Nearly 10,000 years ago at least 11 people living in a neolithic village in Pakistan had holes drilled into their teeth and presumably survived the experience. Since then, archaeological findings throughout the world have proven that dentistry is one of the oldest medical professions, and already being practised by 7000BC.
The history of dentistry has often been associated with gruesome tales of tooth drawing using any old pair of pliers lying around, often done by anybody willing to give it a go, or local blacksmiths and barbers doubling up as back-street dentists. Teeth pulling was often the only treatment offered for tooth ache, and the pain endured is evident from surviving sketches and early photographs. However, alongside the itinerants carrying out tooth drawing, medical practitioners throughout the ages worked to develop dentistry and oral care into the profession that it is today.
Dentistry as a specialism emerged in the eighteenth century, pioneered by the French surgeon Pierre Fauchard (1678 – 1761). Downplaying mere extraction, Fauchard paid attention and developed expert and refined techniques including drilling, filling, transplanting, dentures, cosmetic tooth straightening and the wider surgery of the gums and jaw. However, as far back as the 1st century, Spanish-born Albucasin (936 – 1013) had already written a 1500 page medical compendium on various medical areas including dental procedures.
The advent of microscopy in the 17th century allowed the detailed study of the structure of teeth, and early experimentation with laughing gas (nitrous oxide) heralded a new era of pain-free tooth pulling.
During the early part of the 20th century, advances in surgical techniques meant that surgeons began attempting operations on organs and lesions that previously would have been left alone. This attitude towards believing that all manner of diseases could be cured by chloroforming the patient and applying the knife extended to dentistry, where it was believed that pockets of pus, leading to focal sepsis, were lurking in the body and needed surgical extraction, led to a renaissance in the routine to extract teeth. The belief that these focal sepsis led to mental health ailments explains why in the early part of the 20th century it became routine to extract teeth, sometimes all the teeth, of patients in psychiatric hospitals, a belief that over time was abandoned.
Evolution of our relationship with our teeth
This rich history of dentistry is explored in a new exhibition, 'Teeth', by the Wellcome Collection (London), which traces the evolution of our relationship with our teeth and the pursuit of a pain-free mouth.
‘Teeth’ features over 150 objects including paintings and caricatures, ancient protective amulets, toothpaste advertisements and a range of chairs, drills and training tools, and examines the tensions surrounding tooth-care, whether for health, comfort or confidence.
The exhibition considers tooth-care for both rich and poor. It includes the hygiene set used by Queen Victoria’s dentist, as well as a rare picture of her smiling, dentures belonging to King William IV and Napoleon’s toothbrush. Paintings depict the barber-surgeons and blacksmiths who performed extractions for the less privileged, with caricatures by Thomas Rowlandson contrasting the suffering of the poor with the ostentatious smiles of the wealthy as they display new, gleaming dentures.
Emerging technologies in the 19th and 20th centuries led to a more industrialised approach to tooth care. The exhibition charts the changing availability and affordability of consumer products such as toothpastes and brushes, as well as the evolution of dental drills, the use of x-rays and the advent of anaesthetic. Giant teeth and oversized teaching tools reveal techniques used for training dentists, who practised on large models before tackling the intricacy of a human mouth.
The idea of oral hygiene as a right and a responsibility is also explored. Following World Wars I and II and the birth of the NHS in 1948, poster campaigns, films and animations outlined how responsible adults should look after their own, and their children’s, teeth.
A selection of letters to and from the Tooth Fairy reveal the very particular relationship children have with the gaining and losing of teeth, and how parents, dentists and new technologies can help combat dental anxiety.
As the only visible part of the human skeleton, teeth are intrinsically linked to identity, both individual and cultural. An ancient Mayan tooth embellished with jade and a set of contemporary grillz reflect a desire for adornment.
TEETH runs from 17 May to 16 September 2018. Further details available at: https://wellcomecollection.org/exhibitions/WgV_ACUAAIu2P_ZM
Sources: Porter R (1999) The Greatest Benefit to Mankind. Fontana Press, London; https://www.nature.com/articles/4813555
The photograph illustrating this article is a wood and ivory figure group depicting a tooth extraction, 17th century, Science Museum / Science & Society Picture Library