A selection of 
Dental hygiene and mouthwash products

from a variety of medieval and Renaissance sources

-- Jadwiga Zajaczkowa

Abstract:

Despite modern ideas to the contrary, people in the middle ages did spend time trying to take care of their teeth and combat bad breath. This article presents a number of period dental hygiene methods and products, with the some general comments on their production, safety and effectiveness.
To emphasize that many medieval health care prescriptions are not harmful, the selection  has been limited to largely non-toxic products. Also, only one mild abrasive has been included, and only one caustic, the alum combination, is included.

The dentifrices and mouthwashes come from all over Europe and from a variety of periods. Dental care prescriptions seem to center around rinsing the mouth, often with an acidic substance (wine or vinegar), though sometimes with a caustic. Teeth were rubbed with a cloth, and/or with mixtures of herbs and/or abrasives. Toothsticks, toothpicks, and rubbers of various kinds are documented in books and archeological sites. Some products, such as the bay leaf/musk combination and the pills of spices, provide a good smell; though spices also were used to heal infection.
The common and repeated ingredients include wine, salt and mint; alum and abrasive materials are included frequently in other recipes. I would say that for SCA use, the sage/salt tooth powder and the mint-vinegar rinse, along with rinsing with clear cold water, would be the best and easiest to use.


Dental Hygiene Recipes and Suggestions


Water Rinse

Hildegarde of Bingen, Physica, 1158 (German)
"One who wishes to have hard, healthy teeth should take pure, cold water into his mouth in the morning, when he gets out of bed. He should hold it for a little while in his mouth so that the mucus around his teeth become soft, and so this water might wash his teeth. If he does this often, the mucus around his teeth will not increase, and his teeth will remain healthy. Since the mucus adheres to the teeth during sleep,  when the person rises from sleep he should clean them with cold water, which cleans teeth better than warm water. Warm water makes them more fragile." (Book 2, Section 2]
Redaction:
Provided is a goblet and pitcher of cold water.

What happened when I tried it?

I took a mouthfull of cold water immediately upon getting up, and swished it around the mouth until it warmed up a bit (1-2 minutes), then spat it out. My mouth certainly felt less gunky and some of the early-morning buildup appeared to be gone.

Would it work?
Bearing in mind that people in the middle ages and Renaissance seldom if ever drank plain cold water, a quick morning rinse might well remove some of the tartar and bacteria that attack the teeth. Holding cold water in the mouth for a few minutes, swishing it around and spitting it out, certainly leaves the mouth feeling cleaner, especially when done first thing upon awakening. It would certainly loosen stuck particles of food adhering to the teeth.


Wine Rinse and Herb chewing

Trotula, 11th Century, On Women's Cosmetics (book 3)
"The woman should wash her mouth after dinner with very good wine. Then she ought to dry [her teeth] very well and wipe [them] with a new white cloth. Finally, let her chew each day fennel or lovage or parsley, which is better to chew because it gives off a good smell and cleans good gums and makes the teeth very white."
Redaction:
Provided is a [empty] goblet of which would hold white wine, a white cloth for polishing the teeth, and green herbs to chew.

White wine was my choice because in the few instances where type is specified in other tooth care items I've looked at, it has been white. Fennel and Parsley are included because that is what is available fresh at this time of year. Lovage, a slightly soapy tasting relative of celery, is not commercially available. All of these have seeds, but I choose to go with the fresh plant material since parsley is generally the herb, and I generalized from there that lovage and fennel would also be the herbs rather than seed.

What happened when I tried it?
Rinsing out the mouth with wine loosened some particles of food, and certainly left the mouth feeling less gunky-- but this might have been influenced by the use of a white wine. I suspect the percieved cleaning effect varies depending on how dry the wine is. Rubbing the teeth with the cloth removed more tartar and food particles. Chewing either fennel or parsely made the mouth smell of those herbs, not of the previously consumed food.

Would it work?
Essentially, you are washing the mouth out with an alcohol (though slightly sweet alcohol) and chewing green herbs that are high in chlorophyll. It has been established for years that chlorophyll is what allows parsley to kill bad breath and fishy or garlic breath. Fennel and lovage would also add a spicy scent to the breath. So the wine might kill some bacteria and loosen stuck food, and the chlorophyll would help with any bad breath.


