Neanderthal tooth shows signs of invasive dentistry 59,000 years ago

Long before dental chairs, waiting rooms or local anaesthetic, a Neanderthal in Siberia was sitting very still while someone drilled into their tooth with a piece of stone. Researchers now believe this 59,000-year-old molar is the earliest known example of intentional caries treatment ever discovered, predating the next oldest evidence by more than 40,000 years.

The researchers behind the new study, published in PLOS One, theorised that stone perforators also discovered in the cave could have been used to remove damaged tooth matter with a rotating drilling motion. To verify this, they conducted experiments on three modern teeth with reproductions of the stone picks made using local jasper.

Co-author Lydia Zotkina said: ‘Comparison of the microscopic traces on the original Neanderthal specimen with those produced experimentally revealed a clear match. The findings demonstrate that drilling a carious lesion using a sharp, thin stone tool is entirely effective, permitting the rapid removal of damaged dental tissue.’

The results suggest that Neanderthals had the capacity to identify the source of pain, determine how to treat it, apply the manual dexterity needed for an efficient operation, and endure painful treatment to alleviate future discomfort. This is the first time it has been observed in Neanderthals rather than homo sapiens.

‘The world’s oldest evidence of successful dental treatment’

The researchers said: ‘This finding currently represents the world’s oldest evidence of successful dental treatment. The damage documented on the neanderthal tooth from Chagyrskaya Cave in Siberia points not only to intentional pulp removal but also to antemortem wear – wear that could only have developed if the individual kept using the tooth while alive. 

‘We also identified areas of demineralisation where remnants of carious damage were preserved, further indicating that the concavity in the tooth was associated with treatment.’

Explaining how they distinguished the hole in the tooth from natural wear, co-author Alisa Zubova added: ‘We were intrigued by the unusual shape of the concavity on the tooth’s chewing surface. It differed from the normal morphology of the pulp chamber and did not match the typical pattern of carious lesions seen in homo sapiens. Moreover, distinctly visible scratches suggested that the concavity was not the result of natural damage but of intentional actions.’

Human manipulation of carious lesions has been documented in the upper paleolithic, mesolithic, and later periods. The researchers therefore hypothesised that the tooth markings were a sign of similar activity – taking place much earlier than previously documented. Previously, the earliest example was found in Italy at 14,000 years old.

In addition to caries damage and treatment, the same tooth showed pronounced tooth pick grooves and signs of repeated interproximal cleaning behaviour.

Neanderthal teeth in Siberia

Co-author Ksenia Kolobova also explained how Neanderthals came to be in the region now known as Siberia. She said: ‘Neanderthals arrived in this region 70-60 thousand years ago during a migration from central and eastern Europe and inhabited it until at least 40-45 thousand years ago.

‘Altai became a new and suitable home for them thanks to its biological diversity, climate similar to that of Europe, abundant raw materials for stone tool production, and their usual prey – wild bison and horses.

‘Analysis of stone tool industries and paleogenetic studies have shown that the Neanderthals from Chagyrskaya Cave are very closely related to the bearers of the so-called Micoquian industry, who also lived in the Caucasus and Crimea.’

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