The Rotten Tooth: A Brief History of Dentistry

The sharp pinch of a large needle piercing the tender flesh inside the mouth. The high-pitched sound of a drill shattering tooth enamel. The metallic taste of blood. The smell of antiseptics.  The loss of sensation in the lips, tongue, and cheek. The swelling, the bruising, the pain.

For many, there is nothing to be dreaded more than a trip to the dentist’s office.

So it probably came as a surprise when I asked Dr Timothy King to take pictures of a procedure I was undergoing this past week. After all, most people would like to forget the experience as soon as it is over. But as I lay there—my mouth stretched into an inhuman grimace—I started to think back to the 17th century, and to the barber-surgeons who used to be the guardians of oral health.

Just like today, tooth decay was an unpleasant part of life in the past. Unlike today, however, there was not a lot that could be done to prevent it. Most people who found themselves with a toothache ended up in the hands of the local barber-surgeon, who would then extract the rotten tooth sans anaesthetic. Before the 18th century, this often involved tying a string around the tooth; a drum might be played in the background to distract the patient, getting louder as the moment of extraction grew nearer.

To advertise their services as ‘tooth-pullers’, many barber-surgeons hung rows of rotten teeth outside their shops. In 1727, the poet John Gay, wrote:

His pole, with pewter basins hung,

Black, rotten teeth in order strung,

Rang’d cups that in the window stood,

Lin’d with red rags, to look like blood,

Did well his threefold trade explain,

Who shav’d, drew teeth, and breath’d a vein.

As time wore on, new techniques were invented for extracting teeth. The tooth key (right) was first mentioned in Alexander Monro’s Medical Essays and Observations in 1742. The claw was placed over the top of the decaying tooth; the bolster, or the long metal rod, was placed against the root. The key was then turned and, if all went well, the tooth would pop out of the socket. Unfortunately, this did not always go to plan. Often, the tooth shattered as the key was turned and had to be plucked from the bleeding gum tissue piece by piece.

Of course, the loss of a tooth could leave a person aesthetically challenged.  Wealthy patrons were increasingly unhappy to go around in public with missing teeth. In the 18th century, surgeons began experimenting with implants. Patients who could afford it might choose between ‘live’ or ‘dead’ teeth.  With the former, the recipient would have his or her rotten tooth removed before a ‘selection of donors’, who would then have their own teeth extracted until one was found that was ‘deemed acceptable in appearance’. Afterwards, the tooth was inserted into the empty socket and fixed using a silver wire or silk ligatures. [1]

Although desirable, having a ‘live’ tooth implanted into one’s mouth was a costly endeavour. For the thrifty costumer, teeth extracted from the mouths of the dead proved cheaper. According to one resurrectionist, ‘It is the constant practice to take the teeth out first…because if the body be lost, the teeth are saved’. [2] During the 19th century, a good set of teeth could fetch as much as 5 guineas. Indeed, the practice was so profuse that one Professor of Anatomy at Trinity College remarked, ‘very many of the upper ranks carry in their mouths teeth which have been buried in the hospital fields’. [3]  Unfortunately for some unlucky recipients, syphilis and tuberculosis were unknowingly transmitted into their mouths from infected donors.

Dentistry, as we understand it today, did not emerge as a licensed profession until the end of the 19th century. That said, one need not suffer in the past with a toothache as long as a barber-surgeon was at hand. For little cost and a lot of pain, the rotten tooth could be extracted and put on display in front of the barber’s shop.

As Dr King began drilling into my tooth, I was blissfully unaware of any pain.  In fact, sitting there in the heated office as the novacaine worked its magic, I nearly fell asleep.

I have never felt happier to live in the 21st century… Although I do think Dr King should consider putting the rotten teeth of his patients on display outside his office door!

1. Roger King, ‘John Hunter and The Natural History of Human Teeth: Dentistry, Digestion, and the Living Principle’, Journal of the History of Medicine and Allied Sciences 49 (1994), p. 510.

