In 1886 in the Wyoming Territory, ex-Confederate soldier and notorious gunfighter Clay Allison had a toothache. His mouth was swollen and his head throbbed. He rode his horse through small towns until he found a dentist in Cheyenne. The dentist recognized Allison from Wanted posters. He became fearful due to the outlaw’s murderous reputation. Allison demanded the dentist pull his tooth. In those days dental equipment wasn’t much more than a bottle of whiskey and a large pair of pliers. Allison took a swig of booze and laid back in the dental chair. The dentist clasped pliers around a back molar and started pulling. Unfortunately he pulled the wrong tooth. Allison jumped out of the chair and found another dentist in town to pull the correct tooth.
After the ordeal, Allison returned to the first dentist’s office. He forced the dentist into the chair and removed one of the dentist’s healthy molars with pliers. The dentist screamed in pain. Allison attempted to pull a second molar but the screams were heard by local men who ran inside and pulled Allison away ending the incident.
Dentistry in the Old West was not easy for the patient or the practitioner. Procedures were barbaric and primitive. Thousands died from botched treatments or succumbed to sepsis from infected abscesses. At the end of the Civil War, there were only three dental schools in the United States. As a result, dentistry was often practiced by doctors, bartenders, barbers and blacksmiths. The best dentist was one who knew how to wield pliers. A dentist would locate an offending tooth then remove it with brute force.
Old West dentists used clove oil to numb the affected area but this did little to minimize the pain of extraction. In some towns nitrous oxide was available but it was dangerous and could be fatal. In 1884, Viennese doctor Carl Koller discovered a cocaine solution that deadened nerve pain. The completion of the transcontinental railroad in 1869 made cocaine available throughout the US territories. Opium was another option but could lead to cases of over-medication killing or causing brain damage in patients.
Dental hygiene during and after the Civil War was nearly non-existent. Toothbrushes were patented in the 1850s, but they were expensive and largely unavailable in small towns. Sometimes neighbors pooled funds to purchase a “community toothbrush.” People scrubbed their teeth with water and abrasive powders made from crushed chalk, charcoal or salt. Old West toothbrushes were carved from cattle bone with stiff hair taken from wild boar or horses. Theft of a toothbrush was considered larceny and was punishable by jail time, banishment from town or a $25 fine (equivalent to a month’s wages).
Most people used chew sticks instead of toothbrushes. These were small pieces of birch wood masticated until one end frayed. The soft end was used to scrub teeth while the sharp end was used as a toothpick. Native-American hygiene methods were more advanced. They chewed on pine sap that acted like a gum to clean teeth. They also used sage and mint to freshen their breath.
Nearly everyone in the Old West had tooth decay, stained teeth and bad breath. According to author Chris Enss, “The average person was toothless by the time he or she was fifty.” A cracked tooth could be a death sentence. The red-and-white barber pole originated when barber/dentists hung bloody rags outside to dry after savage dental procedures.
Some cowboys were so fearful of dentists, they turned to cocaine drops. This numbed tooth pain but turned wranglers into addicts. Other denizens avoided the trauma of tooth decay by pulling all their teeth at a young age. According to Old West Magazine, newly-married couples were often given a full mouth dental extraction as a wedding gift.
Teeth replacement options were no less horrid. During the Civil War, dentists used “Waterloo Teeth.” These were human teeth pulled from fresh corpses, boiled to remove bacteria, then affixed to someone’s mouth with pins or rivets. Around the 1870s, porcelain teeth became available. They were carved to size and colored to look natural. They were then attached to vulcanite, a type of durable rubber. These early dentures affixed to the mouth palate with suction cups.
Classic western films depict outlaws as having gold teeth. Gold teeth were available in frontier towns but weren’t common. Cowboys and outlaws were typically poor and transient and unable to afford gold or silver teeth replacements. They opted to live with missing or cracked teeth. A common saying of the day was “He’s got a mouth like a steer’s pasture.”
In 1879, stagecoach robber and horse thief Cornelius “Lame Johnny” Donahue was lynched for his crimes. After his burial, grave robbers dug up his remains and ripped out his gold fillings. The cost of gold in 1880 was $20 per ounce. Thieves traded stolen gold teeth for goods like food, coffee or tobacco at a general store.
In 1868, dentist George Green patented the first pneumatic dental drill. It was operated with a foot-powered bellows. Drills arrived in the Old West in the 1870s. This allowed dentists to drill away tooth decay instead of pulling a tooth. The procedure was agonizing. No amount of whiskey or cocaine could numb the pain so patients often chose extraction instead of the torture of the drill.
As the western population grew, professional “traveling” dentists journeyed from town to town. They announced their arrival in advance and set up temporary offices in storefronts or hotel rooms. The most famous Old West dentist was Doc Holliday. He was a gambler and gunfighter who graduated from the Pennsylvania College of Dental Surgery in 1872. At 20, Holliday was diagnosed with tuberculosis. Hoping the Southwest climate would heal his symptoms, he moved to Dallas and opened a dental practice. Holliday was a talented dental practitioner who won an award for “Best set of teeth in gold.” As his tubercular coughing spells increased, he dissolved his dental practice and turned to gambling as his primary income.
In the 1880s, dentistry segued from brutal barber surgery into a regulated profession. Ether, chloroform and laudanum (opium and alcohol) was used to put patients to sleep. Cavities were drilled from teeth and filled by mixing mercury with alloys of silver, tin, copper or zinc. Mercury was known to be toxic but the low cost made it popular.
In 1890, dentist Willoughby Miller published a book called Micro-Organisms of the Human Mouth. The volume asserted that bacteria was the source of tooth decay. This triggered a global oral hygiene movement focusing on flossing, rinsing and brushing with tooth powder. In 1895, X-rays became available allowing dentists to view teeth beneath the gum line.
Dentistry entered the modern age in 1905 when German chemist Alfred Einhorn synthesized Novocain. The drug was combined with epinephrine and injected into a patient’s gum with a hypodermic needle. This restricted blood flow and acted as a nerve block allowing dentists to work on teeth without causing pain.
Dentists are still viewed with horror to this day. When Sean Penn was asked to name his favorite curse word on Inside the Actor’s Studio he answered, “You dentist.” The only thing that makes people curse more is not having access to a dentist when they need one.