My son is ten and his baby teeth were slow to come in… and they’re slow to fall out.
He’s only had a few fall out on their own, even though his adult teeth were coming in behind them. The first time he had four bottom teeth pulled, and then a year later he had two more extracted. This will be regular thing for him.
His dentist is great, and they use laughing gas to help him relax, novocaine to numb the pain, and the procedure itself is over in ten minutes. I think it’s more agonizing for Mommy to stand there and watch the dentist tug than it is for my son. Soon, we’re in the car and, before I know it, he’s asking when he can have a snack.
It’s a little different from the dental care our favorite characters would have experienced. The first mass-produced toothbrushes were available in 1780, so by the time we imagine Darcy smiling at Elizabeth, the upper and middle classes would have had their own toothbrushes rather than a linen cloth. They would used either homemade or apothecary-bought tooth powders commonly made from sodium carbonate and an abrasive like chalk or salt, and flavorings like peppering, cloves, or cinnamon.
In general, oral hygiene wasn’t an advocated practice. But even if a physician in the Regency recommended daily teeth cleaning, they weren’t the ones taking care of their patients teeth. Dentistry was an emerging medical practice at this time, and tooth drawers, apothecaries, and surgeons acted as what we might now consider dentists. Many entered the profession after an apprenticeship, and you were more likely to find someone whose sole profession was a dentist in London than in the country.
Jane Austen wrote to her sister Cassandra in September 1813:
The poor girls and their teeth! I have not mentioned them yet, but we were a whole hour at Spence's, and Lizzy's were filed and lamented over again, and poor Marianne had two taken out after all, the two just beyond the eye teeth, to make room for those in front. When her doom was fixed, Fanny, Lizzy, and I walked into the next room, where we heard each of the two sharp and hasty screams.
Marianne Knight was around 12 at this time. My son’s dental extractions went a little differently than Marianne’s did. There was no screaming.
This is a dental key; they were introduced in the early 1700s and were the instrument of choice for tooth extractions until nearly the 20th century. The first keys were made of iron, with straight shafts and the claw held in place by a pin, and had handles made of iron, ivory, mother-of-pearl, or different types of wood. They came in different sizes—smaller ones for children like Marianne, who might have needed baby teeth pulled to make space for adult teeth just like my son needed.
Basically, you place the key in the mouth, tighten the claw around the tooth to be pulled, and rotate to loosen it, like turning a key in a door lock. This could result in gum damage, broken teeth, and even jaw fractures.
Around 1765, the straight shaft was replaced with one with a single bend. This prevented pressure from being put on the tooth next to the one being pulled. Aside from single or double bend and wrapping the bolster in linen or leather, there was no significant change in tooth extraction for a long time. It wasn’t until the end of the 19th century that dental forceps were developed and replaced the key.
With dental forceps, which resemble a pair of pliers, you were less likely to damage gums or break a jaw, and this is the tool that my son’s dentist used.
If you’re feeling brave, here’s a short video—just a computer animation!—of what it looks like to have a tooth pulled using a dental key. It’s not as bad as watching your son have teeth pulled…but I still think it was worse for me than for him.
Science Museum Group. Dental key. A656897Science Museum Group Collection Online. Accessed August 9, 2020. https://collection.sciencemuseumgroup.org.uk/objects/co101979/dental-key-dental-key.
OSU Medical Heritage Center. Tooth key. Accessed August 9, 2020. https://library.osu.edu/site/mhcb/2012/04/30/tooth-key/