Mint mouthwash

Bankes' Herbal, 1525
"For the stinking of the mouth and filth of the gums and of the teeth, wash thy mouth and gums with vinegar that mints have been sodden in; after that, rub them with the powder of mints or with dry mints."
Redaction:
1 pint jar filled with mint sprigs (Mentha Citrata, orange bergamot mint)
1 pint red wine vinegar
Vinegar was poured over the mint and left to steep all winter; for use, the vinegar is poured off and used to rinse the mouth.

Finely cut dried mint is provided to rub the teeth with.

I used Mentha citrata because that was what I happened to have a lot of. Mentha citrata is not the North American Bergamot, but a variety of plain European mint that is carries a whiff of the bergamot citrus fruit. While I can't document that this particular variety existed in Europe before 1601, its existence as a cultivar is quite possible. Walafrid of Strabo (9th century) points out how vigorously mint hybridizes: "Mint. . . in all its varieties. How many there are I might as well try to count the sparks from Vulcan's furnace beneath Etna."

Mint's action against halitosis and indigestion was well known to period herbalists and appears again and again. It's also associated with eating, as in Ovid where someone rubs the table with the herb before setting the table for dinner .

What happened when I tried it?
Oh, my mouth felt clean all right! I had to rinse with water after ward to remove the tart taste. I don't know that it reduced the tartar content, but I certainly felt that I had killed the germs that caused bad breath. I smelled strongly of mint vinegar for about 15 minutes at least afterward.

Would it work?
The acidic nature of the vinegar might discourage some bacteria as well as eating into tartar a bit, and the minty flavor would refresh; the gums might also help in cases of gum sores and gum disease. Rubbing the teeth with anything would also help remove accumulated sugars and gunk.


Wine washes and tooth rubbing

 Gilbertus Anglicus, [England], 11th century
". . . let the mouth be washed with wine that birch or mint has simmered in. And let the gums be well rubbed with a sharp linen cloth until they bleed. And let him eat marjoram, mint, and pellitory, til they are well chewed. And let him rub well his teeth with the chewed herbs and also his gums. . . .
And let him drink every evening wine that hyssop, or cinnamon, or spike, or quibibis (fruit of Piperaceae, Piper cubeba) has simmered in.. . And after every meal, let him wash well his mouth and rub well his gums and his teeth so that no corrupt matter abides among the teeth."
Redactions:
Redaction #1: Mint wine [in deference to site policies, this wine is with the Brewing entries across the street]
6 sprigs of fresh spearmint/garden mint about 3-4" long, with about 40 leaves between them.
2.5 cups white wine
Simmered until all the mint is light brown in color, then poured into a container and allowed to steep.

Redaction #2: Mint wine
[in deference to site policies, this wine is with the Brewing entries across the street]
2 tablespoons of dried peppermint
1 cup white wine
Simmered for half an hour and set aside to cool.

The dried mixture came out more flavored, but I think the fresh version might be more chemically active.

Herb Chew/Rub:
Fresh marjoram and mint, equal parts

Just to make the instructions complete, I include here a paste made of marjoram and mint. Unfortunately, you cannot obtain pellitory commercially, and my pellitory-of-the-wall plant has not come back this spring. Rather than leaving the judges to masticate their own, I've combined equal parts of the fresh leaves in a mortar and pestle.

Gerard says, "Sweet marjerome is a remedy against cold diseases of the braine and head, being taken any way to your best liking,.. the leaves are excellent good to be put into all odoriferous ointments, waters, pouders, broths and meates" and combined with the mint (whose digestive properties are covered above)

Redaction: After-dinner wine [in deference to site policies, this wine is with the Brewing entries across the street]
1 tablespoons of cinnamon (cassia) chips or one cinnamon stick
1.5 cups of red wine
Simmered for 20 minutes

I used red wine mostly as an alternative to the white, though it also seemed more of an after-dinner drink. Of the four possible additives (hyssop, cinnamon, spike, or cubebs) I chose cinnamon/cassia as the most like a hypocras (after-dinner mulled wine) spice by itself. All of those period herbs/spices were considered heating and astringent.
I used cassia (the type of 'cinnamon' sold in American stores) instead of true cinnamon because that was what I had available; I probably would have used a larger quantity of cinnamon had I used that instead of cassia.

