Since ancient Egypt ranges from the Predynastic period through the Greco-Roman period, it is an ambitious task to characterize dental health throughout this vast period of time. The literature concerned with dentistry and dental health during that three thousand year span is fragmentary. Therefore, the study of dental health in ancient Egypt has been based on two principal sources: (1) the direct examination of teeth and skulls and (2) written records from medical papyri and tomb inscriptions. The problem is that conclusions have often been based on a small number of samples or even on single mummies, usually from museum collections. Many of these mummies date from the later periods, particularly the Greco-Roman period, whereas fewer examples date from the Old, Middle, or New Kingdoms. Hence, overgeneralization may exist for the discussion of dental health in ancient Egypt. Nevertheless, the most significant dental disease identified was attrition, wear that resulted in the reduction of the protective enamel. The teeth were

Dental Care

Dental Care. Lateral X–ray of the mummy of Ramesses II. Note the extreme wear of the teeth, with resulting exposure of the pulp chambers and periapical abscesses. (Courtesy James E. Harris)

rapidly worn down throughout life by the chewing of a coarse diet, made even more abrasive by the sand of the Nile Valley or from the flour produced by millstones made of sandstone. In time, this wear became so extensive that the enamel and dentine were eroded and the pulp chambers were exposed. Once the living tissue inside the tooth died, empty root canals became a source of chronic infection and abscesses.

The second major dental problem was periodontal, disease of the supporting tissue. Periodontal disease is often associated with plaque or calculus (tartar) deposits on the teeth at the gumline that may lead to deep periodontal pockets, loss of the bony support of teeth, and therefore loose teeth. Severe periodontitis may ultimately lead to infection, abscesses, and loss of teeth. The teeth of Ramesses II are excellent examples of the effects of old age, with periodontal disease (loss of bony support), dental attrition, and root abscesses. James H. Breasted (1930) examined a twelfth dynasty mandible (lower jaw) that had two circular openings at the apex of the right first molar root tip and concluded that a dental surgeon had drained these root abscesses through a hollow reed.

Dental caries (cavities) were infrequently seen in ancient Egypt. Caries were attributed in the Papyrus Anastasi IV to a worm. The ancient kings, queens, and nobles did not have extensive dental decay; where it was observed, the decay tended to be the pit-and-fissure variety (top of the tooth) rather than interproximal (decay between the teeth). Two major environmental factors reduced the amount of dental decay. The first was the absence from the diet of refined carbohydrates, such as sugar. The second was the extreme attrition (wear) mentioned earlier, because the wear occurred not only on the occlusal surface (top of the teeth) but also between the teeth (interproximally). Extensive wear provides a difficult environment for both plaque and decay. (It has been suggested that the increase in caries in ancient Egypt was due to the availability of honey among the more affluent population.)

A brief comment should be offered here on dental occlusion or malocclusion and facial types. In general, perhaps owing to extreme wear, the dentition of the ancient Egyptians exhibited normal molar relationships with only moderate dental crowding. The faces of the queens of the New Kingdom (early eighteenth dynasty), however, resemble many modern European, African, and American faces, with maxillary (upper jaw) prognathism (protrusion). This condition may be either hereditary or environmental, the latter resulting from thumb sucking or other oral habits. Queen Ahmose Nefertiry of the eighteenth dynasty is an excellent example of this type of occlusion.

There has been considerable controversy concerning the role of a dental profession in ancient Egypt. F. Filce Leek, an English dentist has been the most quoted proponent of the view that there is not a sufficient body of evidence to indicate that there were dental specialists (“The Practice of Dentistry in Ancient Egypt,” Journal of Egyptian Archaeology 53 [1967], 51–58). In contrast, Paul Ghalioungui, in The House of Life: Magic and Medical Science in Ancient Egypt (Amsterdam, 1973), and Kent Weeks (1980) in his chapter “Ancient Egyptian Dentistry” in An X-Ray Atlas of the Royal Mummies, conclude that there were dental specialists.

