Neanderthals used to drill teeth for cavities up until 59,000 years ago (19459000)
The oldest dental evidence is thought to be a back molar discovered in a Siberian Cave. Someone carefully drilled out a hole in a tooth 59,000 years before to relieve a toothache.
The Neanderthal did it.
Chagyrskaya 164 is an upper left second molar found in Chagyrskaya Cave, Russian Altai Mountains. The tooth has a huge cavity that extends almost to the occlusal surface of the crown and reaches into the pulp chamber.
Researchers report in PLOS One’s May 13 edition that the concavity is not caused by wear or decay alone. It was created with a tiny, pointed tool used to treat severe tooth decay.
Neanderthal medicine has long fascinated researchers. They may also have used medicinal plants. It’s not clear if this is planned medicine or more instinctive self healing, like some non-human primate species.
This discovery is the first time that an ancient Homo Sapiens from Ripari, Villabruna (northern Italy) has been found to have had invasive dentistry. Researchers have now dated this discovery to Chagyrskaya 164, which extends the record by over 40,000 years.
What amazed me is how the owner of this tooth was able to pinpoint the source of the pain and realize that it could be eliminated. Tech Explorist spoke with Alisa Zubiova, one of the lead authors of the study and an anthropologist working at the Peter the Great Museum of Anthropology and Ethnography, St.
Petersburg.
The Neanderthals and modern humans of much later times have not seen anything similar before.
Chagyrskaya Cave, southwestern Siberia, Russia. a. cave location map (created in ArcGIS software, using open data from https://www.usgs.gov/products/maps accessed on December 15, 2021); b.
stratigraphic sequence with Chagyrskaya 64 molar discovery location indicated in orange; c. general view of the cave; d. discovery location of the Chagyrskaya 64 molar in situ in Layer 6c/2.
Credit: Zubova et al., 2026, PLOS One
Ancient DNA shows the Neanderthal clan
Chagyrskaya Cave, located in the northwest Altai Foothills region of southwest Siberia in northwestern Asia, contains the most extensive collection of Neanderthal Fossils in Northern Asia. This site was settled by people who came from Central and Eastern Europe between 70,000 years and 60,000. A molar, which dates back to 59,000 years old, was extracted at the bottom of one of cave’s oldest sedimentary layers.
The central concavity is 4.2mm long, 2.8mm wide, with a depth maximum of 2.6mm. The concavity is situated on the molar occlusal surfaces and comprises three depressions that are partially overlapped, interconnected.
This concavity is found to cover the entire pulp chamber, according to a micro-CT. The mid-crown also shows transverse expansion.
The results of the CT scan of Chagyrskaya’s 64-molar. The five projections show the morphology of the concavity, starting from the left: Mesial 1, Distal 2, 3, disto-buccal 4, buccal 5.
Credit: Zubova et al., 2026, PLOS One
The dentine under the cracks displayed clear demineralization, which is characteristic of advanced dental caries. This would have been graded as a 4-5 on the standard scale.
It means that decay has progressed beyond the enamel into the dentine. Another molar in the same area, belonging to an ancient Neanderthal, showed no signs of severe decay.
The question is: Was that hollow purposefully made or was it caused by something natural? The surface is smooth and round, and this is far too precise for a freak accident. Trauma usually causes sharp edges and fractures at the junction of bone and soft tissues.
Only normal wear was also excluded, because while extreme wear of the teeth can expose the pulp at times, it doesn’t create a large cavity that expands to the surface as seen in this image. Geological processes cannot produce such precise and deep voids within dental tissue.
The researchers did not stop with the ancient teeth to test their theory. The researchers used jasper drills to bore into modern molars.
These are the same tools that were found in cave sediments. The researchers created a mouthlike environment, complete with water, before carefully drilling into the teeth.
The results of their work were astonishing: fine, thin linear scratches etched in the dentine walls that resembled those found within Neanderthal teeth. The only way to achieve this unique pattern was by scraping. Each experiment was finished in under an hour.
This shows how obsessively focusing on one narrow area can provide relief.
Treating a tooth carious is more than just protecting or feeding someone. Ksenia Kolobova is the director of the Siberian Branch of the Russian Academy of Sciences’ Institute of Archaeology and Ethnography and an archaeologist.
It requires diagnosing and treating the pain source, choosing the appropriate tool, and performing an invasive, painful action. This is an active and targeted medical intervention.”
Two scratches left on the same tooth by a dental pick are a trivial, unremarkable detail. They’re fine, linear lines that were created when a narrow, continuously pushed object was pressed between the teeth. The scratches are consistent with the behavior of ancient populations including several species of Homo.
On the same tooth were several toothpicking marks and drilling invasively, indicating at least two different types of dental treatment, received by or done by the owner.
The combination of these two marks has never before been found in a Neanderthal’s tooth.
Raman spectroscopy on 14 different areas of the surface was used to search for any plant matter, wax or resin which might have been placed in the pits after the treatment. The authors warn that the absence of such residues is not proof of an empty pit, as organic materials can deteriorate in just one year.
This finding has far greater neural implications than your own practice.
The drilling process required the use of the fingers together to keep fine motor control and endure a prolonged period of concentration. The archaeological evidence of Chagyrskaya’s Neanderthals suggests that they also were more sensitive to pain than modern people, which makes their decision to perform or undergo such a process even more humbling.
I can tell you that this Neanderthal was a very strong-willed individual. This is something which continues to impress me.” Lydia Zotkina is a traceologist and co-author of the study at the Institute of Archaeology and Ethnography.
He must have understood that the discomfort of the procedure, although greater than the inflammation pain, was temporary and needed to be tolerated.
Fewer than 10 cases of dental caries have been confirmed in Neanderthals. These sites include Palomas and Bau de l’Aubesier. Researchers note that another tooth, from the Chagyrskaya group, belonged to a Neanderthal aged 9 to 11 years old. It also showed carious lesions.
This suggests that some of the members in this population carried the bacteria that caused the disease.
Human diseases that are deadly may be responsible for the extinction of Neanderthals
It is not yet clear whether the treatment given to Chagyrskaya #64 was a technique that had been passed from group member to another or an intuitive act by a person with unusual perceptiveness.
Other studies will include looking at the dental calculus of Chagyrskaya populations for any traces that could indicate medicinal plant usage, as well as examining skeletal specimens from around the world for subtle marks.
As Zubova put it, This is the first case in which the correct idea to treat a particular disease was discovered 60,000 years before its time.
Journal Reference
- Zubova, A. V., Zotkina, L. V., Olsen, J. W., Kulkov, A. M., Moiseyev, V.
G., Malyutina, A. A., Davydov, R.
V., Markin, S. V., Maksimovskiy, E.
A., Chistyakov, P. V., Krivoshapkin, A. I., & Kolobova, K. A. (2026).
Early evidence of invasive reduction in dental caries caused by Neanderthals. PLOS ONE, 21(5), e0347662.
DOI: 10.1371/journal.pone.0347662