This left a harsh tasting wine, but the quality of the wine seems to be more indicative of the product than the presence of cinnamon.

What happened when I tried it?


Rinsing with the mint wine and rubbing with a cloth made my teeth feel cleaner and less gummy. The faint odor of the mint lingered for a few minutes. Chewing the herbs made my breath sweeter. Rubbing them on my teeth caused some of the green to stain the teeth, though, but it eased some of the soreness of the rubbed gums. The After-dinner wine didn't seem to do much, but rinsing the teeth and rubbing them felt significantly like modern toothbrushing.

Would this work?
Rinsing the mouth with alcohol, especially combined with an herb known to combat digestive illness and halitosis, would be a good first step in cleaning the teeth. Rubbing the teeth with a high chlorophyll, low sugar paste would also remove stuck food and buildup, and help with bad breath, and the recommendations to clean the teeth and to finish meals with wine with antiseptic spices might well cut down the buildup and disrupt the lives of bacteria in the mouth.


Rosemary Charcoal Rub

 Bankes' Herbal, 1525 [English]
"Also take the timber thereof [rosemary] and burn it to coals and make powder thereof and put it into a linen cloth and rub thy teeth therewith, and if there be any worms therein, it shall slay them and keep thy teeth from all evils."
Redaction:
I burned about a small plant's worth of dried rosemary stems, and wrapped the remains in a piece of linen. For convenience, I've drawn this package tight with a piece of string, though the original users probably simply made a twist in the fabric. It didn't seem reasonable to sew this closed or make a permanent rubber in any way, since the damp ash/charcoal would probably be discarded.

Burning rosemary is a long and ardous process: I finished it by browning the remaining sticks in an iron pan on the stovetop! I suspect using the actual wood from the trunk of a more mature rosemary bush would be better.

Rosemary charcoal is also used in a mixture of rosemary charcoal and 'burnt alum' to be rubbed on the teeth that appears in Plat's Delightes for Ladies, originally published 1602. The author of Banckes' Herbal, as well as other herbalists, had great faith in rosemary's "worth against all evils in the body."

What happened when I tried it?
As when the teeth are rubbed with a regular cloth, some of the gunk came off on the teeth. The charcoal inside did add to the abrasiveness. The ashy taste was not exceedingly pleasant, but the wet bundle of ash did make a decent rubber and tasted better than regular wood ash.

Would it work?
The ashes would certainly help change the pH of the mouth temporarily; also, the rosemary is somewhat antiseptic, though burnt it would have lost most of its essential oil. As in the other cases, the best benefit of this recipe would come from rubbing the teeth with the cloth and the slightly abrasive charcoal.


Sage tooth whitening scrub

Gervase Markham, The English Housewife. 1615

"For teeth that are yellow:
Take sage and salt, of each alike, and stamp them well together, then bake till it be hard, and make a fine powder thereof, then therewith rub the teeth evening and morning and it will take away all yellowness."
Redactions
I wasn't sure whether the sage should be fresh or dried, so I tried it both ways. I also wasn't sure if 'of each alike' meant equal volumes or equal weights.

Redaction: Mixture #1
1 quarter cup of dried sage leaves, firmly packed.
1 quarter cup of seal salt
Ground together in a mortar until combined into a sort of green salt mixture, spread on a baking sheet and heated at 300 degrees Fahrenheit for 45 minutes, and 350 for 30 minutes

The mixture never showed any sign of hardening. The mixture did make a strong, bitter/astringent tooth powder though, when I tried it.

Redaction: Mixture #2
60 fresh (small) sage leaves
2 tablespoons sea salt
I beat the sage leaves into the salt in groups of 10-20 leaves, adding sufficient leaves to form a rather dry paste. More sage and less salt would have formed a thicker paste; I may try that next time. When spread on a baking sheet baked for 20 minutes in a 300 degree oven, it did form a hard crust. I left it in the oven overnight to dry, crumbled it up, and stored it in a container.

