Smile, Smile, Smile: Teeth in Historical Fiction

One reader told me she wonders about the clean, white and often straight teeth of the heroes and heroines in historical fiction. I have as well, especially as I read Diana Gabaldon’s OUTLANDER series in which Claire, the main female character, often describes people’s bad breath or decayed and broken teeth.

Hygiene questions often arise in romance novels as heroes and heroines discuss their lover having a clean sweat smell, or enjoying the scent of the person or that their mouth smelled of brandy and cloves. And it’s hard to fit the ideas we have of the eighteenth century being a stinky place with the characters making love spontaneously, after days on the road. It is especially noticeable in historical fiction because of what we believe we know about history.

I researched this topic very quickly, so if there are any errors I apologize and would be glad to make correction.

The movie Les Miserables with Hugh Jackman and Ann Hathaway offers a far less romantic view of  the past (19th century) very graphic in showing the build up of tartar in the faces of peasants on the street – a bit too much so for me.

I have to believe the reality lay somewhere between the people in Les Mis and the highly improbably shiny, straight-toothed heroes in many books.

“The first mentions of teeth and dental hygiene were found in inscriptions from Mesopotamian clay tablets, so called ‘oral hygiene products’ including toothpicks, chewing sticks, tooth powders and mouthwashes, dating back to 5,000 years. “(1)

Historians have recorded tooth brushes and tooth picks excavations across the world, from China to Persia and Egypt. Some religious texts promote oral health for the purposes of making it easier to achieve intimacy, to assisiting in maintaining dietary laws, and in Islam the use of a special wooden stick, the siwak, for cleaning the teeth and preventing bad breath. (2)

In Europe, England and the Americas, dental health varied and cavities seem to have been commonplace especially, when the owner of the mouth could afford sugary treats and white flour.

Dentistry came into its own during the seventeen hundreds.  Treatises were published, scientific lectures were given, the first surgeons were trained specifically in dentistry, exposed nerves leading to pain were considered, nonsense remedies were rejected, and many inventions   were patented.  Though dentistry was still in its infancy, more could be done to ease pain, help patients chew their food, and improve general appearance.  As always, the quality of care and materials determined on the class of an individual.(3)


There seem to be three, very interrelated, components of the history of oral care

1. Cleaning the teeth

In Asia brushes started to appear around the 1400s. Tooth brushes were made of bamboo or ivory handles and boar hairs or, in the West, they were made of bone with boar bristles or horse hair. In ancient Egypt the toothbrush was a twigs that had been mashed at one end that was rubbed around the teeth..

The concept of toothpaste and mouth washes is pretty old – almost as old as the Egyptians toothbrush. The earliest known toothpaste was created by the Egyptians. It was said to contain a drachma of rock salt, two drachmas of mint, one drachma of dried iris flowers and 20 grains of pepper. This was then crushed and mixed together to form a powder. When mixed with saliva and applied to the teeth, it would help whiten and clean your teeth. When experimented with by an Australian dentist, the mixture worked far better than anything else created until the twenty first century. The only downside was the fact that it caused his gums to bleed.(4)

"Silver toothbrush set, Birmingham, England, 1793 Wellcome L0058115" by Wellcome Library, London - Licensed under CC BY 4.0 via Wikimedia Commons -,_Birmingham,_England,_1793_Wellcome_L0058115.jpg#mediaviewer/File:Silver_toothbrush_set,_Birmingham,_England,_1793_Wellcome_L0058115.jpg
“Silver toothbrush set, Birmingham, England, 1793 Wellcome L0058115” ( see resources below)


The bristle brush was reinvented in the late 18th and early 19th centuries. Due to the high price of the hog bristle, brushes did not become widely used until the end of the 19th century. In the first part of the 20th century in the United States, a family toothbrush was common among the poor. Shared toothbrushes were found in boarding houses and college dormitories.

The affluent not only quickly added toothbrushes to their toilet sets but elevated the handle to an art form. Ornate handles of precious metals were prized, and such Victorian toothbrushes are currently popular collectibles.

Mechanical tooth cleaning and mouth rinsing were established practices by the 16th century. The Zene Artzney (Medicines for the Teeth), published in Germany in 1530, the first printed work devoted exclusively to dental therapeutics, contained a section on “How to save the teeth’. The recommendations included washing the mouth with burnt alum mixed with vinegar or myrrh boiled in wine. The final suggestion was “always after eating, wash the mouth with wine or beer, in order to wash away all that might adhere to the teeth and make them decay, produce bad odor, and destroy them”. This very popular book underwent 15 separate editions between 1530 and 1576. (5)

In the History of Hygiene: Bathing, Teeth Cleaning, Toileting, & Deodorizing , author Eliza Knight talks about how teeth were cleaned in different periods of history, but, I have found  difficult to find anything about the Renaissance through the

Regency periods so her information from then was particularly interesting:



* The same practices for cleaning were in use [as in previous periods], but the “barbers” aka dentists had begun to learn more about dentistry.
* The first dentures, gold crowns, and porcelain teeth, were constructed in the 1700’s.
* 1790 brought about the dental foot engine, similar to the foot pedal of a spinning wheel, it rotated a drill for cleaning out cavities.
* The first dental chair was made in the late 1700’s.

