If you dread going to the dentist now, imagine how our ancestors must have felt all those years ago. Let’s take a journey back in time where dentistry was more about bravery than it was about knowledge or skill – to a land where barbers and blacksmiths reigned king of the dental world, and modern anesthesia was nowhere to be found.
Dental Care in the Dark Ages: What We Know
At the time, there was no formal dentistry and the modern dental techniques and instruments that we know today ceased to exist.
In fact, barbers and blacksmiths actually doubled as “dentists,” and visiting them was not for the faint of heart. For those brave enough to seek treatment, the experience was more for survival than comfort. Whether they knew that untreated tooth infections can lethally spread throughout the body or whether the discomfort just became unbearable, these patients endured unimaginable pain during such visits. With gruesome procedures and no real understanding of tooth decay or gum disease, it makes me wonder how these people coped.
The fact that having all of your teeth was a rare sign of beauty and vitality tells us a lot about dentistry during the dark ages.
Tools of the Trade
Dental treatment of this age was extremely primitive, which is reflected in the tools that were used and relied upon (again, often by barbers!):
- Dental Pelican: Getting it’s name from it’s beak-like shape, this ominous sounding instrument had a long handle and a curved, claw-like hook on the end. Made of iron and steel, it was used to grip and pull out teeth. It not surprisingly often damaged surrounding teeth and gum tissue, while causing considerable pain.
- Tooth Plier: A far cry from today’s extraction forceps, these pliers were cumbersome and heavy. This tool was used to remove infected teeth, often inadvertently fracturing them and leaving fragments behind.
- Tooth Key: Another tooth removal tool, the tooth key was a large, heavy key made of iron or steel. It’s hook-like claw was placed around the base of a tooth and twisted to, hopefully, twist it out of it’s socket without breaking it.
- Chisels and Mallets: The most fearsome of all tools used for tooth extractions, chisels and mallets were used to bang against a tooth to break it apart before removal. Ouch.
- Bloodletting and Cupping Tools: Because barber-surgeons of the age believed that removing blood could restore balance to someone suffering from a tooth infection, lancets were used to cut the skin to “cleanse” the body. Suffice to say, this never worked.
As I’m sure you’ve noticed, almost all of these tools were used to perform crude tooth extractions. With no modern dental drills or dentists to expertly remove cavities and repair teeth, people of this age had no choice but to let their decayed teeth rot to the point of no return, and the teeth had to be removed (hopefully in a safe manner – though unfortunately for those that lived in this time – unlikely).
Herbal Remedies
Without modern medicine and pain-killers, medieval dentistry relied heavily on herbs to treat infections and alleviate discomfort. Herbal knowledge was widespread at the time, and many natural treatments were passed down among generations.
- Cloves: One of the most common toothache remedies of the time, the eugenol in oil of clove has analgesic (pain-relieving) and antiseptic properties.
- Myrrh: Used to sooth inflamed gums, myrrh is a resin from tree sap that has antiseptic and astringent properties.
- Sage and salt: With antibacterial properties, ground sage was typically boiled with salt to create mouthwash to help fight bacteria and relieve mouth sores.
- Rosemary: Both antiseptic and anti-inflammatory, rosemary helped treat gum inflammation and infection.
- Peppermint: As is it’s current use, peppermint was often used to freshen breath. It’s cooling effect also provided some relief from inflammation and pain.
The method of application of these herbs was often similar, with many being made into mouth rinses, powders and pastes, or poultices that could be applied directly to the gums or affected teeth. While these remedies were very limited in their ability to actually cure ailments, some were relatively effective in relieving symptoms. In fact, we still recommend salt water rinses (though we omit the sage) for post-surgical care.
Anesthetics and Infections, Oh My!
Most patients tell me that their least favorite part about visiting the dentist is the needles that we use for administering local anesthetic to numb the teeth and tissues. While this is understandable, looking back at what was used (or wasn’t) in medieval times – it makes me grateful that we even have such effective numbing agents in the first place.
Not only did patients of this time have to rely on barbers to perform clunky, violent tooth extractions with zero sterilization, but they had to feel the entire procedure. This was absolutely excruciating. The only minor relief available came in the form of alcohol and opium and primarily, physical restraint and distraction. Yikes.
To make matters worse – if you were able to sit through the entire agonizing experience – your chances of severe infection from the procedure were extremely high. Without any modern sterilization techniques, complications were inevitable and patients often developed abscesses and ongoing infections that sometimes resulted in death.
The Plight of the Poor: Dental Care Across Social Classes
While dental care was not ideal for anyone during this time, rich nobles still fared better than poorer peasants. Dental issues among peasants would often go untreated as they rarely had access to barber-surgeons while living in rural villages. Richer nobles, on the other hand, were able to receive visits from the most-skilled barber-surgeons of the time and, importantly, had access to alcohol and herbs as anesthetics.
Final Thoughts
Looking back at the harrowing and brutal methods of medieval dental treatment, dentistry has truly come a long way. From the unsterilized tools wielded by barbers and blacksmiths to the herbal concoctions used to dull toothaches, dental care in the middle ages was a far cry from the knowledgeable dentists and high tech equipment we often take for granted today.
So the next time you find yourself in a comfortable dental chair, take a moment to appreciate modern dentistry…and perhaps thank your lucky stars that an untrained blacksmith is not about to roughly pull your tooth out with zero anesthesia.
Cheers to the advancements of modern dentistry!
What would have been the hardest part for you about living in a time of medieval dental care?
~Dr. Lee
Sources: Anderson, T. “Dental treatment in Medieval England”. Br Den J 197, 419-425 (2004). https://doi.org/10.1038/sj.bdj.4811723