Bryn Mawr Classical Review

Reviewed by Clara Bosak-Schroeder, University of Illinois, Urbana-Champaign (cbosak@illinois.edu)

Version at BMCR home site

Preview

As we were recently reminded by an Egyptian prosthesis known as the Cairo Toe, people in antiquity modified and adorned their bodies in ways that seem eerily familiar. Becker and Turfa's book celebrates Etruscan gold-band dental appliances, ancient prostheses that should be better known. Some of these appliances were made to be worn over existing teeth, while others include replacement teeth. The earliest is dated to the seventh century BCE.

The book aims to: (1) establish once and for all the primacy of Etruscan dental appliances and place them in a broader history of dentistry; (2) provide cultural context for these appliances, all worn by women, many following "dental ablation," the deliberate removal of one or more teeth; and (3) collect and analyze the twenty-one gold-band appliances known to us, as well as the seven much later Near Eastern wire-appliances with which they are often conflated. The authors are largely successful and offer readers other delights along the way: we learn that ancient Greeks and Romans subscribed to a "tooth worm" theory of dental disease (p. 16), that Neanderthals used toothpicks (p. 27), and that the Twelve Tables exclude gold dental bands from sumptuary restrictions (p. 36). But Becker and Turfa's framing of their study also raises important questions about how we tell the history of medicine and technology, especially when women's bodies are involved.

A short Preface and Introduction preview the main contributions of the book, the corpus of appliances, and the authors' extensive publications in the areas of Etruscan culture and the history of dentistry. The Introduction also provides a detailed historiography of the appliances and lays out the problems that have plagued their study, in particular the almost complete lack of archeological context; the multiplication of spurious examples; and anti-Etruscan bias, which has led many scholars to claim the appliances have an Egyptian origin. This discussion would have been strengthened by a critical consideration of how dress history and dental history interpenetrate (see my concluding paragraphs). A Background section introduces readers to the main ancient cultures discussed. These are listed alphabetically and end with a short bibliography for further reading.

Chapter One presents dentistry in Mediterranean medical history, starting with evidence for dental extractions in Greece and Rome (including a fascinating hoard of extracted teeth from the Roman Forum, p. 19) and extending past the professionalization of dentistry in 1500s Germany and France. The authors remind us that dentistry in classical antiquity was not a medical profession. As we learn from the Hippocratic corpus, dental decay was considered peripheral to internal medicine, a minor problem associated with aging. Extractions were probably DIY or (as the Forum find indicates) performed by cosmetologists. Dental appliances, on the other hand, were made by skilled goldsmiths. This chapter also presents ancient literary evidence arranged chronologically by author, but these analyses nevertheless build on one another and offer many leads for future research. Chapter Two, an oddly short ten pages, elaborates the authors' arguments for the Etruscan rather than Greek or Egyptian invention of dental appliances.

Chapter Three offers a narrative of the features, distribution, and use of the Etruscan appliances (these findings are presented as a catalogue in Chapter Five). Gold-band appliances were molded from super-refined gold, anchored to healthy "post" teeth, and stretched to adorn or stabilize (on this uncertainty, see below) either the wearer's own loose teeth or replacements riveted in place. Only one appliance (the Satricum device, No. 18) sports a gold replacement tooth; bone, ivory, and cut-down, recycled teeth are more common. Although organic material originally associated with the devices has usually been lost, the size of teeth holes demonstrates that all wearers were women.

Even more remarkably, the loss of these women's teeth cannot be explained by disease or trauma relative to the rest of the Etruscan population. Therefore, the authors argue that Etruscan culture practiced sex/gender-specific, "deliberate tooth evulsion," also called "ablation," the removal of teeth for cosmetic or ritual purposes, perhaps as a sign of mourning, coming of age, or status. We learn that dental ablation is common in many times and places, including Neolithic Italy, but that only the Etruscans fitted replacements after ablation. Turfa speculates that the wearers of Etruscan dental appliances may not have been Etruscan, but rather women from other Italian communities who filled in their smile after joining Etruscan society, a strategy paralleled among some African immigrants today. Turfa freely admits that there is too little evidence to securely identify these women, but her suggestion helpfully expands our sense of elite Etruscan life.¹

Chapter Four, another short chapter, describes the seven wire-appliances known from Rome and the post-Etruscan Near East (the earliest c. 400 BCE) and the development of modern dental appliances in Europe. The authors distinguish the development of dental appliances from the much longer (2000-3000 BCE) and wider-spread history of drilling, including Classical Mayan dental inlaying. Chapter Five presents the history of each gold-band or wire appliance, its associated human remains (if any), acquisition, original documentation, identifying information, illustration, and bibliography. These entries are accessible and would be perfect for assigning in class presentations, e.g. for a course on the history of technology. Appendices include uncertain examples of Etruscan dental appliances, copies, spurious objects, amulets and votives confused with appliances, and Pliny's dental cures. It is too bad that this rich work was allotted such a meager index.

