Dentistry in ancient Rome

Dental practices in ancient Rome

Dentistry developed during the early parts of Roman history,[1] which may be due to the arrival of a Greek doctor named Archagathus. Ancient Roman oral surgical tools included the dental drill, chisels, bone levers, tooth and stump forceps.[2][3][4] The ancient Romans invented the usage of narcotics during dental surgery.[5] These tools were used to treat conditions such as toothache and to extract teeth. It was believed in ancient Rome that the cause of the conditions that necessitated such treatment was a "tooth worm."

History

According to Pliny the Elder for much of Roman history they lived without a medical community. During this time medicine was confined to popular homemade remedies rather than professionally trained doctors. The profession of medicine was introduced to the Romans by the Greek doctor Archagathus, who traveled to Rome and established himself as a physician. Eventually, he garnered a reputation for violent use of steel and fire costing him his reputation and granting him the title of "butcher." Archaeological and historical evidence disputes this narrative. The Twelve Tables, which was the set of legislation forming the basis of Roman law,[6] make mention of teeth laden with gold, implying that dentistry had been practiced at this point in history. Other evidence includes the finding of prosthetic materials designed to treat dental and oral health conditions in Roman cities such as Teano. Despite this, historians and archaeologists are inconclusive on this matter.[7] Analysis of teeth samples from the Roman era and the Early Middle Ages, shortly following the collapse of Rome, indicate the prevalence of dental lesions and caries rose during the transition to the Middle Ages.[8]

Cosmetic dentistry

Etruscan dentures

The ancient Romans whitened their teeth using toothpaste made from human urine and goat milk.[9][10][11] Dental bridges and crowns were developed in ancient Rome in 500 BCE.[12] This form of dentistry was a craft the Etruscans were skilled at.[13][14] This civilization developed the first "true" dental bridges.[15] Roman dental bridges were commonly made of bone or ivory, and were in high demand during the Roman Republic.[16] Ancient Roman dentists also used dental implants made of gold.[17][18][19] It is unclear which Roman profession or professions would have performed dentistry. There may have been medical specialists trained to perform dental procedures, it is also possible that dentistry was practiced as a subset of other professions, such as barbery.[20]

Tooth

Tooth anatomy

According to the Hippocratic text, De Carnibus, teeth were considered bones since they extended from the bones inside the head and mouth.[21] Galen stated that the human body contained 32 teeth divided equally between the upper and lower jaw. Galen grouped these teeth into three categories: molars, canines, and incisors. Incisors, as described by Galen, were wide and sharp teeth used to cut through food. Galen wrote that there were four incisors in the front part of each jaw. There were also only four canine teeth; they had a wide base and were located on both sides of the jaws. Their name derives from supposed similarities to the teeth of dogs. Although Galen noticed the molar teeth, however he failed to distinguish between molars and premolars. Galen further documented cases of individuals with 4 molars in each part of the jaw instead of 5, incidents of birth defects that resulted in abnormalities in molar teeth, as well as cases of people with excess molars. According to Galen, formation of teeth begun inside the uterus and that their growth was completed after the skull bones had been shaped. Galen incorrectly claimed that teeth were the only example of innervated hard tissue.[22]

