Dental care was a vital part of daily life for the Ancient Greeks and Romans, who recognized the importance of maintaining healthy teeth and gums. Although these societies lacked toothbrushes, fluoride toothpaste, and professional dentistry as it exists today, they developed practical methods for cleaning their teeth and treating common oral problems.
Medical writers such as Hippocrates and Galen recorded observations on oral diseases and recommended methods for preventing and treating dental issues. Archaeological evidence, along with a historical analysis presented in Dr. Roger Forshaw’s study Dentistry and Dental Care in the Graeco-Roman World, demonstrates that the Greeks and Romans possessed a practical understanding of oral hygiene even though many of their treatments were based on the medical theories of their time.
The foundation of ancient dental care rested on the belief that oral health was closely connected to general health. In the Hippocratic tradition, disease was understood through the theory of the four humors—blood, phlegm, yellow bile, and black bile. According to this model, illnesses, including those affecting the teeth and gums, resulted from an imbalance among these bodily fluids. While this explanation was scientifically inaccurate by modern standards, it encouraged physicians to pay careful attention to oral symptoms as signs of broader health conditions. Dental hygiene was therefore part of maintaining bodily balance rather than simply keeping the mouth clean.
Dental care was routine for the ancient Greeks
One of the most common forms of dental care in ancient Greece and Rome was regular teeth cleaning. Instead of nylon toothbrushes, people used cloths, their fingers, or small wooden sticks wrapped in fabric to clean their teeth. Chewing sticks made from aromatic wood or plant stems were also used to dislodge food particles from between the teeth. These simple tools functioned much like primitive toothbrushes, mechanically removing debris and reducing plaque buildup. Although they were far less effective than modern dental instruments, their use demonstrates that maintaining oral cleanliness was considered an important part of everyday life.
Tooth powders also played a significant role in ancient oral hygiene. Dr. Forshaw notes that a wide variety of abrasive substances were combined to polish the teeth. Recipes often included crushed bones, powdered oyster shells, pumice stone, charcoal, charred eggshells that were crushed, and even animal horns or hooves ground into fine powder. Salt was frequently added for its cleansing properties, while aromatic herbs such as mint improved the taste and freshened the breath. Certain formulas also contained myrrh or frankincense, which were valued for their pleasant fragrance and believed to contain medicinal properties. Although these abrasive mixtures could help remove surface stains, repeated use may also have worn away tooth enamel. Nevertheless, they represent some of the earliest attempts to develop specialized products for cleaning the teeth.
Ancient physicians also recognized the importance of keeping the gums healthy. Hippocrates described swollen, bleeding, or painful gums and recommended various mouth rinses made with wine, vinegar, herbs, or plant extracts. Wine was commonly used because its alcohol content was thought to cleanse wounds and reduce infection, while vinegar provided mild antiseptic effects. Herbal preparations containing sage, thyme, or other medicinal plants were believed to strengthen the gums and reduce inflammation. Although the explanations behind these remedies differed from those of modern medicine, some of their ingredients do possess antibacterial or anti-inflammatory properties and may have provided genuine therapeutic benefits.
Clean breath was a sign of wealth
Bad breath, or halitosis, received considerable attention in both Greek and Roman society. Personal appearance and social etiquette were highly valued, particularly among the educated and wealthier classes. Ancient writers recommended chewing aromatic herbs such as parsley, mint, anise, fennel, or cardamom after meals to freshen the breath. Mouthwashes made with wine and herbs were similarly popular. Some individuals also chewed resins, including mastic gum from the Mediterranean region, which helped clean the teeth while stimulating saliva production. Modern research has shown that increased saliva can naturally reduce bacterial growth, suggesting that some ancient practices may have been more effective than their practitioners realized.
Diet also played an important role in dental health in antiquity. Compared with modern populations, many Greeks and Romans consumed less refined sugar because cane sugar was largely unavailable. Their diets relied mainly on grains, vegetables, fruits, olive oil, fish, cheese, and wine. Although honey served as the principal sweetener, it was used less extensively than processed sugar is today. As a result, dental caries, or tooth decay, were generally less common than in modern industrial societies. However, the coarse, stone-ground flour used to make bread often contained tiny fragments of grit from grinding stones. Over many years, these particles caused severe wear on the chewing surfaces of teeth, producing the heavy dental attrition frequently observed in archaeological skeletons. Thus, while tooth decay may have been relatively limited, tooth wear remained a widespread problem.
When preventive measures failed, ancient practitioners attempted a variety of treatments. Hippocrates recommended stabilizing loose teeth by treating inflamed gums and applying medicinal compounds. Painful teeth were often treated with herbal poultices, heated oils, or mixtures intended to numb discomfort. If the pain became unbearable, extraction was considered a last resort. However, Hippocrates advised physicians to avoid removing teeth unless absolutely necessary, reflecting an awareness of the dangers associated with extraction in an age without anesthesia or antiseptic surgery. Instead, practitioners generally sought to preserve the natural tooth whenever possible.
The Romans followed ancient Greek dental care practices
Roman medicine built upon Greek traditions through the work of Galen, whose writings dominated medical education for centuries. Galen regarded oral hygiene as an essential part of preventive medicine. He emphasized regular teeth cleaning and recommended avoiding foods that could damage them. Like Hippocrates, he believed that healthy gums were essential for maintaining strong teeth. Galen also examined the relationship between diet, digestion, and oral health, arguing that proper nutrition supported the body’s overall balance and reduced susceptibility to disease. Although his conclusions were rooted in humoral theory, his emphasis on prevention rather than treatment echoes important principles of modern dentistry.
Forshaw’s study highlights the practical surgical skills of dental care practitioners among the ancient Greeks and Romans, despite their limited scientific knowledge. Archaeological discoveries have revealed dental forceps, probes, elevators, and other instruments resembling modern dental tools. Evidence of carefully extracted teeth suggests that experienced practitioners developed effective techniques for removing them while minimizing damage to surrounding tissues. In some cases, loose teeth were stabilized with gold wire, creating one of the earliest known forms of dental splinting. Artificial replacement teeth, although uncommon, have also been identified, particularly among wealthier individuals who could afford more sophisticated treatments. These findings demonstrate that ancient dentistry extended well beyond simple tooth extraction.
The “tooth worm” and other popular beliefs
Many beliefs about dental disease reflected the medical understanding of the period. Some ancient authors accepted the idea of the “tooth worm,” a mythical creature believed to burrow into teeth and cause pain. Although Hippocratic physicians increasingly sought natural explanations for disease, popular beliefs often coexisted with more rational medical theories. Likewise, magical remedies, amulets, and religious healing rituals occasionally accompanied practical treatments. The coexistence of empirical observation and superstition illustrates the transitional nature of medicine in the ancient world.
The effectiveness of ancient dental care varied considerably among the ancient Greeks and Romans. Mechanical cleaning with cloths, chewing sticks, and tooth powders likely removed some plaque and food debris, while herbal rinses may have reduced bacterial growth and inflammation. The widespread use of mastic resin and aromatic herbs probably contributed to fresher breath and healthier oral tissues. However, the abrasive nature of many tooth powders may have accelerated enamel wear, while the lack of modern understanding of bacteria, fluoride, and sterilization limited the long-term success of treatment. Serious infections could remain life-threatening, and severe tooth decay or abscesses often resulted in extraction rather than restoration.
Although ancient dental care could not match the effectiveness of modern techniques, it laid important foundations for later developments in dental medicine. It also illustrates that concern for healthy teeth has been a continuous feature of human civilization for more than two thousand years.
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