Our relationship with teeth is uneven, messy and grim

By A.L.

EYES are not the window into the soul—teeth are. They can be rotten, wise or broken; they reveal our diet, health and wealth. As babies, we learn about the world around us by munching our way through it. Teeth are the only exposed part of our skeleton while we are alive. And when we die, they will be the part of our body that longest remains on earth. If we perish in a particularly grisly fashion, our dental records may be what identifies us.

These are all good reasons to visit the dentist. But, as a new exhibition at the Wellcome Collection in London shows, for most of history that visit was an ordeal that didn’t involve a dentist armed with anaesthetic and suction tubes so much as a tooth-puller with crude pliers. The craft was more a spectacle than a science. One practitioner, known as Le Grand Thomas, made his living in 18th-century Paris by lifting people off the ground by their teeth, letting gravity do the yanking.

Pierre Fauchard, the first self-styled dentiste, helped put a stop to that with his scientific approach to oral health. The author of the first treatise on the subject—“Le Chirurgien Dentiste (“The Surgeon Dentist”), published in 1728—he pioneered the use of fillings, braces and even the dental chair. Fauchard believed that what the world’s wealthy needed was to have nice teeth that functioned properly, and he became rich in his own right by providing dentures to Parisian elites.

But healthy human chompers were a rare commodity. Anatomy schools were one source; fabricated porcelain dentures were another, but their brittleness and lack of verisimilitude put off self-conscious aristocrats. A better alternative came from the dead: grave-robbers and battlefield-scavengers were dentists’ earliest business partners. The site of the battle of Waterloo, which left over 50,000 dead, was said to have been left toothless within 24 hours. The practice spawned a following—a “Waterloo tooth” was the name given to any gnasher filched from a deceased soldier, as tooth-robbery continued into the Crimean and American civil wars.

The exhibition is at its best when it probes the inequalities of the dentistry business. Even after Fauchard’s innovations, gruesome and bloody customs persisted. Doctors viewed oral pathologies with contempt, and left tooth removal to “barber-surgeons”, whose job it was to trim hair, amputate limbs and pull teeth. One 16th-century surgeon sympathetically warned that wrenching out teeth “should not be carried out with too much violence” since it carried the risk of “bringing away a portion of the jaw together with the tooth”. For those who could not afford even these rudimentary services, blacksmiths did the trick. Unsurprisingly, their instruments of choice were heavy-duty pliers, more fitting for metalwork than molars.

In one cartoon (pictured, top), a chimney-sweep coated in soot has his teeth wrenched out in order for them to be transplanted into the mouths of the wealthy; children observe with glee. This scene may well have been plucked from reality: an 18th-century dentist in New York ran a newspaper advertisement offering two guineas (equivalent to about £350, or $475 today) for people to give up their front teeth. But inequality cut both ways. Queen Elizabeth I was said to have painful cavities from excessive sugar—a luxury item.

The exhibition’s overview of the modern era has rather less bite. Giant teeth used at dentistry schools are displayed, opposite clever and artsy toothpaste advertisements, posters of public health campaigns and the ever-dreaded dentist’s chair. But the theme of inequality is less clear. One poster from the 1990s, produced by Britain’s Health Education Authority, espouses the dangers of sugar to babies’ teeth and is accompanied by a thin description. We are told that there are significant regional inequalities in tooth decay today without learning what those inequalities are. Age and socioeconomic inequalities aren’t probed either: the poorest over-65-year-olds in England, Wales and Northern Ireland have on average eight fewer teeth than the wealthiest. A study in Sweden showed that the poorest three- to six-year-olds are four times more likely to be at risk of tooth decay than their wealthy counterparts.

Another section deals with the desire for a “Hollywood smile” that has driven modern dentistry. Alongside a set of “grillz” (replaceable blingy retainers adored by celebrities, pictured below) there is a tooth from Mayan civilisation encrusted delicately with jade. This is a truly fascinating artefact—and is almost 1,000 years older than everything else in the exhibition, which deals only with the past 300 years of Western society’s relationship with teeth. The Mayan tooth intrigues, raising more questions about dentistry’s history than the exhibition can answer. Some viewers may long for a wider-ranging show in order to really get their teeth into the subject.

The exhibition brings the fascinating history of dentistry—grim, messy and socially unequal—to life, but one burning question remains. A tooth exhibition in Britain might have been expected to answer whether the English really do have bad teeth. There are tantalising hints: a dentist on the Finchley Road advertised his practice as “Riddle Stower’s English & American Dental Association”, suggesting that association with America added prestige. Visitors also learn that, within nine months of its founding in 1948, the National Health Service provided 33m individual artificial teeth. Have things changed since? By 2004, the tide seems to have turned: 12-year-old American children had almost twice as many missing or filled teeth as British kids. Something to chew on.

“Teeth” is showing at the Wellcome Collection until September 16th