Ancient Medicine in Prehistoric Times: Neanderthals, Root Canals, and the Oral Microbiome

Overview

In this episode, Flora Lichtman speaks with archaeologist Penny Spikens and microbiologist Laura Weyrich about medical care in deep prehistory. The conversation highlights evidence from Neanderthal dental calculus, ancient injuries that healed with care from others, and surprising signs of medicinal plant use. It also discusses a near root canal performed in a Neanderthal and what that implies about social care in our ancestral line.

• Neanderthals and caregiving: healed injuries suggest others in their group cared for the ill.
• Dental calculus as a time capsule: plant residues and microbes reveal medicines and health status in the distant past.
• Root canal in the deep past: a Jasper drill may have been used to treat tooth decay, indicating pain management and dental intervention.
• Early medicine and social structure: medical knowledge likely spread culturally, not via a single specialist.

Overview

The podcast dives into the origins of medicine by looking far before traditional texts and well-known ancient civilizations. Penny Spikens, an archaeologist at the University of York, and Laura Weyrich, a microbiologist at Penn State, discuss how our closest extinct relatives and early humans practiced care, deal with injuries, and respond to infections. The narrative challenges the stereotype of prehistoric humans as solitary or relentlessly harsh, instead presenting a picture of social care and evolving medical knowledge that may lie at the heart of human success.

Evidence for Early Caregiving and Medical Practice

The discussion begins with a broader evolutionary context: while modern humans attribute care to ourselves, chimpanzees already show rudimentary medical behaviors, such as deliberately flushing parasites with spiky leaves or using wound dressings on others. This sets the stage for asking how far back medical care extends in the human lineage. One pivotal example is Homo gaster KMN 1813 from Kenya, estimated at around 1.7 to 2 million years ago, who suffered severe hypervitaminosis. The individual would have endured weeks to months of pain and unconsciousness, yet survived — likely because others in the group assisted, suggesting that caregiving was not incidental but perhaps central to group survival and human evolution.

Dental Health and Diet in the Deep Past

The conversation then turns to dental health as a proxy for past health and diet. Neanderthals generally show excellent oral health compared with many modern humans, reflecting a diet rich in leafy greens and protein. Laura Weyrich explains that dental calculus forms when plaque calcifies at night and preserves a biological archive of ancient microbes and dietary residues. Analyzing these calcified deposits can reveal past diseases, immune function, and even medications that neighbors used to alleviate symptoms, offering a window into prehistoric pharmacology and health care practices.

Root Canals and Pain Management in Prehistory

A striking highlight is the report of an oldest-root-canal-like procedure in a Neanderthal. Researchers found evidence of a drill used to penetrate a decayed tooth, likely aided by a Jasper stone, rotated and manipulated by skilled hands. This process would have taken tens of minutes and probably required restraint and post-procedure care, implying someone actively managed the patient’s pain and recovery. Such evidence suggests a surprisingly advanced understanding of dental pain, infection control, and the social coordination needed to perform a medical procedure in ancient times.

Neanderthal Medical Knowledge and Childbirth

The Neanderthal fossil record also reveals a pattern of care for ill or injured individuals, including evidence for assisted childbirth and the management of chronic conditions such as osteoarthritis. Dental calculus from Neanderthal remains shows plant-based medicines like yarrow and chamomile and even hints of analgesics and antibiotics being used, indicating that Neanderthals possessed practical pharmacological knowledge and resources. However, it remains unclear whether there was a dedicated medical specialist; instead, this knowledge was likely shared culturally within groups across generations.

Implications for Our View of Prehistory

Together, these insights challenge the stereotype of prehistoric life as solitary or purely survival-driven. The evidence points to social support systems that cared for the vulnerable and a repertoire of plant-based remedies that were tested and transmitted across generations. The episode emphasizes that the integration of social-emotional capacity with practical intelligence to assist others is a hallmark of humanity, likely contributing to our evolutionary success as a cooperative species. Teeth, bones, and calculus thus become powerful records, not only of health, but of culture and social organization in our ancient relatives.