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What Did Ancient Egyptians Do When They Got a Toothache? — Transcript

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0:00Bite into a piece of bread right now,
0:02and the worst thing that happens is a
0:03dry crust. Bite into bread in ancient
0:06Egypt, and you get sand. Not a little,
0:09not once. Grit in the loaf at breakfast,
0:11grit in the loaf at midday, grit in the
0:14loaf your employer hands you as wages.
0:17Because in Egypt, bread was money. And
0:19every one of those bites drags a fine
0:21layer of quartz across your back teeth.
0:24Do that for 20 years, and here is what
0:26your mouth becomes. The peaks and ridges
0:28on your molars are gone. The crowns are
0:30worn flat like stone steps in a church
0:32walked on for four centuries. Look at
0:35enough Egyptian skulls, and you find
0:37molars sanded so far down that you can
0:39see straight into the middle of the
0:40tooth, where the nerve lives. That is
0:43where an Egyptian toothache begins. Not
0:46a hole eaten from the inside by sugar, a
0:48mountain sanded into a plane. So, what
0:50did they do about it? The answer is
0:52better than you expect, and much
0:55stranger. You are going to meet a man
0:57buried at Giza with two holes drilled
0:59through his jawbone under a rotten
1:01molar, and the argument over who drilled
1:03them. Two teeth bound with gold wire,
1:06and a fight over whether that was
1:08dentistry or funeral housekeeping. A
1:10paste of cumin and frankincense pressed
1:13into a gum, which lands closer to modern
1:15practice than it has any right to. A
1:18worm that lived between the tooth and
1:20the gum, and had to be spoken to out
1:22loud three times. A palace official
1:25whose job title translates as guardian
1:27of the anus, and why he mattered to your
1:30mouth. And a queen who kept her own
1:32tooth in a box and got her name back
1:33because of it. And underneath all of it,
1:36the strangest fact in the story. When an
1:38Egyptian got a toothache, they almost
1:40never did the one thing you would do.
1:43Throw out the picture in your head
1:45first, because a modern toothache and an
1:47Egyptian toothache are two different
1:49injuries. Ours works from the inside
1:52out. Sugar feeds bacteria. Bacteria make
1:55acid. Acid drills a tunnel down through
1:57the enamel, and one day that tunnel
1:59arrives at the nerve. There's worked
2:01from the top down. No tunnel.
2:04No secret decay hiding under a healthy
2:06surface. Just relentless mechanical
2:08grinding. Taking the roof off the tooth
2:11until there was no roof left. The word
2:13for it is attrition. And in Egyptian
2:15remains, it is not a common finding. In
2:18adults, it is close to a universal one.
2:20Farmer, scribe, priest, soldier, queen.
2:22So, the first real question is not what
2:24medicine they had. It is where all that
2:27sand was coming from. Three sources, and
2:29the third one did the damage. The first
2:31is Egypt itself. The whole country is a
2:34green ribbon lying in the middle of an
2:36enormous sandbox. And the wind never
2:39stops making deliveries. Fine sand
2:41settles on the threshing floor, on grain
2:44drying in the sun, on the open mouth of
2:46the storage jar. The second is how grain
2:48was processed. Emmer wheat was beaten
2:51out on packed earth in the open air,
2:53then tossed up so the breeze could carry
2:56off the chaff. Everything that came back
2:58down came down through dust. The third
3:01is the grinding stone. Flour was made on
3:03a saddle quern. A slab of sandstone or
3:05quartzite with a smaller stone pushed
3:07back and forth across it by hand. Push
3:10stone against stone for an hour, and
3:12stone comes off. Those particles go
3:14straight into the flour. And you cannot
3:16sieve out a grain of quartz that is the
3:18same size as the grain of flour beside
3:20it. So, the tool that made their food
3:22was quietly feeding itself into their
3:24food. And the last grinding surface in
3:26the whole process was not the quern. It
3:29was the inside of a person's mouth. This
3:31is not a guess. Loaves survive from
3:34tombs left as provisions for the next
3:36world and preserved by the dry air. Take
3:39one apart under a microscope, and you
3:42find quartz, feldspar, and mica sitting
3:44in the crumb. There is still an argument
3:46about how much blew in and how much
3:48ground in. Nobody argues is whether it
3:50was there. And here's the cruel part.
3:53Bread sat at the center of Egyptian
3:55life. Workmen were paid in it by the
3:57loaf alongside jars of beer. A better
4:00job meant a bigger ration, which is a
4:02strange way of saying that in ancient
4:04Egypt a raise came with extra sandpaper.
