Scientists have made a remarkable discovery that challenges our understanding of ancient human relatives. A Neanderthal tooth found in a Siberian cave shows clear evidence of dental surgery performed approximately 59,000 years ago – tens of thousands of years before modern humans began similar procedures.
The ancient molar, discovered at Chagyrskaya Cave in Russia’s Altai Mountains, belonged to a Neanderthal who suffered from severe tooth pain caused by a deep cavity. Rather than endure the agony, someone deliberately drilled into the tooth using a small stone tool to remove the decay and provide relief.
According to archaeologist Ksenia Kolobova of the Institute of Archaeology and Ethnography of the Siberian Branch of the Russian Academy of Sciences, this represents the earliest-known example of invasive dental surgery. Her team published their findings Wednesday in the journal PLOS One.
“This is important because it proves Neanderthals possessed sophisticated cognitive abilities, including planning, precise motor skills and deliberate medical strategy, challenging the outdated view that such complex behavior was exclusive to modern humans,” Kolobova said.
The procedure would have required significant skill and understanding. “The procedure required diagnosing the source of pain, understanding that removing decayed tissue could bring relief, deliberately selecting an appropriate stone tool and executing precise drilling with controlled finger movements,” Kolobova explained.
Researchers determined the surgery was intentional by examining the tooth’s central hole, which extends into the pulp chamber where nerves and blood vessels were located. The hole’s distinctive shape and microscopic markings indicate deliberate modification rather than accidental damage. Evidence of continued wear suggests the individual lived for an extended period after the procedure.
To confirm their theory, scientists conducted experiments on modern human teeth using stone tools similar to those found in the same cave. They successfully recreated holes with identical patterns and microscopic grooves.
The tooth belonged to an adult Neanderthal, though researchers cannot determine the individual’s gender. Study lead author Alisa Zubova of the Peter the Great Museum of Anthropology and Ethnography in St. Petersburg noted that the treatment approach aligns with modern understanding of treating deep cavities.
“This is consistent with modern understanding of the treatment of deep carious lesions,” Zubova said.
Previously, the oldest evidence of dental surgery was a modern human tooth from Italy dating to about 14,000 years ago, making this Neanderthal discovery significantly older.
The cave site has yielded a wealth of information about Neanderthal life. These ancient relatives of modern humans occupied Chagyrskaya Cave between roughly 59,000 and 49,000 years ago, using it as a base camp for processing bison and horse meat, as well as a living space where they raised children.
Study co-author Lydia Zotkina, a traceologist at the Institute of Archaeology and Ethnography, emphasized the remarkable endurance required for such a procedure.
“It seems to me that this is also evidence of astonishing willpower. Do you know many people who could perform such an operation without anesthesia or special equipment? Or those who could endure it themselves? Every time I think about this, I am filled with admiration,” Zotkina said.
The drilling covered nearly the entire chewing surface of the molar. Experimental testing showed that a rotating or hand-drilling motion with a small stone tool would have been most effective. Zotkina conducted her experiments using a jasper tool, similar to those discovered in the cave from the Neanderthal period.
Researchers also found evidence that Neanderthals, including this individual, used toothpicks to clean food from their teeth, suggesting regular dental hygiene practices.
The discovery adds to growing evidence that Neanderthals were intelligent beings who created art, used complex hunting strategies, developed symbolic objects, and communicated through spoken language. These robust relatives of modern humans, characterized by larger brows and stronger builds, vanished approximately 40,000 years ago, though most people today carry traces of their DNA due to ancient interbreeding.
Scientists speculate that the drilled cavity might have been filled with a substance like wax, though no such evidence remains.
