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. 
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’.  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’.  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!