Monday, 8 October 2018

Who was the worst dentist in world history?

Undeniably, Louis XIV's dentist, whose teeth were so badly treated that at the end of his life, he was literally edentulous...

From his earliest childhood, Louis XIV was known for his teeth.
Indeed, it is said that when Anne of Austria gave birth to the Dauphin, he was already born with two incisors and that he would have savagely mutilated the nipples of his nurse, Pierrette Dufour.
He may be the heir to the throne, but it deeply hurts.
And the Sun King's teeth will cause him many problems from the age of 39 until his last days.
As we know, Louis XIV did not have impeccable hygiene, he changes his shirt every morning but he does not like water on his skin or in his mouth.
If toothpaste was widely used in the Middle Ages, in Versailles we don't want it.
The same for mouthwash, the strict minimum for royal teeth.
Did the king stink from his mouth? Yes, but against that, he chews cinnamon pellets.
It's antioxidant, of course, but it doesn't protect the teeth from the king's gargantuan meals.
In 1676, while he was going to the countryside in Flanders, the king complained of pain in his teeth and quickly cloves were slipped into his mouth in order to calm him. Sometimes also thyme. Whatever.
It may sound silly, but cloves and thyme are natural antiseptics and anti-inflammatories that are widely used and quite effective.
But given the condition of his teeth, we must act more effectively.
Two years after his first pains, the king complains about his right cheek being swollen and his painful gum.
A poultice is then applied to him, which has no effect.
The surgeon then decided to cut the royal abscess with a lancet.
The pus escapes and the pain disappears but some time later, it is on the left that the monarch has infections, so in 1682 the dentist pulls out several teeth on his left upper jaw and there, it is really the beginning of dental problems for Louis XIV.
Apparently, it was Charles Boisguerin, still called Dubois, who pulled the King's teeth for the first time (it would be several incisors and a canine tooth).
The function of operator of the Court's teeth is not very popular, there are not many royal dentists, in fact, the surgeon acts alone but his only function is to clean and cut the teeth, and provide roots and opiate when the King washes his mouth.
But error is human and Dubois is doing something stupid : he makes a hole in the king's palate.
Indeed, his palate is deeply damaged. And not a little.
Due to the king's poor hygiene and lack of knowledge of antiseptics, the wound remains open and a fistula begins to appear.
From now on, his nose communicates with the mouth through a beautiful and wide bucco-sinus fistula.
Today we know a very simple system in order to discover if we have a fistula or not : just plug your nose, open your mouth and blow through your nose, if bubbles come out through the wound, it's a fistula. Sexy, isn't it?
In 1685, the king's doctor, Daquin, gave a description of the particularly disgusting fistula, explaining that “this hole was made by the bursting of the jaw pulled out with the teeth (...) and that it healed in a way that left a sinus, or an open duct between the nose and mouth that could be seen with a malodorous pus flow.”
In fact, let's be fair, this is not a Dubois mistake but a rather rare but possible consequence and that it was not treated quickly enough.
However, many interventions will be tried because it is painful and not very elegant.
When the king drinks wine or his morning broth, the liquid flows through his nose.
In early January 1686, Dionis, the king's surgeon, decided to cauterize the fistula.
First, he disinfects the king's mouth with alcoholic and perfumed mouthwashes (more for the comfort of the dentist than to really sanitize...) and then he he heats a small gold instrument with a round tip blank, which he sticks it fourteen times on the fistula.
This is the “fire button” method generally used for nasal polyps, uvula removal or nasal ulcers but before Louis XIV never for oral-sinusian fistulas.
Thanks to that intervention, Louis XIV no longer spits breakfast out of his nose.
However, he has almost no teeth left and the ones he has left are in a very bad state.
The Sun King can no longer chew, but he wants to keep the same food, so he cuts his meat into very small pieces and swallows them without even chewing them...
As a result, it is his stomach that suffers and he must undergo many enemas to cure his stomach aches…

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