Toothaches

Ancient Roman dental forceps

Galen distinguished between diseases of the root and of the pulp in his work De ossibus; the same text in which he also identified the medical issue of a toothache in his work De ossibus.[21] Roman doctors believed that toothaches were caused by a "toothworm."[23] Treatments for toothaches were popular and widely desired due to the intense pain and dental decay this condition caused. In his work Natural History, Pliny the Elder discussed therapies for tooth pain. He wrote that a patient could pour the remedy into their ear. Some medication was supposed to be poured into the ear on the same side of the head as the toothache, others were supposed to be poured in on the opposite side. Some treatments included the inhalation of wild mint, the use of hare bones to incise the gums, wearing bones covered with feces, and gargling the ash of deer horns.[24][25] Another treatment included catching a frog in moonlight and spitting into its mouth, then commanding the frog to leave and carry the toothache with it.[26] Saffron, opium, pepper, matgrass paste, fried worms, and spider eggs may also have been used as painkillers.[27] Excavations of a taberna by the Temple of Castor and Pollux unearthed a deposit of 86 teeth most of which are afflicted with carious lesions. Each tooth was unbroken, suggesting that they had been removed by a skilled dentist. Further analysis of these teeth revealed that the front of the cavities had hypermineralized areas, possibly indicating the usage of analgesics.[28] Many of the teeth likely had the soft part of their carious sections removed prior to surgical treatment, leaving the cavities uniquely round or circular. Some examples of teeth from this site have the remains of dentin along the sections of pulp impacted by caries, suggesting that the pulp was preserved throughout the procedure until it was entirely exposed.[29]

Tooth extraction

Portrait of Galen, a Roman doctor

Tooth extraction is an oral surgical procedure conducted for the purpose of removing teeth. In ancient Rome, it may have been practiced by specialists who were not associated with any other Roman medical professionals. This practice presented numerous dangers for patients and challenges for physicians. Celsus recommends that physicians remove teeth straight to avoid risking the bone being broken by the roots. Extraction of teeth in the maxilla risked damaging the eyes and the temples; Celsus advises addressing this issue by making an incision into the gingiva, allowing for the forceps to move easier. Such dangers also resulted in the practice becoming rare;[20] Celsus cautions physicians against the technique, advising that it should only be employed in herbal remedies had failed to address the issue. According to Celsus, when teeth were extracted, the bone near the teeth should also be removed and physicians should refuse to extract children's teeth unless they were preventing adult teeth from growing.[30][31] He further writes that, if the root had been left behind, the physician should remove it utilizing a pair of forceps called a rhizaga. The rhizaga could also be used to remove a cavity, although according to Celsus this procedure should be performed after the cavity had been filled with a lead amalgam to ensure the dental crown remained intact.[32] In one tooth extraction process, the tooth would be grabbed and rocked until it could be removed with hands. Another practice involved cutting the gum and bone surrounding a tooth, and then extracting.[30][31]

Gum disease

Ancient Roman medical writers believed that teeth could become loose due to root weakness or a gum disease. They would treat this by cauterizing the gums, then covering it in honey swilled with mead. Afterwards medication was placed on the teeth. If the tooth became painful it would be extracted. This procedure would be conducted by "scraping" the tooth in "round order" then shaking the tooth until it could be safely removed.[33] Celsus described a treatment for tooth loss which involved chewing either purslane or apples and pears.[34]

Cleft lip and palate

Celsus described treatments for the medical condition known as cleft lip and palate. He wrote that applying a suture and abrasions to the lips was Celsus' suggested method of treating small defects. Larger and more problematic defects were treated using surgical procedure known as flaps. Galen, another Roman doctor likely described either coloboma or facial cleft. To treat this condition he recommended scarifying the skin and unifying the disparate parts of the skin, removing callouses, and then finishing the procedure through sewing and glue. It was believed that a healthy palate was necessary for proper speech.[33] The ancient Romans also killed children with cleft lips, due to the belief that they were possessed by evil spirits.[35]

