The History of Anesthesia and Tooth Extraction - Ancient Greece

The Greeks, unlike the Egyptians had no specialized doctors or healers for a specific disease. If you have toothache had to go to a usual doctor. There is some evidence that Greeks used to replace teeth that were lost using golden wire.

Hippocrates of Cos (460-377 BC.) left numerous writings which included dental topics. He called for a separation of church and medicine and advised doctors to leave the temples. He is known for his extensive series of observations and theories including the famous Hippocratic oath. The treatment that he developed for mandible fractures is still used today.

Paul of Aegina (625-590 AD.) wrote a compendium comprising seven volumes describing oral tumor excision, incision and drainage of abscesses (which he called parulis).

A common mistake in the interpretation of ancient dental surgery is the idea that the ancients knew and used secret anesthesia techniques such as the use of drugs, arterial or carotid compression and hypnosis. It is not the fact. Surgical procedures were extremely conservative and were applied only in cases of absolute necessity. Writings and drawings from that time show the performance of surgical maneuvers on conscious patients, who were kept immobilized by friends or relatives.

The misinterpretation stems from the fact that the Greeks knew that performing carotid compression would lead to loss of consciousness, but this is all that they ever said and there is no evidence about the use of this procedure in medical purposes.

The History of Anesthesia and Tooth Extraction - Ancient Egypt

The population of ancient Egypt was constantly suffering from toothache mostly because they used to grind their teeth until pulp exposure. It is extremely interesting that they had no cavities. One of the reasons may be the lack of carbohydrates (sugar) from their diet. The presence of cavities and abscesses was later observed on mummies which is probably due to the use of a softer and more refined diet.

Egyptians were advanced in terms of dental care. They had specialized doctors which were dealing only with teeth, draining abscesses by using "burs of fire" (a heated pointed instrument, which was introduced in the collection of pus). They also reconstructed edentulousness with artificial teeth.

Dental jewelry found on ancient mummies

Nefer-ir-etes (2.600 B.C.) was mentioned in historic documents as one of their best dentist. Although they had advanced knowledge about teeth (for that time), the Egyptians believed that toothache is caused by worms.

In 2600 BC Hesy-Re dies, an Egyptian scribe known as the first dentist. His grave is marked as "the greatest of those who deal with teeth and of doctors". Dated between 1700-1550 B.C. the Ebers scroll describes diseases of the teeth and different dental pain remedies. As the Mesopotamians, dental remedies were composed by mixtures of herbs and minerals.

They were also used in conjunction with prayers and incantations. These were used for centuries because of two reasons: first of all procedures on the teeth were very difficult and had a small percentage of success. Dental extractions were likely to worsen things and sometimes resulted in patients death.

Secondly, dental pain is characterized in some cases by the presence of spontaneous remission periods. With this manifestation of the disease, it was very easy to conclude that any treatment tried before the disappearance of pain was successful.

The History of Anesthesia and Tooth Extraction - China

Emperor Shen Nung (2800 BC) influenced the practice of medicine in China a long time. He was an authority in the use of herbs for medicinal purposes and acupuncture, an alternative therapy which is still widely used today.

Acupuncture began as a practice during the time of Nei Ching and was apparently designed by Huang Ti around 2600 BC. The Chinese believed that health is a given balance of yin and yang. They thought that inserting needles along the 12 meridians of the human body can correct the imbalance between them. Each of the 355 points of a meridian is responsible for the function of an organ. When drug based treatments failed, they resorted to acupuncture. The drugs used by them include ginseng for the treatment of nervousness and agitation and willow for rheumatic pains.

The History of Anesthesia and Tooth Extraction - Mesopotamia

Imagine the horrors of having a tooth extracted before the age of anesthesia (which started roughly around 1844). There are many testimonies illustrated in paintings or literature depicting the people who would rather bare the dental pain rather than the one caused by the extraction. In many cases the patient had to be sedated (often through drugs or alcohol) and tied up. Dental pain seems to be as old as man, archaeological evidence pointing out that even Neanderthals had suffered because of it.

Mesopotamia

Mesopotamia and the territory known today as Iraq existed around 3000 B.C. The inhabitants of the Mesopotamian region as well as the Babylonians believed that pain is a sentence and appealed to Asu, a healer to cure them. Asu used a combination of drugs and surgical maneuvers. He was assisted by an exorcist and a priest-physician. Because of their profession, these early doctors were responsible for their actions. In a manuscript which dates to around 1700 BC we find out that "if a doctor treated a patient with a metal knife and the damaged eye, he will have his hand cut off".

Mesopotamian surgical instruments

Opium was most often used in pain relief. Some mixtures contained small amounts of opium. It has no analgesic action through local or topical application but if swallowed it can produce general analgesia and euphoria. Unprocessed opium had an unpredictable action which varied from one patient to another. This was a known fact by Mesopotamians which regarded it as poison and only experienced practitioners used it exceptionally.