2. York Chronicle, 1831. Originally quoted in Ruth Richardson, Death, Dissection and the Destitute (1987), p. 67.

3. Quoted in Richardson, Death, p. 106.

By | 2012-05-04T09:30:58+00:00 May 4th, 2012|Casebooks|22 Comments


  1. allhomosapienswelcome May 4, 2012 at 2:45 pm - Reply

    Very interesting! I love all of your posts, and I look forward to the next one! I’m so very glad that I don’t live in the 18th century just because of dentists. With the number of teeth that have been pulled from my head, I hate to imagine what it would have been like back then. *grimace*

    • The Chirurgeon's Apprentice May 4, 2012 at 2:59 pm - Reply

      Thanks for your kind words! I agree – one of the worst things about living in the 18th century would have been the lack of anaesthetics when having teeth pulled!

  2. Scott Moore (@scottmoore) May 4, 2012 at 5:26 pm - Reply

    Do you know if, when extracting teeth of the teeth were rolled toward or away from the center of the mouth?

    Also, I recently came across these articles about the Apothecaries Act of 1815 and the emergence of dentistry as a profession. Thought it might be of interest to folks.

    Ethics: How the Apothecaries Act of 1815 shaped the dental profession.
    From: British Dental Journal 193, 627 – 631 (2002)

    Part 1. The Apothecaries and the emergence of the profession of dentistry

    Part 2. The chemist–dentists and the education of dentists

    • The Chirurgeon's Apprentice May 4, 2012 at 5:31 pm - Reply

      Hi Scott – unfortunately, I’m not sure what type of technique was used when pulling teeth. Thanks very much for the article references! I will read them with relish (while nursing my sore jaw).

  3. nightsmusic May 5, 2012 at 4:42 pm - Reply

    Unfortunately, when I was young, we had no “extra” money for dental anything so most of my fillings and pullings were done sans anesthetics. I think that is the single most reason why I shudder to think of even getting my teeth routinely cleaned now, though of course, I do.

    I’ve often thought I was born in the wrong century. Then I read something like this and am reminded how fortunate I am these days.

    You write about the most fascinating stuff. Thanks for another great post.

    • The Chirurgeon's Apprentice May 5, 2012 at 4:54 pm - Reply

      Thanks for your kind words! The past is often romanticized by Hollywood – but when I think of the 17th or 18th centuries, I can’t help but think of the barber’s shop with his bloody rags tied outside the shop.

  4. jorobco May 10, 2012 at 12:50 pm - Reply

    Great post. The image here that strikes* me most is the drum. I refuse to believe that the barber-surgeons didn’t have a little fun with it; coming up with beats that they thought might distract better than others, sharing tunes with their peers. It’s actually a great idea for a musical genre – “anaesthetic groove”. There’s an album in this I’m sure.

    * I couldn’t help myself.

  5. […] painful story behind the history of dentistry Share this:TwitterFacebookLike this:LikeBe the first to like this post. From: Uncategorized […]

  6. T (@ToscaSac) May 24, 2012 at 2:24 am - Reply

    There is a book you can find on Amazon and on the web about healing or curing tooth decay naturally so as to not need as much dental care. I am fascinated that they used to implant donor teeth. Oh man I would love that. I had a tooth pulled last August and I have one that…the words root canal follow the diagnosis of an abscess about, that is capped. I will not get a root canal and other wise things seem normal so for now…I need that book plus raw milk & butter.

  7. […] Lindsey Fitzharris of The Chirurgeon’s Apprentice brings smallpox into her dissecting room, and a peek into the history of dentistry. […]

  8. […] Lindsey Fitzharris, the Chirurgeon’s Apprentice, uses her own dental procedure as a starting point for a discussion of the history of tooth decay, dentistry and anesthesia. […]

  9. Tom George September 12, 2012 at 2:31 pm - Reply

    Amazing article related to dentistry that how time change which make the life easy in every walk. In past visiting the dentist and getting treatment was a scary thing, but now a days it is quite easy and comfortable to go dentist and gets a treatment without any pain and awful procedure. Even now a days
    Full Dentures , Dental implants, crown and bridge and others surgeries are doing without pain.

