Writing and Teeth: Should Your Characters Have Bad Teeth?

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by Ben Steele

It’s one of those tiny details that trips authors up a lot. How much do you focus on the teeth of your characters? Do you gloss over it? If it’s a romance, do they need Hollywood teeth? Or does everyone of low class look like the meth addicts from Orange Is the New Black?

Many people think in linear terms: the further in the past characters are set, the worse their teeth are. But this may not be a reliable rule of thumb if you’re looking to splash a little bit of historical accuracy into your characters’ faces. But it’s not just about historical accuracy. Thinking about teeth can be one of those little details that speak volumes about your narrative, the technology and tone of your world.

So, how does that impact what you’re writing? Does it mean that the characters in a long-ago era would all have bad teeth? Would it be regional? Sociological? And, what about Austin Powers? The answer is a little more complicated than you might think. Let’s look at history a bit to get a better understanding.

Human History Is a Tangled Web

In general terms of technological and societal advancement, we did not progress in a linear fashion. For thousands of years, human civilization enjoyed a thriving system of government, trade, advanced building technology and medical know-how that provided a high quality of life and allowed for a complex social order. Then, around 1200 BCE, the Bronze Age collapse brought us low, and we would not even begin to recover for centuries. The same level of material wealth enjoyed by the average person would not be seen again until the Classical period.

During the height of the Bronze Age, as early as 3000 BCE, the Ancient Egyptians seemed to know a lot about teeth. Ancient Egyptian dentistry was advanced enough that they wrote manuals on the practice. They drilled cavities, treated teeth ailments with antiseptic solutions and even created physical prosthetics like dental dams, binding replacement teeth into the mouth with gold wire.

Other ancient civilizations, like the Etruscans, made heavy use of these prosthetics, as well as dentures made of gold, advancing dentistry yet further.

Rise and Fall

We didn’t hear much else about history until the return of writing and complex societies that allowed for the existence of scholars and philosophers. Hippocrates and Aristotle both wrote about treatment of decaying teeth and gum disease. A few centuries later, the Roman writer Celsus expanded on dental science, writing about tooth stabilization and treatment of fractured jaws. The Romans appeared to have picked dentistry up from the Etruscans after conquering them.

After the fall of Rome, written records and medicinal knowledge all but halted for nearly a millennia. Dentistry and other medical procedures were still practiced, but mostly by monks, as education and skilled trades became associated with religious standing.

Dentistry popped up again around 1200, when barbers, of all people, began to practice it. From there, the development of dental science became fairly linear in Europe.

Location, Location, Location

The history of dentistry in Asia, and in the Middle East, was very different to European, Mediterranean and North African development. Countries with historically Muslim populations focused on medicinal, preventative dentistry. The religious rules of Islam forbid altering the physical body, and so dental surgery was not historically performed. This didn’t mean that their dental science was inferior; instead that they focused on cleanliness and non-invasive oral treatment. Early Asian civilizations were also rather advanced in their dentistry practices, but going into the dental differences between the ancient Muslim world, Chinese empires and early India is too large a scope for a little post like this.

What Does it Mean for Your Characters?

Based on the history, I think it’s reasonable to draw this conclusion:

The dental hygiene of your characters doesn’t necessarily depend on the time period, but upon the context of the civilization around them.

A civilization at the height of its grandeur — pre-collapse — is likely to have good dental hygiene and experienced surgeons, because their society can support specialists, writing and science. Characters might have prosthetics, replacement teeth and generally cleaner mouths.

On the other hand, dental care will tend to be worse in other circumstances. If the character exists in a post-collapse world, where societies are organized into small village groups rather than empires or nations, this will be especially true. Even in the context of kingdoms and empires, feudal systems with demographics spread over large rural areas will likely have much worse care. But, even if prosthetics and dental knowledge were rare, people still had access to remedies, tooth drilling and removal through the religious elite. A farming serf is more likely to have missing teeth than a mouth full of rot. There is even evidence that neanderthals practiced rudimentary dentistry, as proven by chips and toothpick grooves found in their teeth.

