Tooth gems trace their roots back more than 2,000 years to ancient Mesoamerica, where the Maya affixed jade, turquoise, and pyrite to the front of their teeth. The practice resurfaced in various forms across ancient Mediterranean cultures before becoming a mainstream fashion trend in the 1990s and cycling back again with Gen Z in recent years.
Ancient Maya: The First Tooth Gems
During the Classic period (200 to 900 CE), lowland Maya people across what is now Guatemala, Belize, and Mexico were embedding colored stones into their teeth. These weren’t crude decorations. The adhesives they used were surprisingly sophisticated, combining plant resins with ground minerals, including hydroxyapatite sourced from bones and teeth. Biochemical analysis of eight teeth from burial sites across the Maya empire revealed that most adhesive samples contained compounds from pine trees with natural antibacterial properties. Some included extracts from sage plants with antifungal effects, while others from the Copán region near modern Honduras incorporated mint-based essential oils with anti-inflammatory properties.
The results speak for themselves. Janaab’ Pakal, the Maya king of Palenque, died in 683 CE at age 80 with nearly all of his teeth intact and no signs of decay in those that remained.
These modifications carried deep cultural meaning. Dental decoration reflected personal and social identity. Tooth filing, which often accompanied gem inlays, served as a beautification practice for women and a mark of religious authority for men. Some filing patterns held symbolic significance: a “T” shape referenced the Maya glyph “Ik,” meaning wind, breath, or soul, tying the body directly to spiritual concepts.
Gold Dental Work in Ancient Italy
Around the same era, on the other side of the world, the Etruscans of central Italy were developing their own form of dental ornamentation. Before 630 BCE, Etruscan artisans crafted gold bands that wrapped around the front teeth, originally designed as decorative replacements for teeth that had been deliberately removed in a cultural practice known as dental ablation. Replacement teeth, either human teeth or carved ivory, were mounted into gold bands and held in place with gold pins or set into rectangular bezels “like a jewel.” This was cosmetic dentistry in its earliest form, blending function with flash, and it required real skill in gold refining and metalwork.
The 1990s Revival
Tooth gems largely disappeared from Western fashion for centuries before reappearing in the 1990s as part of a broader wave of body modification and accessorizing. Small crystals and rhinestones became a subtle style statement, popular among teens and young adults. The application methods of the era were far less refined than what came before or after. Many people relied on nail glue to stick gems on, and urban legends circulated about holes being drilled into teeth. Hip-hop culture also pushed dental decoration into the mainstream through grills, the removable gold or diamond-encrusted covers that fit over the front teeth and became a signature look for artists in the South and beyond.
The trend faded in the late 2000s before roaring back in the 2020s, this time driven by Gen Z’s appetite for Y2K nostalgia. As one Newcastle-based tooth gem artist told The Guardian, “We saw trends coming back from the 60s and 70s. I think it all does this massive, great big circle.” Today’s versions range from small crystals costing around £35 to custom diamond pieces worth £30,000 or more.
How Modern Tooth Gems Are Applied
The process today borrows directly from orthodontic bonding. A dentist or trained technician cleans the tooth, then applies a mild acid gel to lightly etch the enamel surface, creating microscopic roughness for the adhesive to grip. A bonding resin is brushed onto that etched area and hardened with an LED curing light. Then a dental-grade composite resin is placed on the tooth, the gem is positioned into it, and the whole thing is cured with the LED light from multiple angles for 20 to 40 seconds. The bond is the same type used for braces brackets and composite fillings.
Removal takes 30 to 60 minutes at a dental office. A scaler loosens the gem, and a polishing tool cleans off residual adhesive to restore the natural tooth surface. When done properly, the enamel underneath stays intact.
Risks Worth Knowing
The American Dental Association advises against tooth gems due to the increased risk of negative health outcomes. Their primary concern is plaque buildup. Gems create a small sheltered zone where bacteria can accumulate, raising the risk of cavities, enamel discoloration, gum inflammation, and chipping. These risks climb significantly when oral hygiene is inconsistent or when the gem is applied to a tooth that wasn’t properly cleaned and prepped beforehand. Applying a gem to an already compromised tooth can even cause a cavity to form underneath.
Long-term wear compounds the problem. The ADA specifically discourages extended use because trapped food particles and debris can quietly promote decay and periodontal infection over time. If you do get a tooth gem, keeping up with brushing and flossing around it is the single most important thing you can do to avoid problems.