Fake smiles and false teeth: a his­tory of den­tal pain

Be­fore there was aes­thetic cor­rec­tion there was rot­ten-toothed agony and prac­ti­tion­ers bet­ter versed in hoof­ing horses

The Irish Times - Tuesday - Health - - Teeth Health - John Flem­ing

Plug was the nick­name of an eru­dite teacher who taught me Latin. Like one of the Bash Street Kids, he was named for the promi­nence of his front teeth. Did he know this as he scratched in fang-white chalk a third de­clen­sion noun on the black­board? Dens, den­tis: the Latin word for tooth.

The his­tory of teeth and car­ing for them is one of pain, butch­ery and show­biz. Poor peo­ple sold their teeth to be im­planted in the wealthy. Rusty pli­ers prised mo­lars from con­torted mouths. On a stage-set of agony, char­la­tans and fakes dom­i­nated den­tistry un­til the prac­tice evolved into a pro­fes­sion.

Eigh­teenth-cen­tury Paris crowds roared at Pont Neuf public tooth-pullings as strong arms yanked out mo­lars in an ex­cru­ci­at­ing spew of blood and spit­tle. Through­out the ages, howls em­anated from rot­ten gobs. Mag­i­cal anaes­thetic re­lief ar­rived with laugh­ing gas, chlo­ro­form and co­caine.

And the hos­tile med­i­cal pro­fes­sion be­gan to ad­mit den­tal trades­men who ex­tracted them­selves from black­smith forges and the hoof­ing of horses to turn to the tend­ing of hu­man teeth.

All this is vividly por­trayed in Richard Bar­nett’s The Smile Steal­ers, a tale of the trek to mod­ern den­tistry and the cul­tural back­drop from which the pro­fes­sion emerged.

As far back as the 19th cen­tury we find the para­pher­na­lia of the prac­tice: “the den­tal drill, the den­tal chair, a cer­tifi­cate or li­cence on the wall and, most of all, the prospect of fill­ings and ex­trac­tions with­out pain.” Den­tal keys and pli­ers were the ba­sic tools: there is grim amuse­ment in pe­rus­ing these pages of crude in­stru­ments and il­lus­tra­tions of wretches with toothache.

The un­named guinea pigs of pain have been spat into his­tory’s den­tal spit­toon. Prac­ti­tion­ers dom­i­nate the land­scape. The Paris-based Jean Thomas both en­ter­tained and cured by lift­ing shriek­ing pa­tients off the ground with an in­stru­ment locked on to their rot­ten tooth, counter-lev­er­ing their weight to ex­tract the eroded stump.

Show­man­ship

Bar­nett de­scribes a 1729 en­grav­ing: “With his right hand, Thomas grips the boy’s head, firmly but kindly, and be­tween the thumb and fore­fin­ger of his out­stretched left hand he holds a mo­lar which seems to glow faintly against the sky.” Thomas was a mas­ter sur­geon, but his show­man­ship was frowned on by the emerg­ing pro­fes­sional class of tooth doc­tors who sought par­ity with physi­cians.

Fel­low French­man Pierre Fauchard was a con­duit for this pro­fes­sion­al­ism. He shifted the trade from ex­trac­tion to tooth preser­va­tion and aes­thet­ics. His den­tistry was about fill­ings, about im­plant­ing ivory and bone den­tures in bar­ren jaws.

His del­i­cate im­ple­ments came from jew­ellery and watch­mak­ing, and he shunned show­man­ship for a “light, steady and skil­ful” hand. Den­tistry was no longer just about pain; its prac­ti­tion­ers were agents of a con­sumer cap­i­tal­ism that linked “good teeth, beauty and suc­cess”.

And the clients? Pow­dered-wigged dandies who un­der­stood one thing: “a mouth­ful of straight, gleam­ing teeth was a po­lit­i­cal as­set”. The poor had to just grin and bear it.

Ge­orge Washington had just one tooth in his head when in­au­gu­rated in 1789. For public ap­pear­ances he had painful den­tures – of hu­man and elk teeth. Pres­i­den­tial din­ners were tricky and, Bar­nett in­forms us, the US pre­mier re­tired to his abode af­ter­wards “to gum his way through plate­fuls of soft pick­led tripe”.

Hov­er­ing over ev­ery white-knuck­led adult or child in the den­tist chair is the pro­fes­sion’s pa­tron saint, St Apol­lon­aire. Her ha­giog­ra­phy has her tor­men­tors break all her teeth be­fore she leaps into the fire at whose stake it was planned she would burn. But re­lax. You won’t feel a thing.

False teeth gags

The comics and TV of my early child­hood were filled with false teeth gags but you don’t hear such jokes any­more. In a world of elec­tive or­thodon­tics, the buck-toothed are phas­ing them­selves out. Near-pain­less fill­ings, crowns and ex­trac­tions have scoured the tan­nin from our prim­i­tive fears. If we don’t fear den­tistry so much, we don’t have to laugh at it so of­ten.

Gone are the sit-com set-ups of den­tal wait­ing rooms. Gone are the car­toon-strip il­lus­tra­tions of peo­ple with a ban­dage cradling their rot­ten-toothed jaw. Gone are the ref­er­ences to laugh­ing gas whose crude oper­a­tion was it­self deemed funny. In our white-fang world of con­fi­dent smiles, false teeth gags have been lost as a genre. But it seems the gurn­ing jokes of Step­toe and Son and 1970s sit­coms may have had their roots in the 1942 Bev­eridge re­port and sub­se­quent

‘‘ Eigh­teen­th­cen­tury Paris crowds roared at Pont Neuf public tooth-pullings as strong arms yanked out mo­lars in an ex­cru­ci­at­ing spew of blood and spit­tle

pro­vi­sion of free den­tal treat­ment in Bri­tain. With the found­ing of the UK’s Na­tional Health Ser­vice in1948, den­tists is­sued two mil­lion sets of false teeth in the first year.

Se­ries of ex­trac­tions

False teeth were a sim­ple so­ci­o­log­i­cal fact that bit into the post-war pop­u­lar con­scious­ness. And they pro­vided ma­te­rial for end-of-pier co­me­di­ans to chew over be­fore they too lay down be­side a glass of wa­ter con­tain­ing their set of gnash­ers. Rather poignantly, Bar­nett points out that, pre-NHS, “well into the 1930s, some work­ing-class Bri­tish women re­ceived a full set of den­tures as a present for their 21st birth­day or their wed­ding – hardly ro­man­tic but cheaper and less painful than a se­ries of ex­trac­tions over two or three decades.”

The pri­mary func­tion of teeth is bit­ing and chew­ing, ide­ally on food. A sec­ond func­tion is speech: teeth are the fur­ni­ture around which the rest of the mouth ar­tic­u­lates sounds such as den­tal frica­tives. But for many there is a third el­e­ment: fre­quent den­tal trips. Not for me. Un­til last De­cem­ber, I had not been to the den­tist for 10 years. I made an ap­point­ment, fear­ing the worst. But af­ter 30 min­utes and a tooth scrap­ing, it was thumbs-up: the tar­nished smile of suc­cess.

I walked home think­ing there is no need for the dis­mal his­tory of den­tistry – not when there is the magic of chil­dren leav­ing their baby teeth un­der pil­lows; not when I am con­vinced that teeth can grow back.

The Smile Steal­ers: The Fine and Foul Art of Den­tistry by Richard Bar­nett (Thames & Hud­son)

PHO­TO­GRAPH: GETTY

The Den­tist, 1608-1609, by Michelan­gelo Merisi da Car­avag­gio (1571-1610), oil on can­vas.

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