Detail of an interior of a Dutch House with an operator attending to a man’s teeth. Photo: Wellcome Collection

SMILE and the world smiles with you. But for some smiling was not an option. Take, for example, Elizabeth I. Her love of sugar that had recently made its way to British shores, left her with a mouth full of black, rotten teeth.

A German visitor to the court of the Queen in 1578 reported that “her lips are narrow and teeth are black, a defect that the English seem subject to, from their great use of sugar”.

Sugar, then a luxury, was an affliction of the elite.

Even when Elizabeth was “excessively tormented by toothache” she refused treatment, which admittedly was pretty brutal and crude. It was only when the Bishop of London had an extraction performed in front of her to show “the pain is not so much” that she relented and had treatment.

Fast forward to Queen Victoria and the story is quite different. It is thought that she was one of the first European monarchs to reveal her teeth in a portrait. Up until the 18th century open-mouthed smiling was deemed impolite and vulgar. Generally it was a good thing as it hid the fetid wreckage of most people’s mouths.

However, with new sensibilities and expensive dental procedures people began to want to show off their investment.

A wide-ranging and impressive exhibition at the Wellcome Collection picks over the subject of teeth. We follow the rise of dental treatment from the early days of the tooth-pullers (usually barber surgeons or blacksmiths) – whose brutal extractions took place at fairgrounds and were a form of entertainment – to the birth of dentistry courtesy of the French physician Pierre Fauchard. He wrote the world’s first treatise on teeth – Le Chirurgien-Dentiste – and with it gave this new profession a name: dentiste.

General Medical Council poster dating from the 1960s. Courtesy of the British Dental Association Museum

Fauchard, himself once a tooth puller, quickly realised if he could “reposition” himself he could cater to the vanity of the Paris elite and so make much more money. With professional dentistry came the wish for better and more sophisticated treatments, some including dentures made with human teeth. As demand grew so came the “tooth hunters”, who would go to extreme lengths to collect teeth from the dead.

Goya’s 1799 etching, Out Hunting for Teeth, is a chilling glimpse of an activity that sprung up as the market value of teeth rose. Their booty would be used to make dentures for the wealthy and were also used in sorcerers’ recipes. The market was certainly hungry for them as more and more people opted for cosmetic dentistry. In a stunning example of the demand for human teeth, the exhibition notes that during the Battle of Waterloo there were 50,000 killed yet it took just 24 hours for the battlefield to be stripped of every last tooth.

Our relationship with teeth has long been the subject of anxiety, whether it is the pain of toothache and the worry of the ensuing treatment or the more deeply rooted relationship with teeth as a marker of attractiveness.

Teeth, which incidentally are the only part of the human skeleton which is exposed when we are alive, are also invoked to reveal our mental or emotional state: “through gritted teeth”, “setting one’s teeth on edge” and to “gnash one’s teeth.”

Or as we age we become “long in the tooth”.

Our most vivid dreams/nightmares can be scattered with the imagery of teeth. Have you ever dreamt your mouth is full of crumbling teeth? This is thought to signify a fear of ageing and mortality.

Napoleon’s toothbrush. Photo: Wellcome Collection

Today the connection made between teeth and attractiveness has never been more intense. With dental implants, teeth whitening and veneers, a perfect smile is now seen as the mark of success and according to social historian Malcolm Gladwell it has become another means by which to measure social status.

Good teeth and dentistry, just as before, is seen as increasingly the preserve of the https://wellcomecollection.org/wealthy with the poor unable to afford even the most basic of procedures.

A report in 2017 found that in the past decade the number of tooth extractions on children aged four and under in English hospitals had risen by almost a quarter, from 7,444 in 2006-07 to 9,206 extractions in 2015-2016.

This exhibition does a comprehensive job of tackling all of these issues as well as exhibiting some of the equipment used over the centuries. We see how the dentist’s chair – long feared and maligned – has developed from an admittedly simple construction to the modern ones of today.

We also see the early instruments (which will make your eyes water just to look at them) to the more refined dental equipment of Queen Victoria and Prince Albert’s dentist, Sir Edwin Saunders, who treated her and other members of the Royal Family for 40 years.

With the invention of the electric drill in the 19th century as well as the anaesthetic, trips to the dentist became more efficient but with this new invention came the acrid taste of your burning teeth as the drill took hold.

As for the anaesthetic, leaving a dental surgery with a drooping mouth that seems separate from one’s self, continues to cause anxiety for many people visiting the dentist.

Mindful of this phobia there is a rich strain of public health posters as well as some public health films. One American film equates good teeth with guaranteed romantic success at a high school prom.

However, it is perhaps the rather fabulous 1910 “oral motto” poster put out by a dental manufacturing company which should act a salutary lesson as you leave this exhibition.

“The mouth is the gateway of the body,” it warns. “Guard it well!”

Guard it well, indeed.

• Teeth is at the Wellcome Collection until September 16. Free. The Wellcome Collection is at 183 Euston Road, King’s Cross, NW1 2BE. For more information go to www.wellcomecollection.org

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