Museum of Health Care Blog

*The following guest blog was written by Brendan Cull, 2013 Curatorial Assistant at the Museum of Health Care. 

Oral hygiene and beauty have been interlinked throughout history. Since ancient times, people have attempted to clean their teeth to reduce or eliminate the pain and embarrassment of tooth decay while also working towards a perfect smile.

The earliest known “toothbrushes” were chewing sticks made of wood.[1] In Asia, Africa and the Middle East, people have enjoyed the cleansing qualities and whitening effect of wood fibre on their teeth for thousands of years. These sticks, in Islamic tradition, are called miswak or siwak[2] and were enthusiastically recommended by the Prophet Mohammad, who included instructions for their use in the Qur’an.[3] They were, and still are made from the roots, twigs and stem of the Salvadora persica tree (see below).[4]^,[5]

The preferred wood naturally contains sodium bicarbonate (baking soda is a common ingredient in many toothpastes today) and tannic acid (an antibacterial agent), as well as other beneficial chemicals that help to whiten teeth, remove food residue, support overall oral health, and maintain an attractive smile.[6] Chewing sticks were accessible to many people because they were prepared using readily available materials, and practitioners of the Islamic faith embraced and encouraged them wholeheartedly.

The toothbrush has not been so widely accessible in all cultures; in fact, throughout much of its history, this tool has been enjoyed almost exclusively by the wealthy and powerful. Affluent Roman women are said to have used brushes as well as mastic chewing gum (pictured below) to preserve their teeth or to keep up appearances if they no longer had any, suggesting that they were used as status symbols.[7] The Chinese invented the first toothbrush, as we know it, around either 1000 or 1498 CE[8] and used luxurious and costly materials such as ivory or oxbone, along with horse hair or hog bristles.[9]

Twig brushes were employed by upper class women in Japan during the Tokugawa period (1603-1867 CE) to clean their teeth and apply extravagant black dye to their enamel as a demonstration of fidelity to their husbands.[10] Furthermore, Napoleon Bonaparte’s toothbrush (pictured below) – an elegantly monogrammed, silver gilt and hog bristle brush – demonstrates the exclusivity of such hygiene tools, even into the early nineteenth century, since only the fabulously wealthy could afford to brush their teeth with such an implement.

Another highly decorated toothbrush (in the Museum of Health Care’s collection) from the early twentieth century is clearly a fashionable accoutrement designed to show off its owner’s wealth.

But with a basic design (i.e. a handle with bristles attached at ninety degrees), as well as other options for handles and bristles, why was the toothbrush such an elitist tool? It seems to have been a deliberate choice. Toothbrush makers were aiming to please rich and powerful patrons, and therefore used the best and most luxurious materials they could find.

It was not until the dawn of the twentieth century that regular oral care  reached the masses.[11] Up until then, toothbrushes were simply too expensive.[12] At this time in America, more affordable versions were coming onto the market, but shared, family and even public toothbrushes were common.[13] A dramatic change in the materials used to make these tools occurred around the First World War due to shortages of bone and natural bristles combined with a lack of skilled workers.[14] Out of necessity, North American manufacturers turned to inexpensive and innovative materials such as celluloid, plastic and wood for handles, and nylon fibres instead of natural bristles.[15] As a result, prices dropped significantly so that just about everybody could afford his or her own toothbrush.[16] The health benefits of regular oral care were also being recognized by the British Armed Forces and, as a result, every serviceman was provided with his own brush during the War.[17] These events helped to popularize the toothbrush as a basic home health care tool and the best option for maintaining an attractive smile. Below is a Japanese example of one of these reinvented toothbrushes dating from about 1935-1945 (also in the Museum’s collection). It seems that these improvements were far reaching and had an effect on the manufacturing process as far away as Japan.

With an increased awareness of germs, the introduction of public tooth brushing clinics and, in some cities, free brushes for children, the individual toothbrush entered the household.[18]

Today’s search for the whitest and straightest teeth is a continuation of our obsessive quest for oral beauty. A movie star smile is more attainable than ever due to the dramatic reduction of cavities and periodontal diseases in the past one hundred years (largely thanks to the toothbrush).[19] These medical advances have allowed many dental professionals to begin to focus on fine-tuning the processes and technologies used to replace, straighten and bleach our pearly whites.