The Case of The Exploding Teeth

Feb 21, 2023 0 comments

In the January 1861 issue of The Dental Cosmos, the first major journal of American dentistry, a Pennsylvania dentist named WH Atkinson documented three cases of a remarkable phenomenon that he had encountered over a period of forty years in practice.

The first of his subjects was Reverend DA, who lived in Springfield, Mercer County. In the summer of 1817, he suddenly developed an excruciating toothache.

The right superior canine or first bicuspid commenced aching, increasing in intensity to such a degree as to set him wild. During his agonies he ran about here and there, in the vain endeavor to obtain some respite; at one time boring his head on the ground like an enraged animal, at another poking it under the corner of the fence, and again going to the spring and plunging his head to the bottom in the cold water; which so alarmed his family that they led him to the cabin and did all in their power to compose him. But all proved unavailing, till, at nine o’clock the next morning, as he was walking the floor in wild delirium, all at once a sharp crack, like a pistol shot, bursting his tooth to fragments, gave him instant relief. At this moment he turned to his wife, and said, “My pain is all gone.” He went to bed, and slept soundly all that day and most of the succeeding night; after which he was rational and well.

Photo: stockking on Freepik

Thirteen years after this singular incident, another case of an exploding tooth fell upon Atkinson’s lap. One of his patients, a Mrs Letitia D, was suffering from a prolonged toothache, when suddenly the tooth burst into pieces with an audible report, and the toothache vanished.

The final case occurred in 1855. Another of his patient, Mrs Anna PA reported that one of her canines split from front to back with a “sudden, sharp report”, providing her with, as in the other cases, “instant relief.”

Although quite unusual, these stories are not unique. In the book Pathology and Therapeutics of Dentistry: With Miscellaneous Essays on Dental Subjects published in 1874, the author J. Phelps Hibler reported several such cases, one of which occurred in his practice. Dr. Hibler had a woman as patient who was suffering from a terrible toothache, when all of a sudden, the previously aching tooth, a right lower first molar, “bursted [sic] with a concussion and report, that well nigh knocked her over” and “rendering her quite deaf for a considerable length of time.” The raving pains eased up greatly soon after.

Similarly bizarre tales were reported by the British Dental Journal , brought to light through correspondence with its readers, some of which have been dug up by the editors and republished in 2015. The most peculiar of these tales involve one narrated by the mother of a seven year-old girl whose teeth had fallen out. This correspondence was originally published in 1965:

These teeth became loose and fell out quite normally and didn't appear to be damaged or cracked when I examined them as soon as they fell out. The double tooth was placed on the mantelpiece which gets warm but not excessively so; several hours later it 'exploded' sending pieces all over the room. I collected as many pieces as I could find but some are still missing. The two single teeth were put on the mantelpiece in a tortoiseshell snuffbox and I didn't realise they were also split until some weeks afterwards.

Although it is common for deceased teeth to fracture, especially those teeth with caries, very few dentists have heard of one that goes off in a bang. When a Canadian practitioner encountered a case of an exploding tooth in a horse-riding back-woodsman in the 1920s, he deduced that the rupture was caused by “swelling of the pulp due to raised blood pressure, possibly enhanced by the protracted exercise of horse riding.”

In his original 1860 article, Atkinson suggested that a substance he called ‘free caloric’ was building up in the tooth and causing a dramatic increase of pressure in the pulp. This hypothesis was based on an obsolete scientific theory that heat consists of a self-repellent fluid called caloric that flows from hotter bodies to colder bodies. We now know that such a fluid does not exist. Atkinson also provided a second explanation that seems more credible. He suggested that decay within the tooth might have caused a build-up of gas, which eventually made the tooth fracture.

Hugh Devlin, Professor in Restorative Dentistry at the University of Manchester’s School of Dentistry, is skeptical— “It is highly unlikely that gas could build up in a tooth sufficient to cause it to explode – teeth are extremely strong. The 19th Century dentists didn’t understand caries – they thought it came from within the tooth. It’s only in the last century that we started understanding that caries is caused by diet and by bacteria building up on the surface of the teeth.”

J. Phelps Hibler had a different idea: he believes that caries inside the tooth and the accompanying decomposition of the pulp and other parts caused the accumulation of carbonic acid and hydrogen gases that somehow ignited, causing the teeth to explode.

According to another report from an American dentist, the explosions were caused by the reactions between silver and ammonia mixtures that dentists used to treat caries at that time.

Andrea Sella, Professor of Inorganic Chemistry at University College London, believes that the wide variety of metals used to make dental filings could be a cause, especially if two different metals were used which would create an electrochemical cell, effectively turning the whole mouth into a low-voltage battery: “Because of the mixture of metals you have in the mouth, there might be spontaneous electrolysis. My favoured explanation is that if a filling were badly done so that part of the cavity remained, that would mean the possibility of build-up of hydrogen within a tooth.”

This pressure could cause an already weakened teeth to burst. Unfortunately, there’s no evidence that any of the original patients actually had fillings. So for now, the “mystery of the exploding teeth” will remain unsolved.


# The gruesome and mysterious case of exploding teeth, BBC
# From the archive: The mysterious case of 'exploding teeth', British Dental Journal
# W.H. Atkinson, Explosion of Teeth With Audible Report, Dental Cosmos


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