* A letter from Lord Chesterfield to his son urges the use of a sponge and warm water to scrub the teeth each morning.
* The recommendation of using one’s own urine in France was widely flouted by Fouchard, the French dentist.
* Gunpowder and alum were also recommended. (6)


Toothbrush in Use 1899 Paris
Toothbrush in Use 1899 Paris



2.  Freshening the breath:

Bad breath and poor dental hygiene are very closely related.   Today we know more about it and it remains a concern for most people.

Folk remedies for bad breath abound including these from Jadwiga at

The Bible (Genesis) mentions labdanum (mastic) Oddly enough this is something we have in my family to flavor the bread we made for Greek Orthodox Easter

Parsley (Italy),
Cloves (Iraq ),
guava peels (Thailand),

Eggshells (China).

peppercorns. The Talmud


Trotula, 11th Century, On Women’s Cosmetics (book 3)

“The woman should wash her mouth after dinner with very good wine. Then she ought to dry [her teeth] very well and wipe [them] with a new white cloth. Finally, let her chew each day fennel or lovage or parsley, which is better to chew because it gives off a good smell and cleans good gums and makes the teeth very white.”(7)

Jadwiga’s post includes a variety of recipes the authors tries out and reports on, including sage and salt ground and baked then the resulting cake of salt pulverized, rosemary charcoal, and wine.
Toothpowders were for teeth and breath:

Toothpowders were based on three or four components: abrasives such as chalk, orris root, heavy magnesium carbonate or cuttlefish bone; antiseptics and detergents, represented by powdered hard soap and borax; and astringents which could be the tannins found in cinchona bark, bayberry leaves, essence of sassafras, and, very commonly, tincture of myrrh. Aromatic substances were often added as breath sweeteners, common ones being cardamon, cloves, peppermint, oil of lemon and aniseed. (8) DENTAL PRACTICES IN EUROPE AT THE END OF THE EIGHTEENTH CENTURY


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3. Dentistry
A dentist visit was not at all pleasant, especially considering the absence of any anesthetic. But filthy tools, and hands didn’t help.

Jane Austen records accompanying her nieces to the dentist

In two letters to Cassandra, on Wednesday 15 & Thursday 16 September 1813, Jane [Austen] describes in some detail accompanying her young nieces Lizzy, Marianne and Fanny, on a visit to the London dentist Mr Spence. It was, she relates, ‘a sad business, and cost us many tears’. They attended Mr Spence twice on the Wednesday, and to their consternation had to return on the following day for yet another ‘disagreeable hour’ . Mr Spence remonstrates strongly over Lizzy’s teeth, cleaning and filing them and filling the ‘very sad hole’ between two of the front ones. But it is Marianne who suffers most: she is obliged to have two teeth extracted to make room for others to grow. (9) Jane Austen’s World JASA
Dental practitioners migrated to the American colonies in the 1700s and devoted themselves primarily to the removal of diseased teeth and the insertion of artificial dentures. In the 1800s, dental practices included such duties as extracting teeth with a turnkey (a primitive tool like a ratchet wrench, used for extracting teeth), cleaning the teeth with scrapers and removing cavities with hand instruments. The filling materials used then were tin, gold foil, lead and silver. Dentures were carved from ivory or fashioned from the teeth of cattle. Know Your Teeth (10)

In 1700 John Hunter transplanted teeth tying them to adjacent teeth until they stabilized. The procedure was less than successful.  Modern dentistry begins in 1728 when a Frenchman, Pierre Fauchard published THE SURGEON DENTIST.

Dentistry came into its own during the seventeen hundreds.  Treatises were published, scientific lectures were given, the first surgeons were trained specifically in dentistry, exposed nerves leading to pain were considered, nonsense remedies were rejected, and many inventions   were patented.  Though dentistry was still in its infancy, more could be done to ease pain, help patients chew their food, and improve general appearance.  As always, the quality of care and materials determined on the class of an individual. (11)

But none of this answers, really, what were teeth like in reality? It’s really hard to know.

People apparently did think about dental care, but a big smile, at least in France until the mid 18th century was considered a sign that one was of low birth or insane.

