The Old West wasn’t exactly New York City or Charleston or Philadelphia. When a toothache turned mean as a rattler, who could a body turn to for help?

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Have you ever had a toothache? A real, full-blown, agony that feels like someone’s stabbing a branding iron through your tooth and into your jaw? I have. Believe you me, I was never so grateful for 21st-century dentistry.

Only 3 dental schools existed in the United States at the end of the Civil War. Most folks sought dental care from their physicians, whose skills were limited to simple extractions, lancing and bloodletting.

A few dentists did go west. One of the most famous was Doc Holliday (John Henry Holliday, D.D.S.), graduated from Pennsylvania College of Dental Surgery in 1872  but took himself off to frontier town Dodge City, Kansas, when tuberculosis caused him to seek a bit of living. Doc Holliday practiced dentistry by day and played cards by night. Citizens were delighted to have a real dentist on hand and Holliday was purportedly highly skilled.


Most often, though, the best a body could do was find someone handy with a pair of pliers.

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Western frontier folks pretty much managed until things got so durn ugly the only thing to do was pull the offending tooth, if they could identify which molar caused the pain. The pliers could’ve been wielded by the medical doctor (if’n they had one), the blacksmith, or barber. Plenty of chairs intended for a haircut and shave doubled as a dental chair. Extractions were accomplished by brute force and the only anesthesia available was copious amounts of alcohol. Though opium could be had on the west coast, it wasn’t readily available through much of the Old West, and controlling dosages proved near impossible, leaving the patient over-medicated, under-medicated, or dead.

Gunfighter Clay Allison’s Dental Nightmare

Old West dentistry could be dangerous for both patient and practitioner. In Wyoming Territory in 1886, notorious gunfighter Clay Allison, aggrieved that a dentist had mistakenly extracted the wrong tooth, later returned to the scene of the “crime”. Here the maniacal  Allison grabbed a pair of forceps and proceeded to pull out one of the doctor’s own molars. Allison was prevented from doing any further harm when a group of passing men responded to the dentist’s frantic calls for help.

Perhaps part of the Code of the West was the law of retaliation, eye for an eye, tooth for a tooth

Even with today’s diagnostic techniques, pinpointing the tooth (or teeth) in need of work is often a challenge.

Most emigrants who made their way west did not

Chris Enss, Author of The Doctor Wore Petticoats: Women Physicians of the Old West

Chris Enss, Author of The Doctor Wore Petticoats: Women Physicians of the Old West

practice any kind of dental care. As a result rotten teeth and bad breath were commonplace. Toothbrushes were available in country stores by the late 1850s, as well as soap and chalk toothpastes. However, not everyone used them. Dentists wouldn’t become common on the frontier until the 1870s. The average citizen was completely toothless by the time he or she reached fifty.

~ The Doctor Wore Petticoats; Women Physicians of the Old West by Chris Enss

Dental Chair Patent Drawing, 1892

Dental Chair Patent Drawing, 1892

Civil War Era Dental Instruments

Civil War Era Dental Instruments

Victorian Dentist Office with Antique Instruments (evidently in a city and not the frontier)

Victorian Dentist Office with Antique Instruments (evidently in a city and not the frontier). Note the cabinet to hold the tools and provide easy access. See the foot-pedal drill, center.

Related Article: Old West: Toothbrushes and Toothpaste Related Article: The Old West: Dental Floss & Toothpicks Book Review: Legends of the Wild West: Tombstone, Arizona (by Charles River Editors)

Please forward this article to fans of Old West History, Old Time Dentistry, and lovers of Westerns or Western Historical Romance. It’s valuable to understand the reality behind the glossy veneer of fiction.

Copyright © 2015 Kristin Holt, LC