4:06Now, if you have been wincing through
4:08all of that, I have good news that
4:10genuinely surprised me. A tooth is not a
4:12passive lump of mineral. It is a living
4:14organ with a blood supply and it fights
4:16back as the surface wears away. The
4:19cells lining the nerve chamber
4:21underneath lay down fresh dentine,
4:23thickening the floor and pulling the
4:25nerve down out of reach. The tooth is
4:27being resurfaced from below while it is
4:29sanded from above. Give that process
4:32enough time and it wins, which is why
4:34Egyptian cemeteries are full of adults
4:37with molars ground to smooth brown
4:38stumps and no sign of infection
4:40anywhere. Their teeth looked ruined.
4:43Their teeth were fine. The toothache
4:45arrives when the grinding gets ahead of
4:47the repair. Sometimes that is a hard
4:49bite on one large stone in a loaf and a
4:51corner shears off. Sometimes one spot
4:54simply wears faster than the rest.
4:56Either way the sealed chamber opens.
4:58Bacteria walk into a space that has
5:01never had any and the nerve dies in the
5:03dark. Then it gets serious. The
5:06infection travels down the root and
5:08settles at the tip inside the bone of
5:10the jaw and starts building a pocket of
5:12pus in a place with absolutely no room
5:15for one. That is the pain people
5:16describe as the worst of their lives. It
5:19has a pulse. You can feel your own
5:21heartbeat in your face. And that is the
5:23moment your Egyptian goes looking for
5:25help. You do not go to a dentist. You go
5:28to a cupboard. Egyptian household
5:30medicine was written down and a lot of
5:32it survives. The largest collection is
5:34the Ebers Papyrus, copied around 1550
5:37before the common era. More than 60 ft
5:40of it unrolled, carrying over 800
5:43remedies. Inside is a short run of
5:45recipes for the mouth. One treats a
5:47tooth being eaten away where the gum
5:49begins. The prescription is cumin, resin
5:52from the terebinth family, the same
5:54aromatic world frankincense comes from,
5:57and the fruit of the carob tree. Grind
5:59to powder, apply to the tooth. Another
6:03is for a tooth gone loose. Powdered
6:05ochre and honey packed onto it. It is
6:07easy to read that and hear folklore.
6:10Look closer because three separate
6:12things in that list are doing real work.
6:14Honey is a true antibacterial, not folk
6:17wisdom chemistry. It pulls water out of
6:19bacterial cells. ID runs acidic, and it
6:22releases small amounts of hydrogen
6:24peroxide as it sits. Hospitals still put
6:27medical grade honey on wounds, which I
6:29find quietly delightful. The resins
6:32carry compounds with measurable
6:34antimicrobial and anti-inflammatory
6:36activity, but the biggest effect is the
6:38least glamorous one. Press a thick paste
6:41into a worn-out crater in a molar and
6:43you have sealed the exposed dentine away
6:45from cold air, cold water, and food.
6:48Anyone who has had a tooth turn
6:50sensitive knows how much of that pain is
6:52simply contact. That is not
6:55superstition. That is a temporary
6:57filling, and a modern dentist places one
6:59most days of the week. They were
7:01cleaning, too. A papyrus in Vienna
7:04carries a tooth powder from the 4th
7:06century of the common era. Rock salt,
7:08mint, dried iris flower, and pepper.
7:11Ground fine described as a powder for
7:13white and perfect teeth. Modern dentists
7:15have reportedly mixed it up and tried
7:17it. The verdict was that it worked
7:19impressively well and that it made their
7:21gums bleed, which is roughly how I feel
7:24about most ancient recipes. Then there
7:26is willow. Egyptian remedies use it on
7:29swelling, and willow bark contains
7:31salicin, the compound aspirin was
7:33eventually built from. No papyrus tells
7:36anyone to go chew a willow twig for a
7:38sore tooth. What we have
7:40is a culture laying a genuine painkiller
7:44on to inflammation without any way of
7:46knowing why it helped. To understand the
7:49rest, you have to understand what they
7:51believed was happening in there.
