Humans aren’t the only animals that take care of their health.
Researchers have seen how chimpanzees will go out of their way to find medicinal plants to chew when ill. Long-tailed macaques have been seen using strands of hair and plant fibers in ways that look like flossing.
But drilling into a diseased and painful tooth seems pretty next level. Yet evidence that Neanderthals did just that was recently published in PLOS One. Markings were found on a roughly 59,000-year-old molar that suggested that someone intentionally used a stone to work on it. The markings extended all the way into the pulp chamber — the living center of the tooth that contains nerves and blood vessels.
The tooth also showed signs that it had continued to be used after the procedure. If the researchers are correct, these findings could represent the oldest known evidence of successful dental treatment.
It’s also a nice reminder that Neanderthals may have been far more sophisticated and clever than the cultural stereotype gives them credit for. As one researcher noted, the finding may represent a transition from instinctive self-medication to a deliberate medical strategy, suggesting that interventional dental care was not exclusive to Homo sapiens.
Most importantly, though, the study highlights something that hasn’t changed in tens of thousands of years: when a tooth hurts, people want relief.
In fact, most of us probably don’t think much about our teeth until something goes wrong. Perhaps a tooth becomes sensitive. It aches when touched by a hot or cold food or drink. Or pressure when biting. Even the touch of a cool breeze while you’re outside talking with a friend.
Then sometimes the pain disappears. Good news, right? Well, sometimes. But when a tooth has been severely damaged by decay or trauma, the opposite is often true. The living tissues inside the tooth may be dying or already dead. The pain disappears not because the tooth has healed but because it can no longer send pain signals.
This is one reason why we pay close attention to a tooth’s vitality. The absence of pain doesn’t always mean the absence of disease.
Those tissues inside the pulp chamber are what make each tooth a living (vital) organ. They include blood vessels, nerves, connective tissue, and immune cells. These tissues nourish the tooth and allow it to respond to injury. Each tooth is also attached by a periodontal ligament, which helps absorb force and provides sensory feedback every time we chew.
A healthy tooth is a vital tooth that participates, both physically and energetically, in the body’s larger biological processes.
Today, when a tooth’s pulp becomes irreversibly damaged or infected, the usual dental response is to recommend root canal therapy. This procedure involves removing all tissues from the pulp chamber, cleaning the root canals, and filling the remaining space in an effort to preserve the tooth’s structure and function. In many cases, the tooth can remain in the mouth for many years.
From a conventional perspective, this is considered a successful outcome.
Biological dentistry takes a different view. We recognize that while a root canaled tooth may work for biting and chewing, and may keep other teeth from shifting, it’s still a dead tooth. We understand that a healthy tooth is much more than an enamel and dentin shell.
This goes along with recognizing how remarkably complex a tooth’s anatomy can be. Beyond the main root canals are tiny accessory canals, microscopic dentinal tubules, and anatomical variations that can differ dramatically from one mouth to another. Even teeth that look almost identical from the outside may look very different beneath the gumline.
To really appreciate this, take a look at this extracted molar that a dentist recently shared on Reddit (which one commenter referred to as “Toothulhu”):
Asked to picture a tooth, most people probably don’t picture anything close to this. Yet outliers like this help illustrate an important point: Teeth aren’t simple structures. They’re biological structures, and biology is seldom as neat and orderly as the diagrams found in textbooks.
Because of this kind of complexity, researchers in biological dentistry have long raised questions about the possibility of truly thorough cleaning and disinfection of a tooth’s insides, and what kinds of bacteria may be left behind — not to mention the potential chronic effects on mouth/body health. All these are topics we’ve looked at before, and we encourage you to check out those past posts in our archive.
For now, though, it’s enough to return to the Neanderthal tooth that started this discussion.
Nearly 60,000 years ago, someone seems to have used a stone tool to treat a painful tooth. Was the goal to remove decay? Relieve pressure? Just make the tooth more tolerable? What seems clear is that they were trying to preserve something.
Today, we have far more sophisticated tools and a much deeper understanding of oral health. Yet the same fundamental questions remain. What makes a tooth healthy? What makes it worth preserving? And what happens when a tooth can no longer remain alive?
From a biological perspective, those questions start with vitality. A healthy tooth is more than a structure. It’s a living part of the body. Our first goal is to help each and every tooth stay that way.
