Perfect Teeth Under the Ashes: Pompeii's CT Scan

No toothbrush, no mouthwash, almost no cavities. Radiological examination of the casts of the victims of 79 AD has revealed more about the ancient diet than certain amphorae. And it has reopened a two-thousand-year-old question: what did people do when a tooth was truly lost?

In the fall of 2015, an X-ray tube and a sliding table arrived in a specially equipped room next to the Amphitheater of the Excavations. The patients were the oldest ever to undergo a CT scan: the plaster casts of the victims of the 79 AD eruption, fresh from the restoration laboratory. The plaster cast, cast into the ash cavities based on Giuseppe Fiorelli's intuition, has a density very similar to that of bone, and to understand what was truly inside, a multi-slice CT scan was needed , as then-superintendent Massimo Osanna explained.

Full arches, almost no cavities

The screen showed intact teeth, with all the teeth in place, including the third molars. Elisa Vanacore, the team's dentist, explained that very little decay was found: a sign of a diet rich in fruits and vegetables and very low in sugar.

The details have their own ruthless logic. Refined sugar didn't exist, and the only sweetener available was honey, expensive and rationed. The rest of the diet consisted of grains, legumes, vegetables, and fish. Plus, there was Vesuvius: the area's aquifers are rich in fluoride, the same element we now pay dearly for in toothpaste.

The best-preserved teeth, Vanacore observed, were not those of the wealthy. Honey, after all, was something few could afford. Those same people who chewed without decay bore the signs of physical fatigue that are hard to imagine today. Their mouths were healthy but worn: their teeth served as a third hand for cutting, breaking, and holding things in place, and the abrasions in the enamel are clearly visible. Their teeth were the only part of the body their lifestyle did not punish.

And when was a tooth really lost?

Roman medicine has left us more anecdotes than solutions on this matter. Pliny the Elder, who himself was a victim of that eruption, collected in his Naturalis Historia remedies for toothache that included powders made from animal ash and rather precise instructions on how to address a frog.

Far more interesting, and much older, are the Etruscans. They were extraordinary goldsmiths, and they applied that expertise to the mouth: gold bands and rings that held together natural teeth, human or ox, shaped and attached to the remaining elements. They are considered the oldest prosthetic devices in the Western Mediterranean , dating between the 7th and 4th centuries BC, and functioned not too differently from our bridges.

Two thousand years later

The principle, it must be said, hasn't changed much. A denture is still something that replaces what's missing by resting on what remains. Only 40 years ago, with the arrival of dental implants, we experienced real progress. For the first time in twenty-five centuries, dentures no longer clung to adjacent teeth.

Work continues on that screw. Some lines of research have explored screwless implants . They aren't better alternatives, but rather responses to specific situations.

The most uncomfortable point of the whole affair remains. The Pompeians' advantage wasn't technological, it was nutritional. We have tomography, titanium, and zirconia; they had the right pantry and fluoridated water by pure geological coincidence.

No one is even suggesting a return to garum. But over a sfogliatella and a coffee with two sugar cubes, it's worth remembering that the arithmetic is the same as it was two thousand years ago: the best implant is still the tooth you manage not to lose.