Egyptian Dentists
In an age when Aristotle thought that mares were impregnated by the west wind getting under their tails and the height of medical science was a night spent with the snakes in your local Asklepion, there was, I suppose, some excuse for the reputation that Egyptians held as doctors and healers. There is considerably less excuse these days and yet a surprising number of people still think that ancient Egypt was the repository of all wisdom. The credulous queue up to sit under plastic pyramids or wear charms adorned with hieroglyphs or do other ridiculous things recommended by some trendy guru in touch with his inner Egyptian. Oddly enough, I haven't found anyone eager to indulge in actual Egyptian medicine: vaginal crocodile dung pessaries are in notably short supply in every New Age shop I have encountered.
The other thing that the gullible fail to take into account is the fact that ancient Egypt had no dentists. It is true that seven individuals in the whole of its history have been identified, on the basis of tomb inscriptions, as dentists, but their claims to that status are tenuous, to say the least. It might be expected that "Chief of Dentists" would have a retinue of minor dentists under him, but there is no evidence - either inscriptional or actual - for these lesser dentists and in any case the next title borne by the individual concerned rather casts doubt on his dental qualifications. I would not be very keen on allowing someone with the title of "Guardian of the Royal Anus" to put his fingers anywhere near my mouth!
Although ancient medical papyrii prescribe cures for all sorts of medical problems, from broken bones to hangovers, none of them touch on problems with the teeth, which is all the more surprising given the awful state of ancient Egyptian teeth. From the heights of royalty down to the meanest commoner, Egyptians had rotten and decaying teeth. Rameses II, for example, had such a severe abscess in his lower jaw that it has confidently been claimed that he died from it - but if he didn't, then almost certainly the mouthful of rotting stumps which was all that remained of his teeth prevented him eating a healthy diet.
Oddly, it was the Egyptian diet that was in large part responsible for this epidemic of tooth decay - and in particular Egyptian bread. The first, and perhaps most significant problem, was the way in which Egyptians ground their flour. I first came across this in the report on the Manchester Mummy Project, which noted that Egyptian flour contained a high proportion of sand, far more than could be accounted for from wind-blown sand getting into the dough.
It appeared that the process of grinding wheat into flour was speeded up if you added a handful of sand to the wheat. Both wheat and sand were reduced to powder by the grinding wheels and were eaten together, but whereas the flour merely stuck to your teeth - Egyptian flour was made of emmer which yielded a particularly sticky dough - and hastened tooth decay, the sand formed an abrasive powder that rapidly abraded away the tooth enamel, exposing the pulp to infection and further wear.
Judith Miller, a practising dentist who joined the Manchester Mummy Project team, was so intrigued by what she found that she migrated from treating actual patients to studying forensic Egyptology with particular emphasis on orthodontics. Her most recent study has been to analyse 500 skulls and jawbones from the Natural History Museum in London and the Duckworth Osteological Collection at Cambridge. She has made some interesting findings.
The wear referred to above can be seen from pre-Dynastic times right down to the arrival of the Greeks in the late fourth-century BC, when suddenly it becomes much less of a problem. Miller attributes this to a preference for white bread made from durum wheat (our modern variety of wheat) which came into Egypt with the Greeks.
Miller has also studied the cavities in Egyptian teeth - and she certianly had a lot to study! Dentists today rarely see a really bad cavity because most are picked up in the very early stages by routine examination and those that do escape the net are caught and filled before they have progressed too far. In the absence of dental care, the poor old Egyptians had to grin and bear it, with the result that Miller found cavities that were almost as large as the tooth itself. Just to look at the photographs of some of those decayed teeth is wince-inducing!
The first thing that Miller found was that dental caries increased over time. In pre-Dynastic Egypt only 16% of the population were affected. Once the Hyksos were expelled, however, that figure rose to 25% and when you get to the Roman period 34% of Egyptians had dental cavities. The second thing Miller discovered was that in the early period most cavities were located around the neck of the tooth, down where it is hidden by the gum. From the Persian period onwards, however, this pattern changed with most cavities occurring in the crown of the teeth or at the side between the teeth.
What was worse was that by the time Alexander's successors ruled over Egypt, children suffered from cavities as much as did adults.
Once again, diet was the culprit. As noted above, emmer dough is particularly sticky, so Egyptian bread tended to stick to the teeth after the meal and as the Egyptians, for all their wisdom, had not invented the toothbrush, there was no means of removing this coating of carbohydrate. Tooth bacteria had a field day.
Although the bread situation improved with the coming of the Greeks, increasing prosperity meant that honey, which before was reserved mainly for royalty, now became available to the masses, along with sugary foods such as dates, figs and grapes. The proverbial "sweet tooth" is not restricted to modern, western societies; the Egyptians took to these sweet foods like a duck to water - and paid the price with their teeth.
We have, in these pages, reported on the discovery of prostheses, notably the false big toe worn by an Egyptian to go with his sandals. Even more prosthetic contrivances have been found in mummies; clearly the Egyptians felt that it was important to arrive in the afterlife looking as natural as possible. Curiously, however, this concern does not appear to have extended to teeth. Mummies have been found with all sorts of false bits, even complete false limbs, but never with false teeth.
It does nothing for our image of ancient Egypt to realise that Amenhotep III had no front teeth, or that Rameses II had a mouthful of brown, rotting stumps, but it does even less to picture the great god Osiris greeting the dead with a gappy grin and welcoming them to their eternal abode with crooked yellow fangs. An eternity without dentists might seem like heaven to some people but the alternative of never-ending tooth-ache is less enticing.
