Earliest known example of dental surgery
In 2015, researchers cited striations on a 14,000-year-old molar tooth found at the Italian site of Riparo Villabruna as evidence of the world’s earliest example of treating dental caries. However, it now seems Neanderthals were practising dental surgery 45,000 years earlier.
Researchers studied Chagyrskaya 64, a Neanderthal lower left second molar that was recovered in Chagyrskaya Cave in Altai Krai, Russia. The tooth dates to 59,000 years ago. The researchers found a large human-made concavity on the occlusal surface of the tooth, which was created while its owner was still alive.
Use-wear and microtomographic analyses of the concavity suggested that it had been produced by drilling/rotating with a stone perforator. Experimental work on modern human teeth, using tools manufactured from lithic material locally available at Chagyrskaya Cave, supported the conclusion that the concavity in the Chagyrskaya 64 molar is the earliest known example of dental caries treatment.
Two distinct types of interventions, requiring different tools, seem to have been involved in the treatment: drilling the carious concavity and toothpick-like grooving. The drilling/rotating techniques require complex finger manipulations, implying that Neanderthals possessed sophisticated cognitive capabilities. These would have included identifying pain sources, understanding potential pain-mitigation strategies, and selecting the appropriate dental treatment.
References
Zubova, A. V. et al. Earliest evidence for invasive mitigation of dental caries by Neanderthals. PLOS ONE 21, e0347662 (2026).