"The instruments used for extraction are large pincers which grasp the tooth and do not let go their hold even if the patient shrieks as much as he likes...Then the dentist takes a crooked, knobbed instrument, with which he loosens the tooth with difficulty and causes horrible pain. Then he takes another kind of instrument, similar to a hammer, with which he strikes the pincers from above and drives home the tooth a little more at each blow. And the greater part of the time, the patient is overcome by the pain, and shrieks dreadfully."
—1728 text The Surgeon Dentist by French dentist Pierre Fauchard
Throughout most of recorded history, dentistry remained a rudimentary practice grounded more in superstition than science.
The often excruciating and even life-threatening dental treatments endured by past generations underscores the tremendous advances made in modern dentistry.
By examining some darker chapters from the long history of dentistry, we better appreciate how far this healing art has progressed in recent centuries.
Prior to the 1840s, receiving dental care was an agonizing and dreaded experience.
The surgical extraction of rotten or damaged teeth, in particular, was a traumatic procedure that tested the limits of a patient's fortitude.
Without access to anesthetic agents like nitrous oxide or ether, the only resources for dulling pain were alcohol, opium, or physical restraints.
Patients faced a stark choice—endure the merciless agony of an extraction, or allow the decay to progress further, often sealing their fate to systemic infection.
When forced to undergo an extraction, patients steeled themselves against the impending onslaught of razor-sharp instruments prying and tearing at fragile teeth lodged deep within swollen gums.
The crescendo of pain reached a nearly unbearable zenith when the practicing dentist braced his knee against the chair for leverage, yanking and wrenching the tooth from its socket in a burst of blinding pain.
Patients reeled from the shock, as blood gushed from the newly hollowed space in their gum-line. Quick work was the dentist's only mercy, though his speed amplified the procedure's savagery.
Those fortunate enough to survive the initial agony then faced weeks of inflammation and throbbing discomfort as the disturbed tooth socket slowly healed.
Though dentistry has since progressed remarkably, the ominous memory of extraction's torture lingered over patients for decades after anesthetics became routine.
The introduction of modern pain management blessedly ended extraction's reign as dentistry's most feared and barbarous procedure.
The curious practice of harvesting human teeth from the dead to fabricate replacement dentures for the living emerged in the late 18th century.
Even America's first president George Washington had dentures made from teeth extracted from slaves.
With no means of artificial fabrication, dentists relied on the grim trade in cadaverous teeth pulled from battlefields, graveyards, and the mouths of the exploited.
This ghoulish commerce reached its peak following the Battle of Waterloo in 1815, which left over 50,000 men dead. Opportunist scavengers pried teeth from deceased soldiers abandoning on the field, selling them to dentists in England and America. Dubbed "Waterloo Teeth," dentures made from the grim bounty were greatly prized for their soundness.
For those of lesser means, teeth were extracted from the poor, whether through consent, coercion, or stolen from fresh graves.
Most disturbingly, teeth were routinely pulled from living slaves on Southern plantations. Their owners considered slaves mere property, and dentists paid small sums to subject them to the agony of unsanitized extractions without care for after-effects.
The destitute also sold their teeth willingly out of desperation.
In a grotesque irony, those who sacrificed their teeth ultimately enabled the wealthy to flaunt prestigious smiles.
By the late 1800s, dentists eagerly transitioned to use of artificial porcelain teeth, finally ending dentistry's macabre dependence on the dead and downtrodden. Though disconcerting by modern standards, the practice reflected the extreme difficulty of acquiring human teeth during dentistry's early days.
In dentistry's early days, practitioners relied heavily on hazardous mercury-based amalgams for filling dental cavities, ignorantly subjecting generations to its insidious effects.
Throughout the 1800s and into the early 1900s, dentists liberally used so-called "silver fillings" containing liquid mercury mixed with powdered metals like silver, tin, and copper. The malleable amalgam was packed into prepared cavities, where it hardened into a durable sealing agent.
While convenient, these primitive fillings slowly released vaporous mercury over time.
Prolonged exposure could lead to neurological disorders, kidney damage, and other chronic ailments. Yet the underlying risks were not understood by dentists or patients at the time.
Dentists were isolated in their private practices, with little incentive to document cases of toxicity.
Patients simply assumed the succeeding generations were increasingly prone to disease.
More disturbingly, some early amalgam fillings also contained arsenic, an outright poison added to improve flexibility.
As arsenic's toxicity was well-established, its inclusion underscores the cavalier attitude towards patient safety in early dentistry.
It was not until after World War I that dentists phased out arsenic additives due to rising ethical concerns. However, mercury amalgams persisted even into the 1950s before being relegated only to posterior molars.
With today's emphasis on biocompatibility, the primitive materials used in early dentistry seem reckless, though they were simply the only options available at the time.
Among the crude improvisations that characterized dentistry in its primitive era, few methods were as gruesomely inventive as the notorious practice of "door-string dentistry."
Employed in rural areas lacking professionally-trained dentists, this DIY extraction technique involved no specialized tools, just a simple string and door.
The suffering patient would tie one end of a string to the offending rotten or damaged tooth, leaving the other end to dangle.
The string was then wrapped around a door handle or knob, securing the tooth. When ready, the door was abruptly slammed shut, violently yanking the tooth from its socket in a single explosive motion.
Though cleverly conceived using items commonly at hand, this shockingly brutal practice scant regarded the pain and trauma inflicted.
The sudden force often cracked teeth and tore up gum tissue, leaving patients to endure throbbing agony while healing from repulsive extra-oral lacerations. Risk of infection from the jagged, skin-piercing wounds was high in the absence of sterilization.