Hesy-Re (third dynasty) was the earliest person to carry the title of physician, and he called himself “Chief of Dentists” (wr ibḥ swnw). There are many medical papyri, such as the famous Ebers Papyrus (Eb. 739, 740, and 743), that prescribe medicines to relieve dental pain and even describe how to fix loose teeth. According to Ghalioungui (1973): “resin, chrysocall or Nubian earth” was recommended for stopping or filling teeth. Harris, Iskander, and Farid (1975) reported the discovery of an Old Kingdom dental bridge, from the fourth dynasty, c.2500 BCE. This bridge replaced two upper front teeth (a maxillary lateral and central incisor). The bridge consisted of prepared extracted teeth, drilled with very fine holes, and fixed with gold wire to the patient's remaining teeth. Two teeth bound by gold wire were also found in an Old Kingdom burial site, and silver bridge was found in a skull at Tura el-Asmant from the Ptolemaic period. These finds add support to Paul Ghalioungui and Zeinab el Dawakhly in their Health and Healing in Ancient Egypt (Cairo, 1963), when, speaking of Egypt's specialization of medicine, they observed: “Men-kau-Re-ank who was called a maker of teeth (iry-ibḥ), to distinguish him from Niankh-Sekhmet who figures on the same stele as a “tooth physician” (ibḥ swnw”).

Kent Weeks (1980) listed six Egyptian dentists known to us, but only one, Psammetik-seneb of the twenty-sixth dynasty, was not from the Old Kingdom. Weeks speculated that the specialty of dentistry may have peaked in the Old Kingdom (c.2400–2000 BCE); nevertheless, the Greek historian Herodotus noted the existence of dentists during the Greco-Roman period in Egypt. On the whole, the evidence indicates that professional dental specialists existed in ancient Egypt; however, the extent of their knowledge for diagnosis, treatment, and restoration requires further examination of both the biologic and written records.

See also HYGIENE.

Bibliography

  • Breasted, J. H., trans. The Edwin Smith Surgical Papyrus. 2 vols. The University of Chicago. Oriental Institute Publications, 3–4. Chicago, 1930. Provides evidence of surgical drainage of dental abscesses.
  • Ebbell, E., trans. The Papyrus Ebers. The Greatest Egyptian Medical Documents. Copenhagen, 1937. Chapter 89 deals with dental concerns.
  • Harris, James E. “Dental Health in Ancient Egypt.” In Mummies, Disease and Ancient Cultures, edited by Eve Cockburn, Aidan Cockburn, and Theodore A. Reymond, 2d ed. Cambridge, 1998. Contains an extensive bibliography.
  • Harris, James E., Zaki Iskander, and S. Farid. “Restorative Dentistry in Ancient Egypt: An Archaeologic Fact.” Journal of the Michigan Dental Association 57 (1975), 401–404. Detailed description of the only true bridge found in an Old Kingdom tomb.
  • Hoffman-Axthelm, W. E. “Is the Practice of Dentistry in Ancient Egypt an Archaeological Fact?” Bulletin of the History of Dentistry 29.2 (1979), 71–77.
  • Iskander, Zaki, and James E. Harris. “A Skull with Silver Bridge to Splint or Replace a Central Incisor.” Annales du service des antiquitiés de l'Égypte 62 (1975), 85–90.
  • Nunn, John F. Ancient Egyptian Medicine. Oklahoma, 1996. An excellent review of medical history, with a brief section on dentistry.
  • Piccione, P. A. Comprehensive Bibliographical Database of Ancient Egyptian Medicine and Medical Practice. Chicago, 1996. Includes practically every medical and dental publication relating to ancient Egypt.
  • Weeks, Kent R. “Ancient Egyptian Dentistry.” In An X-Ray Atlas of The Royal Mummies, edited by James E. Harris and Edward F. Wente. Chicago, 1980. Probably the most authoritative review of the dental profession in ancient Egypt.

James E. Harris