(Coinci)DENTAL: The Terrifying History of Dentistry

I’m one of those tediously uber-rational types who disavow all superstitions, pseudoscientific claims and assertions of cosmic destiny.  As far as I’m concerned, with 7 billion people bumbling around the planet, the odds of spooky ‘I-bet-you-can’t-explain-that’ stuff happening on a daily basis are actually pretty high. It’s surely just statistical probability that coincidences will fling themselves into our laps, but being gullible creatures we respond by looking skywards and blaming the alignment of the planets.  Belief in ghosts, déjà vu, prophetic dreams, and celestial pre-determination are all just psychological blips in our internal operating systems. Frankly, we’re just installed with shoddily-coded software.

Still, I can’t deny that there was a weird moment of doubt on my part when I received a text one afternoon in late 2012. I had spent the morning researching the ghastly history of dentistry for my book A Million Years In A Day, and had scared myself stupid with tales of surgery in the days before anaesthetic, when suddenly my phone chirruped to say a text message had arrived. It was from my dentist, asking if I wanted an appointment?

Coincidental? More like coinciDENTAL! (sorry…). Still, despite my refusal to believe in any supernatural influence over this quirky happenstance, the timing of the message did make me think. For many of us a trip to the dentist is still fraught with nervous anxiety. Fillings aren’t terribly pleasant, root canal is still seriously painful, and even a basic check-up requires the curious indignity of reclining awkwardly while a stranger pokes PVC-clad fingers and polished metal scrapers into your gaping mouth. No-one enjoys the dentist, but we go because the alternative is far, far worse.

Horrifyingly, people have been saying the same thing for millennia. The unanaesthetized torture of historical oral surgery sounds like the sort of thing we might now see only in depraved horror movies, but for the patients it was the lesser of two evils.  Toothache is agonizing and debilitating to the point of despair, and it always has been. There is evidence dating back 8,000 years that suggests dental drilling existed in the Stone Age – a rather telling indication of the lengths people would go to for relief – and a Neolithic era jaw from Slovenia even had a beeswax filling applied to a cracked tooth, presumably to mollify an exposed nerve.

Two millennia ago, dentistry was fairly advanced but surgery could be truly horrific. The Romans had to rely on natural anaesthetics such as burned henbane seeds, which produced a woozy trance-like state, or various blends of opium, beaver musk, mandrake root and cinnamon. Alternatively, another technique to quell localised pain was to apply pressure to the nearest major artery, which, in the case of toothache, meant squeezing the carotid artery until the patient passed out. This, if done with too much gusto, might accidentally starve the brain of oxygen, thereby inducing swift death.

The brilliant Aulus Cornelius Celsus was one of the great medical writers of his age his list of dos and don’ts of surgery would have made even Freddy Kruger wince. Though he advised medicines as a first defence, to extract a tooth he advised cutting back the gum and then rocked the offending chomper back and forth until it loosened up because “it is very dangerous to extract a tooth that is tight, and sometimes the jaw is dislocated.” But the cautionary tales weren’t over yet, and he warned against the perils of wrenching, snapping, and yanking teeth – all of which might cause severe blood loss or bone fracture – and also for the dentist to be wary when drawing out the upper teeth, as a loose grip could result in the dentist accidentally smashing the patient in the face with his forceps.

Perhaps this explains why Celsus himself – and the battered and bruised patients – avoided the agony of surgery, and why several ancient writers offered a bizarre assortment of alternative cures for the terrified or untrusting.  Galen was arguably the most influential of all the Roman physicians, and was an arch-exponent of Hippocrates’ theory of the Four Humours in which illness was caused by an imbalance in the body’s levels of black bile, yellow bile, phlegm, and blood.  While he may have been the first to discover nerves in dental pulp – the cause of all that agony – his recommendation for toothache cures were less impressive, involving medicines comprised of hare’s brains or dog’s milk.

The brilliant natural philosopher, Pliny the Elder, also looked to nature for remedies, telling sufferers to catch a frog under a full moon, open its mouth and spit into it while saying, “Frog, go and take my toothache with you!” Pliny was a superb scholar, and it’s unfair to mock him for what seem rather eccentric beliefs, though it didn’t help his historical reputation that he coined the phrase “fortune favours the brave” shortly before sailing towards the erupting Mount Vesuvius. His subsequent death measured highly on both the Richter scale and my patented irony-o-meter.

Still, while Pliny’s life ended abruptly, his list of natural dental treatments was pretty lengthy. For example, a loose tooth could be coerced back into its stable position by hanging a frog from the jaw (did he hang out near ponds a lot?), and nor was the rest of the animal kingdom safe from Pliny’s enthusiastic suggestions. The Egyptian hobby of chewing a sliced mouse corpse received his lukewarm endorsement, as did the suggested oral application of a lizard jaw removed during a full moon, powdered wolf’s head, hare’s ear bone, pig’s trotters, donkey’s milk, or the teeth of a hyena. One gets the feeling that, if he were alive today, Pliny would almost certainly be banned from London Zoo…

But he wasn’t just a menace to the animal kingdom. Even fellow humans could be transformed into medicine – sore gums might be alleviated with a little rubbing from the extracted tooth of a man who had died violently, while various herbs and grasses could also have curative effects, but only if grown in a plant-pot made of an upturned human skull. Thinking about it, Pliny would have been banned from most modern garden centres, too…

More recently, in 1578, Queen Elizabeth I suffered such toothache that it gave her sleepless nights but she cowardly refused to have the tooth pulled until the Bishop of London volunteered as a guinea pig to prove it wasn’t such a tormenting operation. She finally relented and the offending tooth was ripped out, but she would still spend the last few years of her life shuffling around the palace with her finger in her mouth, trying to quell persistent pain from her other rotten teeth.

The 18th century was the oral hygiene nadir, with the mass introduction of sugar destroying teeth in their tens of millions and dental surgeons responding in brutally crude fashion. Once the decayed dentition had been prised out of bleeding jaws they needed to be replaced so that people could chew their food. George Washington, the hero of the American Revolution, possessed several sets of false teeth made of animal bones (including hippo ivory) and gold.  Other Georgian solutions included falsies made of teeth yanked from the mouths of dead soldiers – so called Waterloo teeth – or even the transplant of a child’s tooth into the recipient’s mouth. This required a child to donate his/her tooth in return for a few pennies, essentially exploiting the poor for their body parts – it’s lucky organ transplants weren’t possible back in the 1800s.

Even the invention of anaesthetics in the 19th century didn’t totally conquer the discomfort of dental surgery, or the commonality of trips to the dentist. Indeed, these days we go more often than ever before, preferring a regimen of precautionary check-ups to the drama of leaving things to get progressively worse until bloody, terrifying intervention is required. Yet, despite our electric toothbrushes, flossing kits, anti-bacterial mouthwashes and daily oral hygiene regimens, many of us will still require additional dental work beyond the mere scraping and polish. Just this year I had my first filling, and having received this text message from my dentist, I’m now fearful I may need another… prepare the beeswax!