Civil War Dentistry: Tooth-Pulling and Pain on the Battlefield

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The American Civil War was a time of great suffering and hardship for soldiers on both sides. While we often think of the terrible wounds inflicted by bullets and cannons, soldiers also faced another painful enemy: tooth decay and gum disease. Let’s take a look at the state of dentistry during the Civil War and how soldiers dealt with dental problems on the battlefield.

The Sorry State of Soldiers’ Teeth

When the Civil War began in 1861, dental care was primitive by today’s standards. Many soldiers came from rural areas where they had little access to dental treatment. Their diets were often high in sugar and low in nutrition, leading to widespread tooth decay.

Poor oral hygiene was common, as regular tooth brushing wasn’t yet a widespread habit. Soldiers’ teeth were often in bad shape before they even joined the army. Once in military camps, their dental health only got worse.

A Diet Designed for Decay

The typical soldier’s diet did their teeth no favors. Hardtack, a rock-hard biscuit made of flour and water, was a staple food. Soldiers would often soak it in coffee to soften it, but the combination of refined flour and sugar was terrible for dental health. Canned foods, which became more common during the war, were often high in sugar as well.

As one soldier wrote in his diary: “The hard tack and coffee were the basic dots and this is why digestive systems among these Soldiers are going to be Sicily and pea.” The poor diet and lack of fresh fruits and vegetables led to vitamin deficiencies that further weakened teeth and gums.

Dental Care in the Field

When toothaches and dental problems inevitably arose, soldiers had few good options for treatment. Most regiments did not have dedicated dentists. Instead, medical doctors with little specialized dental training were expected to handle tooth problems along with other medical issues.

Extraction: The Go-To Solution

For many soldiers suffering from tooth pain, extraction was the only treatment available. Army surgeons and doctors would use pliers or forceps to yank out decayed and infected teeth, often without anesthesia.

As one account describes: “Army surgeons used the same saw to amputate limbs of different soldiers without cleaning or sterilizing, and, although some anesthesia existed, it was rarely used, and many injured soldiers had to drink liquor or bite leather or a bullet during amputations.”

While this description refers to limb amputations, tooth extractions were often performed under similar crude conditions. Soldiers might get a swig of whiskey to dull the pain, but that was about it.

Lack of Sterilization

The germ theory of disease was not yet widely accepted during the Civil War. This meant that doctors and surgeons did not understand the importance of sterilizing their instruments between patients.

As one historian notes: “Surgeons commonly operated in old clothes stiff with blood or pus, dressing wounds with torn-up rags when bandages were not available, and they did not clean, let alone sterilise, their instruments and did not keep wards or operating theatres free of disease-carrying insects.”

This lack of sterilization led to frequent infections after dental procedures. What started as a simple toothache could turn into a life-threatening infection.

Dental Innovations Born of Necessity

Despite the overall poor state of dentistry, the Civil War did lead to some advancements in the field. The sheer number of soldiers needing dental care pushed practitioners to develop new techniques and tools.

The Dental Key

One innovation was the increased use of the “dental key” for extractions. This tool, which looked a bit like a large corkscrew, allowed for more leverage when pulling teeth. While still painful, it was often more effective than simple forceps.

Vulcanite Dentures

The war also saw advancements in prosthetic dentistry. Vulcanite, a type of hardened rubber, began to be used to create more affordable dentures for soldiers who had lost multiple teeth. These were a vast improvement over earlier dentures made of ivory or human teeth.

The Birth of Army Dentistry

As the war dragged on, military leaders began to recognize the need for better dental care. In 1864, the U.S. Army created its first dedicated dentistry department. While too late to help many soldiers, this was an important step in recognizing dentistry as a crucial part of overall health care.

Lessons Learned

The experiences of the Civil War highlighted the importance of dental health for military readiness. In the decades following the war, the U.S. military gradually improved its dental services. By World War I, dental examinations were a standard part of the enlistment process.

Famous Figures and Their Teeth

Even some of the war’s most prominent figures weren’t immune to dental woes. Union General Ulysses S. Grant was known to suffer from severe toothaches that sometimes affected his ability to command. Confederate President Jefferson Davis had dental problems so bad that he often had difficulty speaking clearly.

These high-profile cases helped draw attention to the need for better dental care, both in the military and in civilian life.

Dental Myths and Folk Remedies

With professional care often unavailable, soldiers turned to folk remedies and superstitions to deal with tooth pain. Some common “treatments” included:

  • Placing tobacco on the gum near an aching tooth
  • Rubbing whiskey on the gums
  • Chewing on willow bark (which actually contains a natural form of aspirin)
  • Placing a hot compress on the cheek

While some of these might have provided temporary relief, they did nothing to address the underlying dental problems.

The Lasting Impact of Civil War Dentistry

The dental suffering of Civil War soldiers had a silver lining. It highlighted the need for better dental care and led to advancements in the field of dentistry. In the years following the war, dental schools were established, and dentistry began to be recognized as a distinct medical profession.

The war also led to improvements in prosthetic dentistry. As one account notes: “We have a very technologically advanced arm from 1863… This is the technological advancement that came out of the Civil War.” While this refers to prosthetic limbs, similar advancements were made in dentures and other dental prosthetics.

A Toothy Legacy: How Civil War Dentistry Shaped Modern Care

The dental horrors of the Civil War may seem far removed from the clean, anesthetized dentist offices of today. However, the suffering of those soldiers played a crucial role in advancing dental care.

The war highlighted the importance of preventive care, sterile practices, and specialized dental training. It also spurred innovations in tools and techniques that laid the groundwork for modern dentistry.

So the next time you sit in a comfortable dentist’s chair, with pain-free anesthetic and high-tech tools, spare a thought for those Civil War soldiers. Their toothy tribulations helped pave the way for the advanced dental care we enjoy today.

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