Neanderthals performed dental treatment far earlier than once believed, according to a new study that examined a damaged molar from a cave in Siberia.
The study, led by Alisa V. Zubova and published in PLOS One, suggests Neanderthals may have drilled into a diseased tooth about 59,000 years ago. Researchers say the find could be the earliest known evidence of invasive dental treatment in human evolution.
A painful tooth from Siberia
The tooth came from Chagyrskaya Cave in the Altai Mountains of southwestern Siberia. The site has produced one of the richest collections of Neanderthal remains in North Asia.
Researchers studied a lower molar known as Chagyrskaya 64. The tooth belonged to an adult Neanderthal. It had severe wear, deep decay, and a large hollow area on its chewing surface.
The hollow reached the pulp chamber, the inner part of the tooth that contains nerves and blood vessels. Such damage would likely have caused intense pain.
Signs of deliberate drilling
The team used microscopes, micro-CT scans, scanning electron microscopy, and Raman spectroscopy to study the tooth. They found that the hollow did not appear to come from normal wear, trauma, or natural damage after burial.
A 59,000-year-old Neanderthal tooth from Siberia may contain the earliest known evidence of dental treatment in human history.
Researchers say Neanderthals likely used sharp stone tools to drill into a decayed molar to relieve pain — thousands of years. pic.twitter.com/CUTEXFXuxM
— Tom Marvolo Riddle (@tom_riddle2025) May 14, 2026
Instead, the shape and marks suggested deliberate action. The cavity appeared to include three connected depressions. Researchers also found fine scratches and grooves along the walls of the hollow.
To test the idea, the team used small stone tools on modern human molars. The experiments showed that a pointed stone tool could create similar marks through a drilling or rotating motion.
Researchers said the Neanderthal tooth likely had a deep cavity caused by decay. Someone may have removed damaged tissue to reach the painful pulp chamber.
More than toothpick use
The molar also showed marks from toothpicking. That means the individual may have used more than one method to deal with dental pain.
Toothpick marks have been found in earlier human relatives and even in some primates. But drilling into a tooth would require more planning, control, and skill.
The study says this action likely involved careful hand movement, tool selection, and pain tolerance. It also suggests Neanderthals may have understood that removing damaged tissue could reduce suffering.
A new view of Neanderthal care
The finding adds to growing evidence that Neanderthals were not simple or primitive. Previous studies have shown they cared for injured group members, used tools with skill, and adapted to harsh environments.
The Chagyrskaya molar may now push the history of dental treatment back tens of thousands of years before similar evidence in modern humans.
Researchers said the tooth offers rare insight into Neanderthal health care. It suggests they may have carried out deliberate medical actions, not just instinctive responses to pain.
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