Cosmetic dentists have been around for millennia, making teeth beautiful long before anyone figured out how to keep them healthy. The Maya are a great example of this.

No Anesthesia and No Power Drills

Maya civilization flourished through southern Mexico (especially the Yucatan) and much of Central America from about 2000 BCE throughout the first millenium.

One of the most common procedures the Maya cosmetic dentists performed was inlaying teeth with jade, pyrite, and other precious stones. First, the teeth were drilled using a tool called a bow drill, in which a bowstring is wrapped around the shaft of the drill to spin it as the bow is moved back and forth. Abrasives may also have been added to speed the process. Once the hole was drilled, the gemstone was set inside.

Typically, the inlaid teeth were the front four or six teeth in the front on top and on bottom. Because this is a cosmetic process, like porcelain veneers, only visible teeth are treated.

Without anesthesia, the procedure was likely quite painful, but not nearly as painful as some of the tooth filing also practiced by Maya cosmetic dentists.

Reshaping Teeth

In addition to inlays, Maya often filed their teeth. There were many different shapes for filing down teeth. Sometimes one or both sides were notched. These tended to be square notches, not angled sides, so they didn’t create a sharp point. Other times, the entire tooth was filed down to create a shorter tooth. This may have been to replicate the tooth wear that was common among the Maya, to give a person an impression of age.

Who Had Their Teeth Treated?

Although in some societies cosmetic dentistry was reserved for only the very few, the Maya seem to have been more like us in that it was open to many people. Depending on where the survey was conducted, perhaps as much as 65% of the population had modified teeth. Again, depending on the time period, tooth modification was more popular among men or women, but it seems to have always been used by both sexes.

What about Reconstructive Dentistry?

The Maya had all the tools necessary to practice reconstructive dentistry to at least some degree–they could have made fillings–they didn’t seem interested in repairing damaged teeth. Some people will tell you that this is because the Maya didn’t suffer from tooth decay, but this isn’t true.

In one sample of 20 adults and 10 children from a single burial, nearly every member of society had some degree of dental decay. Among the 20 adults, tooth wear was present, and often severe. Dental calculus was present on 19 out of the 20 adults, and 15 adults had cavities. Although life expectancy at this time was only  25-35 years, 11 of the adults had lost teeth before they died. Six had abscesses in their jawbones, evidence of infected teeth that we would treat with a root canal. They also had orthodontic problems, but fewer than modern Americans. One skull had rotated teeth, another malocclusion, and a third had an impacted wisdom tooth.

Seven of the 10 children had cavities, starting at age two.

With the technological means and the medical need, the Maya could have practiced reconstructive dentistry, but they don’t seem to have even tried. For them, cosmetic dentistry was the only dentistry.