Dental Hygiene in Ancient Rome


Steve Martin as Orin Scrivello, the sadistic dentist in Little Shop of Horrors (Warner Bros. 1986)

You'll be a dentist! (You'll be a dentist)
You have a talent for causin' things pain! (Pain)
Son, be a dentist! (Son, be a dentist)
People will pay you to be inhumane! (Inhumane)

Every six months, the classic song from Little Shop of Horrors echoes in my mind. Thankfully, I was born with good teeth, never required braces, and my dentist visits are usually brief and painless. It helps brushing twice a day, having an electric toothbrush that can reach way back to my wisdom teeth ... and because I actually floss! I've also never smoked and rarely, if ever, consume processed sugar.

But what of our ancestors? We all know the stereotype, as seen in endless films, of the medieval peasant with either missing or black, rotten teeth. So naturally, going back another thousand years or so, we must assume the Ancient Romans also had wretched teeth, right? Actually, on the whole, neither did! While they didn't have electric toothbrushes, water picks, dental floss, Crest, Colgate, or Listerine (#notsponsored), poor dental hygiene across history is largely a myth. It is well documented that white teeth and fresh breath were considered attractive qualities in medieval times, even amongst the peasantry.

As for the Ancient Romans, we have first-hand evidence of their dental health, owing to a horrific disaster. In 79 A.D., Mount Vesuvius erupted, destroying the cities of Pompeii and Herculaneum. Much of the city and its unfortunate inhabitants were preserved until around the 19th century, when archaeological teams began unearthing the buried cities. Plasters were made of many of the bodies, and in recent years, imaging technology, such as CT scans, have enabled us to learn the state of their bones and teeth. Scans of nearly forty remains found almost no evidence of cavities or any sort of tooth decay. Researchers concluded that, in many ways, the Ancient Romans had better teeth than we do today!

A 3D scan of teeth from remains at Pompeii, taken in 2015 

So, what changed? What caused the healthy teeth from ancient and medieval times to take such a drastic downturn into vile decay? Two words: Sugar, and Tobacco. 

Tobacco, indigenous to North and South America, did not come to Europe until the 1550s. Use was popularised by men like the French diplomat and scholar, Jean Nicot (1530-1604), from whom we get the name nicotine. And to show just how backwards medical science was, Europeans believed tobacco was a "miracle cure" for everything from bad breath to cancer! Baffling that it took hundreds of years, people's teeth turning black and rotten, breath smelling like hot garbage, and spiking levels of cancer, before society realised, "Hmm, maybe this isn't as medicinal as we thought!"

Our ancestors' poor teeth took a double whammy with the widespread usage of sugar. While Alexander the Great (356 - 323 B.C.) was introduced to sugar cane in India, it did not become readily available in Europe until introduced by Arabs to Sicily during the 9th century. Even then, its use was limited to predominantly the wealthy. It didn't become widespread popular until late in the Tudor Dynasty. Queen Elizabeth I was notorious for having wretched teeth.  In December 1597, when Her Majesty was sixty-four, the French ambassador, Andre Hurault-Sieur de Maisse, recorded his meeting with her. Amongst his recollections he said, "As for her face, it is and appears to be very aged. It is long and thin, and her teeth are very yellow and unequal, compared with what they were formerly, so they say, and on the left side less than on the right. Many of them are missing so that one cannot understand her easily when she speaks quickly."

You can read de Maisse's full account here on Eyewitness to History.

Going back just a hundred years, even the peasantry had white teeth and healthy gums. Yet Queen Elizabeth, the last Tudor monarch, one of the most powerful people in the world, under whose reign began what would become the British Empire, had such wretched dental health that even the sadistic Dr Scrivello would have fled in terror from. The cause? For starters, she brushed her teeth with honey, and later sugar! Bad enough what eating cane sugar can do to one's dental health just by eating it. But for one to think it makes a descent toothpaste ... yeah, I have nothing. Oh, and thanks to Sir Walter "Ooo What a Big Ship I've Got" Raleigh, she was enticed to try tobacco smoking around 1600.

It's small wonder that by the Victorian Era, dental health was in the gutter, as was overall quality of life and life-expectancy (another topic for another post).

Returning to Antiquity, we know the Roman world did not have access to the teeth destroying vices of sugar cane and tobacco. Their nutrition was also far sounder than their descendants 1,500 years later. Though not vegetarian, they ate a lot of fresh produce, dairy, plenty of grain, and some meat, usually in the form of pig or lamb. As evidenced by the remains recovered in Pompeii and Herculaneum, Ancient Romans had a highly balanced, nutritional diet which not only led to healthier smiles, but allowed them to reach their full height. While the average Victorian Era man was only around 5'5", most Romans were of similar height as we are today.

The late Terry Jones (yes, the same Terry Jones from Monty Python) did a fantastic documentary on daily life of an Ancient Roman, visiting Pompeii, and looking into the average citizen's diet. You can watch it here: 

The first bristle toothbrush was not invented until the 1400s in China, made of boar bristle. Europeans adapted a similar, less coarse variant using horsehair. The modern nylon toothbrush was invented by Dupont in 1938. The Romans and their medieval descendants used the ends of frayed sticks, appropriately called chewing sticks. They also experimented with various forms of toothpaste. While there is no singular recipe, crushed eggshells, ashes, ground up ox hooves, and pumice were common. Pumice is still used in modern toothpaste, as it helps polish enamel and cleans away plaque. Ancient toothpastes were quite abrasive, especially if the ingredients were not sufficiently ground up.

They also utilised a form of "natural" mouthwash, which is pretty gross, if effective. While some amongst the patrician class used a mixture of vinegar and salt, the most common means of rinsing one's mouth was urine. While disgusting, it actually worked, due to the high ammonia concentration from liquid human waste. The ammonia was also used for bleaching and cleaning linen, a practice which continued well through the Middle Ages. So widespread was its use, Emperor Vespasian (69 - 79 A.D.), placed a tax on the collectors with large jugs waiting on the streets ready to collect from those needing to "have a go." Vespasian, revered as one of Rome's greatest generals before his rise to become Caesar, who is forever immortalised in his building of the Flavian Amphitheatre (what we now call the Colosseum), was once criticised by his eldest son, Titus, for this practice. According to Suetonius, whose writings must often be taken with an entire bag of salt:

When Titus found fault with him for contriving a tax upon public conveniences, he held a piece of money from the first payment to his son’s nose, asking whether its odour was offensive to him. When Titus said “No,” he replied, “Yet it comes from urine.”
"I conquered half of southern Britannia in my younger days, re-captured Galilee, won a civil war after a trio of pretenders seized the throne, founded a new dynasty, gave the Empire more than a decade of peace, and people are still complaining about that damn urine tax!"

In summary, the Ancient Romans, and indeed most of their descendants up until the late Tudor Era, had excellent teeth, rivalling, and sometimes surpassing modern standards. Personally, I will gladly stick to brushing, flossing, and not having to rinse with my own passed water! Still, I guess we can add proper dental hygiene to the list of; WHAT HAVE THE ROMANS EVER DONE FOR US?


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