From the results, I suspect that equal weights of salt and sage are meant, and that the fresh sage is indicated.

Belief in sage's antiseptic and healing properties is cited in Banckes' Herbal:  "It will make a man's body clean; therefore who that useth to eat of this herb or drink it, it is marvel that any inconvenience should grieve them that use it."

What happened when I tried it?
I rubbed some on my teeth with a finger, and also tried it with a toothbrush. The effect was similar to toothpaste, though a bit mouth-puckering. Certainly, gunk was removed from the teeth and the breath was fresher; the mouth (after rinsing) felt cleaner too!

Would this work?
Salt is one of the common alternative tooth brushing powders suggested in modern texts, and its granular nature would help polish the teeth. The chlorophyll in green herbs such as sage freshen the breath, and sage is a somewhat astringent/antiseptic, so it might promote gum health and discourage bacteria growth. It certainly worked fine as a tooth powder.


Breath freshening powder

Gilbertus Anglicus, about 1400, English
"And let him use this powder: Take of pepper, one ounce; and of mint, as much; and of rock salt, as much. And make him to chew this powder a good while in his mouth, and then swallow it down."
Redaction:
1 oz pepper
1 oz dried peppermint leaves, ground
1 oz kosher salt
Mixed together.

I chose to use dried peppermint because a powder is indicated. This recipe created a lot more than could be concievably used at one sitting, so I suspect a spoonful or less, chewed and swallowed, is indicated.

What happened when I tried it?
This recipe produces a spicy, hot tasting, slightly abrasive chew, which certainly makes the mouth feel fresher. I didn't think my teeth were markedly cleaned, though.

Would it work?
The salt, the essential oil in the peppermint and the almost caustic oil of the pepper would combine to make the mouth at least temporarily hostile to bacteria. It would also give the patient a temporarily positive breath smell, and chewing the salt might loosen some food particles.


Spice Balls

Gilbertus Anglicus, 15th century, English
"And let him use these pills that are good for all manner of stinking of the mouth: Take of cloves, nutmeg, cinnamon and mace, eight drams; of red sandlewood, ten drams; of quibibis, seven drams; of cardamom, five drams. Mix them with the juice of mint and make pills of the size of a fig. And let him to have two of them under either side of his tongue at once."
Redaction:

One (modern) dram is a little over a teaspoon, so I cut the recipe down significantly:

1 tsp. Saunders (red Sandalwood)
3/4 teaspoon Cinnamon
3/4 teaspoon Mace
3/4 teaspoon Cloves
3/4 teaspoon  Nutmeg
scant 3/4 teaspoon  Cubebs
1/2 teaspoon Cardamom
1-2 bunches mint
The other spices were ground and combined.
The Mint was macerated in a food processor and the juice strained through a muslin bag to wet the spices. The resulting paste was rolled into balls about the size of a dime, which were really too big to fit two under the tongue, but smaller than figs. I'm not sure how the original author would fit two fig sized balls under the tongue-- perhaps he was thinking of raisins.

What happened when I tried it?
I tried putting one pea sized ball under one side of my tongue. There was a certain amount of burning sensation caused by the hot spices, but the breath was noticeably sweet!

Would it work?
The patient would certainly have breath that smelled of spices and the essential oils of the spices could well disrupt the life cycles of bacteria that cause bad breath either in the mouth, sinuses or stomach. Both Spices and mint were believed to promote digestion, and good digestion was believed by all authors to assist with bad breath. I'm unclear on the reason for including red sandalwood-- it's a food coloring and the modern stuff has no smell of its own, but would stain the inside of teeth a bit. It doesn't produce the tartar-test red effect, because sandalwood isn't soluble in water, just in alcohol.


Women's Breath freshener

Trotula, 11th Century, On Women's Cosmetics (book 3)

"I saw a  certain Saracen woman liberate many people with this medicine. Take  little bit of laurel leaves, and a little bit of musk, and let her hold it under the tongue before bad break is perceived in her. When I recommend that day and night and especially when she has to have sexual intercourse with anyone she hold these things under her tongue."

