Oral Care in the Middle Ages
The purpose of this project was too explore various items used for oral hygiene during the Middle Ages. While I had done quite a bit of research into the art, literature, and archaeology of teeth in our period, what people seemed most interested in were things they could use in the course of their re-enacting.
Teeth in the Middle Ages
A casual look through illuminations produced in the Middle Ages might lend credence to the misconception that no one cared to clean their teeth back then. Closed lips predominate in just about all depictions of people all through our period and have lead to many an undergraduate paper discussing what must lie behind the Mona Lisa's smile. When teeth are depicted they belong to monsters or low born people like those on Well's Cathedral.  (Fig 1)
However, the literature of the Middle Ages makes it clear that teeth were very much in mind. Toothache sufferers even have their own patron, St. Apollonia. She is depicted all through period, always in the current fashions, and holding a tooth with a pair of pliers. (Fig 2).  There are many literary reference to beautiful women which include a description of their straight, white teeth. 
And who shall speak of her laughing mouth, which God shaped with such great skill that none might see it and not suppose that she was laughing? And what about her teeth? They are so close to one another that it seems they are all of one solid piece, and in order that the effect might still be enhanced Nature added her handiwork; for any one, to see her part her lips, would suppose that the teeth were of ivory or of silver. There is so much to be said were I to portray each detailed charm of chin and ears, that it would not be strange were I to pass over some little thing.
CLIGES   Part I: Vv. 1 - Vv. 2278 
Online Medieval Library Release #22
http://sunsite.berkeley.edu/OMACL/Cliges/cliges1.html
For the not quite so beautiful there is a lot of  "gnashing of teeth" in anger, in battle and, of course, in hell.
THE SOMPNOUR'S TALE.
THE PROLOGUE.
The friar up start, as doth a wood* lioun,                                   *fierce
"Ah, false churl," quoth he, "for Godde's bones,
This hast thou in despite done for the nones:*                       *on purpose
Thou shalt abie* this fart, if that I may."                                     *suffer for
His meinie,* which that heard of this affray,                            *servants
Came leaping in, and chased out the frere,
And forth he went with a full angry cheer*                                 *countenance
And fetch'd his fellow, there as lay his store:
He looked as it were a wilde boar,
And grounde with his teeth, so was he wroth.
http://www.online-literature.com/view.php/canterbury/4?term=teeth
Our teeth are what can connect us to our animal nature. A folklore tradition held that a child born with teeth had some demon blood them. The 15th century tale of Sir Gowther has a very colorful description of what this could do to the child's mother.
Archaeology proves that teeth were not necessarily bad. The caries rate was definitely lower (Fig 3) for a number of reasons.  The wear from a rougher, non-processed diet removes small cavities before they have a chance to establish, and also helps to clean out the space between teeth. Clearly, sugar and sweets were not nearly as prevalent as they are today. This rougher diet also helps to keep teeth straighter.
This chart, and the medical treatises of the time show a sharp change in dental care during the Renaissance. Changes include the technology to produce softer food, sugar from the new world, and the use of the fork.
Teeth and Medieval Medicine
Information about care of the teeth has to be gleaned from many sources. Oral care wasn?t necessarily seen as any different from other medical advice, as they are ususally found in the same manuscripts. Some medieval advice for tooth care is extremely practical such as Hildegarde of Bingen's suggestion to rinse one?s mouth with cold clear water in the morning and after each meal. Another common suggestion is to rub one's teeth and gums with linen.
The following quote from Guy de Chauliac is particularly illuminating on dentistry in the Middle Ages. He quotes three different Arabic author and incluces such practical advice as avoiding hard or sticky foods. However, he subscribes to the theory of humors and bleeding the patient. The last section is lists the tools of a well-stocked dentist.
";In curing the affections of the teeth a double treatment is given, one universal and the other particular. The universal treatment generally has two purposes, on concerned with living habits, and the other with evacuation. According to Avicenna, six things are specified regarding living habits. First, no perishables such as fish or dairy products should be used. Second, excessively hot or cold should be avoided, especially one immediately following the other.'
'Third, no hard things should be chewed, such as bones, or viscous ones such as figs or honey products.  Fourth, foods known to be harmful to teeth, such as leeks, should be avoided.  Fifth, the teeth should not be picked in a painful or rough manner. Sixth, they should be rubbed with honey and burnt salt, and if vinegar is added, ultimate results may be obtained, according to Haly Abbas' declaration in his fifth section in the second part of the 'Royal Disposition.' As a purgative, hiera is suitable. Also acceptable are phlebotomies of the cephalic vein and the veins of the lips and tongue. One must also divert with massages and suction cups and cleansing of the head, and dry the rheum by comforting the head, as has often been mentioned. Phlegmatic humors must be cleared out with pyrethrum, mastic, and similar things.