7:52Egyptian medicine had a concept called
7:55wekhedu, usually explained as a kind of
7:57rot or pain matter that could form
8:00inside the body, travel, and settle
8:03somewhere to cause disease. Follow that
8:05idea honestly, and a bad tooth is not a
8:08local problem at all. It is a whole body
8:10problem that happens to be surfacing in
8:12your mouth, which is why remedies for
8:14teeth sit in the same papyri, inside the
8:17same system, as purges and enemas. If
8:20rot travels, you flush the pipe. That
8:23logic produced one of my favorite job
8:25titles in the history of employment. The
8:28royal household included an official
8:30whose title is usually translated as
8:32shepherd or guardian of the anus, the
8:35palace enema man. There was a career
8:38ladder, and somebody climbed it. Now,
8:40the worm. Egyptian texts name small
8:43creatures, feneti, in connection with
8:46teeth. The fullest version survives from
8:48Mesopotamia, on a clay tablet in the
8:51British Museum. After the gods finished
8:53making the world, a worm comes before
8:55the god Ea and weeps. It is offered figs
8:58and apricots,
9:00it refuses them, and asks instead for a
9:02home between the tooth and the gum, so
9:05it can drink the blood of the tooth and
9:07gnaw at the roots. Then the tablet gives
9:09the treatment. Mix beer, ale, plantain
9:12oil, recite the incantation three times,
9:15apply to the tooth. Do not laugh too
9:18fast because more is going on than a
9:20fairy tale. Start with the fact that the
9:22pain genuinely feels like a living thing
9:25burrowing. Anyone who has sat up with a
9:27bad tooth at 2:00 in the morning has
9:29felt something in there that seemed to
9:31be moving with intent. Then look at the
9:33instruction. Recite three times, then
9:35apply. That is a dosing schedule. The
9:38incantation is what makes an unwritten
9:40treatment repeatable, teachable, and
9:43timed. It is the procedure card. And
9:45there is the part we are worst at
9:47admitting. When you cannot remove the
9:49cause of someone's pain, managing their
9:51terror is not a consolation prize. It is
9:54a large share of what medicine has
9:56always actually done. So, where were the
9:58dentists in all this? Egypt had them,
10:01which is the confusing part. Roughly
10:034,600 years ago, in the reign of Djoser,
10:07a man named Hesy-Ra held an office
10:09recorded as great one of the teeth and
10:12of the physicians. Hesy is the earliest
10:14human being whose name we hold alongside
10:16a dental title. His tomb at Saqqara was
10:19lined with carved wooden panels, showing
10:22him lean and alert with a scribe's kit
10:24over his shoulder, still among the
10:26finest wood carving to survive from the
10:28Old Kingdom. So, Egypt gets a chief
10:30dentist before it has finished inventing
10:33the pyramid. And then almost nothing
10:35then follows. Across 3,000 years of
10:37Egyptian record keeping, the number of
10:39people known to carry a tooth title is
10:42startlingly small, in the single digits
10:44and low teens depending on who is
10:46counting. Specialists still argue over
10:48whether some of those men treated
10:50anybody or simply held the rank.
10:53Herodotus reached Egypt more than 2,000
10:55years after Hesy-Ra and wrote that the
10:57country was crowded with specialists,
10:59each physician handling one disease and
11:02no more. Some for the eyes, some for the
11:05head, some for the teeth, some for the
11:07belly. He was a tourist collecting
11:09stories from guides, and he never met a
11:11good story he wanted to shrink. But the
11:14surviving titles do back his general
11:17shape. So, here is the turn. Egypt had
11:19named dentists at the very start of its
11:21written history, and physicians of
11:23remarkable sophistication for the
11:25ancient world. What it does not seem to
11:27have had, judging by the bones and the
11:30instruments, is very much dentistry.
11:32There is one find that keeps everybody
11:34honest, an old kingdom jawbone from Giza
11:38with a molar that had gone bad and an
11:40abscess in this bone beneath it. And in
11:42the outer wall of that jaw, directly
11:44under the tooth, two small holes running
11:46into the abscess pocket. To see why that
11:49matters, you need one fact about the
11:51pain. An abscess is a bag of pus
11:53expanding inside bone, and bone does not
11:56stretch. The pressure has nowhere to go,
11:58so it leans on the nerve. That is the
12:01entire mechanism, which means the relief
12:03is not complicated either. Open the bag
12:06and the pain drops away in seconds.
12:08Still true, by the way. When a modern
12:10dentist meets a face swollen tight with
12:13infection, the first move is often not a
12:15drill and not an extraction. It is a
12:18small cut to let it out. Same principle,
12:214 and 1/2 thousand years apart. Now the
12:23caveat, because it matters. This is one
12:27jaw, and the debate is whether a person
12:29made those holes or the disease did.
