Most people in the 1700s had visibly damaged teeth. Cavities were widespread, missing teeth were normal even among young adults, and the tools and knowledge to prevent decay barely existed. But the full picture is more nuanced than “everyone had terrible teeth,” because diet, social class, and geography created enormous variation in what a person’s mouth actually looked like.
How Many Teeth Were Missing
Skeletal remains from 18th and 19th century London paint a stark picture. In a study of 105 individuals buried at St. Bride’s Lower Churchyard, over 90% had lost at least one tooth during their lifetime, with an average of six teeth gone per person. People over 46 had lost nearly nine teeth on average, meaning they were walking around with roughly three-quarters of a full set at best. Even young adults between 18 and 25 were already missing teeth, with 83% of that age group showing at least some loss.
About 90% of individuals in that same sample had at least one cavity, averaging nearly five cavities per person. Roughly 40% had developed abscesses, the painful infections that form when decay reaches deep into the root. Without antibiotics or effective fillings, an abscess usually meant the tooth had to come out, if it hadn’t already crumbled on its own.
Sugar Changed Everything
Teeth in the 1700s were actually getting worse compared to earlier centuries, and the main culprit was sugar. England industrialized sugar production before any other country and experienced a corresponding spike in tooth decay. By the early 1800s, the English had worse teeth than Americans, largely because of how deeply sugar had penetrated the English diet.
The contrast with earlier populations is revealing. Among adults who died during the Great Plague of Marseille in 1720, only about 12.6% had a cavity. Soldiers from Napoleon’s army who died in 1812 showed even lower rates, with just 8% affected. These were populations eating coarse bread, vegetables, and dried meat rather than sugar-laden tea and pastries. For wealthier Europeans who could afford imported sugar, candied fruits, and sweetened drinks, decay was dramatically more common. Bad teeth, ironically, could signal that you were rich enough to afford the foods that destroyed them.
What People Used to Clean Their Teeth
Toothbrushes existed in the 1700s, but they were luxury items. Early versions had handles made from silver, gilt, or gold, and only the wealthy used them. It wasn’t until 1780 that an English manufacturer began producing a simpler version with a cow bone handle and boar hair bristles, and even those didn’t become widely affordable until the mid-1800s. American dentists started recommending brushing as early as 1779, but toothbrushes had to be imported from Europe and were rarely used.
Instead, most people relied on tooth powders, cloths, or simply nothing at all. Tooth powders were a mix of abrasive and medicinal ingredients ground together and rubbed onto teeth with a finger or rag. Common ingredients included cream of tartar (a mild abrasive), burnt alum (thought to treat gum disease), cinnamon for flavor and its mild antiseptic quality, cuttlebone powder as a polishing agent, myrrh gum for its antiseptic properties, and various plant resins. Some recipes called for “spirit of vitriol,” which was sulfuric acid, a substance that would have stripped enamel and made teeth even more vulnerable to decay. These powders could scrub away surface stains, but the harsher formulas likely caused as much damage as they prevented.
Who Fixed Your Teeth (and How)
Professional dentistry as we know it didn’t exist for most of the 1700s. If you had a painful tooth, your options were a barber-surgeon or an itinerant tooth puller. Barber-surgeons were jacks of all trades who cut hair, set bones, performed bloodletting, and yanked teeth. For people in smaller towns or rural areas, traveling tooth pullers would set up at marketplaces and fairs, drawing crowds with singing, dancing, juggling, and storytelling before getting down to the business of extraction. The whole thing was essentially public theater, with the patient’s agony on full display.
Extraction was the main “treatment” for any serious dental problem. There were no effective fillings, no anesthesia beyond alcohol, and no understanding of the bacteria that cause decay. Pierre Fauchard, a French surgeon often called the father of modern dentistry, published a foundational text in 1728 that began to professionalize the field, but his ideas spread slowly. For the vast majority of people throughout the century, a bad tooth simply got pulled or fell out on its own.
Dentures and Replacements
For those who could afford them, false teeth were available, though nothing like modern dentures. The most famous example is George Washington, who struggled with dental problems his entire adult life. Contrary to the persistent myth, his dentures were never made of wood. His various sets were crafted from hippopotamus ivory, human teeth (often purchased from the poor or taken from the dead), and probable horse and cow teeth, all held together with lead, tin, copper, and silver alloys, gold wire springs, and brass screws. The only surviving complete set, preserved at Mount Vernon, contains this mix of human and animal materials.
Washington’s dentist, John Greenwood, was considered a pioneer, but even his best work was bulky, ill-fitting, and uncomfortable. Washington’s dentures visibly distorted his facial appearance, which is noticeable in later portraits. At the very end of the century, a Frenchman named Alexis Duchâteau crafted the first porcelain dentures, but they chipped easily and never caught on during the 1700s. For most people who lost teeth, the replacement was simply an empty space.
Did Bad Teeth Carry Social Meaning?
In most of Europe, white teeth were preferred, and people who could afford tooth powders and early toothbrushes made efforts to keep their smiles presentable. But the relationship between wealth and dental health was complicated. The rich had better access to cleaning tools, yet they also consumed far more sugar. A laborer eating rough bread might have worn-down but relatively decay-free teeth, while a merchant’s wife drinking sweetened tea could have a mouth full of cavities.
In Japan, a completely different aesthetic existed. Women practiced ohaguro, painting their teeth with a dark solution to give them a deliberately blackened appearance. This was considered beautiful and signified sexual maturity in women over 18. The coating actually helped protect enamel, making it functional as well as decorative. The practice continued until the Meiji government banned it in 1870. No equivalent fashion existed in Europe, where dark or missing teeth were generally seen as unfortunate rather than attractive, even if they were extremely common.
The overall picture of an 18th century smile, then, depended heavily on where you lived, what you ate, and what you could afford. But for the average person, a mouth with several missing teeth, visible cavities, and darkened or worn enamel was simply the norm.