White background with gray border. Green speech bubble in center with question inside: "How do the characters have such nice teeth?" Title at the top of the box in gray: Questions a Registered Dietitian asks about Game of Thrones.

Questions a Dietitian asks about Game of Thrones: How do the characters have such nice teeth?

About 1.5 seasons into Game of Thrones, it occurred to me that most of the characters have nice teeth. I didn’t notice many instances of missing or rotting teeth or hear characters complaining about smelly breath or toothaches.

Was the show being inaccurate by failing to manipulate the actors’ teeth to reflect poor dental hygiene? Or did people of medieval times actually have pretty nice pearly whites?

What causes dental caries?

Long story short, dental caries (aka cavities) occur whenever acid degrades the enamel and eventually the dentine of the tooth. The acids that cause the destruction are produced whenever bacteria on the teeth feed on sugar. Thus, one of the prevention strategies for dental caries is to decrease the consumption of sugars and brush the teeth to remove the sugars.

So…wouldn’t people of medieval times have a lot of cavities?

I assumed that people in medieval times didn’t brush their teeth, and thus dental carries would be very prevalent. While I wasn’t completely wrong, it wasn’t as much of a problem as I had thought.

A 2013 British Dental Journal research study looked at King Richard III’s dental remains and found evidence of tartar build-up over time and several missing teeth (likely from tooth decay). These findings led researchers to conclude that tooth decay varied with class; people of the upper classes had more dental caries and tartar build-up than those of the lower classes.

This assumption makes sense; sugar was very expensive in medieval times, and cooking carbohydrate foods required access to the proper equipment. Thus, people of lower classes did not consume crystalline sugar or cook carbohydrates as often as those of the upper class. Even those of higher classes more often used fruit to sweeten foods, and if they did consume sugar, it was used sparingly–as a topping or minor ingredient.

Did people of medieval times practice dental hygiene?

There is evidence that people of medieval times practiced dental hygiene. In the early 1400s, a professor of medicine named Giovanni de Arcoli published an outline of 10 rules to follow in promoting good dental health. The items included practicing moderation in consuming sweets and tough foods, as well as rinsing and cleaning teeth after eating.

While they didn’t have access to toothbrushes and toothpaste, medieval people apparently did have methods for cleaning their teeth. They brushed their teeth by rubbing some variation of a paste or powder on their teeth with a linen cloth or twig. Usually, these recipes consisted of some sort of abrasive material (powdered charcoal, crushed pepper) mixed with herbs or spices (sage, mint, cinnamon, mace, cloves). Mouthwashes were also used, made out of spices and herbs steeped in wine or vinegar (mint, marjoram, cinnamon). Chewing fennel seeds, parsley, or cloves was a remedy for bad breath.

The Conclusion

Due to a lack of refined sugar and highly processed carbohydrates, most people (especially those of lower classes) probably did have decent looking teeth. Dental hygiene practices weren’t completely unheard of, which helps their case. I still like to think that Cersei had disgusting teeth just because she’s…ya know…Cersei.

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