12:32Abscesses carve their own escape routes
12:34through bone, and Egyptian jaws are full
12:37of those natural drains. Either reading
12:39leaves something standing. These were
12:41people living in mouths where holes
12:43opened by themselves and delivered
12:45instant relief over and over in front of
12:48everyone. They had every reason to learn
12:50what a burst swelling does, and tools
12:52were not the obstacle because this is a
12:54civilization that was drilling stone
12:56vessels out of granite. I keep thinking
12:59about what that procedure would have
13:00been like. Not for the man holding the
13:02drill, for the man holding still. Then
13:05there is the evidence everybody wants to
13:07be true. Two famous finds, one from Giza
13:10and one from El Qatta, each with molars
13:13bound together by fine gold wire. For
13:15decades, these were shown off as proof
13:17that Egyptian dentists were building
13:19bridges and splinting loose teeth. The
13:22trouble is what the gold looks like up
13:24close. On at least one, there is little
13:26sign of the wear you would expect from
13:28years inside a working mouth. So, the
13:31reading most specialist now favor is not
13:33treatment at all. It is preparation for
13:36burial, a repair made to a body rather
13:38than to a patient. So, the dead would
13:40enter eternity complete. Set that beside
13:43the Etruscans in Italy around 700 before
13:46the common era. They were making gold
13:48band bridges with substitute teeth fixed
13:51into them. And those pieces show real
13:53wear. People ate with them. So, the
13:56difference is not craftsmanship. And it
13:58is certainly not access to gold. Egypt
14:00had goldsmiths who could do finer work
14:03than that in their sleep. They could
14:05have. They mostly did not. That is a
14:08decision, and it has reasons. So, why
14:11not simply pull it? Three of them, and
14:13they stack. The first is physical. A
14:16worn Egyptian tooth is not the tooth a
14:18modern dentist grips. When a tooth takes
14:21years of punishment, the body reinforces
14:24it. Laying extra cement onto the root,
14:26and roots can thicken, spread, and lock
14:28into the socket. Removing that is not a
14:30lever job. It is a demolition job inside
14:33a bone you cannot see into. And no
14:36surviving Egyptian instrument set
14:38contains anything resembling dental
14:39forceps. The second is medical. Picture
14:42the wound you have just created. An open
14:45socket in an already infected jaw in a
14:47hot country with no antiseptic, no
14:50antibiotic, and no reliable way to stop
14:53bleeding. The extraction can kill the
14:55patient faster than the tooth was going
14:57to. The third is the Egyptian reason.
15:00The body had to enter the next life
15:02whole. That principle runs through
15:04everything they did with the dead.
15:06Through the care taken with organs.
15:08Through burials where a lost limb was
15:10kept and buried with its owner. Nobody
15:12left us a note saying that is why the
15:15tooth stayed in the jaw. But, it fits
15:17everything else they believed about
15:19bodies. Put the three together, and the
15:21strategy make a sense or a toothache in
15:24Egypt was managed, not solved. You
15:26packed it, you dozed it, you said the
15:29words over it, you flushed the body and
15:31you waited to see whether it would
15:33settle or burst because on their terms
15:36that was frequently the better bet. An
15:38angry tooth might go quiet for years and
15:40an open hole in the jaw might never go
15:43quiet at all which brings us to the most
15:45impressive document in this whole story
15:47and the bleakest sentence in it. The
15:50Edwin Smith Papyrus is a surgical text
15:52copied around 1600 before the common era
15:55from an original that was already
15:57ancient. It works down the body case by
15:59case starting at the head and the
16:02structure is the astonishing part. Every
16:04case gives an examination, then a
16:06diagnosis, then a verdict and the
16:08verdict is one of three. An ailment I
16:11will treat, an ailment I will contend
16:13with, an ailment I will not treat. That
16:17is triage written down, standardized, 35
16:21centuries old. The jaw appears more than
16:23once. One case describes a jaw that has
16:26come out of its joint and gives the fix.
16:29Put your thumbs on the back ends of the
16:31lower jaw inside the mouth. Put your
16:33fingers under the chin and press down
16:35and back until it seats. That is very
16:38close to the maneuver an emergency
16:39doctor performed on somebody this week.
16:42So they were not helpless when the
16:44problem was mechanical. They were
16:46excellent and then comes the other case.
16:48A fractured jaw with a festering wound
16:51and a fever. The verdict is the third
16:53one, an ailment not to be treated. That
16:56deserves a moment because it is not
16:58fatalism. It is accuracy. Here is what a
17:01spreading dental infection does when
17:02nothing stops it. It leaves the bone and
17:05moves into the soft tissue under the
17:07tongue and the floor of the mouth swells
17:09and pushes the tongue up and back until
17:11the airway closes or it travels the
17:13other way toward the sinus and the veins
17:15behind the eye. This is not safely
17:18ancient history, either. People still
17:20die of dental infections today, where
17:22care does not arrive in time, and rank
17:24protected nobody. The mummy of Ramesses
17:27II, who ruled for 67 years and lived
17:30into his ninth decade, carries teeth
17:33worn to the roots, abscesses, and severe
17:35gum disease. Amenhotep III is in similar
17:38condition. There is an unfair twist in
17:40it, too. Wealth bought finer,
17:42better-sieved bread, which meant less
17:45grit and less wear. Wealth also bought
17:47honey, dates, figs, sweet cakes, and a
17:51great deal more beer. What elite remains
17:54suggest is that the rich mostly traded
17:56one disease for the other. They ground
17:59their teeth down less, and they rotted
18:01them more. Everyone at that table paid.
