Medieval Dentistry: Ancient Methods for Modern Care

Dental care in the medieval period combined practical knowledge, superstition, and rudimentary techniques. Without an understanding of bacteria or anesthesia, people relied on herbal remedies, religious beliefs, and hands-on procedures to manage oral health. Despite their limitations, some methods laid the groundwork for practices still used today.

Examining medieval dentistry reveals early dental tools, treatments, and professional roles that influenced later advancements.

Common Beliefs About Oral Health

Medieval perspectives on oral health were shaped by humoral theory, religious beliefs, and basic observations. The dominant medical framework, based on Hippocrates and Galen, suggested that imbalances in the four humors—blood, phlegm, black bile, and yellow bile—led to dental decay and pain. Physicians recommended dietary adjustments to maintain balance, avoiding foods considered too moist or too dry.

Religious beliefs also influenced attitudes toward oral health. Many attributed toothaches to divine punishment or demonic influence, seeking relief through prayers, charms, and relics. Some made pilgrimages to religious sites believed to offer healing, and Saint Apollonia, the patron saint of dentistry, was frequently invoked for relief.

Beyond humoral and religious explanations, medieval individuals recognized external factors affecting dental health. They acknowledged food debris and plaque as causes of bad breath and decay, leading to rudimentary cleaning methods such as chewing herbs, rubbing teeth with cloth, and using twigs or bone tools to remove buildup. Some texts recommended rinsing with wine or vinegar as an early form of oral hygiene. However, misconceptions persisted, including the belief that worms caused cavities, a theory dating back to ancient Mesopotamia. This led to treatments aimed at “expelling” the worms, such as applying heated substances or herbal concoctions.

Tools And Materials Used

Medieval dental instruments were crude but functional, often adapted from general surgical or household tools. Lacking modern precision, practitioners used forceps, scalpels, and rudimentary drills made of iron or steel. Forceps, sometimes called “tooth keys,” were notorious for their brutal efficiency in pulling teeth, often causing fractures and additional trauma. Some included screw-like mechanisms to improve grip, but these frequently worsened injuries.

Files and rasps, made from iron and manually sharpened, were used to smooth jagged edges on damaged teeth. Bow drills, borrowed from woodworking, were adapted to bore into decayed enamel, though the procedure was excruciating without anesthetics.

Materials for dental care were largely natural. Heated metal rods or herbal pastes with caustic substances dulled pain and prevented further decay. Resin-based mixtures, sometimes combined with crushed bone or ground oyster shells, served as primitive fillings, though their effectiveness was limited. Beeswax was occasionally molded into cavities for temporary relief. Astringent solutions derived from vinegar, wine, or alum were used as early antiseptics to cleanse wounds and reduce inflammation.

Key Procedures For Dental Relief

Medieval dental treatments were often painful and invasive due to limited anatomical knowledge and the absence of anesthetics. Various procedures were developed to address decay, infection, and structural damage.

Extractions

Tooth removal was the most common dental procedure, often the only solution for severe pain or infection. Barber-surgeons used forceps or a “tooth key” to grip and twist the affected tooth until it loosened. Without anesthesia, patients endured extreme pain, sometimes numbed only by alcohol or herbal tinctures. If a tooth was deeply embedded or fractured, a chisel and mallet were used to break it apart before extraction.

Complications such as broken roots, excessive bleeding, and infections were frequent. Some practitioners cauterized wounds with hot irons or applied herbal poultices to reduce swelling and prevent infection. Despite the crude nature of these extractions, they remained a primary dental treatment for centuries.

Filing And Smoothing

When teeth became jagged or uneven due to decay or fractures, practitioners used metal files or rasps to smooth rough edges. These tools, repurposed from surgical or metalworking instruments, were imprecise and sometimes caused further damage.

Filing was also performed for cosmetic reasons, particularly among the wealthy. Some cultures engaged in decorative dental modifications, shaping teeth into specific patterns. However, excessive filing weakened enamel, making teeth more susceptible to decay and breakage. Without an understanding of enamel’s protective role, some individuals inadvertently accelerated dental deterioration. Despite its risks, the concept of reshaping teeth evolved into modern dental contouring techniques.

Poultices And Ointments

To reduce pain and swelling, practitioners applied poultices and ointments made from natural ingredients. These included herbs with analgesic or anti-inflammatory properties, such as cloves, myrrh, and sage. Clove oil was particularly valued for its numbing effect and was applied directly to aching teeth. Other poultices contained crushed garlic, onion, or mustard seeds, believed to draw out infection.

Some ointments incorporated animal-derived substances, such as ground bone or fat, mixed with plant extracts. While these treatments provided temporary relief, they did not address underlying infections, which often worsened. In severe cases, practitioners lanced abscesses to drain pus, followed by herbal salves to promote healing. Though largely based on trial and error, these methods demonstrated an early understanding of pain management and wound care.

Herbal And Organic Remedies

Medieval dentistry relied heavily on plant-based treatments for pain, swelling, and infection. Herbalists and apothecaries formulated remedies using ingredients with natural analgesic and antimicrobial properties. Clove oil, known for its numbing effect, has since been validated by modern research for its anesthetic and antibacterial properties due to its eugenol content.

Myrrh, used in mouth rinses and pastes, was believed to strengthen gums and reduce inflammation. Modern studies confirm its antimicrobial effects against oral pathogens. Sage was frequently boiled into infusions for mouth rinses, observed to reduce gum swelling and freshen breath. Recent research has identified its antibacterial activity against Streptococcus mutans, a primary contributor to tooth decay.

Licorice root, often chewed or ground into powders, was thought to prevent cavities. Modern studies highlight that licorice contains glycyrrhizic acid, which inhibits bacterial growth and plaque formation, aligning with its historical use.

Role Of Barber-Surgeons

Medieval dentistry was not a specialized profession but was instead handled by barber-surgeons, who performed a range of medical procedures alongside grooming services. They managed everything from bloodletting and wound treatment to tooth extractions and minor surgeries. Their role focused on practical interventions rather than preventative care, as they were primarily called upon when pain or decay necessitated immediate relief.

Without formal medical training, barber-surgeons learned through apprenticeships or battlefield experience, leading to varied effectiveness. Tooth extractions were their most common service, performed with iron forceps or the infamous “tooth key,” which could easily fracture the jaw if used improperly. Lacking anesthesia, patients endured excruciating pain, sometimes numbed only by alcohol or herbal concoctions.

Beyond extractions, barber-surgeons engaged in cauterization to seal wounds and prevent infection, though they lacked an understanding of microbial causes. Despite their crude methods, they were among the only accessible practitioners for most people, as trained physicians typically catered to the wealthy and rarely performed dental procedures. Their influence persisted for centuries, shaping early surgical practices until dentistry emerged as a distinct medical field.