The First Dentist Was a Neanderthal

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SCI103: Sixty thousand years ago, a Neanderthal sat still while someone drilled into their infected tooth with a sharpened stone — no anesthesia, no chair, no numbing agent. The procedure worked. And a paper published in PLOS One confirms it is the oldest known invasive dental procedure in the human fossil record.

The tooth — a lower left second molar from Chagyrskaya Cave in the Altai Mountains of southwestern Siberia — had a severe pulp infection visible on micro-CT scanning: deep demineralization and structural damage to the dentin that would have caused excruciating, debilitating pain. The individual had also been aggressively using toothpicks — bone, wood, or plant stalks — to try to get relief, leaving Stage 4 and Stage 2 wear grooves on the tooth’s sides. None of it solved the underlying infection.

What solved it was a stone point. High-resolution microwear analysis of the hollow’s interior walls found parallel horizontal lines and a polished finish that can only result from repeated mechanical friction during life — clear evidence that someone took a sharp tool and manually rotated it into the tooth to clear the infected tissue. The hollow measures 4.2mm long, 2.8mm wide, and 2.6mm deep. This is prehistoric dentistry, predating any known Homo sapiens dental procedure by more than 40,000 years.

Researchers tested the conclusion by replicating it. Using Jasperoid perforators — the same hard, fine-grained stone implements found in the same cave layer as the tooth — an experimenter manually rotated a stone tip against a freshly extracted modern wisdom tooth. The process took 35 to 50 minutes. The resulting marks matched the Neanderthal molar exactly: same stepped grooves, same profile measurements, same horizontal micro-striations. The stone-tool drill worked then, and it works now.

That the patient survived is not in question. Post-operative wear on the drilled surfaces shows the individual continued chewing on that tooth long after the procedure. The infection resolved. Life went on — 59,000 years before anyone invented the dental chair.

Caroline Knight walks through the anatomy, the archaeology, and the experiment in detail, joined by Lindsay Sant and Lino Saubolle on Let’s Science!

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