While improvisational dentistry was the norm in rural areas prior to the establishment of formal training programs, the distinct sadism of door-string extractions reflected the indifference towards patient suffering at the time.
The communal nature of the ritual also spawned public spectacles, with crowds cheering victims to follow through after the string was affixed.
Though myths surely exaggerate its prevalence, oral histories confirm door-string dentistry was a REAL last-resort remedy that should remain buried in dentistry's barbaric past.
For the vast span of human history, dental care was not a practice of science and medicine but a side-hustle of craftsmen with no formal medical training.
In the absence of dentistry as a recognized profession, the care of teeth fell to blacksmiths and barbers, whose qualifications extended little beyond rudimentary tools and a capacity for stomach-churning gore.
These budding dentists hammered out their own dental instruments on a blacksmith's anvil, improvising crude extraction pliers and drills powered only by the strength of the wrist.
Many tools resembled those used to shoe horses or shear the wool from sheep. The trusted neighborhood barber also pulled teeth between haircuts and shaves, a natural side profession given their familiarity with blades and bloodshed.
Unsurprisingly, outcomes tended towards the nightmarish, as patients were subjected to agonizing butchery.
Procedures were performed with whiskey as the only anesthetic and leather straps as the only means of restraint. With no concept of sterilization, infection ran rampant.
Those lucky enough to survive an extraction often faced worsening deformities as the jawbone eroded away.
While their entrepreneurial spirit is admirable, their understanding of oral health was non-existent.
Only in the early 20th century did dentistry emerge as a real science, requiring rigorous training and credentialing. The days of relying on untrained craftsmen came to an end, sparing future generations predictable torture and disfigurement.
In the harrowing days before modern anesthesia and pain control, a visit to the dentist's chair often involved being forcibly restrained and immobilized while being subjected to agonizing oral surgery.
Without recourse to numbing agents, early dentists relied on brute physical restraints to compensate for a patient's instinctual impulse to flee the professional tortures awaiting them.
The dental chair itself was outfitted with thick leather straps to bind the legs and arms, preventing the slightest movement or twitch during an invasive procedure.
Patients laid pinned helplessly as whirring drills bore deep into sensitive nerves or forceps wedged teeth from swollen gums. Their muted screams and frantic writhing against the restraints only grew more desperate as the dentist pressed on unrelentingly with his work.
While utterly inhumane by modern standards, restraining patients was deemed a necessary measure at the time to counteract pain-induced thrashing that could cause severe injury.
Patients sometimes broke fingers or bit off their tongues during extractions without anesthetic.
The dentist merely strove to maintain a stable operating field, ignoring the psychological toll of being strapped down amid excruciating pain.
Nonetheless, the primitive practice reinforced the popular conception of dentists as sadistic tormentors.
Those strapped to the chair endured not only physical pain but deep humiliation and trauma in their utter powerlessness.
Though it improved procedural outcomes, the dehumanizing use of restraints for conscious dental surgery remained in use far longer than necessary, fading only in the early 20th century as anesthetics got rid of the need to physically fight against patients’ desperate survival instincts.
The earliest origins of orthodontics at the turn of the 20th century emerged more as a practice of medieval torture than medical therapy.
Lacking a modern scientific understanding of gradual realignment, pioneering orthodontists employed archaic headgear mechanisms capable of exerting extreme forces on the still-developing craniofacial structures of youths.
Devices such as the repulsive "head collar" encompassed children's heads in a halo of metal and leather straps, tightened down by screws to exert sustained inward pressure up to 15 pounds or more.
Children were subjected to this cranial vise for nearly the entire day, often to forcibly retract the jawline.
Other equipment used tightening springs and wires to contort teeth into alignment, applying whitening pressures on par with a blacksmith's vise grip.
Patients endured not only constant pain from the devices' unyielding pressures but severe bodily harm as well.
The impact on still-soft bones and sutures was often growth restriction and permanent deformation.
Few even achieved significant correction, as the crude devices were ill-designed for gradual adjustment.
Nonetheless, pioneering orthodontists continued subjecting adolescents to these medieval contraptions well into the 1930s before milder methods based on gradual repositioning prevailed.
In retrospect, the sheer brutality of early orthodontics appears grounded more in torture than therapy. However, these misguided practitioners acted in keeping with the prevailing thinking of the time that the body could be forcibly reshaped like pliant metal.
The study of dental anatomy faced a major impediment in the 1800s—a severe scarcity of human remains on which students could comprehensively study the structures of the oral cavity.
Driven by demand, some early dental schools turned to ethically dubious methods of acquiring cadavers and anatomical specimens.
As dental education formalized in the mid-1800s, institutes struggled acquiring sufficient human jaws and skulls for each aspiring dentist to dissect.
Grave robbing became shockingly common, as dental students raided interred coffins under cover of darkness to procure bones. Some schools attracted scrutiny for suspiciously robust anatomy collections despite minimal legal access to bodies.
Outright body snatching also occurred, targeting the unclaimed dead from potter's fields and morgues.
To the opportunistic student, resurrectionists, or freelance grave robbers, the high value of cadavers justified violating burial rights. These illicit means arose from a genuine instructional need, but rarely considered personal dignity.
By the late 1800s, mounting ethical concerns and legal restrictions curtailed body snatching.
Improved channels for legal cadaver donation developed, such as unclaimed bodies from prisons and asylums.
Dissection gradually became viewed as a respectful method of scientific learning rather than defilement.
Anatomical knowledge gained legitimately allows modern dentists to ply their trade without relying on the pilfering sins of the past. However, it's worth acknowledging dentistry's unavoidable history in grave robbery that today seem so egregious.