Then vs. Now: The Evolution of Oral Hygiene

People believed “tooth worms” caused tooth decay in 5000 BCE.

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Today, your dental hygienist knows lots of science-backed tips to help keep your teeth clean, sparkling, and healthy. The goal isn’t just to treat your problem teeth, but to keep your smile from having any problems to begin with.

It hasn’t always been that way. Various societies had a number of different beliefs about what caused tooth decay, what to do about cavities, and the best ways to clean the gunk out of their smile. 

Ancient Oral Hygiene

Way back in 5000 BCE, people actually believed tooth decay was caused by “tooth worms.” Imagine worms creating tunnels in the dirt, and you can see how someone might blame a cavity on a small worm. (Ew.)

The toothbrush might look sleek and modern today, but people have been “brushing” with different items for millenia. Toothpicks and teeth-cleaning sticks have been found that date back to 3000 BCE, although these were made from natural items like twigs.

Aesculapius—the Roman god of medicine and a powerful healer—advocated for mouth cleansing. (Fun fact: The common symbol of medicine with a snake wrapped around a staff comes from Aesculapius, who always appeared with a serpent since he believed they had a special ability to find herbs with healing powers, according to mythology.)

A little later, the famous Hippocrates recommended dentifrice powder to clean the teeth in 355 BCE. Dentifrice is a generic term for a teeth-cleaning paste or powder (so the tube of paste you have in your own bathroom qualifies as a dentifrice). 

The Cause of Decay (and How to Prevent It)

While some people were talking about oral hygiene, it still wasn’t totally clear why teeth decayed. In 1000 CE, one surgeon took the world one step closer to understanding: The Arab surgeon Albucasis was one of the first to describe tartar—those discolored deposits on the teeth made from hardened plaque. 

Albucasis also had his own idea about how to clean teeth. Others around the world tended to chew on twigs or brush with frayed sticks, but Albucasis invented a set of scrapers to scour the teeth clean, knowing it would take something more abrasive to get that tartar off.

In the 1600s, China produced the world’s first “toothbrush,” which had handles made of bone or bamboo, and “bristles” made of hog hair.  Similar styles like this continued for centuries.

In addition to the hog hair toothbrush, some others advocated for other oral hygiene methods that they thought might be better. Pierre Fauchard suggested using a sponge with brandy in 1728, and Levi Spear Parmley suggested waxed silk in 1819. Silk was a popular dental tool: It was also recommended as a flossing device in 1845 in The American Journal of Dental Science.

The Impact of Germ Theory

The discovery of microorganisms that lead to germ theory revolutionized many aspects of medicine, and dentistry was no exception. In 1882, Willoughby D. Miller realized these microorganisms were the cause of tooth decay and cavities. (Find out how germ theory impacted personal hygiene, and check out how germ theory finally halted the practice of bloodletting.) 

This discovery put an even greater importance on dental hygiene, as opposed to just dental repair and treatment. Preventative dentistry emerged in the early 1900s, and dental hygienists were in demand to clean teeth and prevent decay.

Oral Hygiene in the Modern Era

Today seems like a high-tech era for dental devices, but many of the popular devices you might own today—like a water flosser or electric toothbrush—were invented much earlier than you might think.

But let’s back up: The first nylon toothbrush with synthetic bristles (no more hog hair!) appeared in 1938. They were cheaper and easier to make, and the synthetic bristles were softer and more comfortable on the teeth. They quickly took over the market.

In the United States, the fluoridation of city water became the law of the land in the 1950s, after it was found that it greatly helped reduce tooth decay and cavities. The decision was endorsed by the American Dental Association.  

As for electric toothbrushes and water flossers, these devices were actually invented in the 1960s. However, it took decades for both to become a common household item.

In addition to effective devices for oral hygiene, dental experts also have acquired tons of knowledge on the best oral hygiene practices: