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PEOPLE HAVE BEEN getting cavities as long as there have been people, and people before modern dentistry had some strange theories about what was causing them. A popular one believed around the world for thousands of years was the idea of “tooth worms.”

Ancient Sumeria Got the Tooth Worms Ball Rolling

As far back as 5000 B.C., tooth worms were listed in Sumerian texts as being a reason for tooth decay. They’re also mentioned in ancient Chinese scripts from 1500 B.C. in text carved from bone. People in the Roman Empire and medieval Europe also believed in tooth worms, which were said to gnaw at the teeth and live in the gums and cavities.

Why Was the Tooth Worms Theory So Common?

There are a few theories about why people all over the world believed cavities were caused by tooth worms:

• Guinea worms in drinking water, which people would have seen and may have incorrectly connected to tooth problems
• The worm-like structures of dental roots, which could be mistaken for worms by people who didn’t know better
• Henbane seed treatments, in which a person would inhale the fumes of burned henbane seeds. Ironically, the ash of the burned seeds looks like worms, and the plant’s narcotic effects would relieve tooth pain. People may have drawn the wrong conclusions.

Other Cavity Myths

Over the ages, people have attributed cavities to a variety of other causes:

• Chemical agents
• Defective saliva
• Inflammed jaw bones
• Sudden changes in temperature
• Injuries (this one can be true; a tooth cracked by injury is vulnerable to infection)

How Cavities Actually Form

Thanks to modern dentistry, we know that the culprit behind tooth decay isn’t worms but dental plaque, which is a mixture of bacteria, acids, and food debris mixed with saliva. As it builds up, it erodes the outer layer of a tooth, creating tiny holes called cavities. If the bacteria reach the pulp at the center of the tooth, the tooth will become infected and possibly abscessed, which involves swelling and severe tooth pain.

How to Prevent Cavities

Far from the henbane treatments of old, as modern dental health professionals, we can recommend good dental hygiene habits that will actually help prevent cavities, including:

• Twice-daily brushing with a soft-bristled toothbrush and a fluoride toothpaste
• Daily flossing (use floss picks or a water flosser if traditional floss is difficult for you)
• Limiting your sugar intake (especially from soda and fruit juice, which are loaded with sugar and acid)
• Scheduling regular dental cleanings and exams

What’s the Takeaway?

As fun as it is to learn about old, debunked dental health practices, the takeaway is that tooth worms are a myth. Dentists have known this for centuries, and we know the real causes of tooth decay that we should avoid and fight against. Keeping up with your daily dental hygiene habits and dentist visits twice a year are the best ways to protect your oral health.

We love helping our patients maintain healthy smiles!

THERE ARE SO many choices of toothpaste in our grocery stores. With an entire aisle of toothpaste options to choose from, we want to help our patients narrow things down a little based on their individual dental health needs.

Whitening Toothpaste

Choose a whitening toothpaste to remove surface stains, but remember that it can’t change a tooth’s natural color or fight deeper stains. Whitening toothpaste contains abrasives to polish the teeth and peroxide to break down surface stains. Using it twice a day can lead to visible results after several weeks, but make sure to look for the ADA Seal of Acceptance!

Orthodontic patients should wait until Braces Off Day before using whitening products, toothpaste included so that they don’t end up with patches of different colors where the brackets were.

For Sensitive Teeth

Over-the-counter tooth sensitivity toothpaste is a good option for patients with sensitive teeth. It helps rebuild enamel and minimize discomfort, and if the over-the-counter type isn’t enough, the dentist can prescribe a stronger toothpaste.

Popular Inactive Ingredients?

What about ingredients like activated charcoal or aloe vera? There is little evidence to support the benefits these toothpastes claim to offer. Charcoal in particular is abrasive and may actually damage tooth enamel and make teeth more sensitive. Toothpaste with these ingredients also tends to lack fluoride, which helps rebuild tooth enamel.

A PACIFIER OR THUMB/finger-sucking habit that lasts beyond the toddler years can have a negative impact on a child’s teeth and jaws.

A Healthy Self-Soothing Habit

In infancy and toddlerhood, these are perfectly healthy self-soothing habits. They help the child feel happy and safe when encountering a new or stressful experience (which happens frequently, as everything they encounter is new to them). The benefits of pacifiers or thumbsucking are many, both for the babies themselves and for their parents.

When It Stops Being Healthy

However, after a certain age, continuing these habits can change the way the developing adult teeth will come in. It can even change the shape of their dental arches. Most children will grow out of the habit on their own by age 4. If they aren’t showing any signs of stopping by then, it could be time to intervene.

Ways to Discourage the Habit

With pacifiers, it can be as simple as taking it away or trimming it down until the child loses interest. Thumbsuckers can be trickier. Nasty-tasting topical aids are an option but they aren’t perfect. We recommend praising successes rather than scolding failures, giving them activities to keep their hands too busy for sucking, and putting socks over their hands to discourage thumbsucking at night.

IN ONE OF HIS sonnets, Shakespeare described the reeking breath of his lady love, and the subject came up again in two of his plays. He sets a creepy mood with the “black contagious breath” of the night in “King John” and includes the line “his breath stinks with eating toasted cheese” in “Henry IV Part II.” Unfortunately, smelly breath was a common problem for that time period, and so were bad teeth.

The Class Divide of Early Modern Dental Health

Most people in Early Modern England were missing one or two teeth and they had to deal with a lot of cavities, but the problem was actually worse for the wealthy and especially the queen. Sugar was the hot new fad among the aristocracy in Elizabeth I’s day, but it was only available as an expensive import. In fact, sugar was so expensive that it was almost its own currency, and only the wealthy could afford it as an ingredient in their food.

Tooth-Rotting Luxury

Unfortunately for all those lords and ladies, they didn’t realize the dental health implications of luxurious sugar consumption. It wasn’t long until black teeth became a symbol of wealth, which gave rise to the perplexing fashion among the lower classes of artificially blackening their teeth to appear richer.

The Royal Teeth

Few felt the effects of sugar as much as Queen Elizabeth herself. The people around her knew better than to gossip about her appearance, but late in her life, one French ambassador is recorded to have said that her teeth were “very yellow and unequal,” and a German traveler went even further, describing “her teeth black (a fault the English seem to suffer from because of their great use of sugar).”

Despite her dental troubles, Elizabeth was terrified of dental treatment (or what passed for it back then). Before she was willing to undergo a tooth extraction, a bishop had to allow one of his own teeth to be pulled to prove it would be worth it. (To be fair, they didn’t have anesthesia available, so the prospect would have been much less pleasant than getting modern dental work.)

Dental Hygiene in the Elizabethan Era

What did the English do to try to keep their teeth healthy in that time period? They would use quills or wood for toothpicks and wash off plaque with a cloth. (We definitely prefer our modern toothbrushes.) If a tooth became too painful to tolerate, they could go to a surgeon to have it removed. If a surgeon was too expensive, a “tooth-drawer” or even a blacksmith could do it more cheaply.

However, some wealthy people were making matters worse for themselves by brushing their teeth with sugar paste:

For Our Teeth’s Sake, We’re Happy to Live in Modern Times

As fascinating as it is to look back on the history of dental health, it’s such a relief to live in a time when we get to enjoy the benefits of so much dental knowledge that we had to divide it into twelve different specialties, from endodontists to orthodontists to pediatric dentists and more. Make sure you’re scheduling regular appointments and keeping up with your dental hygiene habits!

Take advantage of the benefits of modern dentistry!