Dental hygiene evolved slowly over the centuries
In a world where daily cleansing of the body was uncommon, and even looked at with suspicion, it should come as no surprise most people were negligent regarding cleaning of the teeth and gums. As a result, dental problems prevailed. Ancient Sumerian texts contain references to dental problems, including toothaches and loss of teeth. They believed the teeth were under continuous assault by “tooth worms”. Combatting said worms was a source of concern. While that does not present the modern imagination with an attractive mental image to ponder, it does indicate that concern over the condition of the mouth was present in ancient times. Little was done in the matter of protecting the teeth, other than by fortuitous accident. For example, forensic evidence indicates some Ancient Roman citizens had healthier teeth than most of their contemporaries around the empire.
Examination of preserved corpses from the ruins of Pompeii confirms the Romans, despite lacking even the most basic implements for the care of teeth, had remarkably little tooth decay. Modern science attributes this phenomenon to the lack of refined sugar in the Roman diet. Pompeiians may have had relatively healthy teeth, though it cannot be attributed to an adherence to dental hygiene. Dental hygiene in the ancient world was universally poor, nearly non-existent, though the art of dentistry, that is, extraction and even filling of decayed teeth, developed in several cultures. So did numbing of the affected region among those suffering from toothache. The Aztecs alleviated toothache pain by chewing on coca leaves. Centuries later pharmaceutical cocaine was an accepted analgesic used by dentists on their patients.