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Dentistry in Victorian times

Without proper care teeth may decay very quickly, but even in Paleolithic times - up to about 10,000 years before the present era – patients were already treated for their dental caries[1]. Still, being treated does not equal proper treatment at all and extraction of a decaying molar was almost the only treatment available for toothache until the middle of the 19th century.
People had to choose between the devil and the deep blue sea, because infections in your teeth might eventually form an abscess that may ate away a jawbone. The agony of the toothache would become too great to bear and in despair one would seek treatment.

If you were lucky there might be a tot of whisky to numb the pain but otherwise all that could be offered was a prayer. The result was that tens of thousands of patients died from botched treatment, infections and other complications. In 1665, the year of the Great Plague, the bubonic plague killed an estimated 100,000 people, almost a quarter of London's population in just 18 months. It is now estimated that one in ten of the non-plague related deaths in London were linked to toothache.

Until relatively recently rotten, painful and neglected teeth were a part of everyday life. Proper dentists didn’t exist until the 1800s and prior to that the care of your ivory was in the hands of blacksmiths and barbers who doubled as surgeons. They simply wielded pliers to pull decaying teeth.

However in the late 18th century more efforts were made to understand dentistry. In 1771, John Hunter, a failed doctor, published his book entitled 'Natural History Of The Human Teeth'[2]. In it he suggested a scientific approach and devised names for all the teeth, which are still in use today. But he also proposed transplanting teeth from the dead to the living and it soon became a craze. The rich paid the poor – especially children – to 'donate' their teeth. Unfortunately for some unlucky recipients, syphilis and tuberculosis were unknowingly transmitted into their mouths from infected donors.
The first drills were only introduced in the Victorian era. They rotated slowly but as a method of removing the rotten part of a tooth at least it was an alternative to the dreaded extraction. Nitrous oxide, also known as laughing gas, was the first chemical used for pain relief. This idea from Horace Wells (1815-1848) was soon discredited and other solutions tried, including chloroform, but doses were not precise and deaths were common.

Cocaine was also used as a painkiller and was injected directly into the jaw. The copper needles used were huge but it was a whole lot safer than chloroform and came with the added advantage of targeting the source of pain.

[1] Oxilia et al: Earliest evidence of dental caries manipulation in the Late Upper Paleolithic in Scientific Reports – 2015
[2] King: John Hunter and The Natural History of Human Teeth: Dentistry, Digestion, and the Living Principle in Journal of the History of Medicine and Allied Sciences – 1994

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