot worse than any toothache.
The Onset of Decay
In the middle of the 14th century, tooth decay was the last thing that the world’s biggest population centers were worried about. The Black Death was ravaging the planet and would eventually kill between 30% and 60% of the total population of Europe. Even before and after the deadly 7-year period in which the bubonic plague made its mark, disease was still rampant.
There were many outbreaks of plague and other diseases throughout the time and there were also prolonged periods of famine. The populace was weak, and tooth decay/gum disease was rampant as a result.
The 15th century also saw the introduction of refined sugar into Europe, although it would be another couple of centuries before it became cheap enough to find its way onto every breakfast table.
Between 1300 and 1800, the world experienced one of its bloodiest and most barbaric periods where dentistry is concerned. Even Queen Elizabeth I was known to have many rotten teeth and as dentists had more patients to work with, they began to get a little more creative with their implements.
A device known as the “pelican’s beak” was used during this time. Shaped like the beak of a pelican, it made it easier to grip the tooth, allowing the surgeon to yank it out. This was followed by a dental key, a mental instrument with a wooden handle that could grip, turn, and then pull the tooth. It sounds barbaric, but it was a very ingenious tool and made life easier for the patient and the doctor.
The Advent of Modern Dentistry
In the 19th century, dentistry took on a more modern aesthetic and was treated with the respect that it deserved. It stopped being the preserve of monks and barbers and dental schools began appearing all over the world. Tools improved and, more importantly, anesthetic was used, often in the form of ether.
In the early 20th century, local anesthetics were introduced, which meant that the patient could be completely pain-free as the dentistry treated and/or removed their tooth. Patients were also placed on clean beds and not dusty floors, and germ theory became the dominant theory of the day.
Of course, there was still one big problem: infection. Fast extractions, sterile tools, and a clean environment could only do so much, especially when many doctors and patients still hadn’t fully grasped the need for good hygiene.
But antibiotics were just around the corner.
Penicillin was invented during the Second World War and was initially used to treat wounded soldiers, before becoming available to a wider populace.
It changed the game more than dental keys, forceps, and even dental drills. It meant that getting surgery wasn’t like flipping a coin and it opened the doors for many new opportunities and for a new age of dentistry.
