Oral Health in the Pre-modern Era: Foul Breath, Missing Teeth, and Decay Oral Health in the Pre-modern Era: Foul Breath, Missing Teeth, and Decay Author Karen A. Preston Supervising Editor Kate McPherson Editor Kate McPherson Copy Editor Leah Hamby Senior Encoder Leah Hamby Encoding and Metadata LEMDO Team Copyright Holder (Content) Kate McPherson Copyright Holder (XML and interface) University of Victoria Early Modern England Encyclopedia EMEE

Anthology Leads: Kate McPherson and Kate Moncrief.

 Social Sciences and Humanities Research Council of Canada Mitacs Globablink Research Internship

Released with Early Modern England Encyclopedia 1.0a

 University of Victoria on the Linked Early Modern Drama Online Platform

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Early Modern England Encyclopedia

By Karen A. Preston, MAEd/AET, RDH, FHEA, inspired by Michael Best’s Shakespeare’s Life and Times, Internet Shakespeare Editions

Encoded in TEI P5 according to the LEMDO Customization and Encoding Guidelines

This document uses Canadian English spelling

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Michael Best is Professor Emeritus at the University of Victoria, BC. He founded the Internet Shakespeare Editions in 1996, and was Coordinating Editor until 2017, contributing two editions to the ISE: King John and King Lear (the latter also available in print from Broadview Press). In print, he has published editions of works of Elizabethan magic and huswifery, a collection of letters from the Australian goldfields, and Shakespeare on the Art of Love (2008). He contributed regular columns for the Shakespeare Newsletter on Electronic Shakespeares, and has written many articles and chapters for both print and online books and journals, principally on questions raised by the new medium in the editing and publication of texts. He has delivered papers and plenary lectures on electronic media and the Internet Shakespeare Editions at conferences in Canada, the USA, the UK, Spain, Australia, and Japan.

 Leah Hamby Leah Hamby

Leah Hamby is the primary encoder for the Early Modern England Encyclopedia. Aside from encoding, she also works as an editor for the project and contributed several articles of her own. She has been working on the EMEE since February 2023. As of February 2026, she is soon to graduate with honours from Utah Valley University with a major in history and a minor in creative writing. Her other work with the LEMDO program includes remediating William Kemp’s Kemp’s Nine Day’s Wonder for the Digital Renaissance Editions.

 Navarra Houldin Navarra Houldin

Training and Documentation Lead 2025–present. LEMDO project manager 2022–2025. Textual remediator 2021–present. Navarra Houldin (they/them) completed their BA with a major in history and minor in Spanish at the University of Victoria in 2022. Their primary research was on gender and sexuality in early modern Europe and Latin America. They are continuing their education through an MA program in Gender and Social Justice Studies at the University of Alberta where they will specialize in Digital Humanities.

 Kate McPherson Kate McPherson

Kate McPherson is Professor of English and Honors Program Director at Utah Valley University (Orem, UT, USA). In 2015, she began working to redevelop Shakespeare’s Life and Times, created by Michael Best, into the Early Modern England Encyclopedia. Her other publications include commentary on Pericles and The Comedy of Errors for the New Oxford Shakespeare (2016); the co-edited volumes Stages of Engagement: Drama and Religion in Post-Reformation England with James Mardock (Duquesne University Press, 2014) and Shakespeare Expressed: Page, Stage, and Classroom in Shakespeare and His Contemporaries, with Kathryn M. Moncrief and Sarah Enloe (Fairleigh Dickinson University Press, 2013). With Kathryn M. Moncrief, Kate has also two edited collections, Performing Pedagogy in Early Modern England: Gender, Instruction, and Performance (Ashgate, 2011) and Performing Maternity in Early Modern England (Ashgate 2008). She has also published numerous articles on early modern maternity in scholarly journals. Kate participated in the 2008 National Endowment for the Humanities Institute, Shakespeare’s Blackfriars: The Study, the Stage, the Classroom, at the American Shakespeare Center. She also served as Play Seminar Director, a public humanities position, for the Utah Shakespeare Festival in 2017 and 2018.

 Karen A. Preston Karen Preston

Karen A. Preston is a professor of dental hygiene at Utah Valley University. Prior to joining the faculty, she worked more than 20 years in the practice of Prosthodontist Dr. Gordon Christianson.

 LEMDO Team The LEMDO Team is based at the University of Victoria and normally comprises the project director, the lead developer, project manager, junior developers(s), remediators, encoders, and remediating editors. University of Victoria https://www.uvic.ca/
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 Royal Museum Greenwich.

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 All’s Well That Ends Well, 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 Guild, 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, Much Ado About Nothing, 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. (Much Ado About Nothing 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 Othello, 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. Teeth. Wellcome Collection, London, 17 May-16 September 2018. Design For Health vol. 2, no. 2, 2018, pp. 327–333. Taylor, Gary et al., editors. The New Oxford Shakespeare: Modern Critical Edition. Oxford University Press, 2016. Wynbrandt, James. The Excruciating History of Dentistry: Toothsome Tales & Oral Oddities from Babylon to Braces. St. Martin’s Press, 1998.
Key Online Sources Hue, Daniel Lee. The History Of the Barber Surgeon. The Barber Surgeons Guild. 6 Nov. 2017. https://barbersurgeonsguild.com/magazine/history-barber-surgeon/. Nix, Elizabeth. Why are Barber Poles Red, White, and Blue? History. 23 Aug. 2018. https://www.history.com/articles/why-are-barber-poles-red-white-and-blue. Queen Elizabeth I Facts and Myths. Royal Museums Greenwich. https://www.rmg.co.uk/stories/royal-history/queen-elizabeth-i-facts-myths. Accessed 16 May 2024.