The Evolution of Dental Care: From Finger to Floss
Did you know that the toothbrush is one of the oldest tools that humans still use? In fact, in a survey conducted in 2003, Americans chose the toothbrush as the number one invention over the car, personal computer, cell phone, and microwave. This may come as a shock in a day and age obsessed with technology, but it just goes to show how much value we place on our pearly whites. But it makes you wonder… how have people kept their teeth clean throughout the centuries? How did the toothbrush, toothpaste, and floss come into existence and how have they evolved over time?
One would assume that the first toothbrush was surely the finger, but evidence has shown that as far back at 3500 BC to 3000 BC chewing sticks were used in Babylonia. These chewing sticks were essentially a stick from an astringent tree with a frayed end that acted as bristles to clean teeth. These chewing sticks have also been found in ancient Egyptian tombs. Their predecessors are still commonly used in certain areas of the Middle East, Africa, Asia, and South America and are known as miswak or mswaki sticks.
When excavating Ur in Mesopotamia, ornately decorated toothpicks were found that dated back to 3000 BC. Other archaeological digs have recovered various tree twigs, bird feathers, animal bones, and porcupine quills as the earliest toothbrushes and toothpicks. An ancient Sanskrit text on surgery dating back to the 6th century describes severe periodontal disease and stresses oral hygiene; “the stick for brushing the teeth should be either an astringent or pungent bitter. One of its ends should be chewed in the form of a brush. It should be used twice a day, taking care that the gums not be injured.” Pretty sound advice, even by current standards! Ancient Greek and Roman literature referenced the use of toothpicks to keep their mouths clean, and ancient Roman aristocrats kept special slaves for the sole purpose of cleaning their teeth. Imagine that job!
Ancient Chinese writings from around 1600 BC portray chewing sticks that were derived from aromatic trees and sharpened at one end to act as a toothpick. In the thirteenth century, the Chinese began to attach boar bristles to bamboo, essentially fashioning the first toothbrush. The optimal choice for bristles was taken from the back of the necks of cold climate boars, generally found in Siberia. Traders introduced these toothbrushes to the West and they quickly gained popularity. At that time Europeans were brushing their teeth by dipping a linen cloth or sponge in sulfur oils and salt solutions to rub away tooth grime. This was referred to as “The Greek Way”, as Aristotle had recommended this method to Alexander the Great. As these toothbrushes spread from East to West, in the West they preferred softer horse hairs over the coarse boar bristles, yet horses were deemed too valuable for the sake of toothbrushes, making boar bristles popular well into the early 1900’s.
Fast-forward to 1780 and we meet a man named William Addis of Clerkenwald, England. Addis was sitting in Newgate Prison for allegedly inciting a riot. The method for brushing teeth in jail was to take a rag and dip it in a solution of soot and salt and rub it onto the teeth. Addis believed there had to be a more efficient way, so while he passed his time in jail he began to think up solutions. Spying a broom, inspiration struck him and he took a small animal bone leftover from his meal and drilled holes into it. He then tied some swine fibers into bunches, strung them through the holes, and glued them into place. At this time in Georgian England, refined sugar was being shipped in from the West Indies in mass quantities. This caused a huge increase in the consumption of sugar for Londoners who then suffered from rotting teeth, the only treatment for which was to pull the infected teeth. When Addis was released from jail, he went on to market and sell his toothbrush under the name Wisdom Toothbrushes, which went on to become a very successful business that is still around today.
Toothbrushes continued to be made with animal bone handles and more often than not, boar bristles, although fancy toothbrushes were made with badger hair for those who could afford them. Celluloid handles were introduced in the 1900’s and quickly replaced bone handles. In the 1920’s a new method of attaching bristles to the handle was developed: holes were drilled into the brush head, bunches of bristles were then forced through the holes, and secured with a staple. This method is the same method that is commonly used today.
The next evolution in toothbrushes occurred when Wallace H. Carothers of Du Pont Laboratories invented nylon in 1937. Nylon bristles quickly overtook animal hair bristles for sanitation and cost-effective purposes. Although boar hair bristles often fall out, do not dry well, and are prone to bacterial growth, they strangely still account for 10% of the toothbrushes sold worldwide. The new nylon bristled toothbrushes were sold as “Doctor West’s Miracle-Tuft Toothbrush” due to its more hygienic properties.
With World War II looming in the background, British and American housewives were instructed to waste nothing, which translated to no more bone handles for toothbrushes. Bone handles had long been popular for things like toothbrushes, knives, guns, and handles for many more items. The shift to celluloid was a natural progression as soup bones were needed more than ornate bone handles. World War II gave oral hygiene an unexpected boost. The soldiers in World War II were expected to brush twice daily, a habit they brought home with them, likely due to the fact that Trench Mouth had become so rampant during World War I.
And what about toothpaste? Well, ancient Egyptians were making a “tooth powder” as far back as 5000 B.C.E. It was made from ox hooves, myrrh, eggshell fragments, and pumice. No device was found with the remnants of the tooth powder, which is why it is assumed that the finger was the first actual toothbrush. Other early tooth powders contained mixtures of powdered salt, pepper, mint leaves, and iris flowers. In Roman times, urine was used as a base for toothpaste. And since urine contains ammonia it was likely an effective whitening agent. In later times, homemade tooth powder was made of chalk, pulverized brick and salt. It is said that Napoleon Bonaparte regularly brushed his teeth with an opium-based toothpaste. In 1873, Colgate mass-produced the first toothpaste in a jar called Crème Dentifrice. By 1896, Colgate Dental Cream was packaged in collapsible tubes. Finally, by 1900, a paste of hydrogen peroxide and baking soda was developed, and by 1914 fluoride was introduced and added to the majority of toothpastes on the market at that time.
And what of floss? Researchers have found floss and toothpick grooves in the teeth of prehistoric humans. But it wasn’t until 1815 when a New Orleans dentist named Levi Spear Parmly promoted flossing with a piece of silk thread that floss really gained notoriety. Levi went on to be credited for inventing the first form of dental floss. By 1882 the Codman and Shurtleft Company of Randolph, Massachusetts began mass-producing unwaxed silk floss for commercial use. In 1898 Johnson & Johnson received the first patent for dental floss. Dr. Charles C. Bass then developed nylon floss, which performed better than silk because of its elasticity. Today floss is still made of nylon.
Who would’ve thought that the history of dental care would be so fascinating? And who would’ve guessed that the toothbrush we use today evolved from a stick and was perfected by a convict? Today, there are over 3,000 patents worldwide for toothbrushes. Regardless of how they got here, toothbrushes, toothpaste, and floss are a necessity in our daily lives.
John W. Clemenza, DMD, MD, FACS on
Jan 29th, 2014 10:50 am
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