As with all complex questions, the answer lies somewhere in the middle of the two extremes we’re often presented with. An ancient romantic hero might not have Tom Cruise teeth — he might even be missing one or two. But you don’t need to worry about being inaccurate if you mention that his breath smells nice. The lowliest, grimiest of peasants is unlikely to tolerate rotting teeth. They would likely hit up the local monastery and settle for no teeth at all rather than a grin full of black sludge.

When approached with an eye for wider context, little character details like teeth can be a strong indication of the tone of your setting. They can say a lot about the technology of your world, the wider societal and political situation. For those who care to look, a great deal of information can be gleaned from teeth and other similar subtle character clues.


Ben SteeleBen Steele suffered a bout of infrequent writing due to trivial matters such as moving countries (again), getting married, buying a house, and navigating a fancy new job. Now that he’s running out of excuses, he’s going back to all those projects he said he would finish ages ago. You can follow Ben on Twitter here.

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12 thoughts on “Writing and Teeth: Should Your Characters Have Bad Teeth?”

  1. lmao – what a great post! As I write sci-fi, teeth haven’t really featured in my thinking, but that could be a whole new area of technology to explore. Lose a tooth and regrow it? I’ll bet there’ll be something less intrusive than drilling in the future. And then there’s the issue of sugar. If real sugar is replaced with synthetic sugar, will it be better for teeth? Or will people have sparkling whites in a body riddled with the side-effects of synthetic food? Great fun!

  2. True that the era is not the determining factor. I noticed, for instance, that the Brits I encountered as a diplomat (1982 to 2012) who were middle age or older tended to have bad teeth (relative to Americans), a condition I found out was caused by lack of interest in preventive dentistry in the UK. This, by the way, was not a factor of their economic or social status, either. I’ve noted, however, that of late, many of the Brits (younger, and even a few older) that I meet have better teeth, so I assume preventive dentistry has taken hold. On the other hand, when I served in West Africa in the 1990s, I noted that many of the locals, despite often having bad breath, had relatively healthy teeth. Never discovered why that was, but I think both conditions were diet-related.

  3. Sorry to be off topic, but the reference you quote is a perfect example of a whole bunch of good scientific evidence being used to give credence to some quite precarious archeological theorizing. The state of advancement of the bronze age societies in the Eastern Mediterranean is the subject of a lot of theorizing and a whole lot of the kind of wishful thinking that makes great fantasy 🙂
    However, when it comes to teeth, clothing, weaponry or any other small medical or social detail, I think it’s very important to get your facts straight, even if you only use the data as an aside to enrich a character.
    So thanks for the information.

    1. I think you’re right, archaeology in particular can be risky when it comes to making observations. When you discover data about a particular person or community group, using it to make wider assumptions about a society can get precarious.

  4. This was so fascinating. I’d never thought a lot about teeth of my characters, except if they were lacking them. It was a detail I figured my audience could make up.

    Interestingly enough, I’ve only mentioned a character’s teeth as an indicator of other character traits. The urchin vagabond on the train who can’t get care now, the former hockey placer who’s missing a few teeth, or even the woman who’s self-conscious about the gap in her teeth.

    However, I think teeth can say more, so this was really helpful. Given that you picked to write about this, what are the strangest things you see people write about teeth in their books?

    1. Thanks so much for your comment!

      I think that what you’ve used the mention of teeth for is absolutely GREAT! Those little personal indicators are just as important.

      For me, it’s been less about weird or wacky ways that teeth are mentioned. What I’ve noticed more is a lack of reasoning beyond an impression that an author has wanted to give me. A healthy white smile is such a big part of modern standards of attractiveness that I often see it used as an indicator of a character’s position in the narrative, rather than their position in the society that they live in, or as a consequence of the lives they live. On the flipside I often see a backlash where people will refuse to believe that anyone in fantasy or history should be represented with good teeth.

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