The particular treatment is concerned with two things. First, three teachings necessary in operating on teeth; secondly, the operation in itself, according to the variety of affections. 
The first teaching is that such operations are particular and performed by barbers and dentators (dentists) or tooth-pullers, because physicians have left the above-mentioned operations to them.  However, it is safer that such operations be performed by physicians. The second teaching is that the physician who gives advice about such things should know that advice which is given for the teeth can take different forms, as expressed by Avicenna, namely, by gargles, mastications, fillings, evaporations, ointments, massages, fumigations, cauterizations, head purges, instillations into the ear, and by manual operations, as will be described later.
The third teaching,according to Abulcasis, says that the dentist should be equipped with adequate instruments, namely razors, scrapers, straight and curved scalpels, elevators, both simple and with two arms, toothed tongs, and a variety of picks, cannulas, levers, bores (drills), and also files and many others necessary for the job."
From Cyrurgia Magna by Guy de Chauliac
Translated by Gerald Shklar,DDS,MS
Journal of the History of Dentistry Vol. 45, No. 3, p 116-117
What have I done
I have tried to find as many items as possible that were used for oral care. The following chart lists them. I have tried to figure out what was used most often. I tried to track this by assigning a letter to an individual recipe and cross-referencing that letter with each item involved. Some items have no letter because they are used by themselves or are mentioned in passing in the literature. I was hoping for more dentifrice and mouth rinse recipes, but the medical literature?s purpose and emphasis is on solving problems and not prevention. 
Toothpowder
I didn't find any specifc recipes for toothpowder, just list of items used.
My recipe
Eggshells from 8 eggs (from happy hens)
1 teaspoon myrrh drops
1 tablespoon seasalt
I was a little concerned about the egg shells. I had rinsed them well but decided to boil them for 20 minutes to kill any bacteria. A very modern concern but it didn?t change the consistancey of the shells.  Then I ground everything together in a mortar and pestle. I added a little water to control dust and then let it dry on a dish. The myrrh made it all stick together but it was easy to scrape up and grind some more.
I chose eggshells because they were convenient and the rows of eggs look like nice teeth. I am not sure if anyone in the Middle Ages made the connection that both eggshells and teeth are made of calcium, but it snuck into my reasoning too. Furthermore, I didn't really want to try some of the other suggestions, such as charcoal or ashes.
Myrrh has a long connection with cosmetics and smelling nice as is seen in a quote from Martial about myrrh scented breath.
Salt in several forms is listed as being used as a dentifrice.
Mouthrinse
2 cups Shyrrh wine
handful of mint
1 Tablespoon peppercorns
Boiled all together for 5 minutes. Rinse mouth and swallow. Tastes good too.
Wine and vinegar are often mentioned as mouthrinses on their own or mixed with herbs. I choose Syrrah because that variety of grapes was cultivated in medieval France. It is described as having a peppery taste and since I planned to use pepper, it seem like a good idea to go with this taste rather than trying to counteract it.
Pepper and mint  are mentioned  in several sources. See Big Chart.
Toothache cure
I hadn?t planned on making a toothache cure. I didn?t really need one and would go to a regular dentist if I did. However, I found so many recipes that I felt I had to try one. Of course, henbane was one of the most popluar remedies. Both the plant itself and the seeds have been used. Unfortunately it is considered a poison and is very difficult to find. None of the herb shops stocked it and the recommended online shops didn?t list it. I probably could have found it but it just wasn?t necessary to my project.
Fortunately, one period recipe mentioned using "henbane or leek seeds." There had to be a period substitute. Leeks and leek seeds are also listed as remedies and were easy enough to find at a well stocked plant nursery.
Equal parts leek seeds and candle wax
"Make into a small ball and throw on a braizer or make into a candle and burn. Direct fumes to the aching tooth and wait for the toothworm to die or the pain to cease."
Item Used for found at prep
Candle     beeswax Tooth- already had
                  Tallow Ache
cure
Eggshells Tooth Whole Foods Market from cage-free happy chickens. I boiled to shells for 20 minutes to eliminate salmonella
powder
Leek seeds Tooth- AOK Hatchery As is
Ache Kirkwood MO
cure
Mint Mouth In laws yard No pesticides.
rinse
Myrrh Tooth Merchant at Pennsic Came in dried drops. I rinsed them off as they seemed dusty.
powder
Pepper Mouth Penray Spices
rinse
Seasalt Tooth Whole Foods Market As is
powder
Wine Mouth Cost Plus World Market Syrah
rinse
Conclusions: I think I would be okay with using a bit of cloth to clean my teeth and rinsing them well with water or wine but I?m not giving up my modern toothpaste and tooth brush. I found an alternative toothpaste at a health food store that was made with myrrh. This might be something to take with me to longer camping events to remind me to think and feel different.