References

  1. ^ Andrews, Esther K. (2007). Practice Management for Dental Hygienists. Lippincott Williams & Wilkins. p. 5. ISBN 978-0-7817-5359-3.
  2. ^ Synovitz, Linda Baily; Larson, Karl L. (2013). Complementary and Alternative Medicine for Health Professionals: A Holistic Approach to Consumer Health. Jones & Bartlett Publishers. p. 72. ISBN 978-0-7637-6595-8.
  3. ^ Maynard, Charles W. (15 January 2006). The Technology of Ancient Rome. The Rosen Publishing Group, Inc. pp. 36, 51. ISBN 978-1-4042-0556-7.
  4. ^ "Ancient medicines and bone lever in rare Roman medical kit." Premium Official News, 26 Feb. 2016. Gale OneFile: News.
  5. ^ Learning, Jones & Bartlett (4 May 2020). Comprehensive Dental Assisting, Enhanced Edition. Jones & Bartlett Learning. p. 13. ISBN 978-1-284-26812-6.
  6. ^ Jolowicz, H.F. Historical Introduction to the Study of Roman Law (Cambridge, 1952), 108
  7. ^ Guerini, Vincenzo (27 November 2019). A History of Dentistry from the most Ancient Times until the end of the Eighteenth Century. Good Press.
  8. ^ Manzi, Giorgio; Salvadei, Loretana; Vienna, Alessandro; Passarello, Pietro (1999). "Discontinuity of life conditions at the transition from the Roman imperial age to the early middle ages: Example from central Italy evaluated by pathological dento-alveolar lesions". American Journal of Human Biology. 11 (3): 327–341. doi:10.1002/(SICI)1520-6300(1999)11:3<327::AID-AJHB5>3.0.CO;2-M. ISSN 1042-0533.
  9. ^ Lenkeit, Roberta Edwards (23 October 2018). High Heels and Bound Feet: And Other Essays on Everyday Anthropology, Second Edition. Waveland Press. p. 72. ISBN 978-1-4786-3841-4.
  10. ^ Perdigão, Jorge (3 August 2016). Tooth Whitening: An Evidence-Based Perspective. Springer. p. 170. ISBN 978-3-319-38849-6.
  11. ^ Bonitz, Michael; Lopez, Jose; Becker, Kurt; Thomsen, Hauke (9 April 2014). Complex Plasmas: Scientific Challenges and Technological Opportunities. Springer Science & Business Media. p. 465. ISBN 978-3-319-05437-7.
  12. ^ Reddy, Boreddy (2 November 2017). Acrylic Polymers in Healthcare. BoD – Books on Demand. p. 27. ISBN 978-953-51-3593-7.
  13. ^ Krebs, Robert E.; Krebs, Carolyn A. (2003). Groundbreaking Scientific Experiments, Inventions, and Discoveries of the Ancient World. Greenwood Publishing Group. p. 209. ISBN 978-0-313-31342-4.
  14. ^ Learning, Jones & Bartlett (4 May 2020). Comprehensive Dental Assisting, Enhanced Edition. Jones & Bartlett Learning. p. 5. ISBN 978-1-284-26812-6.
  15. ^ Garg, Arun K. (11 December 2009). Implant Dentistry – E-Book. Elsevier Health Sciences. ISBN 978-0-323-08765-0.
  16. ^ Naso, Alessandro (25 September 2017). Etruscology. Walter de Gruyter GmbH & Co KG. pp. 523–527. ISBN 978-1-934078-49-5.
  17. ^ Lanza, Robert; Langer, Robert; Vacanti, Joseph P. (17 October 2013). Principles of Tissue Engineering. Academic Press. p. 1471. ISBN 978-0-12-398370-1.
  18. ^ Chapman, Michael W.; James, Michelle A. (31 January 2019). Chapman's Comprehensive Orthopaedic Surgery: Five Volume Set. Jaypee Brothers Medical Publishers. p. 4085. ISBN 978-93-5152-497-7.
  19. ^ Eswarappa, Veda; Bhatia, Sujata K. (12 September 2012). Naturally Based Biomaterials and Therapeutics: The Case of India. Springer Science & Business Media. p. 10. ISBN 978-1-4614-5385-7.
  20. ^ a b Ferneini, Elie M.; Goupil, Michael T.; Halepas, Steven (2022). The History of Maxillofacial Surgery: An Evidence Based Journey. Springer Nature. p. 112. ISBN 978-3-030-89563-1.
