It is an election year. When is a better time to explore the oral health of some of our previous commanders-in-chief? If you work in the dental profession, you have undoubtedly heard about George Washington’s not so wooden false teeth. (As a child, I was told he had wooden teeth. I now know that is untrue.)
Washington’s teeth were made from many materials, but wood was not one of them. Additionally, Washington’s famous chompers were once stolen from the Smithsonian. The lower denture was later found in a storage room. Washington had several sets of dentures. They can be found on display at his Mount Vernon estate and the Dr. Samuel D. Harris National Museum of Dentistry.
When George Washington was inaugurated on April 30, 1789, he only had one tooth, a premolar. Historians report that Washington was obsessed with his teeth, always having a toothbrush, tooth powder (what was used as toothpaste at the time), and a set of scalers he regularly used to “scale off” built-up calculus.
Despite his best efforts, Washington lost his first tooth in April 1765. This was the beginning of the end of Washington’s dentition. In every year that followed, he found himself suffering from toothaches and needing more extractions. In a letter penned by Washington in 1783 inquiring about a prospective dentist, he writes, “Having some teeth which are very troublesome to me at times and of which I wish to be eased … by a man of skill.”1
George Washington was certainly not the only president with dental troubles, but he seems to be the most well-known. Here are some highlights of five other presidents with interesting oral health histories.
Theodore Roosevelt
In addition to being the namesake of the teddy bear, Teddy Roosevelt was also known for his smile. Roosevelt was known as the “smiling president.” It has been reported that he is the first president who smiled because he was typically photographed and illustrated with a grin on his face.
Teddy’s teeth became the highlight of his 1904 re-election campaign. His smile was often described as a “double row of teeth.” This description describes a full dentition − quite rare during that era.
As part of his campaign, “Teddy’s teeth” novelties were worn by many of his supporters. The novelty is described by the National Museum of American History as a “metal whistle that could be held between your teeth” giving you a faux Teddy smile, much like the novelty pacifiers seen today. You can view the novelty here, or you can purchase your own “Teddy’s teeth” through Heritage auctions here.
Questions were raised regarding Teddy’s oral health when he suddenly and prematurely died on January 5, 1919, at the age of 60. During the 1900s, the “focal infection theory” presented by Weston Price was the current fad. This caused dentists and physicians to speculate that a “bad tooth” − possibly one that had previously been endodontically treated − was the cause of death.
In the early 20th century, it was discovered that the “focal theory” held no merit and was anecdotal at best. Even with speculations of “tooth sepsis” by many physicians and dentists, Roosevelt’s personal physicians stated, “The immediate cause of death was a clot of blood which detached itself from a vein and entered the lungs.”2,3
Thomas Jefferson
Thomas Jefferson is recognized as one of the founding fathers and is well known for drafting the Declaration of Independence. Jefferson also wrote many letters. It has been estimated that he wrote or received around 50 thousand letters.
In one such correspondence, he wrote, “I have not yet lost a tooth by age.” This was written in response to a letter he received from Dr. Vine Utley inquiring about Jefferson’s personal habits. Jefferson was 76 when he wrote that letter. Jefferson’s grandson, Jefferson Randolph, wrote regarding his grandfather, “Dying in his 84th year, he had not lost a tooth nor had one defect.”
This seems quite unbelievable for the time, and there is much speculation as to if Jefferson’s oral health was as good as he seems to recall or admit in his letters. There are records of Jefferson paying four dentists. The records show three payments to “Baker the dentist.” These payments could have been for Jefferson. However, they very well could have been for a member of the family. The treatments provided are unknown.
In 1789, Jefferson’s records show he paid A.L.B. Brechillet Jourdain, an eminent dental surgeon in Paris. The treatment was most likely for his daughter and not Jefferson himself. Again, the treatment is unknown.
In 1793, Jefferson made two payments to Lewis Gilliams − one charge for $4.66 and the second for $2.33. There is no documentation of who received treatment; it could have been Jefferson or a family member with no mention of the treatment rendered.
Although there is no consensus on who or what type of treatment was rendered during these previous dental encounters, there is a clearer picture of Jefferson’s dental history during his presidential years. The treatment documented was most certainly for Jefferson, but the treatment is only speculation. Due to the different terms of the era and the interchangeable term “draw.” The term meant being used for draining as well as an extraction, making it difficult to discern the treatment. The term “restorations” was never used.
