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King Richard III remains provide insights on oral health, dentistry in the Middle Ages

April 07, 2014
Dr. Rai
The stereotype often seen in movies of peasants with blackened and gapped teeth during the Middle Ages may just be a myth.

Thanks to the remains of King Richard III of England, which were discovered in 2012, researchers continue to gain a better understanding of the oral hygiene habits of that era.

A study in the April 2013 British Dental Journal found that Richard III, the last English king to die in battle, had generally poor oral health, suffering from dental caries and tartar buildup. The study supports research that found, unlike modern day, people in higher social classes suffered a higher incidence of dental carries during the Middle Ages.

"For the lower social classes, access to limited range of dietary sugars and the consistent inability to cook carbohydrates resulted in a reduced caries experience," wrote Dr. Amit Rai, the study's author. "By the same reasoning, it is likely that the more affluent of individuals suffered with a greater caries experience, as was the case with the Grey Friars remains."

The skeletal remains of Richard III, who wore the crown from 1483-85, were found in September 2012 under a parking lot—the former site of the Church of the Grey Friars where he was buried in an unmarked grave.

Historic teeth: Richard III was the last English king to die in battle and had generally poor oral health, suffering from dental caries and tartar buildup.
Researchers found that his left first molar, upper right second premolar and lower right first molar teeth were missing, most likely due to caries. Richard III also had mineralized deposits on the labial and buccal surfaces of the maxillary teeth, suggesting tartar buildup over a period of time.

However, the upper right central incisor showed less evidence of deposits than the adjacent anterior teeth, the study found, suggesting that Richard III had "some degree of insight with dental hygiene, however basic."

Researchers also found that evidence of gap closure on two of the missing teeth point to the "early extraction of these teeth by skilled hands."

According to the study, although mainly unregulated, barber surgeons legally practiced dentistry at the time.

It is also "not impossible" that Richard III had practiced the 10 rules outlined by Giovanni de Arcoli, professor of medicine and surgery in Italy from 1412-27, to help preserve the teeth.

The list includes caution on eating sweets, breaking "hard things" with the teeth, rinsing and cleaning the teeth after every meal using "thin pieces of wood." Giovanni de Arcoli was the first to record using gold leaf as a restorative material despite his unfamiliarity with tooth morphology, researchers say.

"The provision of dentistry in the 15th century was surprisingly sophisticated with evidence of restorative advances," the study concluded.