The gruesome and mysterious case of exploding teeth
In the 19th Century, a Pennsylvania dentist called WH Atkinson came across a condition that sounds like the stuff of nightmares. Writing in The Dental Cosmos, the first major journal for American dentists, Atkinson documented an outbreak of exploding teeth.
He saw it in three patients. The first, the Reverend DA from Springfield, went through this unpleasant ordeal in 1817:
The right superior canine or first bicuspid commenced aching, increasing in intensity to such a degree as to set him wild. During his agonies he ran about here and there, in the vain endeavor to obtain some respite; at one time boring his head on the ground like an enraged animal, at another poking it under the corner of the fence, and again going to the spring and plunging his head to the bottom in the cold water.
Not terribly dignified behaviour for a clergyman, which gives you some idea of how much pain he must have been in. The unfortunate priest had a happ[y] outcome:
All proved unavailing, till, at 9:00 the next morning, as he was walking the floor in wild delirium, all at once a sharp crack, like a pistol shot, bursting his tooth to fragments, gave him instant relief. At this moment he turned to his wife, and said, “My pain is all gone.” He went to bed, and slept soundly all that day and most of the succeeding night; after which he was rational and well.
Thirteen years after this distressing incident, something similar happened to a patient known as a Mrs Letitia D, who lived only a few miles away. She suffered a prolonged toothache, “terminating by bursting with report, giving immediate relief”.
The final case in this trio of dental disasters occurred in 1855. Mrs Anna PA reported that one of her canines split from front to back:
A sudden, sharp report, and instant relief, as in the other cases, occurred in the left superior canine. She is living and healthy, the mother of a family of fine girls.
Although unusual, these stories are not unique. The editors at the British Dental Journal recently highlighted a lively correspondence from its archives, originally printed in 1965
, detailing many other tales of detonating dentine throughout history.
They included a case recorded in 1871 by another American dentist, J Phelps Hibler. He treated a young woman whose toothache ended spectacularly when the tooth, a molar, “bursted with a concussion and report, that well-nigh knocked her over”. The explosion was so loud that she was deafened for some days afterwards.
Although there were five or six reported cases in the 19th Century, there has been no documented case of exploding teeth since the 1920s.
…the answer may lie in the chemicals used to make early fillings. Before the advent of mercury amalgam in the 1830s a wide variety of metals were used to fill dental cavities, including lead, tin, silver and various alloys. Andrea Sella, Professor of Inorganic Chemistry at University College London, points out that if two different metals had been used this would create an electrochemical cell – effectively, the whole mouth would be turned into a low-voltage battery: “Because of the mixture of metals you have in the mouth, there might be spontaneous electrolysis. My favoured explanation is that if a filling were badly done so that part of the cavity remained, that would mean the possibility of build-up of hydrogen within a tooth.”
An already weakened tooth might conceivably burst under this pressure – and the hydrogen could even explode if ignited, for instance if the patient were smoking at the time or if an iron filling caused a spark in the mouth.