Last week I had some dental surgery work (don’t read this part if you’re squeamish); basically, it involved cutting out a small portion of roof-of-the-mouth tissue and suturing it onto the gum holding my lower front teeth in place. Sound awful?
While reclining in the dentist’s chair I started thinking about dental procedures in much earlier eras like Egypt and the Middle Ages. What did they know about filling cavities, or pulling teeth, or lancing abscesses, or ... ?
Turns out they knew quite a lot. Recovered jawbones show carie fillings, evidence of extractions, even wired-together bridgework among ancient Egyptians, Phoenicians, and the old Etruscans (500-700 B.C.) who preceded the founding of Rome. In one case, two incisor teeth were replaced by a single tooth from a calf, grooved to make it seem like two separate teeth.
In Roman times, gold caps were made of two plates of gold riveted together and then riveted to metal bands to hold the cap in place. One source holds that the reason one lady’s teeth are white and another’s dark is that White Teeth bought hers, and Dark Teeth still had her own! Fillings of wax, resin, and lead were used. Giovanni of Arcoli (Johannes Arculanus), a professor of medicine and surgery at Bologna and Padua (died 1484) mentions using gold as a filling material.
Much ancient knowledge was lost in the Middle Ages, though it never disappeared completely; Aetius, an early Christian writer on medicine and surgery, discusses extraction. Paul of Aegina and later Arabian physicians continued the tradition. Sophisticated dental instruments were used to fill teeth or extract them, even correct mouth deformities.
The 12th and 13th centuries experienced a great revival in surgery along with renewed interest in dentistry. One Guy de Chauliac, in his “Le Grande Chirurgie,” reveals that while his understanding of anatomy might be flawed, his discussion of the causes of dental decay is accurate: Don’t eat sweet, sticky foods; clean the teeth often but not too roughly; and avoid breaking hard things with the teeth.
Dental care included use of toothpicks (preferably made of cypress twigs), mouth washes (including rinsing with wine or a concoction of wild mint and pepper), ointments, and tooth powder made of ground cuttle bone, small white shells, pumice, burnt stag’s horn, nitre, alum, rock salt, iris root, and reeds.
Various instruments were used for cauterization, fillings, bridgework and extractions: scrapers, rasps, curved and straight spatulas, toothed forceps, probes, canulas (tubes to probe a cavity or tumor to release fluid), trephines (small circular saws with a center pin mounted on a metal shaft used to remove circular disks of bone or tooth), and files. Treatment of polyps involved making an incision at the root, drawing the polyp out with toothed forceps, and [gasp] daubing the stump with a hot iron or a cotton plug dipped in aqua fortis (nitric acid).
But, alas, no novocaine. Instead, copious amounts of wine and/or opium were used to dull the discomfort. Our ancestors must have been a hardy bunch!
[In contrast, my experience was not awful. I was in the chair at 10 a.m. and out at 11, and I didn’t feel a thing (aside from the initial poke of the novocaine needle). Oh, bliss. I was numb for about 3 hours and only then did it hurt. But I had ibuprofen and Tylenol and straws to drink smoothies through–all in all, I am a happy dental camper.]