Copy of an Etruscan denture, Europe
Image: The Wellcome Collection
FirstsThis week we're taking a look at first things, early things, and—for better or worse—things that are #1.  

The human body is resilient, but not every part is replaceable internally. As a result, people are always on the lookout for better methods of transplant and prosthesis, which we’ve harnessed as medical tools since ancient times, particularly in our mouths.

After thousands of years of attempts, dental science has recently managed to replace human teeth with lasting, authentic-looking implants (if still expensively), but for hundreds of years before that, sophisticated dentures were king.

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According to historian Scott Swank, who curates the National Museum of Dentistry, numerous examples of dental restoration may be found even earlier in history, but they don’t quite qualify as actual dentures. For example, ancient Egyptians developed bridgework to substitute missing teeth, using gold wire affixed to neighboring teeth to hold one or two false teeth in place—usually ones carved from hippopotamus ivory, or donated by another human.

Copy of Etruscan denture, Europe
Image: The Wellcome Collection

In ancient Italy, the Etruscans used similar methods, as did the Romans who succeeded them. Bridges were formed from metal and ivory, bone, or whole human and animal teeth, Swank said, and archaeological remains show that an implant made out of lead was used in at least one case. “Researchers said there was actually some bone-healing around it, though I can’t imagine what that healing process was like.”

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By the 1100s or so, however, humankind was ready to make the leap to full-on dentures; at least, in some corners of the globe. Around this time, Swank said, what historians generally accept as the first-ever dentures began appearing in China and Japan, though few examples from the early Middle Ages survive today.

The records and artifacts we do have show that the bases for these dentures were carefully carved out of hardwoods such as boxwood to naturally adhere to the toothless human mouth (thanks to saliva, mucous membranes, and the principles of absorption). False teeth were generally carved out of ivory, and set into the wooden bases.

Full upper porcelain denture, London, England, 1795-1814
Image: The Wellcome Collection

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Therein lies the big difference between early Asian and European dentures, Swank said: throughout the Middle Ages and Renaissance, China and Japan produced self-attaching dentures made primarily from wood, while European examples only sprang up in the 15th century, and instead relied heavily on metal.

“We’re not sure why that was, but it may have to do with differences in available trees. You have to have pretty dense wood to do the fabrication, and to not end up with the problems you incur with [wet] wood.”

Whatever the reason, European dentists would opt for metal wire, plates, and springs to install patients’ dentures for the next several centuries. Porcelain sets gained some popularity through the 18th century, but chipped easily, and wouldn’t come equipped with more durable (if uglier) vulcanite rubber bases until the 1850s.

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Lower denture with human teeth, England, 1800-1870
Image: The Wellcome Collection

For false teeth, these pre-industrial artisans would use carved ivory or bone, whole teeth from cows or other animals, and even human teeth that had been removed from other patients, sold by willing donors, or recovered from battlefields.

In the fledging American colonies, these methods also gained adoption — leading, in fact, to one of the biggest urban myths in US dental history.

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As Swank explained, President George Washington is well known for having a set of wooden teeth, but he didn’t; all things considered, he probably would have been happier if he did.

Washington’s longest-running dentures contained ivory teeth and a spring apparatus designed to keep them in his mouth. They were reportedly quite uncomfortable, which could account for the myth that sprang up in later years: in paintings and perhaps in public, “his countenance was described as ‘wooden,’” Swank said.

Dentures owned and worn by George Washington at the Discover the Real George Washington: New Views from Mount Vernon, at the National Constitution Center, Friday, July 1, 2011, in Philadelphia.
Photo: AP

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On the other hand, the misunderstanding could have arisen from a newspaper article published in Philadelphia around the time of the country’s centennial, when Washington’s dentures were on public display. A reporter described their appearance—brown, likely tea-stained, and starting to show ivory’s inner layers that are not unlike rings in a tree—and the public’s takeaway may have been literal.

The dentures, which currently reside in the National Dentistry Museum, “probably had a wooden look” to that reporter, Swank said.

As any dentist can tell us, however, it’s what inside that counts.

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