Becker and Turfa's book is written in a lively style with ample sign-posting for scholars "reading around," but has also been well-designed for non-classicists, both scholars of dental history and interested lay-people. The authors have crafted a unified, mostly smooth voice that invites readers into the denser discussions and punctuates these with vivid vignettes of ancient life, especially dental pain; footnotes are minimal and comparative evidence thoughtfully deployed.² Yet the second 150 pages of catalogue and appendices make clear that this is not a "popular" book either; instead, its narrative and technical sections address different needs. This bifurcation results in some redundancy for those reading from cover to cover, but it may be pedagogically useful to have the diverse material of the book periodically reinforced. Classicists will be gratified by the synthesis of literary and archeological evidence, and historians of medicine and technology will benefit from the detailed descriptions of each device, including their manufacture and fitting.

Placing Etruscan gold-band appliances in a larger history of dentistry gives them a great deal of meaning, which the authors frequently trumpet. The appliances "attest to the special character of Etruscan society and ideology, which became the foundation (via its absorption by Rome, credited or not) of our own culture" (p. 11). Unfortunately, this teleological view of Etruscan gold-band appliances forces them to bear more significance than they can sustain. For while Becker and Turfa consider the appliances "dental" in a medical-historical sense, they also admit that their "cosmetic aspects…appear to be the principal and probably only concerns of their users" (p. 115). The appliances "represent the main elements of dental prostheses" but were "not strong enough for heavy-duty everyday biting and chewing" (p. 13). Nor is there a clear connection between the Etruscan appliances and modern dental prostheses. The most the authors can reasonably claim is that "the golden smile of Etruscan women…resonates with our own civilization's embrace of modern dentistry" (p. 1).

This resonance is worth exploring, as the authors do, but their decision to embed the appliances in a history of dentistry would have been strengthened by a critical discussion of this decision. The Etruscan appliances "represent the main elements" of modern prostheses, but why does this qualify them as ancestors of dentistry as we know it? Do the stabilizing effects of the gold-band appliances matter more than what seems to have been their primary aesthetic purpose? Does it matter that the craftsmen of these devices were jewelers rather than doctors? If the gold-band appliances count as "dental interventions" (p. 302) do Neolithic ablations or Mayan inlays? If the later, Near Eastern wire appliances were more therapeutic, should they have pride of place in the history of dentistry? How do we decide?

Moreover, Becker and Turfa's investment in the history of dentistry comes at a cost to the dress history which is vividly evoked by their opening vignette of Etruscan women at a banquet (pp. 1-2).³ It would have been interesting to hear more about the cosmetic side of dentistry, especially orthodontia, and how the gold-band appliances may in a sense be more like modern orthodontic devices than bridges or dentures. The authors note that beauty often signifies health (p. 87); is there a way in which other cosmetic practices intersect with the history of medicine? Taking up these questions would have offered an opportunity to reflect further on Roman authors who mock women for wearing false teeth (pp. 38, 44), our best evidence for the continuation of Etruscan dental appliances in Rome.

I suppose I can only say I wanted more of Becker and Turfa's gold mine of a subject.

1.   If the authors are correct that the owner's own teeth were often cut down and recycled as replacements (e.g. No. 13, Liverpool I), Turfa's suggestion loses plausibility unless women kept their evulsed teeth; is there comparative ethnographic evidence to that effect?
2.   61: With few exceptions. A note about the preservation of teeth in Japan (p. 61) has not been well-integrated into the chapter. The conclusion's comparison between Etruscan gold bands and late twentieth and twenty-first century American grillz (p. 304) makes an important contribution to the decolonization of classics, but more context and deeper analysis are needed.
3.   For dress theory see Mireille Lee's 2015 Body, Dress, and Identity in Ancient Greece, BMCR 2015.07.21; and Cifarelli and Gawlinski's 2017 edited volume, What Shall I Say of Clothes?. Becker and Turfa cite Larissa Bonfante's extensive work on Etruscan dress, e.g. BMCR 2005.04.60.