In a letter written by Jefferson in 1807, he describes a “large swelling on his jaw.” It is assumed the treatment he received was draining of what was possibly an abscess, as it was determined he did not lose a tooth at that time. The swelling began around Christmas Eve; treatment was rendered on January 5, and on February 23, it was noted there was still “a small knot on his jawbone.”
On November 30, 1824, there is evidence of Jefferson losing a tooth via extraction when Jefferson’s physician, Dr. Thomas Patterson, advised it to be immediately removed. On July 18, 1824, two years prior to his death, Jefferson stated in a letter to Charles Wilson Peale, “I am particularly happy in not needing your porcelain teeth. I have lost one only by age, the rest continue sound.” Though Jefferson undoubtedly had impressive oral health for the time, he most likely did lose at least one tooth during his lifetime, and possibly two if we consider the chronologic order of events as he sent the letter in July, yet there is a record of a tooth being extracted in November of the same year.4
Ulysses S. Grant
Legend has said that Ulysses Grant was so obsessed with oral hygiene that he went into battle with no other baggage than a toothbrush. It would be his other habits that would affect his oral health. Grant was known to have been a heavy smoker and a heavy alcohol drinker. It was once estimated that he smoked 12 cigars a day. Once, following a war victory, he was given 10,000 cigars as a celebratory gift.
All of these bad habits would catch up to him. On June 2, 1884, Grant experienced “severe throat and facial pain while biting into a peach.” However, he did not have a formal examination of the area until October of that year. Grant’s physician, Dr. Fordyce Barker, was away in Europe until October.
Grant had an informal examination on his porch by a Philadelphia surgeon, Dr. J.M. DaCosta, and the doctor noted a mass at the right tongue base. However, Dr. DaCosta neglected to report these findings to the president’s physician, giving the mass a 12-week head start before Dr. Barker returned.
Dr. Barker referred Grant to Dr. John Hancock Douglas, the best-known otolaryngologist in New York. Dr. Douglas examined Grant on October 22, 1884. He described the lesion of the right tonsillar fossa “of great epithelial trouble” and also noted an enlarged neck node. By today’s standards, Grant’s lesion would be classified as a “T1 N1 squamous carcinoma of the right tonsillar pillar.”
A biopsy was performed on February 18, 1885, four months after his first examination and eight and a half months after his initial symptoms. The treatment implemented for the lesion was “smoking cessation and local treatment of topical iodoform, saltwater gargles, dilute carbolic acid gargle, gargles composed of permanganate of potash and yeast, and 4% cocaine solution for pain.”
As the disease progressed, Grant became increasingly concerned that he may choke in his sleep. After an episode of “threatened suffocation” on March 29, 1885, Grant slept in a chair in a sitting position with his feet resting on another chair. You can see images of Grant’s sleeping arrangements here.
By the spring of 1885, Grant had experienced severe weight loss. Grant’s weight was around 200 pounds. However, by the beginning of spring, he was down to 146 pounds. On June 16, 1885, Grant was relocated to Mount McGregor, NY, to live out the rest of his days. On July 23, 1885, Grant succumbed to his illness at the age of 63, just a little more than 13 months after he experienced his first symptoms.5
Grover Cleveland
Grover Cleveland’s oral health woes are by far the most fascinating. On June 18, 1893, Cleveland’s physician was summoned to the Oval Office to examine what the president described as a “rough place” on the roof of his mouth that had been present for five to six weeks.
Cleveland’s physician wrote a letter to Dr. Joseph Decatur Bryant, a New York City surgeon and friend of Cleveland. In the letter, the lesion is described as “an ulcerative surface nearly as large as a quarter with cauliflower granulations and crater edges with at least one sinus extending to bone, which is apparently roughened.”
Dr. Bryant examined Cleveland on June 25, 1893. After the examination, the president was quoted as saying, “What do you think it is doctor?” Bryant replied, “It is a bad looking tenant; were it in my mouth I would have it removed at once.” While deciding on the best course of treatment, the president was adamant that this surgery be kept secret. Therefore, it was decided that the operation would take place on the private yacht of a close friend, the “Oneida.”