Redaction:

Provided are 3 redactions:
A laurel leaf is in fact a leaf of the bay laurel, called 'bay leaves'. A piece of bay leaf about 1 cm square seems to be the most manageable and comfortable size, especially if it is to be kept in place during vigorous exercise.

Natural musk is an animal product, in texture similar to an oleoresin. However, since we now consider it cruel to slaughter deer simply for the contents of the glands in their buttocks, the real thing is no longer available. In Australia, musk flavored Lifesavers are available, but I was unable to find musk food-flavoring here in the US. So I had to settle for a non-foodsafe synthetic musk fragrance
oil, Jakarta Musk, and mix it with the bay by anointing the leaf with it.

Kirel from the SCA-Cooks list suggested that the flavor of musk is in the same category as orangeflower water. So I've also soaked a bay leaf in some orange-flower water. My experience of medieval and renaissance recipes is that musk is generally used more for scent than for medicinal properties, so this substitution would not likely decrease any medical properties. Orange-flower water is mentioned in the Manual de Mugeres, a Spanish text, so while it might not have been available to the original readers of Trotula, it would be available in the Mediterranean later on, and used for perfuming purposes.

What happened when I tried it?

When I tried keeping the bay leaf alone under my tongue, it didn't give off much smell. In an attempt to increase the odor, I chewed on it a bit. However, the essential oil of bay thus realized burns the mouth, so I don't recommend it. I believe that the breaking of the fresh leaf should be enough damage to the leaf to release the oils. I wouldn't recommend keeping the bay leaf under the tongue for any long period of time, though,  since oil of bay in large concentrations can be toxic.

Would this work?
Bay oil is a considered antiseptic by essential oil specialists, and also has a pronounced scent.  It might stop the bacteria causing the smell. The sweetish scent of musk would also overpower any nasty smells, and, as the author suggests, is also associated with sexual pheromones. [The use of musk in Australian LifeSavers candy suggests that they, at least, consider it a positive breath scent.]



Tooth-whitening wash

Markham. The English Housewife, 1615.

"To make teeth white.
Take a saucer of strong vinegar, and two spoonsful of the powder of roche alume, a spoonful of white salt, and a spoonful of honey: seethe all these till it be as thin as water, then put it into a close vial and keep it, and when occasion serves wash your teeth therewith, with a rough cloth, and rub them soundly, but not to bleed."

Redaction:
1/2 cup red wine vinegar
2 tsp. pickling alum
1 tsp. white salt
1 tsp. honey

Heated together until incorporated, then simmered about 5 minutes longer.

Alum or burnt alum appears with regularity in recipes for mouth- and tooth- cleaning, as well as in some 19th century household aids recipes. For instance, burnt alum is in a recipe in Plat's Delightes for Ladies.  Some forms of alum, when exposed to water, are supposed to form a weak sulfuric acid,  so this mixture is probably not very safe to use on mucous membranes, like the inside of  the mouth. Certainly, the pickling alum bottle warns that it tastes sour when dry but in pickling solution becomes neutral-- so I tested a tiny bit on the tip of my tongue and was rewarded with a significant burning sensation. I used pickling alum since Mistress Anne Liese's dyeing website suggests that it is most likely to be the period form of alum.

The teaspoon measure of the alum, salt, and honey may have been too small, and perhaps the 1/2 cup of vinegar too big, though 1/2 cup fit just right into one of the modern saucers I have; as soon as the mixture was incorporated, it was 'as thin as water'.   I didn't want to add too much alum to the solution, so I compromised on the teaspoon measure.

The vinegar I used was plain red wine vinegar, 5% acidity; period vinegar would have been rather stronger-- 7% to 15% acidity. I was unable to find a stronger vinegar in my local stores and didn't want to take a chance on adding vinegar concentrate to this particular chemical experiment. I used red wine vinegar because I was too cheap to use white wine  vinegar. Since this is a British recipe and no particular vinegar is specified, cider vinegar might be substituted. (I have no references to cider vinegar, but hard cider was a well known drink in Britain; cider vinegar would have been a by-product of home production of cider.)

