Is there any good data about how common it was for people to die from dental related illnesses such as abscesses and other infections? I’m speaking of a time before antibiotics and modern dentistry. Were certain eras worse than others? Was the risk mitigated by a more natural diet in the past? Is it even possible to know?
We pull skulls out of excavations all the time attached to bones that show physical signs of beonging to a well aged person but which have perfect teeth. Before we had access to sugar I’d bet that tooth problems were about as much a deal as they are for animals–mostly issues with accidental breakage with some wearing down and tooth loss due to age.
Sugar was first introduced to Europe in the 11th century. People had access to it in other parts of the world long ago also. I’m sure sugar is a factor and that’s one of the questions. There are many centuries of history between when sugar was introduced and modern medicine.
Even as late as Tudor England, sugar was the signifier of being rich and powerful. By “available,” I mean readily available to every class of person on a daily or near daily basis. You know, like now.
Dentist here. Sugar has been around a long time but not in the quantities that it has obtained since the 19th century. Prior to antibiotics dental abscesses were usually drained or the tooth extracted, usually took care of it. It is rare but people can still die today from an abscess. One type called Ludwig’s Angina starts in the floor of the mouth and can spread down the neck and constrict the airway. Can happen in only a few hours. In dental school we had a specimen from a man who had an upper abscess the spread down the optic nerve into the brain killing him. I had a patient who bit her tongue eating dinner(perforated with her canine) and by the next morning her tongue was swollen enough the we put her in the hospital on IV antibiotics. Was scary. Fairly rare now for someone to die, but some people get messed up bad in a short amount of time.
I collect old medical books, and have a few dental textbooks from the pre-antibiotic era. Some of the abscesses pictured can best be described as frightful. My own dentist told me that fatal dental abscesses were not uncommon back in the day, and I can believe it.
This would probably have been exacerbated by the patient’s overall poor health for other reasons.
ETA: One of the more interesting ones was a man who had a lower-jaw tooth that became infected, and the sinus was discharging next to his thyroid; until the track was injected with barium and x-rayed, it defied treatment because they thought it was just a neck abscess that kept re-forming.
Some relevant relatively recent archaeological reportage on post-medieval cemetery clearances, which give glimpses at a broader level on what was happening to people and their teeth:
From the authors’ literature review, increasing occurrence of caries relative to Roman and medieval populations, possibly through sugar but also refined flour. Although the paper is focussed on presence of caries there is no mention of any other major dental pathology. At least in this population, which does not seem unusual, dental problems were probably not fatal, but probably just one of many lousy things people had to contend with in their lives at that time.
I thought I saw a dental entry on this post I saw a few days ago and yep, on a certain week in 17th century London121 people died from “teeth.”
That could include some frightening possibilities.
That might have been me. I thought I posted a link to an article on those who died from dental issues in 1600’s England, but I don’t see it now. Odd.
Refined sugar isn’t the only substance that can cause dental problems. Pre-Columbian populations in Panama, and I think elsewhere in the new world, suffered from a high incidence of dental problems including caries, malocclusion, abscesses, and other problems due to a diet high in corn (maize). Maize is soft and sticky and can promote tooth decay. In addition, grit from the metates used to grind the corn could also promote dental problems.
I don’t know how common it was to die from such problems, but I have seen cases of such severe abscesses that they could have contributed to the persons death, particularly in children.
Corn is also very high in sugars, hence the existence of high fructose corn syrup. Sugar rots your teeth, your granny was right about that.
Like the Spinal Tap drummer who choked on vomit, its important that we establish whether these were the victims’ teeth.
Just eating corn isn’t going to expose your teeth to a lot of free sugars. Corn syrup is produced by hydrolyzing corn starch. And HFCS is made by converting some percent of the glucose to fructose.
I was once at a presentation by the Chief Dentist at MetLife. He claimed that dental infections were particularly dangerous, not so much because the infection would directly spread, but because food passing through the mouth would bring the infections to other parts of the digestive system.
I recall an article by some professor of dentistry who said that the Dutch masters were such accurate portrait artists that you could diagnose many dental problems on the portraits they made. The idea was that the increased trade that made Holland rich, particularly with the West Indies, brought sugar in massive quantities to the middle class and the result was dental problems that had been rare for their ancestors.
Of course, we should also mention George Washington and his much joked about wooden dentures.
The surgeon going town to town pulling teeth was a fixture of medieval life.
Go check out how much corn you get to eat on a low-carb diet. Carbs is sugar too.
Saliva contains the enzyme amylase. It immediately begins to break down the starch to sugars. You may notice that as you chew starchy foods such as corn or potatoes they begin to taste sweet.
In order to produce chicha, a fermented alcoholic drink, indigenous women used to chew corn or other starchy foods and spit it into a jar to produce sugar and start the fermentation process. (They still do in some places.)
for the purposes of a low-carb diet, you are far more concerned about what your body is doing to the corn after you swallow it.
Yes, amylase is how we commercially hydrolyze starch. Cultures that didn’t use in-seed or microbial (e.g. Japan) enzymes added their own meager ones. That’s neither here nor there. The vast majority of the starch you put in your mouth goes down your throat as starch.
That’s neither here nor there with respect to the OP. The point is that starch adhering to the teeth from the food you eat will be converted to sugar and provide food for the bacteria that cause caries and other dental problems. Corn is particularly sticky and adheres to teeth, and a diet high in corn can promote caries.