The plan was for the yacht to set sail from New York City on June 30, 1893, and arrive in Cleveland’s Gray Gables in Bourne, Mass. Cleveland, Dr. Bryant, and an expert surgical staff boarded the yacht as planned. On the morning of July 1, 1893, while the yacht was sailing up the East River, Cleveland was prepared for surgery. The details of the surgery were well-documented:
“The President went to his cabin and undressed at 12:31 placed himself in the chair. After lying for a minute or 12:32, the administration of gas began given by Dr. Hasbrouck. 12:36, both bicuspids extracted. Pulse remained first rate, no pain. 12:40, bleeding has stopped.
The parts to be removed were then cocainized, the intention being to make the incisions in the palate, and to dissect the cheek from the jaw by this means and to reserve the ether for the more severe and bloody part of the operation on the jaw itself. By this means also the amount of ether given was much lessened and any ill effects on the kidney avoided. The cocaine, however, did not sufficiently annul the sensibility so that gas was again administered and the incisions… made. 1:06, incision made through gum and hard palate, bleeding stopped by pressure and hot water. 1:14, begun administration of ether.
As soon as he was sufficiently under its [the ether’s] influence, the cheek was dissected loose and the hemorrhage was arrested by hot water pressure and the ligature of one vessel. The front of the jaw was then chiseled loose from the first bicuspid to the posterior extremity of the bone. By the bone forceps the palatal process was then divided from the alveolar bone to the median line.”
The documentation goes on in great detail. However, in summation, the entire left maxilla was excised from the first premolar to just beyond the third molar. The yacht reached Gray Gables on July 5, 1893, at which time Cleveland walked off the yacht straight to his residence, where he remained until he made an appearance on August 7 to address Congress. Cleveland was followed for years by two prominent New York City otolaryngologists with no tumor recurrence noted. Cleveland died 15 years after his surgery on June 24, 1908, his oral cancer likely cured. The cause of death was listed as “heart failure complicated with pulmonary thrombosis and edema.”5,6
Images of models of Cleveland’s mouth after surgery can be found here. An image of the Oneida can be found here.
Conclusion
Often, presidents are scrutinized for their overall health. We very rarely hear about their oral health status. It is fascinating to consider they, too, struggle with many of the same issues we see on a daily basis. Sadly, there is very little documentation on the oral health of many past presidents.
Dr. J.S. Ragsdale, a general dentist, has worked hard to uncover oral health issues from Washington to Reagan. He has found it quite difficult to obtain information regarding many past presidents, as presidents are not required to undergo any physical or oral evaluations, nor is the president obligated to disclose such information. HIPAA laws apply to the president as well. Unless they are willing to openly discuss their oral health, in many cases, it will remain a mystery.
Now Listen to the Today’s RDH Dental Hygiene Podcast Below:
References
- A History of George Washington’s Dental Trouble. George Washington’s Mount Vernon. Retrieved from https://www.mountvernon.org/george-washington/health/washingtons-teeth/a-history-of-washingtons-dental-troubles/.
- Christen, A.G., Christen, J.A. Theodore Roosevelt’s “presidential smile” and questionable dental health. J Hist Dent. 2007; 55(2): 85-90. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17848049/.
- Theodore Roosevelt Dies Suddenly at Oyster Bay Home; Nation Shocked, Paus Tribute to Former President; Our Flag on All Seas and in All Lands at Half Mast. The New York Times. January 6, 1919. Retrieved from https://archive.nytimes.com/www.nytimes.com/learning/general/onthisday/big/0106.html.
- Ragsdale, J.S. What did Thomas Jefferson mean by “I have not yet lost a tooth by age”? J Am Dent Assoc. 1984; 108(4): 643-644. doi:10.14219/jada.archive.1984.0359. Retrieved from https://pubmed.ncbi.nlm.nih.gov/6373889/.
- Carlson, E.R., Reddi, S.P. Oral cancer and United States presidents. J Oral Maxillofac Surg. 2002; 60(2): 190-193. doi:10.1053/s0278-2391(02)86097-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/11815920/.
- Aziz, S.R. The Oral Surgical Operations of Grover Cleveland: A Presidential Cover-up. J Oral Maxillofac Surg. 1995; 53(9): 1088-1090. doi:10.1016/0278-2391(95)90129-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/7643280/.
