How did Neanderthals drill tooth cavities?

Neanderthals treated tooth decay with stone drills

Multiple studies point to deliberate dental care by Neanderthals, based on a molar from Siberia that shows signs consistent with drilling to remove an infected cavity. Researchers describe a deep hole in the tooth that matches what a stone tool could produce, rather than random damage. In other work, the same general finding is framed around “the earliest dentistry,” with a reported age of about 59,000 years.

What the evidence suggests

The tooth has clear marks that indicate more than chewing wear: the shape and placement of the cavity preparation look intentional and are interpreted as treatment for bacterial decay. This matters because dentistry is usually associated with modern humans; the findings push the timeline of dental technology and behavioral complexity far earlier.

Why it matters beyond one tooth

If the drilling was purposeful, it implies Neanderthals understood the benefits of addressing tooth infection—likely to reduce pain and maintain function. It also suggests they possessed the motor skills and tool use needed for precision tasks inside the mouth.

What remains unknown

The studies do not provide direct details about the tools’ exact design, how the person managed infection after drilling, or whether the procedure included pain control. But the core takeaway is that the dental record now contains physical evidence compatible with intentional cavity treatment.

• Key takeaway: a ~59,000-year-old molar shows intentional drilling consistent with cavity treatment
• Implication: dentistry-like behaviors occurred in Neanderthals, not just later humans
• Open questions: medical aftercare, pain management, and procedure success rates were not established from the fossil alone