02/15/2021
From Toothaches to Toothless: George Washington
Patriot, Commander, President, and suffering denture wearer. Washington was a terminal toothache sufferer. One writer put it, “Washington had the sort of teeth that decay fast and need prompt repair work.” His diaries contain numerous references of his bouts of toothache, and his well-known hair-trigger temper may have been the result of his constant battle with pain. At age 22 be began to lose teeth with extractions made on an annual basis. A soldier’s description of Washington at age 28 mentioned George’s bad teeth and reported he generally kept his mouth closed. One of the wealthiest men in America, he bought copious dental supplies and employed an army of oral health specialist in his search of oral tranquility.
The Future Commander and Chief began wearing partial dentures in his early 40’s. Washington suffered recurrent toothache during the Revolutionary War. Due to shortages of supplies and the British army, he didn’t have ready access to dentists. At age 47, when he stood for his portrait, his face had a noticeable scar on the left cheek as a result of a fistula, which had probably developed from an abscessed tooth.
Washington had numerous sets of dentures made, fabricated from a variety of materials such as gold, lead, hippopotamus tusk, elephant ivory, walrus tusk, cow teeth, elk teeth and human teeth (never out of wood)! One set was too short and when Gilbert Stuart came to paint the president’s portrait, he found Washington’s face so sunken that he was obliged to pad his lips and cheeks with absorbent cotton, hoping to give it a more normal appearance.
At his inauguration as president in 1790, he had only one tooth left, a lower left bicuspid. When this tooth was extracted in 1796, the dentures he was fitted with made chewing impossible. His lips now took command of preventing the dentures’ forward parry from his mouth. An English visitor wrote, “His mouth was like no other I ever saw; the lips firm and the under jaw seemed to grasp the upper with force, as if the muscles were in full action when he sat still.” These dentures were equipped with springs of coiled steel so powerful to hold them in place “that even today several strings of wire are needed to keep the upper and lower parts in contact.”
The mental suffering this caused a man known as vain and concerned about appearances cannot be underestimated. Sensitive about the changes in the shape of his face and his articulation, he reduced his public-speaking engagements. As uncomfortable and impractical as his dentures were, he favored keeping them in during mealtime. The resulting pain no doubt added to the “melancholy,” a “certain anxiety,” and “extreme sensibility” dinner guests commended on, and possibly contributed to his bouts of indigestion and short temper he exhibited.
We have come a long way since the late 1700’s. If Washington had today’s oral care available to him, he would have been aggressively trained in home oral hygiene, treated for gum disease, asked to modify his diet, and had decay removed and restored early. If he had avoided having his dental disease treated until his middle years, along with the above, he could have taken advantage of dental implants to replace his missing teeth. Should he have waited until he had no teeth and had lost much of his jawbone, he could have replaced his spring-loaded dentures with implant-retained dentures that anchored his dentures securely to his jaws, freeing him from pain, filling out his sunken lips and cheeks and allowing his to eat and speak in sociality with confidence, with a look so natural, only his dentist would know.
