Oral Health during the Premodern Era

Oral health in premodern Europe was not well understood. What premodern Europeans did know was that aching teeth and foul breath were widespread, noticeable, and offensive. No formally trained dentists were available for the care of teeth or oral tissues. People managed problems associated with oral health, in order to kill the tooth worms or even the demons they believed were the cause of tooth decay.

Tooth Decay in the Early Modern Period

Tooth decay, a longstanding illness with serious consequences, has afflicted humans since teeth existed. Before the 1800s, the cause of tooth decay was unknown. But tooth decay was rare in ancient times due to the absence of processed foods and sugar. As more advanced societies began to farm and produce more sugary foods, and esepcially once sugar began to be actively cultivated in the 15th century, tooth decay became a prevalent health issue.

By the early modern period, tooth decay was a widespread problem. Little instruction existed on practices like tooth brushing and caring for the mouth and gums. In England, Queen Elizabeth I had very poor teeth due to the amount of sugar available to the nobility, including the popularity of elaborate dessert buffets at feasts. Her teeth were eventually black with decay, and it even became fashionable for some women to darken their teeth as a status symbol, according to .

The Tooth Pick

One common method of oral care was the toothpick. Dating back nearly two million years, the toothpick is the oldest tooth-cleaning tool. This discovery was noticed on an ancient hominid that bore distinct marks made by tooth picking (Petroski). The toothpick during the early modern era might indicate high status depending on what it was made from. Toothpicks for the commoner were made from wood and porcupine quills. The wealthy had picks made from precious metals ornamented with gems. It was fashionable at one time to wear the toothpick and pick one’s teeth at a dinner.

In the play , the rogue Paroles quips that Virginity, like an old courtier, wears her cap out of fashion: richly suited, but unsuitable: just like the brooch and the tooth-pick which wear not now. (1.1.132–134). Apparently, toothpicks fell out of fashion as an accessory at some point and so Paroles makes a joke about it.

Early Treatments for Toothaches

Dental treatment during this era was poorly managed and several ways existed to treat aching and rotten teeth. Self-treatment (extraction): Self-extraction of a tooth was done with fingers. Fingers grabbed the decayed or infected tooth and wriggled it back and forth for removal. Removing it would be time-consuming and painful. It was the earliest tooth removal technique and is still used today. Herbal: Herbs and spices were used to treat toothaches. Herbal mouthwashes treated foul breath. People chewed on fennel seeds, cloves, and mint leaves, which also to helped bad breath. Clove oil, for instance, has a mild anesthetic effect, numbing the area where it is applied. There is evidence that tooth powders and paste also were used during this era. The paste was rubbed on the teeth with a strip of cloth. Tooth-drawer: This person, a dentist traveled from village-to-village advertising tooth removal to rid sufferers of their tooth pain. They would set up shop and use theatrical displays of treatment to trick people into believing the tooth could be pulled with no pain. They were widely considered charlatans. The etching from 1523 depicts a tooth drawer extracting a tooth on a man who is being pickpocketed. However, there were also many tooth drawers who were legitimate and skilled in the removal of teeth. Barber: Not only did barbers cut hair, but they also extracted teeth. Because of the sharp tools they had on hand, barbers often also did small surgical procedures such as treating ingrown toenails, setting some basic bone fractures, tooth pulling, and bloodletting. The traditional barber pole colors of red and white still used today were a symbol of bloodletting and small surgical procedures (Nix). According to the , Barber surgeons were considered the medical and grooming experts in Europe throughout the Middle Ages and into the Renaissance. Blacksmith: During the 1700’s blacksmiths had side jobs as dentists because they had tools and upper body strength used in the tooth-extraction trade. In the image below, a blacksmith turned tooth drawer uses horse-shoeing pincers from his shop. Notice the hammer on the wall and the anvil in the foreground.

More Toothaches and Foul Breath in Shakespeare’s Plays

An aching tooth and foul breath are mentioned repeatedly in early modern plays, indicating the pervasive understanding of dental pain. In Shakespeare’s play, , Leonato exclaims, I will be flesh and blood; for there was never yet philosopher that could endure the toothache patiently, however they have writ the style of gods and make a push a chance and sufferance (5.1.33–37). No amount of wisdom spares someone from suffering when a tooth is aching.

When teasing Benedick about his low spirits, the men in the play also have this exchange: Benedick: Gallants, I am not as I have been. Leonato: So say I. me thinks you are sadder. Claudio: I hope he be in love Don Pedro: Hang him, truant! there’s no true drop of blood in him to be truly touched with love: if he be sad, he wants money. Benedick: I have the toothache. Don Pedro: Draw it. Benedick: Hang it! Claudio: You must hang it first, and draw it afterwards. Don Pedro: What! sigh for the toothache? Leonato: Where is but a humour or a worm. Benedick: Well, every one can master a grief but he that has it. Claudio: Yet say I, he is in love. ( 3.2.11–23)

Shakespeare uses the common pain of toothache, and the common treatment of tooth extraction, as Benedick’s excuse for being downcast, but his friends know better that it is pains of heartache, not toothache.

In , Iago uses dental pain as a reason why he hears Cassio talking in his sleep about the intimacy with Desdemona: I lay with Cassio lately; and, being troubled with a raging tooth, I could not sleep (3.3.407–409). This false information is used to manipulate Othello’s emotions, planting distrust. Shakespeare often referenced human ailments and discomfort to add realism or humor to the characters in his plays.

Key Print Sources Gooding, Jo. . vol. 2, no. 2, 2018, pp. 327–333. Taylor, Gary et al., editors. . Oxford University Press, 2016. Wynbrandt, James. . St. Martin’s Press, 1998.

Key Online Sources Hue, Daniel Lee. . . 6 Nov. 2017. https://barbersurgeonsguild.com/magazine/history-barber-surgeon/. Nix, Elizabeth. . 23 Aug. 2018. https://www.history.com/articles/why-are-barber-poles-red-white-and-blue. . . https://www.rmg.co.uk/stories/royal-history/queen-elizabeth-i-facts-myths. Accessed 16 May 2024.