History of Dentistry – Part 2 – The Middle Ages
The Middle Ages (approximately 5th century -15th century AD) was truly a period of suffering for those had toothaches. While there were some minor advancements made, the go-to treatment during that time was having a tooth forcibly and brutally removed.
The first dentist appeared in Egypt in 2600 BC, but where did all the dentists go after that? During the medieval period, monks served as dentists until the 1100’s. As they were typically the most educated people, they were also the ones who practiced medicine. However, this was short-lived as the church decided (through the pope) that barbers should actually take on this task. Given that barbers handled knives and razors, they were considered to be the most adept at such things, certainly a scary proposition. But before we get to the barbers, let’s take a look at where this all began.
The origin of the red and white barber pole is associated with the service of bloodletting and was historically a representation of bloody bandages wrapped around a pole.
From 500-1000 BC, monks were everyone’s go-to dentist. From 1130-1163, the pope issued an edict that stopped monks from performing any sort of surgery. As barbers often helped monks with surgeries, they took over from them and engaged in bloodletting, lancing abscesses, tooth extraction, etc. As you can see from the barber’s pole above, the red represents blood – and truly all of the bloody (surgical) services they offered.
Fortunately, a Guild of Barbers was created in France in 1210. Over time, barbers specialized in two areas: those who got educated could perform more challenging and sophisticated procedures versus those who did the more routine services – a cut, a shave, and a tooth pull. Unfortunately, in the 1400’s, the powers that be decided barbers could no longer practice the more complex procedures; therefore, they engaged only in bleeding, cupping, leeching, and tooth extraction.
In the 1300’s, the tools most commonly used were the forceps and the “Pelican.” The pelican was created by Guy de Chauliac in the 14th century. Hammered out by a blacksmith, it was extraordinarily painful to receive treatment with it and often caused damage on top of that. The pelican was in use until the 18th century when an equally painful “dental key” was invented. In the 20th century, the modern forceps were finally – and thankfully – used in dentistry.
In 1530, the first book entirely focused on dentistry emerged from Germany. Called The Little Medicinal Book for All Kinds of Diseases and Infirmities of the Teeth (Artzney Buchlein), barbers and surgeons could glean knowledge about hygiene, how to extract or drill a tooth, and how to implement good fillings.
A mere 33 years later, in 1563, Batholomew Eusttachius published the first accurate book on dental anatomy, Libellus de dentibus.
Unfortunately, there were also a plethora of quacks running rampant during this time. The richest people could afford an “operator for the teeth,” but for everyone else, the local blacksmith and “tooth drawer” would pull teeth. For the “tooth drawer,” the procedure was done in the local marketplace, in part, as a source of entertainment. Others watched as the suffering individual underwent “treatment.”
Even dental hygiene was at an all-time low with people scrubbing their teeth with a piece of linen, sponge, or toothpicks. As you can imagine, tooth decay was widespread as was tooth extraction.
In a nutshell, the Middle Ages is sometimes referred to as the Dark Ages for good reason. In terms of dentistry, there were gradual advancements, but they were few and far between. Stay tuned for more history as the 18th century yielded the father of dentistry and the first modern toothbrush.