  21. ^ a b Bernardi, Sara; Angelone, Anna Maria; Macchiarelli, Guido (2022). "Anatomy in dentistry: From the beginnings to contemporary reality". Clinical Anatomy. 35 (6): 711–722. doi:10.1002/ca.23869. ISSN 0897-3806.
  22. ^ Koutroumpas, Dimitrios; Koletsi-Kounari, Haroula (2012). "Galen on dental anatomy and physiology" (PDF). Journal of the History of Dentistry. 60 (1): 37–49.
  23. ^ Bird, Doni L.; Robinson, Debbie S. (16 March 2017). Modern Dental Assisting – E-Book. Elsevier Health Sciences. pp. 3–4. ISBN 978-0-323-48517-3.
  24. ^ Engs, Ruth Clifford (11 January 2022). Bizarre Medicine: Unusual Treatments and Practices through the Ages. ABC-CLIO. p. 269. ISBN 978-1-4408-7125-2.
  25. ^ Virnig, Christine (21 July 2020). Dung for Dinner: A Stomach-Churning Look at the Animal Poop, Pee, Vomit, and Secretions that People Have Eaten (and Often Still Do!). Henry Holt and Company (BYR). ISBN 978-1-250-24680-6.
  26. ^ Turner, Tracey (15 October 2019). The Curious Book of Lists: 263 Fun, Fascinating, and Fact-Filled Lists. Kingfisher. p. 92. ISBN 978-0-7534-7609-3.
  27. ^ Fejerskov, Ole; Uribe, Sergio; Mariño, Rodrigo J. (2018), Mariño, Rodrigo J.; Morgan, Michael V.; Walmsley, A. Damien (eds.), "Dentistry in a Historical Perspective and a Likely Future of the Profession", Career Paths in Oral Health, Cham: Springer International Publishing, pp. 3–19, doi:10.1007/978-3-319-89731-8_1, ISBN 978-3-319-89731-8, retrieved 11 June 2024
  28. ^ Becker, Marshall (2014). "Dentistry in Ancient Rome: Direct Evidence for Extractions Based on the Teeth from Excavations at the Temple of Castor and Pollux in the Roman Forum". International Journal of Anthropology. 29 (4): 209–226.
  29. ^ Fejerskov, O.; Guldager Bilde, P.; Bizzarro, M.; Connelly, J.N.; Skovhus Thomsen, J.; Nyvad, B. (13 July 2012). "Dental Caries in Rome, 50–100 AD" (PDF). Caries Research. 46 (5): 467–473. doi:10.1159/000339664. ISSN 0008-6568.
  30. ^ a b Becker, Marshall J.; Turfa, Jean MacIntosh (17 February 2017). The Etruscans and the History of Dentistry: The Golden Smile through the Ages. Taylor & Francis. ISBN 978-1-317-19465-1.
  31. ^ a b Ciment, James (14 December 2015). How They Lived: An Annotated Tour of Daily Life through History in Primary Sources [2 volumes]: An Annotated Tour of Daily Life through History in Primary Sources. ABC-CLIO. p. 181. ISBN 978-1-61069-896-2.
  32. ^ Tanga, Carmen; Viciano, Joan; Monza, Francesca; D'Anastasio, Ruggero; Capasso, Luigi (11 November 2020). "Dental palaeopathology seen through historical, archaeological and biological sources in ancient Herculaneum (79 AD, Italy)". Medicina Historica. 4 (2): e2020007–e2020007. ISSN 2532-2370.
  33. ^ a b Santoni-Rugiu, Paolo; Sykes, Philip J. (10 August 2007). A History of Plastic Surgery. Springer Science & Business Media. p. 215. ISBN 978-3-540-46241-5.
  34. ^ Brkic, Zlata; Pavlic, Verica (2017). "Periodontology: The historical outline from ancient times until the 20th century". Vojnosanitetski pregled. 74 (2): 193–199. doi:10.2298/VSP150612169B. ISSN 0042-8450.
  35. ^ Shi, Bing; Sommerlad, Brian C. (13 January 2015). Cleft Lip and Palate Primary Repair. Springer. ISBN 978-3-642-38382-3.
  • v
  • t
  • e
SpecialtiesDental surgeryOrganisationsBy countrySee also
  • v
  • t
  • e
Tools
Physicians
Medical literature
Roles
Theories
Religion
Plagues
  • Category