Neanderthal May Have Had the World's Oldest Dental Procedure 59,000 Years Ago

A Neanderthal living around 59,000 years ago in the Altai Mountains of southwestern Siberia may have received the world’s earliest dental treatment, according to a new study published in PLOS One.

The evidence comes from a molar found in the Denisova Cave, which exhibited a deep, central cavity. Researchers suggest this hole was intentionally created, possibly as an early form of dental intervention. If confirmed, this would push back the earliest known dental procedure by more than 45,000 years and represent the first recorded case in a Neanderthal, not a Homo sapiens.

Earliest Dental Procedure or Toothpicking?

The claim challenges the long-held belief that the earliest confirmed dental treatment dates to around 14,000 years ago in Homo sapiens. It also contradicts the historical perception of Neanderthals as brutish and incapable of such complex behavior.

However, not all experts agree. José María Bermúdez de Castro, a paleoanthropologist at University College London, argues that the evidence is insufficient to support the claim of deliberate dental surgery. Instead, he suggests the hole may be the result of toothpicking, a palliative practice where early humans used tools to clean or soothe their teeth.

"This could be another case of using a toothpick as a therapeutic remedy, without deliberate intervention from other individuals (surgical intervention), an operation that would be extremely painful without anesthesia," Bermúdez de Castro wrote in an email.

"In my opinion, the authors of this research have '[made] a storm in a teacup,'" he added.

Implications for Neanderthal Behavior

If the study’s findings are correct, they would reshape our understanding of Neanderthal capabilities, suggesting advanced cognitive and social behaviors previously underestimated. Neanderthals are now known to have used tools, created art, and even buried their dead with rituals—behaviors once thought exclusive to Homo sapiens.

The debate highlights the challenges of interpreting ancient dental modifications. While some researchers see evidence of intentional treatment, others argue for simpler explanations tied to daily survival practices like toothpicking.