Jan Bartek – AncientPages.com – Recent research provides new evidence that Neanderthals were more advanced than previously believed. The study shows they could identify tooth infections and had the skills to drill out the damage 60,000 years ago.
Archaeological evidence indicates that Neanderthals used toothpicks to remove food and may have used medicinal plants, though the full extent of their medical knowledge remains uncertain. In this study, Alisa Zubova of the Peter the Great Museum of Anthropology and Ethnography, Russian Academy of Sciences (Kunstkamera), St. Petersburg, and her colleagues investigate this further.
They describe a Neanderthal tooth that was physically altered to treat an infection.
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, CC-BY 4.0
The tooth, a single molar from Chagyrskaya Cave in Russia, is approximately 59,000 years old. A deep hole extends into the pulp cavity. Researchers replicated this by drilling into modern human teeth with a stone point similar to those found in the cave, producing holes and microscopic grooves of the same shape. The damaged molar and toothpick grooves are evidence of a caries lesion in this population, a rare finding among Neanderthals.
While this procedure would have been painful, it likely relieved the discomfort caused by a tooth infection. These findings suggest Neanderthals could identify the source of pain, determine appropriate treatment, perform precise manual tasks, and endure discomfort for future relief. This is the first evidence of such behavior outside Homo sapiens and is the oldest known example by over 40,000 years.
“This finding currently represents the world’s oldest evidence of successful dental treatment. The damage documented on the Neanderthal tooth from Chagyrskaya Cave in Siberia points not only to intentional pulp removal but also to antemortem wear – wear that could only have developed if the individual kept using the tooth while alive. We also identified areas of demineralization where remnants of carious damage were preserved, further indicating that the concavity in the tooth was associated with treatment,” the research team explained.
“We were intrigued by the unusual shape of the concavity on the tooth’s chewing surface. It differed from the normal morphology of the pulp chamber and did not match the typical pattern of carious lesions seen in Homo sapiens. Moreover, distinctly visible scratches suggested that the concavity was not the result of natural damage but of intentional actions.”
Chagyrskaya 64 molar tooth and its macro-features: General view of the tooth in five projections. Credit: Zubova et al., 2026, PLOS One, CC-BY 4.0
Computed microtomography revealed changes in dentin mineralization consistent with severe caries. Human manipulation of carious lesions has already been documented for the Upper Paleolithic, Mesolithic, and later periods. We therefore hypothesized that the damage we observed could also represent traces of such medical intervention – but from a significantly earlier period,” Alisa Zubova adds.
“To interpret the concavity on the occlusal surface of the tooth, we conducted experimental manual drilling on a series of specimens: a modern human tooth and two Homo sapiens teeth from a Holocene archaeological collection of uncertain temporal and cultural provenance. Comparison of the microscopic traces on the original Neanderthal specimen with those produced experimentally revealed a clear match. The findings demonstrate that drilling a carious lesion using a sharp, thin stone tool is entirely effective, permitting the rapid removal of damaged dental tissue,” researcher Lydia Zotkina said.
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“Neanderthals arrived in this region 70–60 thousand years ago during a migration from Central and Eastern Europe and inhabited it until at least 40–45 thousand years ago. Altai became a new and suitable home for them thanks to its biological diversity, climate similar to that of Europe, abundant raw materials for stone tool production, and their usual prey – wild bison and horses.
Analysis of stone tool industries and paleogenetic studies have shown that the Neanderthals from Chagyrskaya Cave are very closely related to the bearers of the so-called Micoquian industry, who also lived in the Caucasus and Crimea,” Ksenia Kolobova explained.
The study was published in the journal PLOS
Written by Jan Bartek – AncientPages.com Staff Writer
