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Dentists in ancient times: Finding cavities in early civilizations

By – Bad Breath Expert
Posted: May 28, 2015, Updated: December 19, 2017
SUMMARY: A look into early attempts at conducting proper dental care in ancient civilizations.

There was once a time when brushing teeth with fluoridated toothpaste, flossing and other dental hygiene practices weren't nearly as common as they are today. By modern day standards, a lot of the methods used by people in ancient civilizations might even be considered a bit unsanitary. Contrary to  popular belief, however, the study of fossilized teeth has unearthed evidence that supports the possibility of ancient dental practices not too different from those of today. 

Early examples of dentistry
Out of all of the dental practices that would make contemporary dental professionals turn their heads, the most surprising is probably the use of urine as a main ingredient in toothpaste. According to the Pacific Science Center, ancient Romans used the ammonia found in rather questionable natural substances as a means to whiten their teeth. The only catch is that this was often reserved for royalty that could afford to have the products brought in from Portugal. Many contemporary dental supplies still use ammonia. Other early civilizations were known to use pumice and toothpicks to clean their teeth.

Using a chemical to clean patients' teeth isn't the only practice used in  early civilizations that are somewhat similar to what people do all over the world today. In 2006, an archeological dig in Pakistan came across eleven preserved bodies that showed signs of tooth drilling from nearly 9,000 years ago. One of the teeth that was drilled even showed signs of post-drilling restoration. Also, after the realizing that the teeth had been smoothed over after the operations, it's believed that the patients went on to live their lives after the fact. Although the procedures may have not been as painless as they would be today, it is believed that they were done for therapeutic reasons.

"While some teeth had been drilled more than once, four showed signs of decay … suggesting a possible therapeutic intervention," said Roberto Macchiarelli, a paleoanthropologist at the Université de Poitiers and lead author of the National Geographic study. 

Dentists in ancient Rome 
Rome is known for having advanced medical practices for the period when it was one of the world's leading civilizations. Roman medical practitioners were able to do things such as amputate limbs, perform caesarian sections and performing pelvic exams , according to Forbes. A bioarchaeologist named Marshall Becker has studied 86 teeth found in the Roman Forum in 1987 to discover that dentists in ancient Rome were removing decayed teeth with intentions of improving a patient's medical well-being. 

While Becker claims that documents full of information about dental care and the "careful instructions for the removal of diseased teeth" were widely used in ancient Rome, there isn't much physical evidence to support that claim. That was until he studied the teeth found in the drain that ran to a taberna, a single room store, were studied more closely. It was found that each tooth had at least one cavity that was the result of tooth decay. Some were so decayed that they were practically hollow. Now these teeth could be used as evidence of what the books touched on. 

Becker studied the teeth, searching for signs that would suggest tools were used to quickly remove them from the patient's mouth to relieve pain with urgency. Surprisingly, he found no marks on the teeth that hint at the use of heavy tools - which is saying a lot, given the relatively indelicate process of properly removing a tooth back then.

Based on De Medicina, a medical treatise written by Celsus, Roman dentists would remove teeth by loosening them  in the socket and removing part of the jaw that was attached to the teeth

"The person or persons who removed these teeth must have been quite experienced in the procedure," said Becker.

If Becker's findings are right, Rome is potentially the earliest purveyor of tooth excavation. Jars found on the scene are also believed to have once held pain relieving ointments for more intense dental procedures.

Appearances of early childhood caries in ancient civilizations 
While most of the teeth Becker found belonged to individuals well into adulthood, he did find some believed to have belonged to infants. This isn't surprising, given that a cemetery in Ancaster, England, dating back to 270-410 AD, provided researchers with insight into some of the worst dental health scenarios in ancient Rome, according to Forbes.

The researchers discovered the skeleton of a child that lived to be around three or four years old and had tooth decay that would traditionally be found in someone several years older. The researchers had a mystery on their hands: what could've led to a young child experiencing this level of tooth decay, where protective enamel was often severely damaged, if not completely missing? To rule out diseases that were common at the time, they compared it to symptoms of dental fluorosis, a result of excess fluoride exposure, perimolysis, which is caused by excessive vomiting, and dry mouth, caused by reduced saliva production. 

Caries, another word for cavities, are a result of sugary substances leaving room for bacteria to eat away at teeth and tooth enamel. After finding that  this particular child's skeleton wasn't victim to any of these common diseases, researchers figured that it may have been tied into the child's lifestyle. They believed that this example of early childhood caries, something that currently afflicts many of today's children in socioeconomically underprivileged environments, was a result of a diet consisting of large quantities of honey and porridge. 

During the second century, medical professionals would recommend raw honey as a way to wean young children off of breast milk and ease the pain of teething. Because this skeleton is presented as an isolated incident, however, the researchers feel that more was at play here. After finding results that suggest the child battled anemia, they believe it "suffered prolonged ill-health and/or poor nutrition with failure to thrive, and may have been fed for long periods with warm, sugary liquids as a compensation and comfort, or simply because normal chewing was painful." Luckily, the ways of handling early childhood caries have improved by leaps and bounds in modern day society.