What happened when I tried it?
I tried this on my teeth (it's essentially a strong traditional pickling brine) and found they certainly felt very clean, even days later, compared to the untreated side of the mouth. I suspect this would be a bad thing to use on a regular basis, because of the alum solution.=

Would it work?
Well, this acidic mixture certainly pulled gunk off my teeth and made them feel fresher. It might also kill germs (or at least seriously inconvenience them) because of the acidic nature of the mixture. It might also cause decay of the enamel of the teeth, though.


Anise, Caraway, Fennel Comfits

Idea from Rumpolt, recipe from Plat's Delightes for Ladies, 1602.

Rumpolt, Ein Neu Kochbuch, 1581.
"Of assorted sugar comfits (as) from the apothecary. . .
2. Anise coated.[with sugar] . . .
6. Caraway coated.
7. Fennel coated."
Redaction:
1/2 cup each caraway seed, anise seed, fennel seed
Syrup: 1 cup sugar, 1/3 cup water
Water and sugar are mixed together and heated. Once the mixture has combined, the heat is adjusted upwards until the syrup reaches the soft-ball stage, about 240 degrees Fahrenheit. It will be ready when a drop dropped into a glass of water forms a soft ball rather than a splat on the bottom.
Put half of one type of seeds (do one type at a time) into the bottom of a small, round metal bowl. Ladle on one tablespoonful of syrup. Stir quickly with a fork, using a scraping motion. Add the rest of the seeds to this mixture, which will first become a sticky ball and then separate out into smaller sections. Stir and squash until seeds have separated and cooled. Add another spoonful of syrup and repeat. Continue this process until comfits are covered with the appropriate amount of sugar. As the coating gets thicker, you may need to cool the comfits between coats in the freezer or out of doors. Be sure not to let the syrup crystallize-- if it does, add water, stir it in, and bring back up to temperature.

These comfits would be served after dinner to clean the breath and combat indigestion and gas. Gerard's Herbal says of anise seed: "Being chewed it makes the breath sweet." Of caraway, Gerards' says "The seed confected, or made with sugar into Comfits, are very good for the stomacke, they helpe digestion, provoke urine, asswage and and dissolve all windinesse; to conclude in a word, they are answerable to Anise seed in operation and virtues."

Note: the directions used here are more similar to those in Plat's Delightes for Ladies than to Rumpolt's. To save space, those instructions have been omitted from this documentation.

What happened when I tried it?
These comfits give the feeling of freshening the breath for 15 minutes or so, up to half an hour. Eating a lot of them seems to alleviate gas as well.

Would it work?
Well, they certainly don't prevent tooth decay, but all three seeds (anise, caraway, and fennel) have carminative effects, widely commented on by the Renaissance herbalists. Even today, Indian restaurants serve candied seeds of this type to combat indigestion and sweeten the breath. They certainly make my breath fresher when I use them.



Other mouth care information:

The Islamic sources make extensive references to the Prophet using a mouth-cleaning stick, either a toothpick or some sort of scraper. (http://www.witness-pioneer.org/vil/hadeeth/riyad/08/chap215.htm).

The Welsh apparently also had a tooth-care regimen, according to Giraldus Cambrensis's "Journey through Wales": "Both sexes take great care of their teeth, more than I have seen in any other country. They are constantly cleaning them with green hazel twigs, and then rubbing them with woollen cloths until they shine like ivory. To protect their teeth they never eat hot food, but only what is cold, tepid, or slightly warm." (http://www.swanseamass.org/wales/travel/gerald1.html#hair)


Bibliography/Resources



Other links:

Copyright Jennifer A. Heise. Contact me via email for permission to reprint: jenne.heise@gmail.com
Permission is explicitly granted for limited reproduction as a printed handout for classes in schools, herb society meetings, or classes or guild meetings in the Society for Creative Anachronism (except to corporate officers and board members of the SCA, Inc.), as long as I am notified and credited and the entire handout is used.
Jadwiga's herbs homepage:  http://www.gallowglass.org/jadwiga/herbs/herbs.html