59,000-Year-Old Neanderthal Tooth May Reveal the Earliest Known Dental Procedure — and Pain Treatment

A Neanderthal sitting in a Siberian cave probably had no idea he was making dental history. He probably just wanted the pain in his tooth to stop. Nearly 59,000 years later, researchers discovered that one of his molars contained a hollow that looked unnatural. When they examined the tooth under a microscope, they realized they were examining what could be the first evidence of a Stone Age dental procedure.

In a new study published in PLOS OneResearchers say a molar discovered in Siberia’s Chagyrskaya Cave preserves signs that someone intentionally drilled a cavity using a stone tool while Neanderthals were still alive. This is the first known example of dental treatment outside of Homo sapiens and the oldest over 40,000 years old.

This shows that Neanderthals not only understood what caused tooth pain, but also that removing the damaged area could help stop it, bringing their medical behavior closer to early humans rather than the more instinctive healing behaviors seen in other primates.

“Our initial reaction was cautious skepticism, because the deep concavity did not correspond to normal wear or trauma. The real turning point came during the microscopic analysis when we spotted parallel striations and V-shaped grooves, diagnostic of a rotating stone tool,” said lead author Ksenia Kolobova. Discover.

Recreating the Neanderthal dental procedure using stone tools

The marks inside the tooth appeared only in the cavity and were parallel to its edges, as if something had repeatedly rotated against the inner walls of the tooth.

In such a worn tooth, the pulp chamber would normally have been protected by a thick layer of secondary dentin accumulated over years of chewing. Instead, it had completely disappeared.

“Its complete absence, combined with micro-CT evidence of significant demineralization due to caries, told us that decayed tissue had been actively removed rather than worn away over time,” Kolobova said. Discover.

The researchers recreated the procedure using modern human teeth and sharp jasper tools inspired by the perforators discovered in the same archaeological layer of Chagyrskaya Cave. The experimental grooves matched the fossil almost exactly.

“Experimental replication then provided the final proof,” Kolobova explained. “The discovery of post-operative wear varnish on the edges of the socket confirmed that the individual had survived and used the tooth subsequently, ruling out any possibility of post-mortem damage.”

Neanderthals may have figured out how to treat tooth pain

Previous findings suggested that Neanderthals used toothpicks and herbal remedies to treat dental problems, but this appears to be the first evidence of an actual procedure.

Whoever performed the procedure seems to have understood that decay inside the tooth was causing the pain and that removing the damaged tissue could help.

“Finding the Chagyrskaya molar tells us that they could diagnose the source of the pain by connecting an internal sensation to a visible, decayed lesion, which is not an obvious advancement without a modern understanding of medicine,” Kolobova said. Discover.

The cavity also appears to have been made in several stages. Researchers found three overlapping depressions inside the tooth, indicating multiple attempts to reach the infected pulp chamber. Experiments showed that the most effective technique was to rotate a sharp stone tip like a hand drill until it penetrated the damaged dentin.

Even in the laboratory, reaching the pulp chamber could take almost an hour. The procedure must have been incredibly painful, with someone drilling through an infected tooth using a sharp stone tool, all without anesthesia.

“Perhaps most telling is that the procedure required the individual to tolerate acute pain in the moment with the long-term goal of relief, a calculated endurance of suffering that demonstrates advanced cognitive regulation and strategic thinking about the body,” she explained to Discover.

Neanderthals were often described as primitive and intellectually limited. But discoveries in Europe and Asia have challenged this image, unearthing evidence of welfare, know-how and perhaps the first known invasive dental treatment.

Learn more: Neanderthals faced a genetic crisis during the Ice Age, paving the way for their extinction

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