18:04They simply paid differently. In the
18:061880s, a small wooden box came out of a
18:09cache at Deir el-Bahari, the great
18:12terraced temple built by the woman who
18:14ruled Egypt as king. Her name was on the
18:16outside. Inside were a piece of
18:19preserved organ and a single molar
18:21tooth. For more than a century, it sat
18:23in a case as a curiosity, an odd thing
18:26to keep. Then, in 2007, a team working
18:30through unidentified mummies took a hard
18:32look at an older woman recovered from a
18:33small tomb in the Valley of the Kings.
18:36She had a gap in her upper jaw. They put
18:38the tooth from the box through a scanner
18:40and compared the two. The team reported
18:42that it fit, and they reported one more
18:45detail I have not been able to shake. A
18:47fragment of the root was still sitting
18:49in the socket in her jaw. Whatever took
18:51that tooth out did not take all of it.
18:54It broke. Their reading was a woman in
18:56her 50s, heavy, with a mouth in ruins,
19:00and a plausible chain running from
19:01abscess to infection to death. Not
19:04everyone accepts it. The identification
19:06is disputed, and you cannot pull a
19:08certain cause of death out of a dry
19:10body. Three and a half thousand years
19:12later, what survives every version of
19:14the argument is smaller and better.
19:16Somebody looked at a tooth that had come
19:18out of the mouth of a king of Egypt and
19:21did not throw it away. They embalmed it.
19:23They boxed it. They wrote her name on
19:25the lid and sent it into eternity with
19:28the rest of her. Because a tooth that
19:30leaves your head is not garbage. It is
19:33part of you and you are going to need
19:35all of your parts. So, what did an
19:37ancient Egyptian actually do when they
19:40got a toothache? They packed it. Cumin
19:42resin, ochre honey, pressed into the
19:44crater to seal it against the cold. They
19:47dosed themselves with whatever the
19:48household had, some of which held real
19:51medicine and none of which they could
19:53measure. They said the words three times
19:56because the words turned a smear of
19:58paste into a procedure. They flushed the
20:00body because they believed the rot had
20:03traveled to get there. If it swelled
20:05hard enough, someone may have opened it.
20:07And if nobody did, the body opened it
20:10alone. And then they left the tooth
20:12exactly where it was. That is the answer
20:15and it is defined by an absence. Modern
20:17dentistry is built on taking things out.
20:20Drill out the decay, take out the nerve,
20:22take out the tooth. Egyptian dentistry
20:25was built on holding on. It half worked
20:28and the reason is the sand. A disease
20:30that arrives over 30 years gives the
20:32body 30 years to defend itself and the
20:35tooth spends those decades building new
20:37floors under the nerve while the great
20:40takes the ceiling away. The most
20:42effective dentist in ancient Egypt was
20:44the inside of the tooth. Everything the
20:46humans added, the paste, the honey, the
20:49incantation, the drainage was buying
20:52time. In a race the body was already
20:54running on its own and when the body
20:56lost that race, the best of them did not
20:59pretend otherwise. They examined, they
21:01diagnosed and sometimes they wrote down
21:04the only honest thing available, an
21:06ailment not to be treated. So, the next
21:09time you are eating and your teeth close
21:11on one hard grain that should not be
21:13there. And you stop chewing for a second
21:15and go still. Notice that reflex. It is
21:18very old. Somebody in Egypt felt that
21:21exact grain in the loaf and in the next
21:24loaf and in every loaf for a whole life.
21:27And they kept eating because it was
21:28bread and bread was everything. And
21:30there was nothing else to be done about
21:32it. Here is what I want to know from
21:34you. If your tooth started hurting
21:36tonight and the only three options on
21:38the table were the cumin and
21:40frankincense paste packed into your gum,
21:42the incantation recited three times over
21:45your head, or two small holes drilled
21:48through your jaw to let the pressure
21:50out, which one are you taking? Put it in
21:52the comments and be honest. I will see
21:54you in the next one.

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