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Historical Romance Writers Dishing the Dirt on Research

15 August 2008

Medieval Dentistry


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.]

10 Comments:

Blogger Kalen Hughes said...

*shudder*

I know I was surprised as a kid to learn that George Washington had wooden dentures!

2:18 PM  
Blogger Maire Jolie said...

I think I might pass out. Pardon. I think the room went black. I have an abnormal childhood fear of dentists. But I must agree, our ancestors were hardy! For goodness sake women had mastectomies without anesthetics.

Like Kalen, I too *shudder*

And wtg for braving your own bit of dentistry

7:50 PM  
Blogger Kathrynn Dennis said...

Yep, and in the middle ages, one-dentist-fit-all species. ;-)

Same tools used on Friar John would have been used on Lord Smith's destrier.

10:22 PM  
Blogger Tracy Grant said...

Lynna, sympathies on your dental surgery--glad it went well! And fascinating about historical dentistry. Have you seen "Shakespeare in Love"? There's a scene where Viola's nurse bring her a sort of tooth pick to clean her teeth.

11:32 PM  
Blogger Doreen DeSalvo said...

Ouch! Lynna, I had that same gum-graft surgery over a decade ago so I feel your pain. I confess I shuddered through the details of the history of dentistry. Fascinating post!

12:34 AM  
Blogger Pam Rosenthal said...

Shuddering and fascinated along with the rest...

And talk about shuddering -- someone should refresh my memory here, but weren't false teeth made from real teeth taken from corpses fallen in battle? (At least at Waterloo, the battlefield being overrun with scavengers in the wake of the fighting)

6:44 AM  
Blogger Louisa Cornell said...

OUCH! Lynna! Here's to a speedy recovery. I too have a deep seeded fear of the dentist, but this post was fascinating. It was great to meet you at Nationals btw, Lynna. Ladies, Lynna gave me a really helpful and insightful crit in one of the first contests I entered and it went a long way toward making me a better writer.

Now, one thing I will NEVER be is a good dental patient. Teeth from corpses, Pam? EWWWWW

6:56 AM  
Blogger Lynna Banning said...

Re: teeth from corpses. For false teeth they also used teeth from calves... but pity the poor calf! They just dug out whatever tooth they wanted, roots and all,
and ... well, it even makes me shudder.

8:39 AM  
Blogger Scott said...

Dentistry hasn't been my forte so this might not be super-rigorous, but there are examples of false teeth made from carved ivory, dead or live animals (dogs were also popular) which may have been reshaped or teeth from human cadavers (not just dead soldiers). All would have been placed in some kind of bridgework as they wouldn't stay in the mouth otherwise.

And if the thought of a corpse's teeth in your mouth is unsavory, the 18thC saw the rise in popularity of tooth transplantation. Again, animal teeth were sometimes used, but just as likely impoverished children would receive a little money to have their teeth extracted and immediately implanted in the mouth of the paying patient.

Wendy Moore has a chapter covering tooth transplantation in her biography of John Hunter (1728 1793), "The Knife Man". Here are a couple of her secondary sources:

Tooth transplantation: a controversial story
Henry W. Noble*
http://tinyurl.com/68j9mm

The Strange Story of False Teeth
By John Woodforde
http://tinyurl.com/5qgez7
(Not all of it is online)

Back to the medieval era, tooth decay was often blamed on the tooth-worm which was treated by counter irritants and smoke. From Tony Hunt's presentation of Roger of Parma's surgery (ca 1200), "A cautery is to be applied to the fontanel. Then seeds of henbane and leek are placed over coals and the patient made to inhale the vapour through a tube or funnel." The fontanel is the top of the head and would have been the counter-irritant (the belief being that a new wound would reduce the inflammation and pain of toothache) and the smoke to directly attack the "worm". (from Tony Hunt, _The Medieval Surgery_)

3:28 PM  
Blogger Samuel said...

Lynna, good to hear that your dental surgery went well.

I also shuddered at the thought of medieval dentistry although quite shocked that they knew a lot. But still, it's a good thing that dentistry nowadays isn't as barbaric as before. And dentists (Bartlett) are always finding and improving ways to a healthy smile.

6:57 PM  

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