I think it is interesting that for the upper classes smiling toothily may have been poor etiquette, but that changed with political and social changes, especially in France. In fact even happiness was not considered an aim in life until the Enlightenment philosophy. One was encouraged to be dour.   Hygiene was determined by status or wealth.   This is discussed in a book, the SMILE REVOLUTION IN NEIGHTEENTH CENTURY PARIS by Colin Jones reviewed by Kathryn Hughes  Friday 17 October 2014 in the Guardian.  (12)

On her pinterest page, Cerulean HMC expresses her understanding of historical hygiene:

There are many misconceptions about hygiene during this time. People were just as concerned with personal hygiene as we are today though the ways they achieved good hygiene was largely determined by social and economic status and geographical location. As far back as the 17th century you can read personal accounts of people complaining about those who did not exercise proper hygiene and personal care. Marie Antoinette even had her crooked teeth fixed by a dentist in the 1760s. (13)

This is a great site with tons of pictures of implements people used for hygiene

In DAILY LIFE IN EIGHTEENTH CENTURY ENGLAND by Kirsten Olsen she discusses that the mouth smelled.

There were plenty of ways to clean the teerh, and dental care was part of the ritual for some at least. The Tatler of April 12, 1709, refers to a young man “washing his teeth” and “rubbing his gums.” The well off chewed cinnamon, cloves, honey, orange peel and other substances to sweeten the breath, and many used abrasive sticks to clean the teeth, or a new invention – the toothbrush. (14)

So people WERE concerned with their teeth and breath.

In her blog Madame Isis’ Toilette she says, To understand hygiene in the 18th century we must understand that their view was different from ours, even if their aim, being clean, was the same.

There were [sic] a definite interest in caring for the teeth and every collection of cosmetic recipes devote quite a lot of space for various mouth washes and the precursor of tooth paste, tooth powder. Some of these recipes contain things that are too abrasive like pumice stone or sugary things like honey, but there are plenty of recipes that do a rather good job of cleaning the teeth. Tooth brushes came along in the 17th century, but were a luxury item, instead the cleaning were done with a piece of linen fabric, sponges, twigs or roots that was prepared in various ways to work as cleaning tools. (15)

I have read in several sources in reading for this post, that scurvy affected a lot of people and it had a profound effect on people’s dental health as it affected the gums and caused periodontal disease.

With the establishment of dentistry as a profession, the end of the eighteenth century saw an increase in awareness of the need for better dental health. A pleasing smile and speech were social elegances to be encouraged. (page 191) and in 1783 it was noted that English ladies were paying more attention to their dental care, but at the time, James Bladen Ruspini noted that the British were prone to greater decay than Europeans due to a lack of attention.   The seventeenth century ushered in a period of dental caries due to an increase in sugar consumption and white flour which is stickier and increases the contact of carbohydrates with the teeth.. In the 1790s tartar was becoming recognized as a cause of periodontal problems and it started to be advertised that dentists would scale and clean the teeth. (16)

To make a long story longer, there are a lot of factors, like status and nutrition, that would make a difference in the dental health and appearance of our heroes’ and heroines’ smiles, but people often did care for their teeth, albeit sporadically. Scurvy was a problem as access to fresh fruit all year was difficult.   Scurvy, sugar, white flour, and less than optimal care increased tooth decay and loss. Dentistry was painful, if people are afraid to go to the dentist now, just imagine if you knew how horrid it would be.

It’s been noted that even highly esteemed personages, like George Washington who had a lot of dental problems showed facial changes as they aged and their dental  problems increased. One can assume that he was not the only person with this experience.


Washington was very self-aware of the impact that ill-fitting dentures had on his appearance. In a 1797 letter to Dr. John Greenwood, Washington complained how his ill fitting dentures were “already too wide, and too projecting for the parts they rest upon; which causes both upper, and under lip to bulge out, as if swelled.” In a separate letter the following year, Washington noted that another set of dentures had “the effect of forcing the lip out just under the nose. (17)”

According to the same citation above Martha Washington urged family members to care for their teeth. And by the way his dentures were never made of wood – real teeth, bone, and ivory were used to make dentures.

But, still can you believe that hero’s gorgeous smile; probably about as much as we believe anything else about the book we’re reading. Reality is always different than fiction, and that’s probably why we read it.



(2) (5)… The history of oral hygiene products: how far have we come in 6000 years? STUARTL . FISCHMAN in Peridontology 2000 ISSN 0906-6713.





(8) p. 214 Dental practice in Europe at the end of the 18th century Christine Hillam
Rodopi, Jan 1, 2003 – History – 518 pages

(9) – The Poor Girls and Their Teeth, A Visit to the Dentist, JASA


(12) (


Greenwood Publishing Group, Jan 1, 1999 – History – 395 pages


(16)  Dental Practice in Europe at the End of the 18th Century, Christine Hillam Rodopi, Jan 1, 2003 – History – 518 pages


Red Cased Toothbrush Picture by Wellcome Library, London – Licensed under CC BY 4.0 via Wikimedia Commons –,_Birmingham,_England,_1793_Wellcome_L0058115.jpg#mediaviewer/File:Silver_toothbrush_set,_Birmingham,_England,_1793_Wellcome_L0058115.jpg