Queen Elizabeth I, the last Tudor monarch, cultivated an image of eternal youth and splendor throughout her 45-year reign. Her clothing, makeup, and portraiture were meticulously controlled to project an ideal of majesty. Despite this powerful public persona, the Queen privately suffered from debilitating dental health, a condition known to her court and foreign visitors. Her deteriorating teeth offer a unique lens into the medical and social history of the Tudor era.
The Extent of the Dental Decay
The Queen’s dental problems became progressively severe, moving from simple discoloration to advanced decay and tooth loss as she aged. By the late 16th century, descriptions from those who saw her firsthand painted a consistent picture of her compromised oral state. In 1598, the German traveler Paul Hentzner noted her “teeth black,” observing that this was a common fault among the English nobility due to their diet.
A French ambassador, André Hurault de Maisse, provided a detailed account in 1597. He described her teeth as “very yellow and unequal,” noting that several were missing entirely. The gaps and unevenness caused noticeable difficulty in her speech, making her hard to understand when she spoke quickly. Beyond the visual issues, Elizabeth endured chronic, severe pain from toothaches. In 1578, the Earl of Leicester reported that the Queen had been “marvellous ill many days with a pain in her cheek,” which often deprived her of sleep.
Sugar: The Royal Culprit
The primary cause of the Queen’s ruined teeth was a dramatic shift in the 16th-century aristocratic diet, driven by the increasing availability of refined sugar. Colonial trade routes made sucrose accessible in volumes previously unknown, transforming it into a widely consumed luxury commodity. Sugar was so expensive that only the wealthiest elite, like the Queen, could afford to consume it regularly and in large quantities.
Consequently, rampant dental caries became a visible marker of wealth and high social standing. The nobility’s blackened, decayed teeth indirectly signaled they could afford the exorbitant cost of the imported sweetener. Some members of the lower classes, hoping to emulate this sign of opulence, would even artificially stain their own teeth black with soot. Elizabeth I was famously fond of sweets, including candied violets and sugar-dusted delicacies, and her chefs created elaborate banquets featuring intricate sugar sculptures. She even utilized a substance referred to as “Tudor toothpaste,” which was a paste made of sugar, further exacerbating the decay.
16th-Century Treatments and Pain Relief
Dental care during the Tudor era was rudimentary, offering little in the way of effective treatment for advanced decay. Dentists, as they are known today, did not exist; instead, the necessary procedures were carried out by barber-surgeons or specialized “tooth-drawers.” The most common and often only definitive treatment for severe toothache was extraction, a procedure performed without anesthesia using heavy metal instruments.
The Queen was terrified of the pain associated with having a tooth pulled and resisted the procedure for years despite her suffering. This aversion led to a famous episode in 1578 involving John Aylmer, the Bishop of London. To encourage the Queen to relieve her pain, the Bishop, a man advanced in years, had one of his own teeth extracted in her presence. This act was intended to demonstrate that the procedure was survivable and relatively quick.
Once a tooth was removed, the Queen sometimes used cotton pads to fill the gaps in her smile for cosmetic and speech purposes. Beyond extraction, pain was managed with herbal remedies, such as sage or lavender, and sometimes with the use of opiates, though these offered only temporary relief from the intense throbbing caused by deep infection.