A trip to the dentist may seem like a relatively modern - and somewhat dread-inducing - luxury, but new evidence suggests humans have been undergoing dental treatments for thousands of years.

Archaeologists have discovered evidence that Palaeolithic humans not only understood the harm that tooth decay could do, but were also digging out infected tissue.

A tooth from a 14,000-year-old skeleton of a human hunter discovered in Italy has been found to show distinctive cut marks made by a small pointed flint tool.

A tooth found on the remains of a young hunter who died 14,000 years ago has been found to show signs of rudimentary dental treatment in a cavity caused by tooth decay. The image above shows the hole in the tooth, which scientists say was created by cutting and levering using a sharp sliver of flint to dig out an infection

Scientists believe this was an attempt to scratch and lever material out of an infected tooth cavity to relieve toothache and is the earliest example of dental treatment to be seen in humans.

The researchers say that a shift in the diet of humans at the time may have introduced more carbohydrate into their diet and so left them at greater risk of tooth decay.

OLDEST CASE OF TOOTH DECAY It is definitive proof, if any were needed, that toothache can afflict anyone and not just those who consume sugary drinks and too many sweets. Scientists have found the first known case of tooth decay - in the fossil of a jawbone belonging to a 275 million-year-old reptile. The discovery of an 'exquisitely preserved' jaw near Coffee Creek in Texas pre-dates the previous earliest-known example of tooth decay by 200 million years. It was found in the jaws of a well-preserved specimen of Labidosaurus hamatus - a fat-headed, omnivorous reptile about 75 cm long, which adapted over millions of years to life on land rather than the watery marshes of its amphibious forebear. With the aid of CT-scanning, researchers found evidence of a massive infection in the jawbone. This resulted in the loss of several teeth, as well as bone destruction in the jaw in the form of an abscess and internal loss of bone tissue. Advertisement

Speaking to Discovery News, Dr Stefano Benazzi, a palaeoanthropoloigist at the University of Bologna who led the work, said: 'Basically, the infected tissue was picked away from inside the tooth carefully using a small, sharp stone tool.

'This shows that Late Upper Paleolithic humans were aware about the deleterious effects of caries, and the need to intervene with an invasive treatment to clean a deep dental cavity.'

The tooth – a lower right molar – was found in the jaw of a complete human skeleton that was unearthed in 1988 at the Ripari Villabruna rock shelter in Val Cismon, near Belluno, north east Italy.

It is thought to have belonged to a young man who was around 25 years old when he died between 14,160 and 13,820 years ago.

He is thought to have been a Cro-magnon hunter and was buried with large river pebbles, some of which showed signs of having being painted with ocher.

However, until now the indentation in the tooth was overlooked as a simple lesion caused by tooth decay.

Dr Benazzi, his student Gregorio Oxilia and their colleagues, however, used an electron microscope to look more closely at the tooth. Their work is published in the journal Scientific Reports.

They discovered peculiar cut marks on the internal surface of the cavity. Experimental tests on teeth using wood, bone and stone points showed the marks were caused by scratching and chipping.

The tooth was found on the remains of a young hunter buried in a rock shelter in Val Cismon in north east Italy

They say it was most likely caused by an extremely sharp and fine flint tool, known as a microgravette, cutting and levering in the cavity.

The dental treatment may have been performed by the man on himself or another person – a Palaeolithic dentist – due to the pain this would have caused the man.

The enamel around the cavity has also rounded and polished due to wear, indicating it was performed quite some time before his death.

The researchers say their findings suggest that later examples of early dentistry, where the ancient Romans, Greeks and Egyptians removed decay by drilling, may have evolved from this early technique and knowledge.

The researchers used an electron microscope to examine the tooth and discovered a series of distinctive cut marks, shown in the images above. The enamel had become worn as if the cuts were made sometime before the individual had died

Early human species like Neanderthals and early Homo species are also known to have used toothpicks to remove food.

Writing in the journal Scientific Reports, said: 'The rise in caries incidence, coupled with appropriate lithic technology during the Late Upper Palaeolithic may have created an optimal context within which to adapt the habitual use of a toothpick (made of wood/bone) towards a rudimentary dental intervention using microlithic tools.

'Specifically, the microgravettes were elongated and strong points designed for use as hafted hunting projectiles, but their small size and hardness were well suited both to enter into small carious cavities and to remove the demineralised but resistant bacterially infected enamel and dentine tissues by levering and scratching.

'Therefore, the earliest incipient dentistry entails levering and scratching but not drilling practices, as observed later, during the Neolithic and in modern dentistry.'