  10. Tochi success January 7, 2013 at 6:16 pm - Reply

    More interesting facts about dentistry

  11. Charliehorse March 12, 2013 at 9:13 am - Reply

    The PAIN is still there! Are you kidding me? If you do not have the $400 per half-hour for the IV Sedation— you feel, hear, & experience EVERYTHING that anyone did in the 18th Century!
    Yes, DDS had Novacaine & Lidocaine THEN & they have those TWO ‘courtesies’ NOW—to people without the BIG BUCKS for IV Sedation! anyone WITH extra financial ability to AVOID this excruciating pain DOES so!
    Last week, I paid $380 per 1/2 hour IV sedation & had my throbbing, infected, & cracked molar pulled—–no pain at all! BUT, THAT IS ONLY because I was able to afford the anesthesia!
    If ONLY our President Obama had not been blindsided by the Republican Congress & given the ‘green light’ to pass the TOTAL Health Care Bill (including Dental) with a full public option — then, MAYBE, by now, we would be well on our way to ADMITTING that our mouths, teeth, etc. ARE TRULY a part of our BODY— & our overall physical/medical health. Maybe DDS care would NO LONGER be ALLOWED to be considered a separate ‘body entity.’. Maybe by now, 2013, DDS care would not be billed as a Insurance Coverage with an archaic & ridiculous Annual Cap of $1,500 maximum per human (which, by the way, is the same $1,500 coverage Americans enjoyed WAY back in 1961 — think about THAT & how HAPPY THAT makes Delta and other DDS Insurance Compnies!). It’s NOT the Dentists that want our insurance to stay in the “middle ages,” it is the Dental Insurance Comanies that LOVE this—- as they sell their $1,500 Max policies to OUR employers as a perk! We need to demand that DDS insurance increases to meet the times WITHOUT Any increase to our employers as these DDS Ins Compnies have enjoyed 50+ yrs NEVER raising the COVERAGE to meet inflation nor even tried to keep-up with Medical Insurance!
    Listen!!! Tooth rot affects the entire body & it can affect the HEART very fast! It’s time USA merges DENTAL CARE into our MEDICAL CARE!

    • Super Man September 8, 2014 at 4:05 am - Reply

      You need sedation? Are you kidding me?
      The “novocaine”(not used anymore) kills ALL pain. There is ZERO feeling when you are getting any work done. Who cares about the sounds? If you are feeling pain, your dentist is a quack.

  12. Charliehorse March 12, 2013 at 9:18 am - Reply

    It is STILL the 18th Century as far as Dental Health Anesthesia & Insurance $ Coverage.

  13. I was looking through some of your blog posts on this site and I believe this site is real informative! Keep posting.

  14. […] The Rotten Tooth: A Brief History of Dentistry […]

  15. Matt Bugaj November 1, 2013 at 2:25 pm - Reply

    seatbelts:reckless driving

    there is a desired amount of pain/death that seems to make the human experience feel normal. you start making dental health easier, people will figure out how to kill their teeth quicker. you make crashing a car safer, people will drive faster and get into more twisted crashes. humanity is so weird.

  16. Andrew Hamilton December 28, 2013 at 2:35 pm - Reply

    Excellent article. Reminds me of the Sweeny Todd. Im researching implants so doing a bit of reading . Incidentally, I found this article quite informative too (skip the first few paragraphs)

  17. Fitzharris InsuranceLifeAct | LifeAct December 5, 2014 at 5:50 pm - Reply

    […] The rotten tooth: a brief history of dentistry « the […]

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