	The reseach on dental anthropology has been the most interesting to me and the least applicable to SCA. The on thing I might do is give up my fork. If you see me eating with my fingers know that it is all for the sake of my teeth.
©2002 Mary M. Haselbauer d.b.a. Slaine ni Chiarain
mary_m_haselbauer@yahoo.com
314-918-1062
Bibliography
Author Title Journal/Book Notes
reference
Arthur R. A new method of using gold foil. Bull Hist Dent 1977 Apr;25(1):46-50 Mentions gold fold used as filling in period. Mostly OOP
Asbell, Milton Dentistry: A Historical Perspective Dorrance Publishing Co, 1988
Camille, Michael Images on the Edge Cambridge, 1992 Excellent book. Gives other suggestions for the "toothache" capitals at Wells Cathedral.
Cohen EM. Teeth and dentists in literature. J Hist Dent. 1996 Mar;44(1):19-24. Mostly Chaucer and Shakespeare. Not much analysis.
Curtis, EK In Pursuite of Palliation: Oil of Cloves in the Art of Dentistry Bull Hist Dent 1990 Oct;38(2):9-14
Fiorato, Veronica Blood Red Roses: The Archaeology of a Mass Grave From the Battle of Towton AD 1461 Oxford, England, Oxbow Books, 2000 Excellent book. The archaeology of the battle of Towton. There?s a whole chapter on the dental remains.
Anthea Boylston, and Christopher Knusel Editors
Getz, Faye Marie Healing and Society in Medieval England: A Middle English Translation of the Pharmaceutical Writings of Gibertus Anglicus U Wisconson Press, 1991 This is a great book. I wish I had found it sooner and had had more time to go though it.
Gorelick L, Gwinnett Aj. Life and death of the tooth worm theory or when I believe it, I will see it. N Y State Dent J. 1987 Aug-Sep;53(7):21-5. Excellent. Rather than a couple of dentists writing a cutsy history article this one gets at the "why" of the toothworm theory.
Hargreaves AS. Toothdrawers in English popular literature prior to 1700. Bull Hist Dent. 1993 Jul;41(2):51-7. Only really talks about Piers Plowman.
Huntstadbratn, K. Tooth and toothache in Norwegian folklore. Bull Hist Dent. 1987 Apr;35(1):31-6. Wonderful descriptions of folklore traditions involving teeth. Especially useful for baby teeth. Not entirely sure when some of the traditions date to.
Kanner, Leo Folklore of the Teeth The major work in this area. Unfortunately, he doesn't always say where he has found something and else to use archaic location names.
Kerr NW. The prevalence and pattern of distribution of root caries in a Scottish medieval population. J Dent Res. 1990 Mar;69(3):857-60. Excellent!
Larsson Ef, Dahlin Kg. The prevalence and the etiology of the initial dummy- and finger-sucking habit. Am J Orthod 1985 May;87(5):432-5 This article is interesting because they used a group of children's skulls from medieval Sweden as their control for a study on modern finger sucking habits.
Mandel ID. Caries through the ages: a worm's eye view. J Dent Res. 1983 Aug;62(8):926-9. Kinda cutsey. Good bibilography. At least he cites his sources.
Prinz, Herman Dental Chronology: A record of the more important historic events in the evolution of Dentistry Philadelphia, Lea & Feibger, 1945
Ring, Malvin Dentistry: An Illustrated History Dr. Ring is the guru of  the history of Dentistry. Nice book. Lots of pictures. Mostly about the science.
Ring, Malvin The legend of the toothworm. Compendium. 1992 Apr;13(4):344-5.
Ring, Malvin Review of Dental Practices in Tudor England JADA 77:1341-1346
Seddon RP A cephalometric study of the Romano-British. Eur J Orthod. 1984 Nov;6(4):303-12. They compared a 5th century series of skulls and a modern one and found them remarkable similar except for wear.
Shklar G. The dental medicine and surgery of Guy de Chauliac with extended excerpts from the Cyrurgia Magna. J Hist Dent. 1997 Nov;45(3):113-9. Great Article!
Original translation.
Worth Health Organization World Oral Health Data http://www.whocollab.od.
mah.se/countriesalphab.
html
Used for comparing modern and medieval caries rates.
Online sources
Botanical.com
Dictionary.com
Orb