Many people assume that the ancient people of the world unilaterally ignored dental health. But the reality is that many had toothbrushes and toothpastes, even if they took a crude setting, and took preventative measures to prevent decay. As well, some cultures consisted on diets that were far less acidic and contributed far less to decay. The level of understanding would have depended on the same thing as everything else, the era and location. Culture is not a monolith, as the popular saying goes. But as much variation as there can be in one group of people, there is even more variation among different groups, times, and places.
There is a long history of humans using simple toothbrushes made up of different materials and plants. These date back at least as far back as 3,000 B.C. The sites where we found the first toothbrushes were the first toothbrushes that they made first were constructed from frayed tree branches. These were then chewed on to brush, for its abrasiveness. Bird feathers, twigs, animal bones and porcupine quills were also used for different crude brushes. Other cultures, like the Greeks and the Romans, as well as the Qin Dynasty, used what were essentially toothpicks to clean their teeth.
In many areas chew sticks are still in use. Especially in areas in the developing world where proper dental care materials cannot be afforded. The first toothbrushes that would have been similar to what is being used today was first patented in 1857. These were still quite different, including animal bones and rough brushes. It wasn’t until the 1900s that they replaced the handles with different synthetic materials and semi-plastic handles. But the ergonomic design goal is more of a recent invention.
The diet of ancient people varied widely, but there are a few trends that were consistent over most groups. For most of human evolution we have what we would call today a “paleo” diet. Women gathered roots, tubers, nuts, plants, and men hunted and allowed for a meat-rich diet. The switch in the amount of sugar and carbohydrates are responsible for most of our teeth problem. The bacteria, both healthy and unhealthy, are influenced heavily by the introduction of those into our diets. The first major change that occurred was the invention of agriculture. This opened the door for more carbohydrates, less meat, more sugar and in general more acidic food. That also opened the door for the absolute permeation of heavily refined foods into our diets as a population that started around the time of the industrial revolution. Directly linked with our diet of high carbohydrates are grains and flours, which contribute to our lack of diet variety.