Jane Elliott

BBC News Online health staff



Treatment was reserved for the elite

But although that might have been the unfortunate state of some people's teeth, others had much better care.

Documents show that, not only were the educationally elite aware of the importance of keeping their teeth clean, but they also knew how to fill cavities and deal with facial fractures.

They could recognise oral cancer and even knew the rudiments of teeth whitening.

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A paper published in the British Dental Journal shows that medieval (12-14th century) literature even makes reference to creating false teeth.

The paper's author, osteo-archeologist Trevor Anderson, said the papers referred to ways of preserving and improving teeth.

There were only a limited number would have access to this

Trevor Anderson

"There were liquids to whiten teeth, methods of removing calculus (plaque) and compounds for filling cavities.

"There is also a reference to dentures made of human teeth or cow bone.

"Surgery is known for oral cancer as well as the repair of fractured jaws."

But Mr Anderson said the documents would only have been available to an elite group of physicians and surgeons, usually based in the larger cities or university towns.

He added: "The richer the person was the more sugar they had in their diet and therefore the more decay. The medieval peasants would probably have been eating a coarser diet and so they would have less trapped in their teeth and therefore less decay.

"Most people would probably have to rely largely on local barber surgeons, the local blacksmith, their friends and their own traditional remedies to treat dental problems."

Herbs

One of the earliest texts 'The Chirurgia of Roger Frugard', which was written in Latin in Italy around 1180AD mentions oral cancer and suggests surgery.

It recommends that in the acute stages the disease can be cured by cutting into the normal flesh around the cancer, cauterising the wound and then sealing it with egg yolk before washing it with wine.

After three days the wound should be rubbed with alum before applying a lotion made from wine and honey and infused with the roots of the herb mullein; honeysuckle, pomegranate and ginger.

It also suggests solving dislocation of the jaw by applying a preparation of marshmallow and giving the patient soft, easily digested food to ensure that chewing does not lead to further dislocation.

The remedy for toothache suggests cauterising the skin behind the ears before heating the plant henbane and leek seeds over hot coals and ensuring the patient inhales the smoke through a funnel.

Welsh folklore makes of the period mentions a variety of herbal remedies and a combination of magic and prayer to cure toothache

Early forms of teeth whitening include using the herb elecampane (Inula helenium) to scrub the teeth and taking sage leaves and making a powder of them and salt.

Our ancestors were far more aware of the value of a good smile than we have previously given them credit for

Jo Tanner, BDA

Sage, along with rosemary and mallows, is suggested to help alleviate gangrene and, soreness of the mouth and along with salt and vinegar to help deal with mouth cancer.

But as well as using the more traditional herbs, writers also suggest several bizarre recipes to promote painless extractions. One instructs medieval dentists to:

"Take some newts, by some called lizards, and those nasty beetles which are found in fens during the summer time, calcine them in an iron pot and make a powder thereof.

"Wet the forefinger of the right hand, insert it in the powder, and apply it to the tooth frequently, refraining from spitting it off, when the tooth will fall away without pain. It is proven."

Prayer

Another, from 1314AD, suggests that simply praying to St Apollonia on her feast day of February 9th,will cure toothache. She was an elderly deaconess who was martyred by having all her teeth extracted and was then burnt alive.

Other literature of the period includes tips to avoid "stinking of the breath" by gargling birch and mint soaked in wine and rubbing the gums with a strong linen cloth until they bleed.

Material used for early fillings include gall nuts, pig grease and myrrh. sulphur, camphor, beeswax, arsenic among others.

Jo Tanner of the BDA said the research showed a fascinating insight into medieval dentistry.

"When most people think about medieval teeth, they think of the likes of Baldrick from Blackadder.

"What this research shows, though, is that our ancestors were far more aware of the value of a good smile than we have previously given them credit for.

"While tooth whitening may be more commonly associated with today's pop stars and Hollywood actors, this research shows that their medieval ancestors were every bit as concerned about projecting star quality with their smiles."