Japan—Heian & Edo Period For centuries in Japan, blackened teeth were a sign of beauty, maturity and social standing. Known as ohaguro, the practise became popular during the Heian period (794–1185) and remained common through the Edo period (1603–1868), particularly among married women, aristocrats and samurai families. Ohaguro was created using a solution made from iron filings mixed with vinegar, sometimes combined with tea. Though intended purely as a cosmetic measure, it likely offered an unexpected oral health benefit: the iron-based coating may have helped protect enamel and reduce decay at a time when sugar consumption was rising. The custom faded during the Meiji era, but it remains a striking reminder that ideas of a “healthy smile” have never been universal. Mesopotamia—Sumerians In ancient Mesopotamia, Egypt, India, China, medieval Europe and the Islamic world, people believed that “tooth worms” burrowed into teeth, gnawing away from the inside and causing pain, holes and tooth loss. The earliest known reference comes from Sumerian cuneiform texts dating to around 3000 BCE, which describe toothache as being caused by a worm that drinks blood and feeds on the tooth’s interior. Similar descriptions appear later in Babylonian medical tablets, often accompanied by spells or incantations intended to drive the worm out. The tooth worm theory remained influential well into the 18th century, despite advances in anatomy. It was only with the development of microscopy, germ theory and modern pathology that cavities were understood as a disease process involving enamel breakdown and bacterial activity. Caring for Teeth During Different Historical Periods 38 | 2026 | Issue 1
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