The sharp pinch of a large needle piercing the tender flesh inside the mouth. The high-pitched sound of a drill shattering tooth enamel. The metallic taste of blood. The smell of antiseptic mouthwash. The loss of sensation in the lips, tongue and cheek. The swelling, the bruising, the pain.

For many, there is nothing to be dreaded more than a trip to the dentist’s surgery. But good news is at hand: this week new research suggested that, contrary to popular myth, Americans do not have better teeth than the British, and indeed the average American has more missing teeth than his UK counterpart. But how did we get to today’s world of celebrities’ near-perfect teeth and cosmetic dentistry?

It probably will not come as a surprise that people in the past suffered from tooth decay the same as we do today. Early toothbrushes with their horsehair bristles often caused more problems than they prevented, and toothpastes or powders made from pulverised charcoal, chalk, brick or salt were more harmful than helpful in the 18th and 19th centuries.

Most of us will have had cavities at some point in our lives. Some of us are even old enough to have had them filled with amalgam: a mixture of mercury, silver, tin and copper. But in earlier periods, having a cavity filled was not an option. Once a tooth began to rot, one had little choice but to have it pulled, without anaesthetic.

Of course, the loss of a tooth could leave a person aesthetically challenged. The wealthy were increasingly unhappy to go around in public with missing teeth. In the 18th century, surgeons began experimenting with implants. Patients who could afford it might choose between “live” or “dead” teeth. With the former, the recipient would have his or her rotten tooth removed before a selection of donors, who would then have their own teeth extracted until one was found that was deemed acceptable in appearance. Afterwards, the tooth was inserted into the empty socket and fixed using a silver wire or silk ligatures.

Although desirable, having a “live” tooth implanted into one’s mouth was a costly endeavour. For the thrifty consumer, teeth extracted from the mouths of the dead proved cheaper. According to one body-snatcher: “It is the constant practice to take the teeth out first … because if the body be lost, the teeth are saved.” During the 19th century, a good set of teeth could fetch as much as five guineas, or roughly £400 today.

As time progressed, the prevalence of tooth decay increased as sugar and tobacco became more readily available, creating a market for dentures. Early versions were made of ivory or animal bone, and typically incorporated the teeth of executed criminals or exhumed bodies.

George Washington: ‘When he was inaugurated as the first president of the United States in 1789, he only had one remaining tooth left in his mouth.’ Illustration: Adrian Teal of <a href="http://www.adrianteal.com">Teal Cartoons</a>

When George Washington was inaugurated as the first president of the United States in 1789, he only had one remaining tooth left in his mouth. Dr John Greenwood – a dentist from New York, and a former soldier in the war of independence – fashioned a set of dentures from hippopotamus ivory, using gold wire springs and brass screws to hold together the human teeth he had procured. There was even a hole left for his one remaining tooth.

Contraptions like this were cumbersome and painful to wear. But more so, these teeth were often plucked from the mouths of those who had died from syphilis, thus infecting their new owners when contaminated tissue came into contact with open wounds in the mouth.

What practitioners really needed was access to young, healthy teeth. That opportunity presented itself during the battle of Waterloo in 1815, which led to the deaths of 51,000 men. “Waterloo teeth”, as they were known, referred to any teeth stolen from the mouths of dead soldiers in the 19th century, and was a term employed during the Crimean and American civil wars. Body-snatchers followed armies into battle, and returned home with bagfuls of teeth that they sold to dentists and surgeons at inflated prices.

As superior as these dentures were to older versions, they still carried with them the stigma of underworld thievery, which didn’t sit well with the toothless upper classes. Eventually, dentists were forced to develop techniques using new materials (such as porcelain) to create dentures that didn’t require the use of dead men’s teeth.

Still, this practice continued well into the 19th century, prompting a professor of anatomy at Trinity College in Dublin to remark on the hypocrisy of the rich towards bodysnatching: “I do not think the upper and middle classes have understood the effects of their own conduct when they take part in impeding the process of dissection … very many of the upper ranks carry in their mouths teeth which have been buried in the hospital fields.”

And, of course, the teeth of those who died fighting their wars.